By Mary Alice Murphy

At the Friday, Sept. 26, 2014, Gila Regional Medical Center Board of Trustees meeting, board and staff members seemed euphoric after the brief executive session at the beginning of the meeting. They heard a report from the auditors about the draft findings of the audit. Because it was the draft audit, which has not yet been submitted to the state, their lips were sealed, but they were smiling from ear to ear.

Members recognized Yolanda R. Maynes for 25 years of service to GRMC in housekeeping. The members applauded her service.

After the executive session, the auxiliary and foundation reports, had no representatives to present them, but were in the board members' packets.

In the chief executive officer report, CEO Brian Cunningham highlighted how proud he is of everybody and all the work done this year. "This didn't happen by accident (referring to the audit report). There has been so much effort in aligning with the plan."

"Thank you," Board Chairman Charles Kelly said to Cunningham. "We have come from a crazy place to a good place, thanks to your team."

Board member Pam Archibald asked if the Community Continuum of Care had a site in mind for the facility. Cunningham said he understood it would be a new building at a new site.

The chief nursing officer report was in the packet and no comments were made or questions posed.

Dan Otero, chief operations officer, asked for approval of the Utilization Management Plan. Several of the points in the plan, which are required by the Centers of Medicare and Medicaid, include providing for the review of the medical necessity of admissions, of extended stays and of professional services.

"The oversight and responsibility is directed at the CEO," Otero said. "We reinstituted this plan about a year ago."

The plan was approved.

The chief of clinical services was not at the meeting, so his report was in the packed. Dr. Donald Stinar, board member, talked about the sleep lab. "It is now officially credentialed so payments can be made. There was no reason anyway to deny payment, but now there really is no reason for denial."

Dr. John Stanley, also a board member, said it was important to let the public know that the sleep lab is now fully accredited.

Chief Financial Officer Omaira Heakin answered board member Jeremiah Garcia's question about the payment for the linear accelerator. She explained that it had not yet been received. Kelly said: "It's stuck in state government." Cunningham said: "We are using all avenues to get it unstuck."

Chief of Staff Dr. Victor Nwachuku said in his report that the Go Live for the Computerized Physician Order Entry project has been delayed until October 14, 2014. One of the main reasons for the delay is to use the time to further refine the medication ordering process.

He also said he would bring all the bylaws to completion before presenting them to the board.

Stinar asked about the status of Dr. John Bell. Nwachuku said Bell would start working at the hospital again on an as-needed basis.

Otero presented the Quality Improvement Committee report, saying the hospital would see ongoing variations over time. "Our goal is to be up 10 percent. We are not there yet, but we continue to work with staff on improvements."

The Finance Committee, headed by Archibald, presented several contracts and agreements for approval. Approved by the board were a one-year, no-automatic renewal agreement with Dr. David Friedman, general surgeon. Next was a one-sentence clarification amendment to the Independent Physicians Association physician services agreement. The clarification is that the on-call schedule is proof of a physician fulfilling his on-call requirement.

Stinar was approved for the ongoing professional practice evaluation consulting agreement.

Amendments, addressing the original contracts to correlate with medical bylaws, were approved for on-call pediatric agreements with Dr. Laura Davenport-Reed, Dr. Brian Etheridge, Dr. Jonathan Jones, and Dr. Michelle Pahl, as well as a urology on-call agreement with Dr. Amos Lash to detail monetary reimbursement and on-call status.

Kelly, in the plant and facilities committee report, noted there were not as many moves around the hospital. "We did finish redoing the water softener system, which was done in stages."

Jeremiah Garcia asked Ashleigh Garcia to present the human resources report.

"These are the caregiver feedback survey results," Ashleigh Garcia said. "There were six questions on the survey. We had an excellent almost 50 percent participatiion, with 312 returning the surveys. The operations department compiled the summary. We did quantitative data, as well as qualitative data, with all comments grouped as themes. These are generating our analyses and driving our recommendations."

She picked specific questions to highlight. In question one on the quality of engagement, 73.1 percent rated engagement with a 9 or 10 agreement rating. The lowest percentage of 9s and 10s was received on the question of strongly recommending working at GRMC, with 51 percent highly agreeing.

Stanley said it concerned him a bit that only a little over half highly recommend working at GRMC, to which Ashleigh Garcia responded with the percentage of those choosing between 5 and 10 on the scale reaching 85 percent.

Another survey question on recommending GRMC for services received a 9 or 10 from 56.7 percent of survey respondents.

She said the survey was done anonymously. "I believe we received some honest feedback."

"We recommend some actions," Ashleigh Garcia said. "We recommend more caregiver education, as well as more access to and more clarity of education, and to continue with current project efforts. We will re-assess in 18 months. This is the first time we've designed and done the survey in-house. This will be our basis."

Cunningham noted the hospital had been paying an outside group to survey, from which the hospital received no actionable results. Holley Hudgins, marketing director, noted the amount was between $7,000 and $10,000 for outsourcing the survey.

"There were no surprises," Cunningham said. "We will also be developing a survey just for physicians."

Jeremiah Garcia said the dashboard showed nothing outstanding other than the high level of contract labor.

Cunningham said the invoices hit in one month, then skip a couple. "We have had the same number of travelers over the past several months."

Board members then went into executive session, after which routine reports and appointments were made.