By Mary Alice Murphy
During the public input portion of the Gila Regional Medical Center Board of Trustees meeting on Friday, June 27, 2014, three people spoke.
The first was Roberta Vesely, an emergency room nurse. "I want to speak up on my deep concern about so many excellent nurses leaving and going elsewhere. I am afraid it will continue without fast action." She pointed to Billy Lee, who was in the audience. "Billy is one of the best nurses in the ER. He's been here for 24 years. If I had to go to the ER, I would want him to be my nurse. Why is he leaving? Joe Kelly handed in his resignation, too. He is a superior nurse."
"I have written a letter to the board and administration, to give you a chance to reply, before I go public," Veseley said. "I would like to return next month to find out what is being done to address the concerns. I love my job, so this really concerns me."
Board Chairman Charles Kelly said the board does not usually interact with the public during public input, but said he had a question. "Have these complaints gone through the channels?"
"Yes, we have gone through our directors and our chief nursing officer," Vesely said.
Gary Stailey, Silver City resident, said he shared the same concern. "We have a lot of experienced people who have walked out or been walked out. We need to look at this."
Charnelle Lee, Billy's wife and an ER nurse, observed that it is hard to get good nurses to live in the area. "It takes up to five years for a nurse right out of school to get good. As we lose our preceptors, we lose the experience mentors. This whole thing is splitting our family up."
The board then recognized Charnelle Lee for 25 years service in the GRMC ER. Also recognized, but not present, were Bertha Calderon for 15 years with Home Health, and Susan Trejo, also 15 years with Home Health.
For the GRMC Auxiliary report, Liz Beilue, president, said she had nothing to add to her report, except they have gotten a couple of new volunteers, and she was off to train one.
GRMC Chief Executive Officer Brian Cunninghamsaid the only thing to add to the Foundation report was that the Gila Regional Golf Classic was a "huge success, and the final report would be given next month."
For his CEO report, Cunningham thanked the board, the community, the caregivers, the hospital staff and everyone, as the facility closes out its fiscal year. "To come from a $9 million deficit at the beginning of this fiscal year and to be approximately $2.1 million in the black at the end of this fiscal year is quite an accomplishment. We acknowledge how much we still need to do in this most challenging time in health care. We continue to work with the caregivers, and many indicators show we're going in the right direction."
Chief Nursing Officer Pat Sheyka said she had no changes to her report and would stand for questions. She received none.
Chief Operations Officer Dan Otero, in his report, highlighted the ribbon cutting for the Varian Trilogy linear accelerator in the Cancer Center earlier that week. "We had a good turnout, and we continue with a strong partnership with the New Mexico Cancer Center. We are making strides in clinical quality, having gone from a composite score of 88 to 96."
Chief of Clinical Services Ray Goellner had no changes to his report and received no questions.
Chief Financial Officer Omaira Heakin, attending her first board meeting, highlighted ending the month of May with $5,000 in the black, "a big sign of moving in the right direction.
Controller Elizabeth Allred pointed out the board members had received a printed first page of the report, as the version originally given to the board members had a typo on the first page.
Board member, Jeremiah Garcia, asked how the hospital was doing on insurance denials.
Heakin said she would be having a meeting on Monday with the key players on how to keep communication flowing, so that denials are minimized.
"We still have a lot of work to do, but we're working on this issue," Otero said.
"I want to make sure we get a return on our investment," Garcia said.
Kelly said the executive committee went over and approved the agendas for the committee and the board meetings.
Garcia, the chairman of the Quality Improvement Committee, asked Otero to go over the details of what was discussed.
"We are looking at three metrics," Otero said. "We are at 97 percent in the 27 items that are measured. For instance, mortality has gone down, inpatient complications have gone down, patient experience is staying within the industry average, and we will work on customer service."
"I'm seeing excellent improvements," Garcia said. "I'm pleased with the staff and how we're collaborating and communicating."
Board member, Dr. Darrick Nelson, reported for the Finance Committee, and recommended the board approve several contracts.
Those approved, after some discussion, included the first amendment to the staff psychiatrist employment agreement for Alan Berkowitz, M.D.; a second amendment to the professional service agreement for on-call special service coverage for pediatrics for Laura Davenport-Reed, M.D.; a second amendment to the professional service agreement for on-call special service coverage for pediatrics for Brian Ethridge, M.D.; a first amendment to Independent Physicians Association professional service agreement for Gila Multispecialty IPA; a neurological medical director agreement for Robert Woody, M.D.; an ongoing professional practice evaluation member agreement for Michelle Diaz, M.D.; and a Bayard property lease agreement for Hidalgo Medical Services.
The only contract that elicited discussion was the one for Dr. Woody. Board member Dr. Donald Stinar asked if Gila Regional "has considered someone who actually comes to the hospital? Maybe we can see if we can get a better deal for the hospital. I've been here for years and I have never seen Dr. Woody."
"We have an out in all our contracts," Otero said. "I would recommend approving, so we can keep our EEGs, but we will address the issue."
To a question by board member Robert Morales, Sr., Cunningham said he also recommended approval of the contract, "because we would lose services, and it will take at least a couple of months to replace the services, if we decide to."
Stinar said he believed the hospital could find someone to do both services that Dr. Woody is currently doing.
Garcia gave the Plant and Facility Committee report. "We are excited to say we had the linear accelerator grand opening. It seems the facility is working on forecasting. We are pleased the IT (information technology) department is looking at cutting costs while getting ready for MedTech6, and while getting physicians ready to use the COWs (computers on wheels). I applaud the outstanding achievement of the maintenance department."
"The maintenance department is in the top 10 nationally," Morales noted. "It shows the loyalty and good work of all the caregivers. It shows we are a top quality organization. I'm proud to be part of it, and we're trying to be the best we can."
Morales said the Human Resources Committee is still working hard on the succession program.
Cunningham said GRMC would roll out the caregiver survey the first week in July. "We will get feedback across the facility, which will help us develop our action plan."
Chief of Staff Dr. Victor Nwachuku discussed the use of computers by the physicians. "I want a group of physicians to make sure the order sets are correct, so we will delay the roll out of the program until August. We are also talking about procedures with patients."
Garcia asked if the physicians are ready to go on board with the computers.
"We don't really have a choice," Dr. Nwachuku said. "That's why we're doing it. We have to make sure we can get them on board and get buy in before the program goes live."
"It's important the physicians have ownership," Garcia said. "The program ties into everything from care to finances."
Stinar noted that computers might not work in the ICU (intensive-care unit), because "we have standing orders and some use them and some don't. It will be interesting to see. A lot of stuff is already not being used, so I'm not sure it will make a difference to have it on the computer."
Dr. Nelson pointed out there are two domains—the order set domain, which are things done the same as often as possible and ongoing orders. "It is more difficult to move through the ongoing orders, because there is no order set, and each will have to be input. The challenge will be getting the physicians to do the ongoing orders, after you get the order sets going. I encourage you to develop a regular set of ongoing orders."
Dr. Nwachuku said the delay for a month would allow getting the physicians to go to training.
"You also have to do mapping for common physician phrases to the pharmacy," Dr. Nelson said. He gave examples of how differently the physician writes the order from how the pharmacy writes the order for the same item, such as saline solution.
The board members took a 15-minute break before going into executive session.