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 2,600 patients (13,300 inpatient days) annually with an average length of stay of 5.1 days each year. The Medical Center also provides 41,000 emergency visits and 2,100 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 58,000 unique patients for a total of 246,000 clinic visits, including 50,000 pediatric visits, 22,000 OB/GYN visits, 14,000 senior care visits, and 17,000 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 3,200 psychiatric evaluations in the psychiatric emergency unit, and care for 500 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 Meeting Target

Cost Per Patient Per Month Below Target


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

In the first half of fiscal year 2017-18, SMMC has focused on improving nursing practice in the emergency department and inpatient and care team transformation in the outpatient area. We have seen some improvement in our likely to recommend scores in the outpatient area compared to fiscal year 2016-17.  This improvement is primarily attributed to "WECARE", an acronym for client interaction (Welcome and personalize customer, Engage and clarify expectations, Communicate and gather information, Address customer needs, Review and resolve questions and concerns, End on a positive note), becoming ingrained in the culture and continued improvement in provider section scores.

There has also been a steady increase in the likely to recommend scores in the emergency department due to a continued focus by the "Patient in the Middle " workgroup and improving nursing scores. We have been challenged in the inpatient area due to staffing issues and the transition of the hospitalist service to a new contracted group.
Our target for fiscal year 2018-19 has not been determined yet as we will be working with a new vendor to measure this metric and the measurement scale and methodology may be revised. 

Cost per Patient per Month

While the number of patients served remains the same, the fiscal year 2017-18 cost per patient per month is expected to be lower than the target of $387 as a result of savings in labor and other fees and purchased services (due to operating efficiencies).

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. This reflects significant work to expand the availability of new patient appointment slots in clinic schedules and successes filling staffing vacancies that have limited overall clinic capacity. In part, this reduction is also a reflection of a broader reduction in the size of the patient population assigned to SMMC by HPSM, due to the elimination of the auto-assignment of patients to some clinics that do not have the capacity to take on new patients. If this trend and the above work continue for the rest of the year, we aim to reduce the assigned unseen population to 15,000 (across all lines of business, including ACE).

Future Priorities
Provide high quality, coordinated, timely care to all assigned 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: 01-25-2018