Volume 16, No.4, Fall 2008
The painful process of righting Cape Cod Healthcare’s financial ship continues. But patient care apparently has not been affected by these fiscal woes. In recent weeks no less than four awards for quality performance have been received by the system’s flagship Cape Cod and Falmouth Hospitals.
First, the fiscal woes.
This past summer, Steve Abbott retired as president/CEO just before news was released that CCHC had incurred a $25 million operating deficit. He was replaced by Dr. Richard F. Salluzzo, who came to the Cape with a reputation as a turn-around specialist. Soon after, CCHC’s bond rating from Standard & Poor’s was dropped from BBB to BBB-, one step from “junk bond” status. However, at the same time, S&P raised CCHC’s outlook from “negative to stable” in acknowledging Dr. Salluzzo’s past success.
Belt-tightening was promised and it has begun. This included early retirements, layoffs in staff and support positions, and 10 percent pay cuts for a dozen top executives.
These have been busy days at the Cape’s major medical institution—and leading employer—and here are some of the latest developments…the good and the bad.
Not to slight the nurses, but the medical staff reduction with the greatest patient impact involved slashing the number of hospitalists. These are physicians employed by the hospital to provide medical services only to in-patients. This relieves outside primary care physicians and other practitioners of these sometimes tinme-consuming duties, which in the past they had to assume in exchange for admitting privileges to the hospital for their patients. (Presence of hospitalists also makes it easier to recruit primary care physicians, a major consideration on the Cape.)
CCHC had 33 hospitalists on staff of its two hospitals representing a $7 million annual outlay; and five were let go. Three others subsequently submitted their resignations.
However, an agreement subsequently was reached to maintain a staff equal to 29.5 fulltime hospitalists—19 at Cape Cod Hospital, which represents a cut of 3.5 positions, and keeping the current 10.5 equivalency at Falmouth. The savings are estimated at $2.4 million annually. CCHC officials said efforts were underway to get the three hospitalists who had resigned to reconsider and they stressed that the new staff levels were well within national guidelines.
(Meanwhile, another non-medical staff cut also received public notice, that of Cape Cod Hospital’s only full-time paid chaplain, the Reverend Marcia West. The hospital stressed, however, that its “Pastoral Care program continues to serve the spiritual and emotional needs” of its patients by returning “to its volunteer roots” with the current complement of 100 volunteers. In addition Cantor Bruce Malin recently was appointed by the Jewish Federation of Cape Cod as a part-time chaplain at the hospital and the Diocese of Fall River provides a full-time and a part-time priest, as well as deacon and lay chaplain at the hospital, all funded through its annual Catholic Charities appeal.)
And now for the good news concerning patient care:
CAPE COD HOSPITAL has been ranked first among 771 hospitals nationwide in terms of risk-adjusted mortality for percutaneous coronary intervention (PCI) procedures, according to a recent database report issued by the American College of Cardiology (ACC).
PCI (previously popularly called Balloon Angioplasty) encompasses a variety of vascular catheterization procedures to open diseased heart arteries that can result in reduced blood flow, or a heart attack.
The ACC releases its national report on a quarterly basis, using a rolling year as its reporting model. Through the year ending March 31, there was just one mortality among 628 PCI cases at Cape Cod Hospital. A year ago the U.S. Centers for Medicare and Medicaid Services named Cape Cod Hospital the only hospital in Massachusetts and one of only 17 hospitals nationwide with outcomes better than national averages for 30-day heart attack mortality rates.
These outcomes are particularly significant because “on Cape Cod, there is a high incidence of heart disease due to the older population of the area,” Dr. Salluzzo pointed out.
Cape Cod Hospital in 1997 became the first community hospital in Massachusetts approved to perform emergency angioplasty. Cape Cod Hospital in 2002 became one of only three community hospitals in Massachusetts approved for cardiac surgery. In 2003, the hospital received its license to perform elective angioplasty procedures.
FALMOUTH HOSPITAL has been chosen by Thomson Reuters, a global health care information service, as one of only 100 hospitals nationally (and one of four in New England) making the greatest progress in improving hospital-wide performance over five consecutive years (2002-2006). The 2007 Thomson Reuters 100 Top Hospitals® Performance Improvement Leaders have set national benchmarks for the rate and consistency of improvement in clinical outcomes, safety, hospital efficiency, and financial stability.
“These are true ‘Good to Great’ leadership teams that have focused on improving quality, efficiency, use of evidence-based medicine, and financial stability,” said Jean Chenoweth, a senior vice president at Thomson Reuters.
The study evaluated 2,867 non-federal hospitals grouped into five categories. Falmouth Hospital was selected in the Small Community Hospital category. The other New England hospitals listed were Beth Israel Deaconess Medical Center and Caritas St. Elizabeth’s Hospital in Boston and Baystate Medical Center in Springfield.
CAPE COD HOSPITAL AND FALMOUTH HOSPITAL each was honored recently by Masspro, the federally-designated healthcare Quality Improvement Organization (QIO) for Massachusetts. The awards were for exemplary commitment to improving the quality of care in the areas of Acute Myocardial Infarction (AMI), Heart Failure, Pneumonia, and Surgical Care.
They were recognized after serving as active participants in a Centers for Medicare and Medicaid program to encourage exemplary benchmark performance. This participation assisted the development and production of quality improvements in these areas