Texas County Memorial Hospital board members were presented at their monthly meeting last week with a breakdown of bid proposals for a construction manager for the hospital’s proposed $13 million expansion project.
“Nine companies submitted bids for construction management,” said Wes Murray, chief executive officer at TCMH. “And any one of the nine companies would do a great job.”
HMN Architects of Springfield, the architects for the expansion, have worked with all of the companies submitting proposals. They helped TCMH administration narrow the nine bids down to four.
Murray said interviews were set for Wednesday at the HMN offices in Springfield. Each bid is slightly different in the breakdown of construction fees and based on the interviews, TCMH will determine which construction management bid best suits its needs.
Murray also presented a potential construction timeline to board members. With the hiring of a construction manager by Feb. 1, the “design development” phase of the project will begin. Detailed blueprints of the site – the interior and exterior – will be drawn up.
The timeline shows construction documents being developed and finalized for bid from March through June. Following bidding and negotiations for the project in early summer, a groundbreaking for the project might take place as early as July.
Murray explained to board members that when architectural renderings of the hospital’s interior and exterior are available, he will make arrangements to speak at various civic and community organizations throughout the county to explain the changes that are going to be made at the hospital.
“Everyone I have spoken with about the project has been very supportive,” Murray said. “They understand that there’s only so much you can do to renovate a hospital with a 50-year-old chassis.”
“We started out with only 32 beds,” said Jane Kirkwood, board member. “Now we’re at 66-beds, and we’re looking at building a new core hospital.”
Board members also unanimously agreed to amend the TCMH bylaws with specific wording regarding currently employed staff serving on the board of trustees.
The new paragraph, Section 10, will be added to Article IV in the bylaws as follows: “It shall be a conflict of interest to serve as an employee of Texas County Memorial Hospital while also serving on the Texas County Memorial Hospital board of trustees. Accordingly, any employee of Texas County Memorial Hospital filing for candidacy for the board of trustees shall offer resignation of their employment with Texas County Memorial Hospital, effective upon filing.”
“In my opinion, state statutes are very specific regarding this issue,” Murray said. “It’s unfortunate that we need to make this addition to our bylaws.”
Murray noted that many hospitals have adopted specific bylaw language such as this “to eliminate the clouds of confusion.”
Patient Satisfaction Discussed
Also at the meeting, board members heard a presentation regarding patient satisfaction surveys.
Sarah Ponder, a consultant with Press Ganey Associates, also answered questions. Press Ganey is an international company that provides satisfaction benchmarking for healthcare providers. Forty-five percent of all hospitals with 55 or more beds in the U.S. contract with Press Ganey for patient satisfaction surveys.
In 2006, TCMH received information from the Centers for Medicare and Medicaid Services that future reimbursement would be based on voluntary participation in Hospital Consumer Assessment of Healthcare Providers and Systems, commonly referred to as HCAHPS.
According to CMS, “HCAHPS is a tool to be used for public reporting of major areas of hospital performance to support consumer choice.” While survey participation was initially considered voluntary, hospital administration knew that HCAHPS surveys would eventually be required for TCMH to receive reimbursement from Medicare and Medicaid, two government funded forms of health insurance held by about 75 percent of hospital inpatients at TCMH.
The HCAHPS survey is 22 questions for hospital inpatients, and it was designed to measure the frequency of interaction between the patient and the healthcare providers.
CMS began gathering the “voluntary” HCAHPS survey data last year. In March of this year, healthcare consumers will be able to access this information online at www.hospitalcompare.hhs.gov.
Doretta Todd-Willis, TCMH director of nursing, chose Press Ganey last year to begin HCAHPS surveys among hospital inpatients. Amanda Turpin, quality management director at TCMH, oversees the contract with the company and utilizes and manages the data gathered by Press Ganey.
The data that has been collected from TCMH patients over the past year will be available online in late 2008. TCMH has not been participating in the data collection throughout the entire CMS reporting period.
In addition to the 22-question HCAPHS portion of the survey, Press Ganey also surveys patients with 38 additional questions regarding the quality of an inpatient’s hospital stay. The survey specifically looks at areas such as nurses, rooms, meals and physicians with questions allowing patients to provide answers on a rating scale of “very poor” to “very good.”
Press Ganey gathers the results from the TCMH surveys, reports the data to CMS and reports the information to TCMH.
Ponder explained to board members that TCMH staff should become familiar with the surveys so that they are aware of “clearly defined service expectations.”
“The survey is not designed to assess what you are doing or the care you provide,” Ponder said. “The survey is designed to assess patient perceptions of care.”
Press Ganey believes that patients should be encouraged to fill out and return the surveys so that personnel from various service lines can create a culture of customer service excellence.
Murray hopes that with employee buy-in, the Press Ganey surveys can be used “for much more than just required reporting to CMS.” Turpin will be working with TCMH staff to study the quarterly data available through the surveys to address specific quality needs or concerns in each department.
Thirty percent of TCMH inpatients are returning the Press Ganey surveys, a number that is higher than the 27 percent national average of returned patient surveys.
“Patients that return the surveys are saving us money,” Turpin explained. “We must receive a certain number of filled out surveys or CMS requires that a second survey be sent to the patients.”
The surveys are mailed to patients about two weeks after discharge, accompanied by a cover letter from Murray. The surveys are returned via U.S. Mail to Press Ganey, where the results are tabulated. Surveys are anonymous unless the patient specifically signs the survey.
“It’s important that our patients realize that we want to hear about their hospital stay and how well we met their needs,” Murray said. “If we utilize this information, we can become a better hospital because of it.”
Currently, HCAHPS surveys are only sent to hospital inpatients. HCAHPS surveys may eventually encompass more healthcare areas such as emergency rooms, home health services and surgery. TCMH is considering utilizing Press Ganey to conduct additional patient satisfaction surveys in other areas of patient care at the hospital, too.
Linda Pamperien, chief financial officer, presented the financial report for December. Revenues and expenses were down for the month, but the hospital had a positive bottom line of $86,068. The bottom line for fiscal year 2007 is at $585,569.
The average daily census in December was 15.
Present at the meeting were Murray; Pamperien; Turpin; Ponder; Joleen Senter Durham, director of public relations; Dr. Steve Hawkins, vice chief of staff; Dr. John Duff, CoxHealth representative, and board members Kirkwood, Janet Wiseman, Omanez Fockler and Mark Forbes.
Board member Larry Southern was absent.
The next meeting of the TCMH board of trustees is noon Feb. 26 in the downstairs meeting room of the hospital.