Health System: San Mateo Medical Center (6600B)

Overview

San Mateo Medical Center is a 509-bed public hospital and clinic system accredited by the Joint Commission. The Medical Center operates outpatient clinics throughout San Mateo County, an acute care hospital, and a skilled nursing facility.
More specifically, the Medical Center provides inpatient and outpatient medical care including Intensive Care, Surgery, Emergency Care, Infusion, Respiratory Therapy, and Domestic Violence Intervention.
The Medical Center also provides Diagnostic Imaging (e.g., x-rays, MRIs, mammograms, EEG/EKG procedures), Rehabilitation, and Laboratory and Pharmacy services. We have 64 Medical-Surgical beds, seven Intensive Care Unit beds, three Operating Rooms, and 15 Emergency Room beds at the Medical Center, providing care to 2,300 patients (13,700 inpatient days) annually with an average length of stay of 6.0 days each year. The Medical Center also provides 40,000 emergency visits and 2,300 hours of infusion procedures each year.
The Medical Center operates 12 clinics throughout the County that provide primary healthcare and preventive services. Included in the 12 clinics is the clinic in Pescadero opened in March 2014 through Measure K funding. Through these clinics, we treat 53,000 unique patients for a total of 236,000 clinic visits, including 50,000 pediatric visits, 22,000 OB/GYN visits, 14,000 senior care visits, and 20,000 dental visits.
The Medical Center also provides emergency psychiatric evaluation and crisis stabilization to mentally ill patients who come in voluntarily or involuntarily. For those patients who are very ill and need extended treatment, the program provides inpatient psychiatric treatment in a locked inpatient acute psychiatric unit. Other patients receive consultations by psychiatrists and psychologists at the medical wards, in long term care or through the Innovative Care Clinic. The Medical Center provides 3,000 psychiatric evaluations in the psychiatric emergency unit, and care for 300 patients on the inpatient psychiatric unit for a total of 10,000 inpatient psychiatric days each year.
For patients who have skilled nursing needs and require rehabilitative services in order to transition from acute care to the community, the Medical Center provides skilled nursing services and rehabilitation on a 24/7 basis. The Medical Center provides skilled rehabilitation, creative arts and recreation therapy, skilled nursing, end-of-life care, hospice care, maintenance and restorative nursing, wound care, and intravenous therapy.

Program Outcome Statement

We partner with patients to provide excellent care with compassion and respect.

Program Services

  • Inpatient and Outpatient Medical Care including Intensive Care, Surgery, Emergency Care, Infusion, Respiratory Therapy, and Domestic Violence Intervention
  • Emergency Psychiatric Evaluation and Crisis Stabilization
  • Inpatient Psychiatric Treatment
  • Skilled Nursing Services and Rehabilitation
  • Diagnostic Imaging, Rehabilitation, and Laboratory and Pharmacy Services

Likelihood to Recommend SMMC to Family and Friends as a Great Place to Receive Care Below Target

Cost Per Patient Per Month Meeting Target


Number of Patients Assigned to SMMC by HPSM Who Have Not Been Seen Continuing to Improve
FY 2017-18 Year-End Story Behind Performance
Likelihood to Recommend SMMC to Family and Friends

In January 2018 SMMC switched vendors for its patient experience survey.  The new vendor uses a different scale, called the top box scale, to rate patient experience which is similar to the scale used by the Centers for Medicare and Medicaid services in its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. According to the new scale, we only count the patients that give us the top score for the survey questions. If the scale is from one to 10, we count the patients that give us nine or 10, and if the scale is from one to five, we only count the patients that give us a score of five. Due to the change in methodology, our score for likely to recommend is very different from and not comparable to the results prior to fiscal year 2017-18. 

We will be using the first three months of calendar year 2018 as the baseline and aim to show a five percent improvement from the baseline over the next 12 months. Preliminary results from the second quarter of 2018 already show improvements in Likely to Recommend scores for the Emergency Department and Clinics. Since nursing communication has the highest correlation with Likely to Recommend in the hospital setting, we plan to focus on inpatient nursing practices to improve our scores in inpatient.
Cost per Patient per Month

The number of patients served remains about the same and SMMC met the target cost per patient per month of $387, which reflects operating efficiencies that SMMC was able to achieve in areas such as revenue collection services and outside services.

Number of Patients Assigned to SMMC by Health Plan of San Mateo (HPSM) Who Have Not Been Seen

SMMC has successfully reduced the number of assigned-unseen patients by over one thousand lives. This achievement reflects significant work to expand the availability of new patient appointment slots in the clinics, as well as the success of clinics at filling staffing vacancies that have limited overall clinic capacity. The reduction is also a reflection of a broader reduction in the size of the patient population assigned to SMMC by HPSM, which has been driven in part by the elimination of auto-assignment to some clinics that do not have the capacity to take on additional new patients.

Future Priorities
  • Focus on improving access to Specialty Care, through our Model Cell work and expanding our Care Team Transformation work.
  • Provide high quality, coordinated, timely care to the patient population assigned to SMMC by HPSM and/or empaneled patients by care teams that deliver the right care, at the right time, and right place in order to avoid unnecessary ambulatory (primary and specialty care), emergency department visits, and acute admissions.

Author: Gina Wilson; Chief Financial Officer, Health System     Contact Email: gwilson@smcgov.org     Last Updated: 08-10-2018