CALVARY HOSPITAL
2013 COMPREHENSIVE COMMUNITY SERVICE PLAN
NOVEMBER 2013
I.
Introduction
II.
Mission/Philosophy
III.
Service Area
IV.
Public Participation
V.
Assessment of Public Health Priorities
VI.
Three Year Plan of Action
VII.
Dissemination of the Report to the Public
VIII. Maintaining Public Engagement
1
I.
Introduction
For over 110 years, Calvary Hospital has been the only acute care hospital in the United States dedicated to the care of the advanced cancer patient, other terminally ill
patients, and their families. The expertise of the Medical Staff is focused on treating the constellation of unbearable symptoms that are associated with the most acutely ill
end-of-life patients.
Calvary Hospital is a 225 bed, fully accredited, specialty hospital exclusively dedicated to the palliative care of adult patients in the advanced stages of cancer and other
serious or end-of-life patients. In addition to its inpatient programs at both the Bronx and Brooklyn Campuses, Calvary provides outpatient, home care, hospice, nursing
home hospice, and palliative wound care services. Calvary is committed to the non-abandonment of its patients and families, and provides its services in an environment
that recognizes the physical, psychological, spiritual, and emotional needs of its patients.
Calvary Hospital is committed to assuring that its quality of care is consistently high and is provided in a safe, effective, and efficient manner. Through a variety of
programs and services, the Hospital has focused its mission on meeting the needs of advanced and serious or end-of-life patients and their family members.
2
II.
Mission/Philosophy
CALVARY INC. (HOLDING COMPANY)
CALVARY HOSPITAL
CALVARY @HOME
CALVARY FUND
MISSION STATEMENT
Calvary Inc. is a voluntary, not-for-profit facility. Since its inception in 1899, Calvary Hospital has been faithfully devoted to providing palliative care to adult patients in the advanced stages
of cancer, other terminal illness, and advanced complex wounds.
Whenever possible, grave diseases will be treated in the home.
As a member of ArchCare, the continuing care community of the Archdiocese of New York, the facility is committed to providing its program of care within the Ethical and Religious
Directives for Catholic Health Facilities. Calvary continues to embody this tradition of caring throughout the continuum of services and programs offered and through the dedication and
concern shown by its staff members, as reflected in the Hospital’s Core Values: Compassion, Caring, Commitment, Dignity, and Non-Abandonment.
Calvary is committed to the sanctity of life of its patients and their families embodied in the central values of compassion and dignity.
Each patient is a gift to each of us through which we may secure our own goodness and holiness. Calvary will strive primarily to expand its programs and services to meet the emerging needs
of our community and church.
In addition, through the Palliative Care Institute, Calvary will endeavor to transmit to other health care professionals, through research and education, the knowledge and competence which
it has developed in the care of advanced cancer and other serious or end-of-life patients. Such activities shall be designed, in all instances, to respect the primary responsibility for patient
comfort, privacy, and care.
Lastly, Calvary is committed to assuring that its quality of care is consistently high and is provided in a safe, effective, and efficient manner.
Revised 09/2012
3
III.
Service Area
Calvary Hospital’s main campus is located in the Bronx, NY. The Bronx is considered the primary community for the purposes of public health planning, and 48% of its
employees reside in the primary service area. In addition, as a tertiary referral center for advanced disease, Calvary Hospital serves the entire tri-state region. 85% of its
employees reside within its designated service areas. This secondary service area is determined based on current referral patterns:
During the 2012 calendar year, 3,033 patients were admitted to the inpatient services. Based on referral data, more than 67.8% of referrals for inpatient admissions
originated from Manhattan, the Bronx, Westchester, and Queens, representing the primary service areas. The balance of the admissions originated from Long Island,
Brooklyn, New Jersey, Upstate New York, Rockland County, Connecticut, and beyond.
Calvary@Home, which includes home care, hospice and nursing home hospice, provided care to 2,481 patients with advanced cancer and chronic and acute advanced
illnesses.
The Center for Curative and Palliative Wound Care provided care to 441 patients with a total of 5,256 visits.
The primary referral sources for admissions continue to be the acute care hospitals. Currently, 77% of admissions are referred by hospitals located within the boroughs of
New York City, Rockland, and Westchester Counties, Long Island, and the States of New Jersey and Connecticut. Other referral sources are Calvary Hospital home care,
hospice, and other home care and hospice agencies, Calvary outpatient services, families, physicians, nursing homes, and community agencies.
In October, 2001, Calvary expanded its services with the opening of Calvary Hospital – the Brooklyn Campus, at Lutheran Medical Center. During 2012, 354 patients
were admitted to the Brooklyn Campus.
4
IV.
Public Participation
1. Primary Community Public Participation
Calvary Hospital uses a variety of methods and services to gather community input, assess the needs of the community, and to assure input in the Community Service Plan. Some of these methods are:
a.
Community Outreach Services
Community Outreach Services functions as a liaison with the community, referrers, physicians, patients, and families, and facilitates admissions to Calvary Hospital. The Department
outreaches throughout the tri-state region and educates the health care and patient communities as to the continuum of services Calvary provides (Inpatient, Outpatient, Home Care,
Hospice, Nursing Home Hospice, and Wound Care). Through on-site visits, public presentations and participation in community and provider activities, the Outreach Staff continuously
assess the needs of the community.
In addition, the following community groups are active at Calvary Hospital:
Narcotics Anonymous (meet Monday, Wednesday, Friday, and Saturday)
Overeaters Anonymous (meet Wednesdays)
Alcoholics Anonymous (meet Saturdays)
Multiple Sclerosis (meets the second Tuesday of each month)
Parents of Murdered Children (meets the third Saturday of each month)
b.
Professional Advisory Council (PAC)
The PAC is a group of 36 Trusts and Estates attorneys and financial executives who work to help Calvary Hospital secure the financial resources necessary to maintain and extend our
unique and historic mission. The PAC hosts an Annual Conference attended by more than 300 of the top T&E professionals in NYC. They serve as advisors to our ongoing planned giving
efforts and write our annual planned giving newsletter, "Foresight," which is published quarterly.
Conferences were held on September 17, 2012, September 20, 2013, and a September date is being planned for 2014.
c.
Health Smart
Calvary Hospital has been selected to participate in this initiative to provide end of life care to first responders as a result of the World Trade Center attack on September 11, 2001. Through
participation in this initiative Calvary will help create the continuum of services necessary for the chronic conditions developing as a result of exposure at the World Trade Center site.
d.
Yeshiva University/REITS (Rabbi Isaac Elchanan Theological Seminary) Collaboration
Calvary Hospital has established an outreach program to the Orthodox Jewish Community and is serving an increasing number of Jewish patients and families.
5
IV.
Public Participation (continued)
e.
Palliative Care Institute (PCI)
The Education and Research provided by the PCI includes ongoing training and interaction with community organizations such as the New York City Fire Department’s Emergency
Medical Services, area medical schools, and healthcare providers from throughout the region and the world. The feedback provided helps shape our research, publications, educational
programs, and community service programs.
f.
Bereavement Program Activities
The Bereavement program provides education at community organizations and meetings including public and private institutions in the Bronx and Brooklyn. Referrals are received through
community sources and clients are followed for 13 months from entry into the program.
2. Public Participation in the Extended Community
a.
b.
c.
d.
e.
f.
g.
h.
i.
Community Outreach Services
See #1a above.
Greater New York Hospital Association
Hospital Association of New York State
American Hospital Association
New York City Department of Health
New York State Department of Health
Catholic Healthcare Association
CMS
TJC
Through ongoing participation in the groups above, Calvary Hospital continuously monitors the trends in the healthcare needs of the larger community. Although the nature of its services
is limited by its specialized mission, Calvary Hospital has identified several activities to participate in improving the health of its extended community. Public notice of these activities is
accomplished on the hospital web-site and through the communications published by the organizations.
3. Barriers to Community Service
As an acute care specialty hospital, Calvary is limited in the scope of services it provides and focuses its efforts in improving the health of its community on its areas of expertise, such as bereavement,
chronic wound care, wound healing, diabetic foot and skin care, pressure ulcer prevention and treatment education. In addition, within our Hispanic Bronx Community, the perception of Calvary
Hospital has historically been that “Calvary was a hospital where you would go to die”. We have begun a radio and print campaign targeted to the Spanish speaking community (featuring the
Director of our Wound Care Center Oscar Alvarez, PhD), to educate and emphasize that Calvary Hospital is not just for those who are at “end of life” but also for inpatients and outpatients with
illnesses and chronic non-healing wounds that require advanced wound care, diabetic limb salvage, and symptom management (palliative care). We feel strongly that such an initiative will ultimately
improve Calvary Hospital’s role in diabetic education among the Hispanic community.
6
V.
Assessment and Selection of Public Health Priorities
Calvary Hospital has identified the following public health priorities based on the ongoing input of its community, public health statistics, and the
limited scope of its Mission:
Category
Mental Health
Project
Community
Bereavement Services
Description
Sources:
Number of deaths by age by County -NYS 2011
https://www.health.ny.gov/statistics/vital_statistics/2011/table35.htm
2012 Annual Statistics:
New York State………………………...147,105
New York City…………………………...51,344
Bronx……………………………………...8,906
Kings (Brooklyn)………………………...15,824
New York………………………………….9,734
Queens……………………………………13,682
Nassau…………………………………….10,688
Westchester………………………………...6,971
Hospice home visits
Hospice phone calls
Hospital phone calls
Community phone calls
Individual hospice therapy
Individual hospital therapy
Individual community therapy
Groups
Events/lectures
Chronic
Disease
Decreasing
Amputation Rates
amongst the Diabetic
Population with a
wound of the lower
extremity
Statistics
Bereavement Services in NYS are extremely limited.
Community based bereavement programs have been
established in the Bronx and Brooklyn communities for
all ages. In addition, Camp Compass, administered in
a joint effort with over 10 different charitable
foundations provides bereavement services to children
in a camp setting.
29
2,861
1,039
2,696
43
163
331
4,824
6,536
Calvary Hospital’s Wound Care Center is the only
outpatient clinic that provides total contact casting for
the treatment of neuropathic diabetic foot ulcers. This
evidence based Gold Standard for the treatment of such
wounds has achieved more than a 90% healing rate
within 20 weeks for patients with diabetic foot ulcers.
By improving clinical outcomes through wound
healing, amputations are prevented and quality of life
significantly improves.
Increase enrollment in the group programs by
15% per year for the next 3 years. Increase the
capacity of Camp Compass by 20% over the
three year period.
Deaths in 2011
County
Goals
Total
20%.…………29,421
20% ………...10,269
20%..................1,781
20%..................3,165
20% ………….1,949
20%..................2,736
20%..................2,138
20%...................1,394
Sources:
Statewide Planning and Research Cooperative Systems (SPARCS), New York State Vital Statistics 2010, New York State
Behavioral Risk Factor Surveillance System (BRFSS), New York State Department of Health Expanded BRFSS 2010, New
York City Department of Health and Mental Hygiene April 2013, No. 26
To decrease the number of amputations in the
Diabetic population in our community through
education, outreach and treatment:
Lower extremity amputations among diabetics in the Bronx is approximately 5 per 1000 people and mortality rates related to
diabetic complications in the Bronx are 443 per 100.000 people. In New York City (including all boroughs) mortality related to
diabetes is 1870 per 100,000 and lower extremity amputations is 5039 or 4.5 per 1000 people.
7
Increase enrollment by 10% per year;
V.
Chronic
Disease
Assessment and Selection of Public Health Priorities (continued)
Improve Wound
Healing Rates in the
Diabetic Population
Utilizing evidence based advanced wound healing
therapies and treatments, healing rates at Calvary
Hospital are among the highest in the nation. The
Wound Center also has a robust clinical research
program offering patients the option to participate in a
variety of clinical trials overseen by the FDA. For
example, an NIH sponsored study regarding emotional
distress in diabetics with wounds is an international
clinical study being conducted at 4 clinical sites
throughout Europe and the U.S A description of our
clinical studies can be obtained at:
www.clinicaltrials.gov
To decrease the number of amputations in the
Diabetic population in our community through
education, outreach and treatment:
Increase enrollment by 10% per year;
Note:
The national average for prevalence of complete healing with in12 weeks is
36% for venous ulcers, 61% for diabetic foot, and 25% for pressure ulcers.
8
VI.
Three Year Plan of Action
Project
Current Status
Strategy for Meeting Goal
The incidence of wound healing rates for
diabetics with neuropathic foot ulceration
treated with total contact casting here at the
Wound Center is presently 90% within 20
weeks. In 2012, >5000 patients were seen
in the Wound Care Center. The amputation
rate was >90% less than the experience in
the targeted population in this area.
A marketing and advertising campaign has been implemented and is designed to increase awareness
among diabetics in the New York Metro area.
Community Bereavement
Services
This program is operational. Goal is for
continued growth.
Through increased Outreach, achieve growth targets.
Improve Wound Healing
Rates in the Diabetic
Population
Since 2004 almost 3000 diabetic patients
with wounds have been treated and healed.
Increase community awareness though advertising, outreach, and foot screening clinics both within
our Hispanic community but also within all minorities who are at a higher risk of diabetes in our
community.
Decreasing Amputation Rates
amongst the Diabetic
Population with a wound of
the lower extremity
9
Goals
To increase the number of diabetics
treated for neuropathic foot ulceration
by 10% in each of the next two years
while maintaining healing rates at or
above 90% and maintaining an
amputation rate below 1%.
Increase enrollment in the group
programs by an additional 15% per
year for the next 3 years. Increase the
capacity of Camp courageous by 20%
over the three year period.
Increase enrollment and participation
by 10% each year in the Bronx and
nearby communities.
VII.
Dissemination of the Report to the Public
•
The Community Service Plan is available on the organization’s web-site and as a brochure which is distributed the public upon request.
VIII. Maintaining Public Engagement
Community Outreach Services, membership in community organizations, and dissemination of the community service plan will ensure that engagement with local partners
is maintained.
10