Community Service Plan 2008

Serving Patients, Improving Public Health

1. HISTORIC HOSPITAL—HEALTHCARE LEADER
2. CORPORATE STRUCTURE AND FINANCIAL ASSISTANCE
3. PROGRAMS FOR THE COMMUNITY

I. HISTORIC HOSPITAL—HEALTHCARE LEADER

Founded in 1863, Hospital for Special Surgery, which is the country’s oldest existing orthopedic hospital, continues to pave the way in the treatment and research of bone and muscle disorders. An independent, 162-bed, nonprofit hospital, Special Surgery leads in its disciplines of orthopedics and rheumatology. For the second consecutive year, HSS was named the top orthopedic hospital in the nation in the annual U.S.News & World Report 2008 "America's Best Hospitals" issue. Additionally, for the 18th consecutive year, HSS was top ranked in orthopedics and rheumatology in the Northeast.

Special Surgery’s immediate community is found within the boundaries of New York City’s Community Board #8, which extends north from 59th street to 96th Street and east from Fifth Avenue to the East River; more generally, its primary service area consists of the five boroughs of New York City; the suburban counties in New York, along with New Jersey and Connecticut, comprise its secondary service area. However, the institution assists its many communities, whether in New York City neighborhoods, in the tri-state area, or around the world.

Mission, Vision, Values

Hospital for Special Surgery’s integrated and focused initiatives to provide the highest quality care to its patients and to improve the health of its varied communities is articulated in its Mission, Vision, and Values statement and implemented through its Strategic Plan. Key principles include:

• Providing the highest quality patient care, improving mobility, and enhancing the quality of life for all and advancing the science of orthopedic surgery, rheumatology, and their related disciplines through research and educationregardless of race, color, creed, sexual orientation or ethnic origin.
  
• Leading the world as the most innovative source of medical care, the premier research institution, and the most trusted educator in the fields of orthopedics, rheumatology, and their related disciplines.
  
• Setting and adhering to the highest possible standards based on Excellence, Integrity, Compassion, Respect, Teamwork, Quality, Safety, Innovation, Education, and Efficiency.

Striving and Achieving Excellence

To fulfill its commitment to provide patients and the community the highest standard of healthcare, Special Surgery focuses on improving performance and measuring outcomes. For example, in 2007, HSS continued its multi-year initiative to adopt the Baldrige Performance Improvement Healthcare Criteria and Values. Recent external recognition for Special Surgery’s achievements includes:

• Special Surgery ranked Number 1 in the nation for orthopedics and Number 3 in rheumatology by U.S.News & World Report.
  
• First Hospital in New York State to be re-designated for Magnet Recognition for Excellence in Nursing Service by the American Nurses Credentialing Center.
  
• Recipient of two major clinical research grants from the National Institutes of health (NIH): 
  • Center for Education and Research on Therapeutics (CERT), a five-year grant to study orthopedic devices in collaboration with the Department of Public Health at Weill Cornell Medical College.
  • Clinical and Translational Science Center (CTSC), a five-year grant to establish an innovative network for biomedical collaboration on New York’s Upper East Side focused on translating research discoveries to patient care.
  
  
• Accreditation Council for Continuing Medical Education authorized HSS to become a national accrediting institution.
  
• Press Ganey survey of patient satisfaction ranked HSS in the 99th percentile for likelihood to recommend the Hospital.

Needs Assessment: Listening and Learning Shapes Services

Hospital for Special Surgery’s needs assessment process incorporates relevant national, state and city health data, goals and priorities. In addition, the institution’s feedback processes facilitate systematic, scheduled input from its varied constituents, which include community members, patients, physicians and staff. This provides invaluable insight into public and patient needs, which is utilized to identify gaps and future programming areas.

Special Surgery utilizes the U.S. Government report, Healthy People 2010, which sets broad-based goals and objectives to expand Americans access to care, and to eliminate health disparities by age, gender, race, or disabilities, and pays special attention to information regarding the needs of all New Yorkers. For example, HSS actively supports New York State’s initiative to reduce and prevent osteoporosis, and to combat obesity in children. These needs and priorities are reflected in HSS public education outreach programs.

The Hospital routinely conducts needs assessments among key groups in its community, on which to base multi-year programs. For example, to assess the public’s healthcare needs, the Public and Patient Education Department, in 2006, conducted a large-scale needs assessment of the HSS community, distributing more than 10,000 questionnaires. The survey collected information on community priorities, probed attitudes on major medical concerns, solicited feedback on public education and exercise classes, and gathered valuable demographic information. The nearly eight percent response rate provided targeted feedback in 2007 to shape Special Surgery’s community programs and its affiliated institutions, such as the Irving Sherwood Wright Center on Aging.

Other needs assessment data is gathered through a rigorous evaluation process of public programs. All Special Surgery Public and Patient Education programs include participant questionnaires, and the feedback from these is tabulated, evaluated, and used in formulating new or refined offerings for the public health. In 2007, 2,734 people participated in 75 different on-site and off-site Public and Patient Education programs.

Further, Special Surgery’s Excellence Council reviews Press Ganey monthly patient comments and quarterly reports, and along with departmental managers and multidisciplinary teams, develops improvements in services based on this feedback of patients’ needs. To sample the range of its constituencies, HSS incorporates findings from its Gallup Survey, measuring employee engagement to strengthen programs that enhance staff development and improve quality.

Finally, to ensure that the range of needs assessment information is interpreted at the highest level of management, Special Surgery’s Board of Trustees receives and reviews ongoing reports that include results of patients’ satisfaction surveys and a summary of the Hospital-wide Quality Assessment and Performance Improvement Program.

Strategic Planning: Collaborative Process Meets Future Needs

In 2005, Special Surgery launched a strategic planning initiative that resulted in a detailed and far reaching document to strengthen the institution and its services. The plan, designed to inform the management and growth of its programs and services, reflected an extremely wide consultative and collaborative process. The result of the strategic planning process provides guidance through 2010, and reaffirms the HSS goal, “to provide the highest quality patient care, improve mobility, and enhance the quality of life for all.” In 2007, the Hospital initiated a strategic planning process and updated our strategic plan. The plan was presented to employees in open forums during the first quarter of 2008 and establishes the Hospital’s priorities over the next five years.

On an operational level, Special Surgery integrates strategic planning into its ongoing management and coordination. Specifically, the Hospital’s Public and Patient Education Advisory Committee, a major interdisciplinary group that includes representatives from Special Surgery's Board of Trustees, ensures alignment and synergy between public and patient education and the institution’s medical specialties. Convened by the Surgeon-in-Chief and meeting six times yearly, the Public and Patient Education Advisory Committee is key to implementing strategy.

Special Surgery’s Public and Patient Advisory Committee recognizes that mounting public health concerns and an aging population will create an increased need for educational interventions relating to HSS specialties in the areas of musculoskeletal health and mobility. Yearly strategic planning by this group enables Special Surgery and its programs to respond to changes in the health care environment and link its programs and external trends. Special Surgery’s Education and Academic Affairs 2006-2010 Strategic Plan ensures alignment and helps prepare the institution to meet increasing constituent needs with measurable results.

Community Service Fulfills HSS Mission

Special Surgery’s Plan for Provision of Care/Service, which is written with input from all Hospital departments, distributed broadly within the institution, and presented to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), expresses the institution’s commitment to improving community health. This community is defined as HSS patients as well as the public and healthcare practitioners. Since arthritis, rheumatism, and spine problems are the country’s most common causes of disability, HSS recognizes that community outreach and service continues to grow in importance, especially in the context of a rapidly aging baby boomer generation. For a full list and description of the services offered by HSS, please view the hospital's Programs for the Community.

II. CORPORATE STRUCTURE AND FINANCIAL ASSISTANCE

Corporate Structure

HSS is an independent 162-bed specialty hospital, a tax-exempt organization under Section 501 (c)(3) of the Internal Revenue Code, which is governed by a Board of Trustees. In addition to Hospital for Special Surgery, there are five organizations that exist to support the mission of the Hospital. Each entity has its own table of organization, by-laws, and financial statements.

Revised Policy Expands Financial Assistance

In 2006, Special Surgery announced a revised charity care policy in order to broaden assistance to patients, regardless of their ability to pay. The institution’s Board of Trustees approved the revised policy to provide financial aid to patients based on their income, assets, and need, which went into effect at the end of 2006.

The new policy liberalized the guidelines used to determine a patient’s eligibility for financial assistance, which is determined regardless of race, color, creed, sexual orientation or ethnic origin. Financial assistance is to be provided to patients who have little or no insurance coverage, and are unable to pay for their hospital services. HSS uses poverty guidelines issued by the U.S. Department of Health and Human Services to determine eligibility. Financial assistance is provided when a patient’s gross family income is less than 400 percent of the Federal Poverty guidelines adjusted for family size. Applications for financial assistance are administered on an individual basis, taking into consideration of each patient’s special circumstances and needs.

Special Surgery distributed a summary of the new policy throughout its clinics and offices, sent email notices to all staff, and prominently displayed fliers at all registrations desks and public spaces. In addition, notification of the policy appears on all patient bills. The Financial Assistance office works with patients and families who request help. To learn more, please read the HSS Notice of Financial Assistance (pdf) or call: 212.606.1505.

For a complete listing of programs and services HSS offers to the public, please visit Programs for the Community.