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CENTERVIEWS
A Publication of The University of Texas Harris County Psychiatric Center

Monday, October 25, 2004

IN THIS ISSUE
DOGS WITH A CAUSE
STAFF KUDOS
HOSPITALWIDE MEETING
EMPLOYEE OF THE QUARTER
FY O4 ACCOMPLISHMENTS
STRATEGIC PRIORITIES
OUTPATIENT SERVICES
MANAGEMENT INFORMATION SYSTEMS
CLINICAL SERVICES
FACILITIES OPERATIONS

DOGS WITH A CAUSE

A hearty hot dog lunch will never taste as good as it will from 10 a.m.-4p.m., Thursday, Oct. 28, at the UT Police Department, 7777 Knight Road. Two hot dogs, chips, cookies and a soft drink will be $4, with all proceeds going toward the 2004 holiday toy drive benefiting pediatric and adolescent patients at the Lyndon Baines Johnson Hospital and the Harris County Psychiatric Center. Contact: Capt. Dominick Verini at (713) 563-7790 for more details.

STAFF KUDOS

Lori Dunham sent in a compliment about MIS staffer Kathy Hoskins, for her “immediate and through assistance to me with a report complication. She actually gave it to me way in advance of my request.”

A special recognition went to Paul Sturdal for all of his work on the Employee Relations Committee this past year. Dr. Moore commended Paul on the increased number of ERC events and staff participation in ERC activities.

HOSPITALWIDE MEETING

The following information is a compilation of what was discussed at UTHCPC’s quarterly hospitalwide meeting. The material was presented by Dr. Guynn and Dr. Moore. For additional clarification on any of the items listed, please discuss your questions with your departmental manager or call ext. 7876.

EMPLOYEE OF THE QUARTER

Congratulations to Employee of the Quarter Brenda Pierre and to nominees Susan Chambers, Yen Phan, and Patty Stone

FY O4 ACCOMPLISHMENTS

•The cost per inpatient day has decreased by 11% year to date from $541.18 in FY 2003 to $501.66 in FY 2004.

•The staff turnover rate at UTHCPC has decreased from 22% in FY 2003 to 13% through the first 11 months of FY 2004.

•UTHCPC was reaccredited by the Joint Commission on the Accreditation of Healthcare Organizations. The hospital earned a score of 96 for its inpatient services and 100% for its outpatient program.

•All physicians at UTHCPC are now using an electronic medical record. All nurses are using an electronic medication administration record. Transcription errors for medications are now 0%.

•Implementing the medication administration record (MAR) improved our safety for medication and timely disbursements of medication.

•All staff minimum training requirements are now provided through the Blackboard system and the education staff hours to provide the necessary training have been cut by 2/3.

•Spring ISD and Galena Park ISD have shown an expanded interest in Tele-health and Tele-education

•The Hospital Wide Education Department has provided adjunct faculty instructors to the psychiatric clinical rotation for The UT School of Nursing.

•Two grants were received from the City of Houston for Bio-terrorism preparedness. These grants have been used to purchase supplies, extend emergency generator access, and improve communication and staff training.

•UTHCPC began participation with the hospital district, Council on Alcohol and Drug Abuse, UT Nursing School, and UT (Austin) School of Social Work in a 5 Year grant funded by SAMHSA to initiate screening, brief intervention, and referral to treatment for substance use and mental health problems within primary care clinics and emergency centers.

UTHCPC was an active participant in a countywide effort organized by the Greater Houston Partnership, Houston’s Mayor and the Harris County Judge to identify service gaps in physical and mental healthcare. This identified the lack of sufficient indigent care mental health services as one of the leading concerns facing the community and urged support for increased funding for UTHCPC.

•Designed curriculum and qualified this facility as a TCADA CIT Training site.

•Upgraded our KRONOS Time and Attendance System to a web-based software

•Started an interface between our ANSOS scheduling system and our KRONOS Time and Attendance System in order to generate better nursing productivity reports.

•Upgraded our time clocks to a Biometric system to provide more efficient and cost effective method of utilizing time clocks.

•Started KNOWLEDGEPOINT, an automated performance evaluation system that will allow us to drill down status of all major competencies across the hospital.

•Implemented an employee recognition week organized to recognize all disciplines at the hospital.

•Implemented salary increases for all employees in order to remain competitive in the market.

•Purged all of 2000 and a portion of 2001 patient charts.

•Generated approximately $27,000 of revenue through Release of Information of patient medical records.

•Created a monthly report for coding that shows the amount of money not collected due to lack of documentation. This report should inspire staff to improve in documenting.

STRATEGIC PRIORITIES
Strategic Priorities for FY05 have been modified to highlight several key areas:

• Revenue Enhancement
• Safe Environment
• Employee Relations

•Develop the continuum of care to achieve a 5% increase in overall inpatients and outpatients while maintaining positive net revenue.

•Increase operating efficiency to maintain or lower cost per patient day that does not exceed the annual change in the U.S. healthcare cost index

•Base clinical and programmatic decisions on data that is current and accurate as determined by an annual data users survey of all management areas with data need satisfaction of 3.2 or better based on a 5 point scale with 5 being the highest while also identifying requirements for the next fiscal year.

•Expand general and non-general revenue achieving an increase of non-general revenue by 5% in FY 2005 compared to FY 2004 and demonstrable actions to help achieve an increase in general revenue in the next legislative session.

•Increase community profile as measured by a 5% increase in positive name recognition and reputation by key publics in FY 2005 as compared to the prior survey

• Maintain local, state, and national recognition for quality and safety demonstrated by JCAHO accreditation, Medicare certification and meet or exceed national and prior year internal benchmarks as well as perception of quality by key publics

•Provide an open and inclusive working environment demonstrated by an annual employee attitude survey with overall satisfaction measurement above the national benchmark

•Serve as a mental health education resource for professionals, patients, families, the community, and the State of Texas establishing an FY 2004 benchmark for those benefiting from UTHCPC as an educational resource, increasing those benefiting by 10% and improving student satisfaction by 10% over established benchmarks within individual education categories.

•Enhance Research through the involvement of more staff by providing at least three lectures at UTHCPC on how to design, conduct, and analyze research, creating a working group for those who would like to develop research ideas, informing staff about UTHCPC-related research publications and presentations, and increasing the number of unduplicated papers with UTHCPC personnel by 5.

UTHCPC is continuing to participate as a member of the collaborative group formed by the Greater Houston Partnership to develop a unified approach to physical and mental healthcare in the Houston region. Recommendations from this effort will be used for local actions as well as legislative initiatives at the State level. Among those recommendations were:

•Restore to UTHCPC the full funding that was cut in the last session of the legislature and full restoration of Medicaid and CHIP mental health benefits.

•Restore the psychiatry residency training slots to the level of 2002 and provide for residency rotations in the public mental health system.

OUTPATIENT SERVICES
•Total number of combined PHP and Outpatient days for FY ‘03 was 7,647.

•Total number of combined PHP and Outpatient days for FY ‘04 was 9,688. This demonstrates a 21% increase in patient days. (Table 1)

•Total number of combined PHP and Outpatient days for FY ‘03 was 7,647.

•Total number of combined PHP and Outpatient days for FY ‘04 was 9,688. This demonstrates a 21% increase in patient days. (Table 1)

Outreach Report

Outreach services continue to be provided for children ages 3 to 6 at Head Start and Neighborhood Centers in the community.

In September, a total of 18 Head Start classrooms were evaluated by our clinicians. In addition, Dr. Randle presented an in-service for 28 Head Start teachers.

Our contract with Bread Of Life for outreach services to their adult dually diagnosed clients has been renewed. Since September, 16 clients have been evaluated for services and will begin treatment.

Prescription Assistance Program:

Successful implementation of the Prescription Assistance Program has provided over 250 patients who had no medication coverage with all of their psychiatric medications. This has positively impacted their clinical care.

Patient Benefits Information and Assistance:

In September, the Program initiated an effort to provide patients with insurance information and assistance. This effort provides patients with the latest available benefit information in order to access the best available resources for medications and clinical care.

This has resulted in a total of 85 clients receiving benefit information and total of 34 completed applications.

Data will be collected and presented quarterly to monitor the effectiveness of this program.

MANAGEMENT INFORMATION SYSTEMS

Allegra System

· A replacement system for Allegra has been selected and the contract negotiations are taking a little longer than expected. Once contract is signed, it will take roughly six months to implement.

CAP Sunrise Project Update

•Jennifer Ray returned on October 11, 2004. She will start work on Sunrise 3.5•Alan Mattingly is a new member in MIS and will be working with Ms. Ray on Sunrise.

•Unit 3C and 2B are piloting the tablet computers and mobile cart for the next six to eight weeks. They will be filling out surveys as time goes on for feedback.

•All social services daily documentation (assessments, progress notes and patient education documents) are on line. Will be working on discharge/placement documentation soon (moving it from Allegra to SCM).

•All Psychology Services documentation is online (assessments and notes)
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• Moved Emergency Medication Orders ("NOW" Orders) and Seclusion/Restraint Orders online, replacing the paper version.

•Have added important statement to the order entry screen regarding the "Read-back" policy for telephone orders outlined by JCAHO.
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•Having orders verified by Pharmacy prior to them posting to the electronic MAR (work in progress)---very big patient safety issue.

All requests on the DPSR must have supervisor’s signature and title. The DPSR no longer can be accepted via e-mail.

•The English version of HCPC's website has been completed and we're waiting to start work on the Spanish and Vietnamese sections.
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•Maintenance of the senior caregiver connection site which is a result of the senior caregiver grant.

•Waiting on UT hardware upgrade for completion of document imaging. Medical records and registration will be first to go on-line.

•Testing tablet PCs for functionality with HCPC staff (Unit 3C a& 2B will be the pilot).

•Automating forms to the web is in the last final weeks of development.
•Building re-wire process is in the third phase. Replacing cables in the offices and units.
•Working with UT to replace e-mail system to Exchange, projected time frame is November/December 04’.

•Working on second batch of computers to roll out.
•UT-H has wireless hardware to configure on UT standards
•Auditorium will have an open house to demo the audio and video capabilities October 15, 2004
•Testing biometric technology with various applications for single sign-on, working with UT-H on this project

•Moving data warehouse from DSS system that will discontinue until November. We were given an extension
•Data encryption hardware is on order. HCPC will meet the HIPAA April 05’ deadline for data encryption.
•Request for quotes has been issued for the replacement intercom system project.

IT Security Initiative

•Stronger effort to prevent viruses & hackers

•Placing computer systems behind various firewalls within UT

CLINICAL SERVICES

•1B assessment process will move to Patient Registration, assessment by Social Services, RN and MD will occur on evenings (M-F) in patient registration area. The target date late October 2004.

•Computer Tablet pilot is under way on 3C/2B

•Discharge waiting area is going well

•All clinical indicators measured were reduced with exception of Elopements

Social Services:
•Revision of pt/family education program continues

•Health fair is scheduled for November 13, 2004 and Holiday planning has begun.

•3LCDC interns trained here last year and UTHCP became certified as TCADA training site

•Beginning October 26, 2004 the Houston Council will provide LCDC counselors Tuesday and Wednesday for patient assessment and referrals

•Weekend programming revision is working very well.

• AA is now offered in-house 6 days/week for adults.

Patient Registration:

• Magnetic lock was installed for safety reasons at double doors
• Buzzer process will be available soon
• Department will begin scanning documents in near future
• New lobby furniture installed

Nursing Services:

Staffing plan changes for 04/05 include:
• Additional Psych Tech IV positions/ LVN role on evening shift
• Department annual turnover rate is very good
• Procedures for fresh air break monitoring and cafeteria monitoring were revised this quarter to prevent elopements

Hospital Wide Education:

• New funds may soon to be available for those interested in teaching nursing and staff who are pursuing RN degrees - Contact Ms. Harris for more information• Mentoring program is being utilized—Thank you mentors!

FACILITIES OPERATIONS
•New stainless steel nourishment stations are being replaced. A total of 4 units completed with 8 remaining. These units are 1986 original equipment. Contractor is HUB Certified (project is on budget).

•Department reduced Fiscal Year 2005 service contracts by more than $230,000.00

Ultraviolet environmental lamps were installed on 13 of 15 air handling units. The remaining 2 units are nearing completion. Air quality test were conducted by the UT environmental safety team. The results showed a significant improvement in the overall air quality in the hospital

•The Pharmacy area was expanded to efficiently utilize the space available in that area.