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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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San Mateo Medical Center
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DATE:
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July 25, 2007
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BOARD MEETING DATE:
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August 14, 2007
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Sang-ick Chang, Interim Chief Executive Officer San Mateo Medical Center
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SUBJECT:
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Agreement with Ronald Greenwald, M.D.
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RECOMMENDATION:
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Adopt a resolution authorizing:
A. The President of the Board to execute an Agreement with Ronald Greenwald, M.D. for $618,000 to provide neurosurgery services for the period July 1, 2007 through June 30, 2009.
B. The San Mateo Medical Center (SMMC) Chief Executive Officer (CEO) or the CEO's designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.
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VISION ALIGNMENT:
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Commitment: To Ensure Basic Health and Safety for All.
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Goal 5: Provide residents access to healthcare and preventive care.
The Agreement contributes to this commitment and goal by providing comprehensive neurosurgery services.
Contractor’s productivity is being measured by the current Medicare Resource-Based Relative Value Scale (RBRVS) Relative Value Work Units (RVUs), an industry-wide measurement of medical care that indicates the level of quality standards being met
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by an individual practitioner. Contractor performance is measured by patient satisfaction and peer review annual surveys.
Performance will also be measured according to adherence with the indicators of the Surgical Infection Prevention Study and the Institute for Healthcare Improvement's (IHI) Surgical Site Infection Bundle. Program measures are:
1) Timeliness of antibiotic prophylaxis administration
2) Appropriateness of antibiotic for prophylaxis
3) Avoidance of shaving surgical site
Performance Measures:
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Measure
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FY 2006-07
Actual
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FY 2007-08
Projected
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1. RVU productivity
2. Percentage of cases with timely antibiotic administration
3. Percentage of cases with appropriate antibiotics
4. Percentage of cases with shaving
5. Overall patient satisfaction
6. Overall peer review
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2933
>95%
>95%
0%
100%
52.68%
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3074
>95%
>95%
0%
>75%
>75%
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BACKGROUND/ DISCUSSION:
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Dr. Ronald Greenwald has provided neurosurgery services to the San Mateo Medical Center for the last several years. This discipline serves as the basis for the evaluation and treatment of brain, spinal cord, and peripheral nervous system disease including brain cancer, brain aneurysms, spinal cord and nerve root impingement syndromes (ruptured/herniated discs), and peripheral nerve impingement syndromes (carpal tunnel). SMMC has a continuous need for neurosurgery services and Dr. Greenwald will offer the hospital the continued benefit of an experienced practitioner familiar with the complex nature of the County patient base.
The increase in level of productivity and contract funding reflects the number of surgical cases Dr. Greenwald is projected to perform.
Neurosurgery services are provided under the general direction of the Chief of Surgery of the SMMC. Monitoring and evaluation of the quality of services provided by contractor are accomplished through peer review by the Quality Improvement Committee and the Medical Executive Committee of the medical staff.
Risk Management and County Counsel have approved the Agreement.
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TERM AND FISCAL IMPACT:
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The term of the Agreement is July 1, 2007 through June 30, 2009. The maximum amount the County shall be obligated to pay Contractor is $618,000. The prior Agreement totaled $604,020.96 and the 2007-09 agreement reflects an overall increase of 2%. Funds are included in the San Mateo Medical Center’s FY2007-08 Tentatively Approved Budget and will be included in the FY2008-09 Proposed Budget.
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