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HomeMy WebLinkAbout~Master - Mary Greeley Medical Center Board of Trustees Minutes 09/30/2025 Mary Greeley Medical Center Board of Trustees Meeting Minutes September 30, 2025 The Board of Trustees met on Tuesday, September 30, 2025, at 11:15 a.m. in the President & CEO’s office for the closed portion of the meeting. Members in Attendance: Natallia Gray, Mary Kitchell, Austin Woodin Member in Attendance (via secure phone line): Beth Swenson Member Absent: Ken McCuskey Others in Attendance: Amber Deardorff, Shane Hopkins MD, Karen Kiel Rosser, Gary Botine, Amber Swett Motion and second (Kitchell, Gray) to go into closed session pursuant to Section 21.5(1)(l) Code of Iowa, to discuss patient care quality and process and marketing/pricing strategies in a meeting of a public hospital, where public disclosure of such information would harm such a hospital’s competitive position when no public purpose would be served by public disclosure; and to review or discuss records which are required or authorized by state or federal law to be kept confidential. Vote: Gray- yes; Kitchell-yes; Swenson-yes; Woodin-yes. Motion carried. The Board went into closed session at 11:15 a.m. Motion and second (Woodin, Kitchell) to close the session pursuant to Iowa Code section 21.5(1)(l) to discuss patient care quality and process and marketing/pricing strategies related to a change in facility activity where public disclos u re of this information would harm the hospital’s competitive position and no public purpose would be served by public disclosure. Motion carried. The Board came out of closed session at 11:51 a.m. The board reconvened in the Atrium A conference room at 12:00 p.m. Members Present: Natallia Gray, Mary Kitchell, Austin Woodin Member Present via Teams: Beth Swenson Member Absent: Ken McCuskey Mary Greeley Medical Center Board Meeting Minutes Page 2 Others Present: Amber Deardorff, Gary Botine, Karen Kiel Rosser, Penny Bellville, Jotesh Chug MD, John Meyers RN, Melissa McGarry, Paul Hudson, Micci Gillespie Consent Agenda a. Minutes  August 26, 2025 b. Financials  Month ended August 31, 2025 c. Dashboard of Indicators d. Home Health & Hospice Report e. Medical Staff Bylaws f. Quality Management Goals & Objectives g. Gifts Policy h. Quality/Performance Improvement Plan i. Patient Concerns & Grievances Policy j. Utilization Management Plan k. Quality Metric Reports  Rehab & Wellness  Facilities  Surgical Services  Radiology l. Approval of Medical Staff and Advanced Practice Providers and clinical privileges as discussed in closed session. Applications for reappointment to the medical staff  Joseph Merchant, MD, Oncology/Hematology, McFarland Clinic, Active  Melissa Wells, MD, Rheumatology, McFarland Clinic, Active Applications for 1-year reappointment to the medical staff  Curtis Waite, DO, Emergency Medicine, McFarland Clinic, Active Applications for initial appointment to the medical staff  Molly Gentle, MD, Family Medicine, McFarland Clinic, Community Based, (refer only)  Timothy Schurman, MD, Plastic Surgery, The Iowa Clinic, Active Request to update privileges  Taher Sabobeh, MD, Pulmonology & Critical Care, McFarland Clinic Natallia asked to pull the Dashboard of Indicators. Motion and second (Kitchell, Gray) to approve the remaining items on the consent agenda. Motion carried. Mary Greeley Medical Center Board Meeting Minutes Page 3 Natallia asked for an explanation regarding the change in format for the Dashboard of Indicators, and if the items that were on the Dashboard previously are still being monitored. Karen shared the new format for the Dashboard was refreshed to align with the big dot goals. Leaders continue to monitor all the items on the current and prior Dashboard. Motion and second (Gray, Kitchell) to approve the Dashboard of Indicators. Motion carried. Facilities Following a request by the trustees at last month’s meeting, Gary shared the following list of buildings owned by Mary Greeley. (main campus) Avenue with 76,679 sq ft of mechanical = 610,045 total sq space is roughly 37,213 sq ft Avenue and Story County House Dakota Street McFarland the building while McFarland owns the Medicine East Avenue Clinic, P.C. Doran Avenue Clinic for Avenue Prosthetics & until 2032 Mary Greeley Medical Center Board Meeting Minutes Page 4 Inc. Story City – MGMC 708 8th Street MGMC 24,829 sq ft Therapies, fitness center, and gym Story City – McFarland 708 8th Street McFarland Clinic 10,040 sq ft Clinic offices Natallia asked why the Ames Surgery Center is not included on the list. Mary Greeley and McFarland Clinic each own 50% of the building, with Mary Greeley owning an additional five acres adjacent to the center. Gary shared the surgery center will be added to the list. Since the last board meeting, Gary shared the administrative team had a discussion with a consultant that specializes in medical campus space planning, which was facilitated by 10Fold Architecture. After further discussions, the administrative team has decided to put the learning center project on hold while conducting a master space planning activity to include all the land and buildings owned by Mary Greeley. An RFP is being prepared to be sent out to a number of firms who specialize in this work. Once a decision has been made, leadership anticipates the process taking six to seven months for a final report. The Facilities Steering Committee met on Monday, September 29. Discussion included expanding Acute Rehab to the 6th floor of the west patient tower. Making this change was previously part of Phase 4 of the Master Facility Plan but was put on hold during the pandemic. Public Forum No one came forward. Engagement Survey Results Karen shared the results of the 2025 provider engagement survey. Key takeaways: • Response rate was 44%. All providers and advanced practice professionals are surveyed. • Engagement – Score increased +0.05 and the rank fluctuated slightly from the 78th percentile in 2024 to the 77th percentile in 2025. • High-quality care – Belief that the organization provides high-quality care improved and is at the 80th percentile. • Alignment – All alignment items dropped in score, and the rank dropped from the 75th percentile in 2024 to the 71st percentile in 2025. • Specialty groups – For those in the largest specialty group (Medicine-45), engagement and alignment improved and are at the 86th and 88th percentiles. • Key drivers – ‘The goals and priorities of providers are reflected by the actions of organizational leaders’ dropped significantly and is a key driver of engagement. Mary Greeley Medical Center Board Meeting Minutes Page 5 • Affiliation – Engagement dropped for those in the 3-5 years of affiliation group and those in the over 25 years group. Recommendations to improve provider’s engagement and alignment: • Develop or enhance ways for providers to share their input and deepen confidence they are being heard.  Include feedback loops in communication processes to ensure providers know their input was heard and considered.  Include provider representatives in discussions on processes, procedures, and hiring.  Executive rounds to maintain a connection with providers and ensure they are being heard.  Provide various ways for providers to share their thoughts and input. • Establish a clear vision and goals.  Define a clear vision for the organization and articulate specific goals that align with the mission and values of both the physicians and the hospital leadership.  Involve senior physician leaders in establishing and refining the vision and goals. • Joint Strategy Development  Involve physicians in strategic planning processes when developing organizational strategies. • Develop strong communication channels.  Implement effective and efficient communication channels that facilitate open and transparent discussion between physicians and hospital leadership. • Partner in quality  Encourage collaboration between physicians and hospital leadership in quality improvement initiatives.  Establish multidisciplinary teams that include physicians, administrators, and other key stakeholders to develop and implement quality improvement projects.  Set patient experience goals and demonstrate the connection between patient experience, quality, and safety.  Partner physician leaders and nurse leaders, including the CMO, and CNO, to drive quality improvement initiatives. Penny shared the results of the 2025 employee engagement survey. Key takeaways: • Engagement – Maintained with a slight improvement in score and a slight change in rank – from 84th to the 83rd percentile. • By position – Engagement by all position types remain above the sub-group average but engagement dropped for several. • Nurses – Engagement for registered nurses (largest group of employees-490) improved +0.03 and is now at the 87th percentile. • Safety culture – Overall and Themes dropped slightly. Actively doing things to Mary Greeley Medical Center Board Meeting Minutes Page 6 improve patient safety and effective teamwork between physicians and nurses dropped significantly. • Tenure – Engagement for those with 1 to 2 years of service dropped -0.11/63rd percentile and dropped significantly for those with 6 months to 1 year of service - -0.17/77th percentile). • The organization provides career development opportunities improved significantly and is the highest ranked item – 93%. • Response rate – 85% Recommendations to improve employee engagement: • Department level action planning.  Goals to maintain or improve performance.  Involve employees in the development of the department action plans.  Provide additional support to departments that have the greatest opportunities for improvement. • Continued leader development.  Training and expectations to support development and engagement.  Continued senior and executive leader presence and support for all employees.  Ensure staff have multiple ways to have their voices heard and to hear the follow-up. • Support emergency department’s goal to improve.  Attention on engagement will support stronger patient experience.  Examine relations and communications between ED and other units.  Work with care givers to identify processes that can be improved and streamlined to provide more time for patients. Volunteer engagement survey results: • Overall score: 4.6 out of 5 • Response rate: 150 out of 259 invited (58%) • Top-rated dimensions  Respect & communication – 4.78/5  Team & leadership – 4.74/5  Engagement and belonging – 4.74/5  Meaningful work – 4.68/5  Support & appreciation – 4.72/5  Mission alignment – 4.63/5  Well-being – 4.55/5 Key themes from volunteer comments: • Making a difference and meaningful impact. • Appreciation and respect from staff and patients. • Connection and belonging to the team. • Flexibility in scheduling and assignments. • Personal fulfillment & growth. Mary Greeley Medical Center Board Meeting Minutes Page 7 • Organizational pride and mission alignment. • Positive experiences with specific roles and staff. The pulse survey will be sent out in November. Penny shared a young professional’s group, as well as a mentorship program recently started at the hospital. Natallia asked about positions that are not covered by Career Pathways. Staff are working with the new facilities director to create pathways in his department. Information Systems continues to work on pathways for their department. Natallia asked how many travelers are employed by the hospital. Penny shared there are very few. The travelers on staff are on the medical units and generally on the overnight shift. Medical Staff Report The medical executive committee met on September 26, 2025. The following items were approved: • Minutes for the August 22, 2025, meeting. • September appointments and reappointments were recommended for board approval. • Policies  Forgoing or Withdrawing Life-Sustaining Treatment and DNR  Adult and Pediatric Organ/Tissue Donation after Cardiac Death or Brain Death  Antimicrobial Prophylaxis for Surgery Gary shared an update on the financial outlook at Mary Greeley. Community Health Needs Assessment Karen shared the Story County community health needs assessment (CHNA) is on a 5- year cycle and is required by CMS. An external firm, PRC, was selected to conduct the assessment. The assessment consists of both primary and secondary data and uses the following for benchmarking: • Previous survey data • PRC national health survey • Iowa BRFSS data • Health People 2030 targets • National vital statistics data Secondary data is county-level data such as census data, vital statistics, and other health- related data. Community stakeholder input included 87 physicians, public health, other Mary Greeley Medical Center Board Meeting Minutes Page 8 health providers, social services, and community leaders. A customized local health survey was population-based and targeted health status, experience, and behaviors. The surveys were conducted via landline/cell phones and internet-based surveys. A total of 755 surveys with 125 items were stratified across the service area with the final sample weighted in proportion to the total population: • 551 in the Ames area • 51 in North Story County • 52 in Nevada • 51 in Eastern Story County Areas of opportunity include: • Health  Mental health  Nutrition, physical activity, and weight  Substance use  Cancer  Diabetes  Access to health care services • Social determinants  Income and poverty  Housing and homelessness  Food insecurity  Transportation Karen stated leaders have been leaning heavily on the results, and there is conversation about doing this survey every three years rather than every five years. Beth asked if the increase in inability to receive services is due to visits to the ED. Karen stated that it could be the reason if people do not have a primary care provider. The report in its entirety has been added to BoardEffect. President’s Report Amber shared leadership and staff have been busy with the Baldrige site visit. The virtual portion of the visit started today. Big Dot Goals – Quarter 1 • One incident of harm • 91st PR inpatient results • Lab – over 200 days without a needle stick! They have approximately 60,000 draws annually. • Operating margin is 2.2% Mary Greeley Medical Center Board Meeting Minutes Page 9 There are six new providers that started in June, July, and August. Specialties include Radiology, Pulmonary Medicine, Nephrology, Podiatry, Anesthesia, and Midwifery. In addition, six new providers either started in September or are scheduled to start in October. Those specialties include Hospitalist, Physical Medicine & Rehabilitation, Ophthalmology, Emergency Medicine, Cardiology, and Plastic Surgery & Reconstruction. Recent PRIDE awards were presented to Human Resource employee health nurses Sarah Buckels and Sarah Ohrtman. Intensive Outpatient Services social worker Chris Ries also received a PRIDE award. Nurse Trent Muhlenburg received the DAISY Award. Board Comments Natallia shared Iowa State University is hosting a Healthcare Management Summit on November 12. The keynote speaker is David Stark. There will be a panel discussion with multiple organizations represented. John Meyer will be moderating the discussion. Adjournment Woodin adjourned the meeting at 1:26 p.m. _______________________________ _______________________________ Austin D.M. Woodin, Secretary Micci Gillespie, Recording Secretary