BETTER… Pursuing Excellence at the NYC Health and Hospitals Corporation 190 The largest languages translated 500,000 municipal health uninsured system in the patients country1.4 1annually treated patients million 36,00011Acute care new MetroPlus hospitals HHC Report to the Community members 1,300,000 enrolled through HIV tests since 2005 healthcare 8,000 exchanges Volunteers 35,000 babies born 2014 staff members 5 21,000 annually million patient visits per community year 70+ based clinics 2 Letter from Alan D. Aviles It is HHC’s mission to extend 3 Letter from Ramanathan Raju, MD 4 Our Guiding Principles equally to all New Yorkers, 5 HHC Facilities 7 Keeping Patients First regardless of their ability to 28 Patient Safety pay, comprehensive health 32 HHC’s Home Care Services 36 Behavioral Health Services services of the highest quality 43 Community Relationships 51 Long-Term Care in an atmosphere of humane 55 MetroPlus care, dignity, and respect. 59 Breakthrough: Process Improvement at HHC 63 Teams Working Together This historic mission defines us as an organization. All that we do flows 64 IMSAL: Simulation Learning from our commitment to fulfilling it and to keeping New Yorkers healthy. 68 Workforce Development HHC’s people – our 35,000 employees, many of whom come from the 72 Information Technology very communities we serve – live that mission in their work every day. 79 HHC’s Response to Financial Challenges They are at the core of what makes us better. 83 Business Innovation Better means more effective and coordinated patient care, safer medical 86 HHC and Sandy practices, modern physical environments, and advanced technologies 89 Facility Modernization and electronic tools. 94 Awards and Acknowledgements Better means deepening organizational unity and “systemness;” ensuring that best practices from one department or facility are spread to all; and Dedication As the longest-serving president of HHC until his retirement that resources are maximized to improve patient care and outcomes, in early 2014, Alan D. Aviles led the organization for nine improve health in our communities, and create economic efficiencies years with integrity, vision, and compassion. Mr. Aviles’s administration was marked by a profound transformation across the organization. in HHC’s approach to healthcare delivery that focused on improving quality and safety for patients and building Better means that we are building on our current baseline of excellence a workplace that sought and respected the dedication and toward improvement in every way. contributions of staff. As an executive leader, Alan Aviles combined strategic and operational intelligence about the business of healthcare with a personal and respectful Seen in the rear-view mirror of the past eight years, and the viewfinder understanding of the complex healthcare challenges that of our future, Better is the story of HHC’s consistent improvement New Yorkers face. and the alignment of vision and guiding principles by frontline staff, HHC thanks Alan Aviles for guiding HHC to its current place in the top rank of healthcare systems in this country. supervisors, administrators, and leadership. He directed our organization through challenge and crisis, solidified our place as an essential service in our city, encouraged innovation and improvement in our staff, and led us always with respect, grace, wisdom, and empathic concern for the patients we serve. Better… BETTER: Pursuing Excellence at the NYC Health and Hospitals Corporation 1 Message from Alan D. Aviles Message from Ramanathan Raju, MD As you will read in this report, HHC is ahead of the has chosen the path that courageously leads to a curve because it has already been walking the walk. future that will serve our patients, our communities, Our organization-wide process improvement work, and our organization better than ever. our uncompromising commitment to patient safety, I am honored to lead the most progressive public our transformative vision of ambulatory care, our healthcare organization in the United States, and facility modernization program, and our strategic especially grateful to Mayor Bill de Blasio for his focus on improving care delivery will serve the confidence and support, and to the HHC Board of organization well as it moves forward. Directors, to whom I shall look to for their collective One of the most important lessons we have learned is experience and insight. I am also thankful to Alan that we have more commonality than difference from Aviles for his wisdom, inspiration, and unending faith one facility to the next – that the system is better and in HHC, and for all that he has taught me about what stronger when we work together. constitutes great leadership. From Mr. Aviles and my colleagues across HHC, I have learned lessons that I It has been nearly eight years since we did a report The story of HHC’s accomplishments and strategic shall not forget. like this one. We knew in 2007 that challenges lay HHC is resolute, resourcesful, innovative, advances over the past eight years, as recounted ahead, but no one could have foreseen the seismic in this Report to the Community, is a remarkable The responsibility to lead HHC at such a historic shifts that have occurred in the world around us and and ready for the future. statement of organizational change and progress time in healthcare is not lost on me. HHC will in healthcare. Between the destabilizing economic inspired by a singular mission and carried out by a continue its commitment to healthcare equity by upheaval that began in 2008 to the early turbulent It has been an honor and a career highlight for me compassionate and committed team. ensuring that every patient gets the quality care they days of the Affordable Care Act, the healthcare need and deserve. But we can’t do it alone. I hope to serve as HHC’s president for the past nine years. As I return to the HHC family after two and one-half landscape has been profoundly and irrevocably that all of HHC and those in the world beyond our In helping to set a strategic agenda to keep our years as CEO of Chicago’s public hospital system, changed. Thanks to insightful strategic planning, walls will join me as we embark on the journey to the organization on a path to a healthy future, my service I do so knowing that HHC has united around an strong senior leadership, and the tireless efforts of next generation of public healthcare in our city. We at HHC reminds me of how noble and essential exciting and transformative vision of care delivery staff, HHC moved quickly and surely to anticipate or will need strong partners in government and in the government can be. I have seen this every day as I that, more than ever, is committed to the wellness of adapt to these changes, while continuing to provide private healthcare sector, and we will always need the have watched dedicated staff work to fulfill HHC’s each patient and the prevention of illness. Wherever safe, high-quality care to all who come through our gift of collaboration and engagement from HHC’s mission to care for all. and however it can, HHC and its staff want to help doors. Nonetheless, monumental challenges remain in exceptional staff. our patients receive the treatment they need in clinics the ongoing struggle to meet the healthcare needs of HHC’s strategic transformation since 2005 leaves it and primary care settings to help them stay out of We have much work to do together. Of course, our city and all of its residents. But HHC is resolute, positioned to deliver healthcare at a level of excellence emergency rooms and hospital beds. it won’t be easy. Overcoming real challenges and resourceful, innovative, and ready for the future. and responsiveness to community needs that is highly competitive with any and all New York City hospitals making real change never is, but as this report clearly This is the final report to bear my name as president. and healthcare systems. And even in the face of demonstrates, HHC is already making healthcare in It comes at a time when revolutionary change is tumultuous change, system-wide achievements are HHC will continue its commitment to our city better. Now, together, we can make it great. beginning to unfold, as healthcare systems are positioning HHC to keep getting better and better. healthcare equity by ensuring that every increasingly being rewarded for offering strong primary care and chronic disease management (to patient gets the quality care they need keep patients healthy and out of the hospital) rather and deserve. than for the sheer volume and intensity of acute care Ramanathan Raju, MD provided through emergency visits and inpatient Alan D. Aviles President, 2014 – The decision to adopt this admirable philosophy services. As the largest municipal healthcare system President, 2005-2014 of care as HHC’s cornerstone and to align the in the United States, a driving force in ensuring organization’s resources behind it is one that I access to care to every New Yorker in every corner wholeheartedly support. The world of healthcare of our city, and an acknowledged national leader in today, and the dramatic changes we have already population health management, HHC is very much in seen as we adapt to the Affordable Care Act, is the forefront of this revolution in care. fundamentally different from generations past. HHC 2 New York City Health and Hospitals Corporation BETTER: Pursuing Excellence at the NYC Health and Hospitals Corporation 3 North Central Bronx Hospital Guiding Principles Jacobi Medical Center Segundo Ruiz Belvis Diagnostic & Treatment Center Our Guiding Principles are Morrisania Diagnostic & Treatment Center the key to HHC’s future. Lincoln Medical and Mental Health Center They are important to all Harlem Hospital Center The Triple Aim of us, no matter what job Renaissance Health Care Network Diagnostic & Treatment Center As we follow HHC’s Guiding we do, and they remind us Henry J.