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The Community Connector
Dear Friends, Community Partners, Physicians and Staff,

I hope this finds you looking forward to enjoyable holiday plans with family and friends. As the year comes to an end, I also hope you'll each take a moment to reflect on recent accomplishments you have helped Kingsbrook and Rutland realize; I have listed just a few highlights below.

This monthly newsletter to our Kingsbrook communities will be a vehicle to share news, upcoming events, and, of course, achievements. On the news front, I am using this inaugural issue to update you on a topic that is top-of-mind for all of us: The Brooklyn Study: Reshaping the Future of Healthcare, commissioned by New York State, formulated by Northwell Health, and released last month. But first...

A Few Recent Achievements
Gold Stroke Award in 2016
Kingsbrook was recognized again this year for its commitment and success ensuring that stroke patients receive the most appropriate treatment according to nationally recognized, research and evidence-based guidelines. The American Heart Association/American Stroke Association's Get With The GuidelinesĀ®-Stroke Gold Quality Achievement Award was given to Kingsbrook in 2016 for achieving 85 percent or higher adherence to all Get With The Guidelines-Stroke for twenty-four months or more.
Excellence Award for Patient Satisfaction 2016
In August, Kingsbrook received the National Research Corporation's (NCR) "Most Improved Facility" honor in the category of large hospitals, having shown the highest percentage increase of patients who gave the hospital a top satisfaction rating of "9" or "10." Kingsbrook was selected from 133 hospitals nationally, and is the only medical center in the tri-state area to receive this recognition.
Kingsbrook Rehabilitation Institute Awarded CARF Accreditation
Since 1984, and again last year, our Rehabilitation Institute has been accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), a nationally recognized designation of excellence. This past year, the Institute expanded its accreditation to include that of excellence in both Stroke and Cancer Rehabilitation. The Cancer program accreditation is an especially important designation, in that Kingsbrook's program is the only one of its kind in the northeast, one of only four in the USA, and one of only six programs worldwide.
Rutland Nursing Home Receives Herb Langsam Pharmacy Service Award
We are very proud of the team of pharmacists, nurses, social workers, physicians, and others who are the recipients of the 2016 Herb Langsam Award from the American Society of Consultant Pharmacists (ASCP) Foundation. The Langsam award is bestowed annually to a pharmacist-led team that demonstrates exemplary pharmacy-related services to residents and patients dwelling in post-acute, long-term care, assisted living, or community settings. The Rutland team was recognized as an outstanding provider of innovative solutions and improvements in quality, leading the development of a performance improvement project that reduced the use of antipsychotic medication prescribed while increasing non-pharmacological measures and methods to ameliorate certain behaviors.
Kingsbrook Recertified as Patient-Centered Medical Home Practice
Kingsbrook successfully recertified its recognition by the National Committee for Quality Assurance (NCQA) as a Level 3 Patient-Centered Medical Home practice, a distinction Kingsbrook has maintained since 2014. Kingsbrook has achieved this benchmark by providing primary care and chronic disease treatment that meets NCQA's highest standards.
Rutland Celebrates 40th Anniversary
Rutland Nursing Home celebrated its 40th Anniversary on October 31st, 2016. The event was well-attended by members of the community, nursing home residents, staff, and local elected officials. Rutland Administrator Michelle Edwards recognized the facility's commitment to providing compassionate elder care with an awards ceremony honoring long standing staff members and nursing home residents. The ceremony included a Proclamation for Rutland Nursing Home from Senator Jesse Hamilton's office.
Launch of the Kingsbrook Neck and Back Pain Center
In fall of this year, we introduced our communities to the Neck and Back Pain Center, a collaboration of specialists -- from across the Kingsbrook Centers of Excellence -- who work together to restore mobility, reduce pain, and improve quality of life for their patients. The Center is led by physicians who specialize in rehabilitation medicine and pain management.
The Brooklyn Study: Reshaping the Future of Healthcare
A brief preamble: I embrace the changes The Brooklyn Study has proposed for Kingsbrook, Rutland, and for Brooklyn overall. It offers an actionable roadmap to create a sustainable, effective, and responsive healthcare delivery system for the communities we serve.

Below is a big-picture summary of The Brooklyn Study and what it means specifically for Kingsbrook and Rutland. I will continue to share with you more details about the transformation plan as they take shape over the coming many months.

Q: What is The Brooklyn Study?

Earlier this year, Governor Cuomo's "Kings County Health Care Transformation Program" committed $700 million to hospitals in our region. In April, the NY State Department of Health awarded a grant to Northwell Health to prepare a feasibility and sustainability study of the private, financially-challenged, safety-net hospitals (and their affiliated entities) in central and northeast Brooklyn: Kingsbrook, Brookdale, Interfaith, Wyckoff Heights, and SUNY Downstate. The Brooklyn Study was commissioned to examine how each of the hospitals operates, the services each provides, and the healthcare landscape of the community as a whole. The goal? To improve the quality of healthcare and overall health in our communities, and to identify the means to deliver that care in a manner that meets the needs of the communities and reduces costs through functional efficiencies.
It's helpful to understand the significant challenges these hospitals face:
  • The residents of our communities have higher-than-average incidence of serious health conditions -- including obesity, diabetes, high blood pressure, congestive heart failure, alcohol and drug dependence, and behavioral health problems.
  • The care for close to 90% of patients in our region is paid by Medicare and Medicaid; reimbursements to hospitals through those plans simply do not cover the actual costs of delivering health services.
  • Medicaid beneficiaries in central and northeastern Brooklyn account for the highest number of potentially preventable emergency department visits, with between 65% and 85% of all emergency visits considered potentially preventable
Q: What does The Brooklyn Study recommend?

The Study proposes the formation of an integrated, unified, healthcare delivery system
that strategically aligns the governance, operations, and clinical programs of its member hospitals, nursing homes, and affiliates. This newly-formed integrated system would be more cost-efficient, effective, and improve the overall quality of care for the residents of the communities we serve. The following are key features of this new system:
  • Increased ambulatory care. The Study recommends the development of a large, ambulatory care network throughout central and northeast Brooklyn, which would include 36 strategically located outpatient facilities providing urgent care, primary care, and specialty services. This network would significantly expand residents' access to conveniently located primary care and specialty care services as a means to promote wellness and disease prevention, and to avert health crises and emergency room visits.
  • Eliminate unnecessary duplication of services among the hospitals, particularly when delivering inherently costly acute inpatient care. This would allow financial resources to be reallocated in support of new "clinical centers of excellence" throughout the health system.
  • Address the social determinants of health -- the conditions and systems in which people are born, grow, live, work, and age - that are shown to have significant responsibility for health inequities in our communities. The Brooklyn Study recommends that Kingsbrook/Rutland serve as a hub for this, and as an incubator for new and innovative "population health" initiatives.
Q: How will Kingsbrook and Rutland change in the future?

Over the next several years:
Kingsbrook will evolve from being a traditional inpatient hospital to become a comprehensive ambulatory care destination. That is certainly something we know how to do: we currently service nearly 150,000 outpatient visits each year. We anticipate the continuation of our current portfolio of outpatient services, including ambulatory surgery, and we will continue to be a 911 ambulance-receiving Emergency Department.
In addition, we will become the rehabilitation specialty hospital for the system, with the continuation of acute inpatient rehabilitation services on the Kingsbrook campus, and of the broad array of post-acute care services at Rutland Nursing Home. As we deliver this portfolio of acute and post-acute services, we will expand into new areas that address the many social determinants of health that impact our communities.

In the near-term
: We will be business as usual in all our current inpatient and outpatient service lines. The Brooklyn Study emphasized: "There are no shortcuts... It will take several years to implement the proposed transformational changes if the new system is to fully realize the benefits of doing so." Kingsbrook will eventually transfer its inpatient medical/surgical and behavioral health beds to Brookdale and Interfaith -- once the renovations, expansions, and improvements of those facilities are able to accommodate the increased inpatient demands.

Q: Will there be job losses at Kingsbrook?

No. The Study calls for retaining current employment across the hospitals. As Kingsbrook transitions from inpatient to outpatient services, some job descriptions will be modified and work sites may shift. For those employees moving to new roles, there will be training to prepare them.

Q: What happens next?

This will be a multi-year process. It has begun this month with the formation of a new parent organization for the system, called One Brooklyn Health, with its initial Board of Trustees comprised of the chairpersons of the boards of Kingsbrook, Interfaith and Brookdale. In January, we will host a town hall meeting to further update the community and to continue to seek input. (Stay tuned for the date of this meeting.) An active planning process will be undertaken throughout 2017 that will involve key stakeholders, including physicians, staff from each hospital, organized labor, community members, and our many civic leaders. This will include on-the-ground research where residents will be asked their views on the state of their health and what they need to improve it. Some examples of responses might include affordable housing, access to safe places to exercise, and availability of affordable and healthy food. I will keep you updated on that process.
Closing Thoughts
While change can bring a measure of anxiety, I ask you to join with me in keeping our focus on what will remain unchanged: our long-standing commitment to delivering exceptional quality, safety, and patient experience at Kingsbrook and Rutland. Every person who walks in our doors deserves excellent, respectful, culturally competent, and compassionate medical care, which we will continue to deliver.

Best wishes for a happy and healthy holiday season. Thank you for your continued efforts and support on behalf of each and every patient and family who entrusts us with their care. You can reach me at drbradycomments@kingsbrook.org with your ideas, questions, or suggestions. I look forward to hearing from you.

Linda Brady, M.D., President and CEO
Kingsbrook Healthcare System