A NNA J AQUES H OSPITAL 2011 Annual Report Anna Jaques Community Health Foundation Donor Listing M ISS A NNA J AQUES –HER L EGACY C ONTINUES Letter from the Chairman of the Board I am happy to report, on behalf of the Board of Trustees, that Anna Jaques Hospital remains a strong, independent, not for profit hospital. We ended FY2011 in the black, posting a gain from operations of $1.015 million despite the unpredictable nature of the healthcare industry today. In FY2011 we took steps to secure a strong future for Anna Jaques. We grew our clinical affiliation with Beth Israel Deaconess Medical Center, a renowned Boston academic medical center and major teaching hospital of Harvard Medical School.We also raised a significant portion of the hospital’s $6 million capital campaign goal and arranged funding to implement the master facility construction plan. FY2011 was also a difficult year as more Massachusetts hospitals succumbed to unsus- tainable negative profit margins resulting in merger, acquisition, or in some cases, closure. These events brought into sharp focus the continued need for uncompromising guardian- ship of Anna Jaques’ financial affairs and reputation. Challenges were presented when patient volume no longer followed historical patterns due in part to continued economic uncertainty, high deductible insurance plans, and public policy aimed at reducing overall costs in healthcare. Flexible staffing patterns were required to conform to the ebb and flow of patient volume while at the same time maintaining high quality patient care. Changing reimbursement rules from third party payers imposed new procedural and documentation requirements and our staff had to modify internal processes quickly in order to secure revenue.As we knew they would, our employees and medical staff rose to meet these challenges. We are proud that Anna Jaques Hospital is a low cost, high quality, community hospital. As such, we are part of the solution to the problem of unsustainably high costs in health care.Anna Jaques has served the people of the lower Merrimack Valley and North Shore for 128 years and we plan to continue that legacy for many, many years to come. Sincerely, George H. Ellison, Jr. Chairman,Anna Jaques Hospital Board of Trustees Letter from the President In FY2011 Anna Jaques focused on strengthening our position as a high quality, low cost hospital delivering care to the local community. That profile makes us desirable to employers and insurers in the new health plan design. New insurance plans will direct patients toward hospitals that have measura- bly high quality at a low cost, and Anna Jaques has achieved that status in all the “tiered” plans. Patient and physician incentives will promote care locally rather than in Boston. Our clinical affiliation with Beth Israel Deaconess Medical Center brings Boston level expertise in a supporting role to Anna Jaques physicians, giving patients access to excellent services without traveling long distances. In addition, patient satisfaction continues to improve and the master facility construction project will increase single room occupancy to be the dominant pattern, so that when you come to Anna Jaques, you almost always get a single! Lower rates of hospital inpatient admissions and testing, higher insurance co-pays and deductibles, and the lingering economic downturn will continue to stress the well-being of community based hospitals. Despite these impediments, we believe that Anna Jaques will continue to thrive and fine tune its programs.We have an encouraging track record. From 1999 to 2005 the hospital suffered significant operating losses. Since 2006, however, the hospital has recorded yearly operating surpluses.The money has been reinvested in technology and updated facilities for the communities we serve. In the year just finished, as in the year ahead, we will continue to focus on the basics: being nice to patients, giving them measurably good care, working with our colleagues at Beth Israel Deaconess Medical Center, and showcasing and supporting our excellent medical staff. Sincerely, Delia O’Connor, FACHE President and CEO Anna Jaques Hospital 1 The Strength of a Clinical Affiliation Anna Jaques Hospital (AJH) is clinically affiliated with Beth Israel Deaconess Medical Center (BIDMC), a renowned Boston academic medical center and major teaching hospital of Harvard Medical School. While AJH remains an independent non-profit hospital, the affiliation offers many benefits to Anna Jaques patients.With the new collaboration between AJH and BIDMC, patients are seen in our own community by the AJH Medical Staff when clinically appropriate, with good access to complex care in Boston. More efficient integration of services between AJH and BIDMC will also mean that duplicative treatments and testing will be reduced. If a patient needs to go to BIDMC for tertiary care, the affiliation enables the patient to return to the community for continuing care as quickly as possible. NeuroCall Maternal/Fetal Medicine ED Transfers In FY2011 Anna Jaques contracted Patients who need advanced care for The relationship between the with NeuroCall, affiliated with BIDMC, to high risk pregnancies can now receive that Emergency Departments at Anna Jaques provide our Emergency Department (ED) care at Anna Jaques, where previously they and BIDMC benefits our patients. In physicians with around the clock access to were traveling into downtown Boston or FY2011, 274 patients were transferred to board certified neurologists. Specialists from Route 128. BIDMC Maternal and Fetal BIDMC for trauma and other clinical the Neurology Department at BIDMC Medicine specialist Henry Roque, MD, conditions that required tertiary care. provide high quality, seamless coverage for FACOG (seen above) came to Anna Jaques Before a transfer our emergency physicians NeuroCall’s network.When patients at Anna three times a month in FY2011 to provide speak to a BIDMC emergency physician Jaques are suffering stroke-like symptoms, high risk ultrasound to the patients of to discuss the patient’s condition, emergency AJH Emergency Department physicians and obstetricians at Women’s Health Care, and treatment, and the best method of transfer the neurologists at NeuroCall talk to one assist them in treating their at risk patients. (ground ambulance or medflight air another face to face over a high speed Access to this high quality specialized transport). BIDMC accepts virtually all internet connection and “Skype-like” video medicine reduces stress on patients who patients from AJH with no delay in the technology to examine the patient together no longer need to travel substantial, transfer.Anna Jaques physicians are able to and discuss the best course of treatment. Our inconvenient distances for specialty care. stay apprised of their patient’s condition collaboration with NeuroCall is helping us It also enhances what the Women’s Health and progress through communication with to improve outcomes for patients and to save Care obstetricians are able to provide BIDMC physicians and access, via elec- lives. It is particularly helpful in the decision their patients in a very integrated way, tronic medical records, to their patients’ whether or not the patient with stroke right down the hall from the Women’s data. Substantial improvements to that symptoms should be given the clot-dissolving Health Care office. electronic access to their patient’s informa- medication, tPA.Anna Jaques received a tion at BIDMC is underway currently. grade of 100% in a recent Massachusetts Department of Public Health (DPH) study of appropriate use of tPA – similar to best practice in Boston area teaching and com- munity hospitals. 2 The Importance of Local Care Seen L to R: Janice Hamerstrom, RN, Recovery Room, Patrice Wood, LPN, Pre-operative Unit, John McManamy, MD, Anesthesiologist, Christine Daragjati Riccardi, MD, Pediatrician, Steven Parker, MD, Anesthesiologist, David Kelleher, Certified RN Anesthetist (CRNA) This year Anna Jaques established a Pediatric Surgery Advisory Team (seen PEDIATRIC SURGICAL SERVICES AT ANNA JAQUES HOSPITAL INCLUDE: above), to ensure that pediatric surgical services are well understood by parents, • A pre-operative Board certified anesthesia evaluation their children, and the pediatricians who • A pre-operative phone call by a pediatric educated care for them. Members of the team were registered nurse selected for their expertise in each of the • An optional pre-operative tour areas involved in the process of pediatric • A designated phone number for your anesthesia surgery.Their involvement helps to ensure questions a smooth and reassuring process, and high quality clinical care for the child from • An Anna Jaques Hospital teddy bear registration to recovery. A pediatric • A TV and DVD player for pediatric friendly entertainment surgical services brochure was produced • Free parking and development of an online video has • A registered nurse to help you navigate your child’s care begun, both with the goal of educating • A surgical tracking monitor so you can follow your child’s parents and children about the surgical surgical progress process, easing the anxiety that can accompany a child’s surgery, and demon- • A beeper to notify you of your child’s status strating the volume of pediatric surgery • A post-discharge phone call by a registered nurse AJH already does with a highly skilled, well-credentialed team. 3 The Importance of Accredited Regulatory surveys and accreditations in healthcare serve to assess the quality of clinical services, staff compliance with established Patient Services standards of performance, and the delivery of healthcare to patients. In FY2011 Anna Jaques Hospital performed well in surveys and received several national accreditations. Regulatory Surveys • The Adult and Child Psychiatry departments completed successful Department of Mental Health surveys.The surveyors said,“Anna Jaques has a model psychiatric program in every way.” • The Respiratory Care Department earned Quality Respiratory Care Recognition (QRCR) from the Nurses and counselors of the child psychiatry program American Association for Respiratory Seen L to R staff from the adult psychiatric unit: located at the Amesbury Health Center.