A 5-Year Progress Report

Clinical Services

Behavioral Health

A few years ago, we made a major commitment to improving access to behavioral health services to meet a growing and critically important community need. Our strategy has involved both programmatic enhancements as well as renovation of the physical inpatient unit.

Although we already maintained a highly regarded inpatient adult psychiatry program, including specialized care for geriatric patients, the unit needed renovations to create an aesthetically appealing and safe environment for a population with unique needs and risks. The renovation of the unit was completed in 2017, and has been enthusiastically received by both patients and staff.

Programmatically, we have committed considerable resources into developing a comprehensive behavioral health outpatient program. In just a few short years, we have made major strides in developing a program that accepts all insurance to which we can refer our patients. We hired our first two full-time psychiatrists into the Englewood Health Physician Network and have begun to recruit a team of advanced practice nurses and social workers. This outpatient behavioral health team will partner with our primary care network to provide behavioral health services. Licensed clinical social workers (LCSWs) will be co-located in primary care offices and available to patients who need counseling and services. Our network of primary care providers and LCSWs will be able to refer to our psychiatrists and advanced practice nurses for those patients who need that care. All will be connected through our new Epic electronic health record system, so the transition of care will be seamless and convenient for our patients.

As we continue to develop resources, we are also focused on battling the opioid epidemic. We have hosted press conferences and other activities with key political officials including our U.S. and state senators and representatives, Former Governor Chris Christie, and other leaders to raise awareness and provide a health system's perspective on the problem as well as potential solutions. On the clinical side, we created an interdisciplinary opioid task force to work on reducing the amount of opioids prescribed; began a partnership with the Opioid Overdose Recovery Program, which sends recovery specialists to meet with patients in crisis 24/7; and are hiring an addiction specialist to develop and oversee a comprehensive program to meet our community's needs in connecting to services in this critical area.

With a focused team, and the support of a number of generous benefactors, including the Alfiero and Lucia Palestroni Foundation and the Lillian Goldman Charitable Trust, we are energized by new opportunities to further improve the mental health of those we serve.

Clinical Services

Bloodless Medicine

Our Institute for Patient Blood Management & Bloodless Medicine and Surgery has long been an international leader in transfusion-free surgery and the optimal use and conservation of blood. Over the years, patient blood management has evolved from a focus on caring for patients for whom blood transfusion is not an option into an elevated standard of care for all our patients, as a result of its demonstrated benefits in patient safety.

As a world leader in this field, the bloodless medicine team is deeply committed to educating other professionals. Between 2013 and 2017, more than 100 peer-reviewed publications were authored by our experts. We delivered more than 200 lectures and presentations at meetings across the nation and globe, and we welcomed professionals from six continents to on-site training activities at the medical center.

The bloodless medicine program also collaborates with our own specialists from across the medical and surgical disciplines. One such joint activity, a presurgical anemia program, was developed with our infusion and anesthesiology teams in 2014, to address the needs of patients who have with low levels of red blood cells prior to undergoing surgery. As a result, patients experience safer, more effective procedures with a lower risk of complications.

As a testament to our team's expertise in this area, in 2017, the longtime director of the bloodless program was named president-elect of the Society for the Advancement of Blood Management. This is the first time that a non-physician has been elected to lead the national medical society.

Clinical Services

Breast Care

Our Leslie Simon Breast Care and Cytodiagnosis Center has long been a model for the diagnosis and treatment of breast cancer and benign breast disease. Over the past five years, the center has expanded its clinical services and enhanced the experience for patients.

As part of the renovation and expansion of our cancer center, in 2015, the breast center moved into brand-new space. Still housed in The Russell and Angelica Berrie Center for Humanistic Care, the breast care center includes the Englewood Radiologic Group Diagnostic Center and the Targovnik and Van Clief Family Screening Center. Warm earth tones, elegant lighting fixtures, floral wall decals, private changing and waiting rooms, and spa-like amenities offer a therapeutic environment, while the new clinical floor plan optimizes patient flow. At the same time, advanced equipment such as 3D Mammography™ (breast tomosynthesis) ensures that patients benefit from a high-tech, high-touch experience.

In 2016, we introduced a new model of care by offering real-time mammography results to all patients. For years, the center had provided immediate results to women coming in for a diagnostic mammogram. Now, the breast center has expanded this patient-centered approach to offer women undergoing screening mammograms—regular mammograms for those without signs or symptoms—their results and many follow-up tests within the same visit. Such a service is not commonplace at large, hospital-based sites. This elevated standard of care was implemented after the team considered the benefits to patients and our community, such as greater convenience and reduced anxiety, and determined that immediate results would support better outcomes by expediting the time from discharge to treatment.

In addition to its nationally renowned leadership in clinical excellence, the breast center is at the forefront of the patient experience, with satisfaction scores that consistently exceed the 90th percentile nationally. As part of the breast care center's commitment to creating an environment that puts patients first, the team regularly conducts quality improvement projects and patient satisfaction initiatives and has presented its accomplishments as best practices at national conferences, including the 2017 American College of Surgeons Annual Cancer Programs Conference.

In 2015, The Leslie Simon Breast Care and Cytodiagnosis Center received three-year full accreditation by the National Accreditation Program for Breast Centers and will soon be undergoing its reaccreditation survey. This survey is our opportunity to showcase our leading breast care program and the advanced clinical services it offers to our community.

Clinical Services

Cancer

Over the past five years, our cancer program has undergone a major transformation. In 2013, our cancer care services were spread out, and our infrastructure was challenged to support our commitment to leading-edge care close to home. We identified a vision for the next few years—literally sketched out on the back of a napkin—that brought together existing and future talent, services, and technology in a single centralized location that would embody a patient-first philosophy.

This vision matured into a multiyear modernization project and strategy that has since elevated cancer care to a level that rivals the quality found at leading cancer centers across the nation. In just five years, we have added three additional floors dedicated to cancer and wellness services. The 185,000-square-foot facility now houses all cancer services and specialists in a single location, minimizing patient anxiety and making for a smooth, seamless transition from one area to another. This project included the development of two newly expanded and enhanced areas: The Wilson Kaplen Infusion Center and The Coe Radiation Oncology Unit, the latter with two leading-edge TrueBeam systems.

We also recruited a medical director for the cancer center, as well as leaders in surgical oncology; invested in advanced diagnostic and treatment equipment; expanded survivor wellness services, integrative medicine, and patient navigation; and instituted team-based approaches to care through the launch of eight disease-management teams. Our treatment approaches have also become more sophisticated, with personalized medicine, immunotherapy, tissue-sparing radiotherapy, and robotic surgery among the more recent advances now offered by our physicians.

In 2016, we named our cancer center in honor of Ronald Lefcourt, the lead donor to the Englewood Hospital and Medical Center Foundation's successful $50 million capital campaign. The Lefcourt Family Cancer Treatment and Wellness Center, the destination of choice for more than 1,200 patients a year, received another vote of confidence in 2017, when the Commission on Cancer of the American College of Surgeons conferred on it a three-year accreditation with commendation.

Clinical Services

Emergency Medicine and Emergency Medical Services

Under the leadership of a new chief appointed in 2015, our Emergency Department has continued and since enhanced its efforts in patient safety and quality, implemented changes to improve the patient experience, and expanded programs and services to address the needs of our community.

Providing high-quality care in any emergency room depends on effective and efficient triaging. To get patients the care they need, precisely when they need it, in 2016, an interdisciplinary group of physicians, managers, and front-line staff developed a split-flow model, which separated patients who would likely be treated and released from those likely to be admitted. This project helped to decrease door-to-triage time to two minutes and door-to-room time to four minutes. The team also reduced the number of patients who left without being seen from 1.2 percent to 0.7 percent, a 40-percent reduction.

In addition to treating common ailments and injuries, emergency rooms must be prepared to respond to life-threatening conditions such as stroke, sepsis, and heart attacks. Continual quality improvement in these and other areas is a primary focus of our team, often in collaboration with our quality department and other clinical areas. As a result of efforts in sepsis identification and treatment, for example, the medical center's sepsis mortality rate dropped from 39 percent in 2013 to 23 percent in 2017, better than the statewide average.

Our Emergency Department success depends on partnering with our Emergency Medical Services (EMS). These two teams developed a system that admits select patients directly from an ambulance to the cardiac catheterization lab. As a result of this and other changes, our door-to-balloon time—the time from a patient's arrival to the start of a cardiac interventional procedure—was 64 minutes by the end of 2017, well below the national goal of 90 minutes.

In 2014, and again in 2017, our EMS received accreditation from the Commission on Accreditation of Ambulance Services, based on national standards of excellence encompassing clinical care, operations, and relationships with other agencies, the general public, and the medical community. Our ambulance service is the only one in Bergen County to have earned this distinction.

Clinical Services

Heart and Vascular

The acquisition of new technology, our rapidly expanding expertise in surgical and catheter-based treatments, and increased coordination with our physician practices have made this an exciting time to be caring for patients with heart and vascular disease. We have a proud history of service: Our team has performed more than 4,000 open-heart surgeries since 2000, with one of the lowest mortality rates in the state for coronary bypass surgery. During an era in which cardiac surgery has seen significant declines in volume both locally and nationally, our program has realized double-digit annual growth in recent years. In 2017 alone, almost 500 patients chose us for their cardiac surgery.

Over the past five years, we have invested significant resources in transcatheter aortic valve replacement (TAVR), a procedure that has given new hope to people who have severe aortic stenosis but are too high risk to undergo traditional open-heart valve replacement. Since the FDA approved TAVR in 2011, our team has performed more than 250 such procedures—and with excellent outcomes—making us one of the most experienced TAVR centers in New Jersey. We recently began offering the procedure to patients at intermediate, but not high, risk.

In addition to TAVR, our recent innovative treatments include Impella, an intervention for patients in cardiogenic shock or with severe heart failure; the WATCHMAN, a device that reduces the risk for stroke in people with atrial fibrillation; the MitraClip procedure to correct mitral valve abnormalities; transcatheter interventions for chronic total coronary artery occlusions; and thoracic endovascular aortic repair, a minimally invasive procedure for aortic aneurysms. Many of these new procedures offer alternatives to major surgery, providing critically ill or elderly patients with a previously unavailable option. Some of these techniques were the result of national clinical trials in which Englewood Hospital and Medical Center participated.

Our Heart and Vascular Institute is now organized around four centers of excellence: structural heart disease, coronary artery disease, aortic disease, and arrhythmia management. Outside of our main campus, we have expanded our cardiac footprint in the community, with new cardiology practices and imaging centers. Together our cardiac surgeons, vascular surgeons, interventional and noninvasive cardiologists, and cardiac electrophysiologists are working toward improving access, expanding treatment programs, pushing quality even higher, and aligning ourselves with efficient partners as we prepare for and participate in new payment models that demand the highest quality.

Clinical Services

Imaging

High-tech tools are essential to making a precise diagnosis and delivering high-quality care. Over the past five years, we have invested in state-of-the-art diagnostic imaging technology, introduced new imaging services, and expanded our leading diagnostic services into additional communities.

In 2014, we began offering low-dose CT scans for patients at elevated risk of lung cancer. This test, recently endorsed by the U.S. Preventive Services Task Force, is bringing new hope in the early detection of lung cancer. Since we began offering this service, more than 1,000 patients have been screened, resulting in nine cancers found. With traditional methods of lung cancer detection, these cancers would likely have been diagnosed at a later, deadlier stage.

In 2015, we introduced a new and powerful imaging tool: a 3T MRI machine. One of the most advanced scanning tools of its kind, it increases patient comfort, reduces anxiety, and improves diagnosis with more detailed, high-resolution images. We are now able to better define the anatomy, see abnormalities more clearly, and make diagnoses that were not always possible previously. A wider, open design helps reduce feelings of claustrophobia and accommodates heavier patients.

New radiologic techniques are improving how we detect and treat cancer. In 2016, we began performing an interventional radiology procedure that combines radiation therapy and embolization, for the treatment of liver cancer. In 2017, we introduced an advanced technology that combines MRI with ultrasound to aid in the diagnosis of prostate cancer. The technology, called UroNav, offers greater accuracy over traditional prostate cancer biopsies.

We have also expanded outpatient services and made them more convenient for patients in the communities we serve. At Advanced Medical Imaging, our outpatient imaging center in Emerson, we expanded services to include breast imaging and breast care, modeled on the same leading program at our Leslie Simon Breast Care and Cytodiagnosis Center. In addition to our busy cardiac imaging center in Glen Ridge, at the end of 2016, we brought on board three new cardiac imaging centers in Fair Lawn, Woodland Park, and Pompton Plains.

Over the past five years, our hospital and outpatient facilities have conducted more than one million imaging tests, including X-rays, CT and MRI scans, cardiac imaging, nuclear medicine, ultrasound, and vascular lab tests. These tests help us rapidly and successfully treat serious, complex cases in orthopedics, neurology, neurosurgery, cancer, and cardiac services, among other specialties. By having access to the best tools, we have improved our ability to identify a problem, make an accurate diagnosis, and offer a more precise treatment plan.

Clinical Services

Joint and Spine

As the population ages, orthopedic and spinal care are increasingly important services for our community. Over the past five years, patients needing a hip or knee replacement or spinal surgery have benefited from an interdisciplinary team committed to improving quality of life, minimizing pain, and maximizing mobility.

In 2016, we began a Medicare-initiated care model called the Comprehensive Joint Replacement Program. This model aims to support better and more efficient care for patients undergoing hip and knee replacements, the most common inpatient surgeries for Medicare beneficiaries. It encourages hospitals, physicians, and post-acute care providers to work together to improve the quality and coordination of care from pre-surgical assessments to hospitalization and through recovery. We brought together representatives from 15 disciplines, as well as from the Visiting Nurse Association of Englewood, to restructure how we deliver and coordinate care for these patients and improve patient safety and experience. Within 18 months of the program's inception, the number of patients discharged from the hospital directly to their home increased from 15 percent to 50 percent. In the second year of the program, our complication rate was zero percent.

That same year, we earned recertification by The Joint Commission for total hip and total knee replacement, as well as spinal fusion. The process involved rigorous on-site reviews, during which Joint Commission experts met with the physicians, nurses, and other team members and evaluated compliance with national care standards and performance measures.

With the successful survey results, we are the only hospital in New Jersey to be Joint Commission-certified in spinal fusion. Also in 2016, we ranked No. 1 in the state and among the top 10 percent in the nation by CareChex/Quantros for both medical excellence and patient safety in spinal fusion, and for the fifth year in a row, we were named a 5-Star Recipient for spinal fusion surgery by Healthgrades.

Also in 2016, we expanded our main operating room with four new state-of-the-art operating rooms dedicated to orthopedic and neurological surgery. The rooms include advanced imaging tools, digital technology, and other features to support patient safety and high-quality care.

Clinical Services

Maternity

Our maternity unit in 2013 was housed in outdated, cramped facilities. To address the growing needs of our community and enhance the childbirth experience for women and their families, we set out to fully modernize our Family Birth Place. As our community has many excellent options for maternity care, the renovation of the Family Birth Place is an example of how we are constantly evolving to provide a high-quality patient experience—one that offers not only compassionate, expert care, but in an environment where patients can feel at home.

Thanks in part to the generous support of donors, an expanded Family Birth Place—consisting of the Labor and Delivery Unit, the Neonatal Intensive Care Unit, and the Mother/Baby Unit—was fully completed in December 2014. The renovations sought to match the Family Birth Place's aesthetics with the exceptional level of medical care that has long been provided at the hospital. The facility's spacious private rooms now feature amenities such as music systems, whirlpool baths, lounging chairs, sleeper sofas for guests, and room service. Earth tones, hardwood floors, attractive lighting, and other warm and inviting decor elements help to create a peaceful atmosphere for patients and their families.

Our infrastructure of advanced medical equipment increases patient safety and quality. For example, central monitors allow continuous access to data, including fetal heart tracing, internal electrocardiogram readings, and blood pressure levels. For babies needing a higher level of care, our neonatal intensive care unit offers state-of-the-art equipment. The upgrades also include a step-down area for the monitoring of high-risk cases and two operating rooms equipped with the latest technology for Caesarean sections.

Over the past five years, we also enhanced our maternity offerings by bringing on new talent, including a large, multi-site women's health practice that joined our physician network in 2014, as well as a new antepartum team in 2017.

Among the patient safety and quality awards that Englewood Hospital and Medical Center receives year after year are several for maternity care, including the Healthgrades Obstetrics and Gynecology Excellence Award in 2016 and 2017 and the Labor and Delivery Excellence Award in 2016 and 2017. In both categories, we were ranked among the top five percent of hospitals nationwide evaluated in these services.

Clinical Services

Medicine

Since 2013, the Department of Medicine has evolved in all aspects of its mission of patient care, education, and research. Our team of hospitalists, which has doubled to 12 full-time physicians, now cares for about half of all inpatients. The hospitalists also play key roles on many hospital-wide committees and initiatives encompassing safety and quality, the patient experience, electronic health record implementation, pharmaceutical use, and more.

In 2013, we began a partnership with the North Hudson Community Action Corporation in Englewood, an important health resource for the underserved and a teaching site for our residents.

The Department of Medicine continues to expand its involvement in clinical research, with a nearly 50 percent increase in research studies over the five-year period 2013–2017. We are also enrolling more patients in clinical trials. In 2015, we began hosting an annual Research Day to showcase research conducted in our department.

Many of the specialty areas within the department, including cardiology, endocrinology, gastroenterology, hematology/oncology, internal medicine, and neurology, have grown and expanded through interdisciplinary programs, centers, and the physician network.

After a 26-year affiliation with Mount Sinai, our internal medicine residency program entered a new era in 2016, successfully transitioning its sponsorship to the Seton Hall University-Hackensack Meridian School of Medicine. Fully accredited by the Accreditation Council for Graduate Medical Education, the program received more than 5,300 applications for the 16 positions in the 2017–2018 class of residents. In our most recent survey, the program was commended for its innovative curriculum.

Community Health

Community Needs and Outreach

Every three years, the hospital embarks on a process to identify and measure the needs of the communities we serve, through a Community Health Needs Assessment. The needs assessment is a systematic, data-driven tool to determine the health status, behaviors, and needs of residents. We then use the findings to inform decisions and guide efforts to improve community health and wellness.

Our most recent Community Health Needs Assessment was conducted in 2016, in partnership with several other Bergen County hospitals, the Bergen County Department of Health Services, and the Community Health Improvement Partnership of Bergen County.

The greatest needs were prioritized as:

1. Access to healthcare services
2. Mental health
3. Heart disease and stroke
4. Cancer
5. Diabetes
6. Nutrition, physical activity, and weight
7. Immunization and infectious diseases
8. Dementias, including Alzheimer's disease
9. Respiratory diseases

From these findings emerged the following goals:

1. Increase access to healthcare through population health management
2. Promote behavioral health
3. Improve health status through chronic disease and care management across the continuum
4. Increase access to immunizations and reduce infectious diseases

We have taken great strides toward implementing these plans. The work, which is closely intertwined with our population health strategy, includes increased outreach and education to targeted populations, development of a behavioral health ambulatory program that accepts all insurances, and exploration of new strategies to enhance access to care, such as telehealth.

In addition to supporting implementation of the Community Health Needs Assessment goals, our outreach efforts help us give back to our community and reinforce our role as a trusted health resource. Through health fairs, free screenings for cancer and other health issues, speakers' bureau programs, visits from schoolchildren and high school students, and other programs that take place throughout the year, we are encouraging our neighbors to take an active role in their own health.

Our commitment to the health and well-being of our communities has been, and always will be, at the heart of our mission, and we will continue to put forth tremendous effort to close the remaining gaps in care.

Community Health

Korean Health and Wellness

Over the years, Englewood Hospital has recognized the need to support Bergen County's Korean community, one of the state's fastest-growing populations. New Jersey's Korean population reached nearly 94,000 people in the latest U.S. Census, with more than 60 percent living in Bergen County.

We recognized that Korean patients and families needed more culturally sensitive services to support them with the many health issues they were facing, including cancer, heart disease, mental health conditions, and other complex illnesses. Through the vision of our board chairman and other trustees and physicians, in 2013 we formalized our commitment to this population by creating the Center for Korean Health and Wellness.

The center's mission comprises patient and family services as well as community education and outreach. For patients and families, we provide important navigation services to help with practical needs during their stay, such as interpretation, billing and financial issues, referrals and appointments, and dietary preferences and needs.

More broadly, the center is dedicated to creating programs in the community that improve access to healthcare, provide early attention to serious disease and illness, and not only treat and heal the physical condition, but also support social well-being. We have partnered with numerous local and regional Korean organizations, including the Korean Community Center, Korean American Medical Association, Association of Korean American Medical Graduates, Esther Ha Foundation, senior centers, and many others on programs such as health fairs, screenings, seminars, and cultural programs that promote health.

To help educate our community, we have also partnered with Korean media outlets, including developing a monthly show with a Korean radio station that is recorded at the hospital. In 2017, we launched a new social media platform that promotes our services and offers health education to a community increasingly using mobile technology.

With the launch of Epic, the hospital's new electronic health record system, we are now able to more accurately collect and analyze demographic and health data for our patients, which will be used to create new programs and services in high-priority areas identified by our recent Community Health Needs Assessment. These include dementia, diabetes, mental health, cancer, and access to healthcare.

Community Health

Physician Network

One of the most significant trends in healthcare in recent years is the forging of partnerships between hospitals and physician practices. Through these partnerships, hospitals and their community-based medical staff can enhance patient care and quality by improving the coordination of services, access, convenience, and efficiency.

The Englewood Health Physician Network, also known as MDPartners, began in 2011 with two multisite group practices. Over the past several years, it has grown to close to 400 providers from a wide range of specialties who provide care at some 75 office locations Bergen, Essex, Hudson, Morris, Passaic, and Rockland counties, as well as on-site at our hospital.

The backbone of our network is the more than 130 primary care practitioners, who are central to managing a patient's care and streamlining access to specialists and tertiary-level care. With care coordinators, social workers, quality coordinators, and patient navigators, the practices are putting patients at the forefront, bridging relationships among patients and families and their care teams. In recognition of this patient-centered approach, all 18 of our primary care practices in our network as of the close of 2017 were named Level 3 Patient-Centered Medical Homes, the gold standard for primary care, designated by the National Committee for Quality Assurance.

Our new electronic health record system, Epic, also supports care coordination. The technological upgrade has created full and seamless integration of patient information from the hospital and physician practices to support continuity of care. Whether a patient is in a primary care office, seeing a specialist, having a test done at one of our diagnostic facilities, or undergoing a procedure at the hospital, that person's entire health record is at the provider's fingertips.

The practices accept almost all insurances, and many offer extended hours and urgent care, have multilingual providers and staff, and have begun to offer transportation assistance through Uber Health.

In 2017, the network went through a governance and leadership reorganization to ensure continued healthy growth and outcomes related to clinical care and value. This includes working closely with hospital leadership on population health and shared savings programs with Medicare and commercial payers.

In 2018, the network will grow further to include more primary care physicians, additional specialties and locations, urgent care, and additional off-campus diagnostic facilities.

Community Health

Population Health

The past several years have been a transformative time for hospital missions. For decades, hospitals have served to provide care to their patients. More recently, hospitals have begun to look beyond the walls of their facility to focus on the health of their community and the health of their patients beyond the acute-care setting.

Population health management is a new way of thinking about how we can meet our community's health needs. It focuses not only on health outcomes, but the factors that determine them. Hospitals are partnering with primary care providers, social service providers, subacute facilities, and insurers to provide integrated care that results in better health, a better experience for patients, and lowered costs.

In just two short years, we have developed a population health strategy and created a new department to oversee and implement this strategy in both our hospital and physician network. Our strategies include improving care coordination, establishing value-based contracts with payers, and exploring innovative ways for patients to access preventive care, such as telehealth.

We have created the Englewood Health Alliance, a clinically integrated network (CIN) of providers committed to providing high-quality patient care through a collaborative approach. The CIN functions will allow Englewood Hospital-affiliated and independent community providers to partner together to bring about meaningful improvements in the efficiency of healthcare delivery and patient outcomes.

We are also participating in value-based programs that encourage doctors, hospitals, and other providers to come together to give coordinated high-quality care to their patients. The goal of coordinated care, such as that provided in our Accountable Care Organization (ACO), is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. Our team focuses on providing preventive care and we track and monitor the health status of their entire patient panel. In addition for patients who are seen in the Emergency Department or are hospitalized, our care management team reaches out and actively coordinates their transition of care back to the primary care provider. Since 2015, we have enrolled more than 50,000 lives into our ACO.

The launch of Epic is expected to have significant benefits on our population health strategy, not only by offering providers a longitudinal view of the patient's entire care, but also by giving our population health exerts access to system-wide data on our patients to help develop interventions.

Community Health

Wellness Programs

As a trusted resource for our community and neighbors, we are committed to serving not only those who are sick, but those who are well. In recent years, we have reaffirmed our commitment to the community's health by introducing new services that promote wellness, preventive health, and longevity. Three programs in particular speak to this commitment.

In 2015, thanks to the generous support of our friends Jennifer and David Graf, we opened the Graf Center for Integrative Medicine. Located in a brand-new space within The Russell and Angelica Berrie Center for Humanistic Care, the Zen-like center offers acupuncture, meditation, therapeutic massage, holistic nutritional counseling, and other evidence-based services focused on prevention, recovery, and support. As integrative medicine has become more mainstream, it is important that such services are overseen by licensed or certified professionals and delivered in coordination with a patient's doctor. In 2017 alone, nearly 3,300 patients sought services at the Graf Center, and the average monthly volume has increased each year since it opened. Increasingly, the Graf Center is partnering with community and civic organizations to bring wellness services and education to more of our neighbors.

In 2016, we began The Braverman Family Executive Wellness Program. Named in recognition of our generous friend and donor Steven Braverman, this program provides a comprehensive head-to-toe assessment and wellness evaluation, tailored to the patient's specific concerns, all in a single visit directed by a dedicated concierge. A niche program created specifically for busy executives and other community leaders, the wellness visits go beyond routine annual physicals, giving patients a deeper, more complete understanding of their health and wellness and helping them create an action plan focused on long-term well-being.

In fall 2017, we embarked on a partnership with another community organization, a partnership that is focused on wellness, but from a different angle. The Kaplen JCC on the Palisades in Tenafly is a community center with a major fitness facility, nursey school, summer camp, senior adult program, and much more. As healthcare shifts increasingly toward preventive care, it is our responsibility to provide resources, to both our employees and patients, to keep them well and free from the development of chronic and avoidable conditions. For our employees, we are now offering free twice-weekly on-site fitness classes. The JCC also offers steeply discounted memberships to our employees and medical staff. For patients, we have launched a series called the Wellness and Longevity Program. The series, which is tailored for people with specific conditions, including cardiac disease and obesity, will consist of specialized fitness classes at the JCC, as well as integrative medicine treatments and information at our Graf Center for Integrative Medicine.

Patient Safety, Quality, and Experience

Awards and Accolades

Hospital-Wide Awards

• Leapfrog "A" Patient Safety Score 2013 2014 2015 2016 2017
• Leapfrog Top Hospital Award 2014 2015
• Healthgrades Patient Safety Award 2014 2015 2018
• Healthgrades Distinguished Hospital Award for Clinical Excellence 2013
• Hospitals & Health Network Most Wired Award 2014 2015 2016 2017
• Magnet Recognition Program redesignation in 2016
• U.S. News & World Report "Best Regional Hospitals" 2013 2016 2017

Cancer Care

• CareChex Medical Excellence Award 2014 2015 2016 2017
• CareChex Patient Safety Award 2013 2014 2015 2016 2017

Gastroenterology and GI Surgery

Gallbladder Removal

• CareChex Medical Excellence Award 2013 2014 2015 2016 2017 2018; No. 1 in New Jersey 2016 2017
• CareChex Patient Safety Award 2015 2016 2017
• Healthgrades 5-Star Recipient 2013 2014 2015 2016

Gastrointestinal Care

• CareChex Medical Excellence Award 2013 2014 2015 2018
• CareChex Patient Safety Award 2013 2014 2015 2016 2018

Gastrointestinal Hemorrhage

• CareChex Medical Excellence Award 2018
• CareChex Patient Safety Award 2013 2014 2015 2016 2017 2018

Major Bowel Procedures

• CareChex Medical Excellence Award 2013 2014 2016 2017; No. 1 in New Jersey 2014 2016 2017
• CareChex Patient Safety Award 2013 2014 2018

General Surgery

Appendectomy

• Healthgrades 5-Star Recipient 2015 2017

General Surgery

• CareChex Medical Excellence Award 2013 2014 2018
• CareChex Patient Safety Award 2014 2015 2016 2017

Heart and Vascular

Cardiac Care

• CareChex Medical Excellence Awards 2013 2014 2015 2016 2017
• CareChex Patient Safety Award 2013 2014 2015 2016 2017

Coronary Bypass Surgery

• CareChex Medical Excellence Award 2013 2014 2015 2016 2017; No. 1 in New Jersey 2013 2014 2016 2017
• CareChex Patient Safety Award 2016
• Healthgrades 5-Star Recipient 2013 2014 2015 2016

Defibrillator Procedures

• Healthgrades 5-Star Recipient 2014 2015 2016 2017 2018

Heart Attack Treatment

• CareChex Medical Excellence Award 2013 2015 2016
• CareChex Patient Safety Award 2013

Heart Failure Treatment

• CareChex Patient Safety Award 2013 2014 2015 2018

Major Cardiac Surgery

• CareChex Medical Excellence Award 2013 2014 2015 2016 2017 2018; No. 1 in New Jersey 2013 2014 2015
• CareChex Patient Safety Award 2014 2015 2016 2017 2018; No. 1 in New Jersey 2016 2018

Pacemaker Procedures

• Healthgrades 5-Star Recipient 2014 2015 2016

Vascular Surgery

• CareChex Medical Excellence Award 2016 2017; No. 1 in New Jersey 2017
• CareChex Patient Safety Award 2014 2017 2018

Orthopedics and Neurological Care

Hip Fracture Repair

• CareChex Medical Excellence Award 2015 2016 2017 2018
• CareChex Patient Safety Award 2018
• Healthgrades 5-Star Recipient 2013 2015 2016

Major Neurosurgery

• CareChex Medical Excellence Award 2018; No. 1 in New Jersey 2018
• CareChex Patient Safety Award 2017 2018; No. 1 in New Jersey 2018

Neurological Care

• CareChex Medical Excellence Award 2014 2015
• CareChex Patient Safety Award 2013 2014 2015

Orthopedic Care

• CareChex Medical Excellence Award 2015 2016 2017 2018; No. 1 in New Jersey 2016
• CareChex Patient Safety Award 2015 2016 2017

Orthopedic Surgery

• CareChex Patient Safety Award for Major Orthopedic Surgery 2015 2017
• Healthgrades Excellence Award 2015

Spinal Fusion

• CareChex Medical Excellence Award 2013 2014 2015 2016 2017; No. 1 in New Jersey 2013 2014 2015 2016 2017
• CareChex Patient Safety Award 2014 2015 2016 2017; No. 1 in New Jersey 2014 2015 2017
• Healthgrades 5-Star Recipient 2013 2014 2015 2016

Spinal Surgery

• CareChex Medical Excellence Award 2013 2014 2015 2016 2017; No. 1 in New Jersey 2013 2014 2015 2017
• CareChex Patient Safety Award 2015 2017; No. 1 in New Jersey 2015
• Healthgrades Excellence Award 2013 2015 2016
• Healthgrades 5-Star Recipient 2013

Prostate Surgery

• Healthgrades 5-Star Recipient for Transurethral Prostate Resection Surgery 2018
• Healthgrades Excellence Award 2018

Pulmonology

Pneumonia

• Healthgrades 5-Star Recipient 2013 2014 2015 2016

Pulmonary Care

• CareChex Patient Safety Award 2014 2015 2018
• Healthgrades 5-Star Recipient 2013
• Healthgrades Excellence Award 2013

Stroke Care

• CareChex Medical Excellence Award 2013 2014
• CareChex Patient Safety Award 2013 2014 2015 2018
• Healthgrades 5-Star Recipient 2013 2014
• Healthgrades Excellence Award 2013

Trauma Care

• CareChex Patient Safety Award 2018

Women's Health and Maternity Care

Gynecological Surgery

• Healthgrades 5-Star Recipient 2013 2014
• Healthgrades Excellence Award 2013 2014

Labor and Delivery

• Healthgrades 5-Star Recipient for Vaginal and C-Section Delivery 2016 2017
• Healthgrades Excellence Award 2016 2017

Maternity Care

• Healthgrades 5-Star Recipient 2013 2014
• Healthgrades Excellence Award 2013 2014

Obstetrics and Gynecology

• Healthgrades Excellence Award 2016 2017

Women's Health

• CareChex Medical Excellence Award 2015 2016 2017 2018; No. 1 in New Jersey 2016 2017
• CareChex Patient Safety Award 2013 2015 2016 2017

Overall Care

Hospital Care

• CareChex Medical Excellence Award 2013 2014 2015 2016 2017
• CareChex Patient Safety Award 2014 2015 2016 2017 2018; No. 1 in New Jersey 2014 2015 2016

Surgical Care

• CareChex Medical Excellence Award 2013 2014 2015 2016 2017; No. 1 in New Jersey 2014 2016
• CareChex Patient Safety Award 2014 2015 2016 2017; No. 1 in New Jersey 2014 2015 2016 2017

Medical Care

• CareChex Patient Safety Award 2013 2014 2015

Patient Safety, Quality, and Experience

Epic

In 2018, Englewood Hospital and Medical Center joined the ranks of major hospitals and health systems around the country with the installation of Epic, a single-platform electronic health record system. After more than two years of planning, the system was implemented in the hospital in March and in the physician practices later in the spring. This major investment consumed significant time, attention, and resources but is already transforming care across our hospital and physician network.

The foundation of Epic is the concept of "one patient, one record." Rather than patients having separate records tied to each point of care, such as the emergency room, an internist's office, a lab or imaging center, or an inpatient unit, all data and information about a patient are consolidated into a single Epic record. This longitudinal record gives every member of the care team real-time access to the patient's entire history of treatment provided in Epic facilities. The resulting benefits related to quality, safety, coordination and collaboration, efficiency, and patient experience are profound.

Epic also allows healthcare providers to access information from hospitals outside their network. If, for example, one of our patients seeks emergency care in another state while on vacation or traveling for business, the receiving emergency department can pull the record of the patient's care at Englewood Hospital and Medical Center, and vice versa. In fact, within two months of the hospital's Epic go-live, our emergency physicians retrieved records from more than 100 other healthcare facilities, enabling better, more-informed patient care.

Robust reporting and analytics, a user-friendly and powerful patient portal, additional patient safety tools such as barcode technology for blood products, and customizable templates and tools for providers are just some of the additional benefits for the medical center, our medical staff and employees, and, most important, our patients.

Patient Safety, Quality, and Experience

Nursing Excellence

Cheers, applause, and confetti filled the Chiang Auditorium on May 18, 2016, during the jubilant celebration announcing Englewood Hospital and Medical Center's fourth consecutive designation by the American Nurses Credentialing Center as a Magnet®-recognized facility. Just 7 percent of hospitals in the country have earned Magnet designation—the highest tribute and gold standard for nursing excellence in the United States and the world. Our hospital, and our nurses, received this honor after demonstrating superior quality in nursing care through a rigorous review and onsite survey. The survey looked at the degree to which leaders transform the organization to meet changing needs; empower staff members and prepare them to face all challenges; promote exemplary professional practice; foster innovation in staff knowledge, clinical practice, and systemic improvements; and measure and evaluate outcomes throughout the organization.

Earlier that year, Englewood Hospital and Medical Center welcomed a new chief nursing officer. Over the next two years, with renewed energy, the Department of Nursing engaged in both intra- and interdepartmental efforts to provide exceptional care to patients. Specific areas of focus included supporting nurses' attainment of professional certification, a primary tool in the provision of high-quality care; supporting professional development opportunities through an expanded Center for Clinical Practice; encouraging nurses' participation in research projects; and initiatives aimed at improving the patient and family experience. As Englewood Hospital and Medical Center embarked on implementation of the Epic electronic health record system, the nursing team was key to all steps of the system's build, testing, training, and go-live.

Nursing is an ever-evolving profession, and our nurses are committed to changing and advancing along with the profession and with healthcare. As we are already preparing for the next quadrennial Magnet survey, our nursing team is well poised for the future, one in which exceptional patient care is a hallmark.

Patient Safety, Quality, and Experience

Patient Experience

Over the past five years, we have invested in enhancing our patient experience efforts that recognize the dignity of patients and caregivers and take into account their physical and emotional needs. From the renovations of our units to redesigned patient flow processes to support programs for the caregiver, we are focused on understanding patients' concerns and needs, and delivering a consistent yet individualized experience.

Specific highlights include leadership development and training to foster a patient-centered culture on the front lines, increased staff reward and recognition activities and tools, new programs to support patients and caregivers in outpatient areas, upgraded amenities including food service options, and additional rounding on inpatients by volunteers to address patients' nonclinical needs and connect them with the appropriate hospital staff for issue resolution. Bridging quality with satisfaction, in 2016, we brought on clinically trained staff to make follow-up phone calls to patients after their discharge, a best practice that allows us to better identify any barriers to a patient's follow-up care and learn more about their experience to guide improvements.

Our Patient and Family Engagement Department was established in 2017 to partner with clinical and operational leaders and staff on activities related to the patient experience and satisfaction. We established a Patient and Family Advisory Council in 2017 at the hospital and separate councils at the physician practices. These councils ensure that the perspectives and voices of patients and their family members are considered in operational decision-making and identifying areas for improvement, such as patient care practices, caregiver support services, marketing materials, and facility improvements.

Research shows that patients' perceptions of their care are not only about being satisfied, but are critical to patient outcomes and safety. Our breast care center, for example, has embraced the importance of the patient experience, realigning its services to provide real-time mammogram results as part of delivering an exceptional, high-quality experience. Our emergency department, another leader at our hospital in the patient experience, has also restructured its patient throughput process and implemented a caregiver support program.

For us, relationships are at the heart of providing excellent care. By focusing on our relationships with patients, we can be a destination of choice for both clinical excellence and an excellent experience.

Patient Safety, Quality, and Experience

Renovations and Expansions

A decade ago, as part of our 2008 Strategic Plan, we developed a Facility Master Plan for our campus. Developed to address the growth of our strategic clinical objectives, as well as to create a patient-centered, safe, and aesthetically appealing environment for healing, the plan eventually touched nearly every corner of our campus. Since 2013 alone, more than 200,000 square feet of space have been renovated or added. Many of these projects were made possible thanks to the support of generous donors to the Englewood Hospital and Medical Center Foundation's successful $50 million Transforming the Future capital campaign.

The two biggest projects were multiyear renovations and expansions to support the growth of our maternity and cancer services. The Family Birth Place project included the labor and delivery unit, the postpartum unit with 24 private rooms, and the neonatal intensive care unit. We simultaneously invested in an 18-month, three-floor addition to our Russell and Angelica Berrie Center for Humanistic Care to create The Lefcourt Family Cancer Treatment and Wellness Center, a transformative project that included The Wilson Kaplen Infusion Center, The Leslie Simon Breast Care and Cytodiagnosis Center, The Coe Radiation Oncology Center, Graf Center for Integrative Medicine, The Braverman Family Executive Wellness Program, and physician practices and offices, as well as The Taub Family Education Center and administrative space.

In addition to these two major projects, several of our other inpatient units have been completely renovated; these include the Alice and Bruce Youngman and Family Neurology/Oncology Unit, the James and Lisa Cohen Cardio/Pulmonary Unit, and behavioral health unit. As we renovate our units, a key goal is to create private rooms whenever possible. Private rooms not only provide a better experience for patients and families, but help reduce hospital-acquired infections.

In 2016, we expanded our main operating room with four new rooms dedicated to orthopedic and neurological surgery. The rooms include advanced imaging tools, digital technology, and other features to support patient safety and high-quality care.

Other projects over the past five years include the renovation and/or relocation of the pre-admission testing unit, the Yaz and Sweta Shah/Hudson Drug of Cresskill Patient Registration, the Edith and Walter Kleineke Hospitality Shop, medical suites and physician offices, and chapel; behind-the-scenes infrastructure and engineering projects to ensure a safe environment; and enhancements to the facilities at many of our offsite physician practices and outpatient departments.

One of the most visible changes to our campus in recent years is the new architectural landscaping, comprising a decorative fountain and granite sign at the hospital entrance. Named The Richard J. Kurtz and Family Plaza, the fountain area provides a sense of arrival and welcome to a modern, high-tech, and high-quality medical institution.

Reaching to the Future

Behavioral Health

Improve access

The ability to access behavioral health services is a barrier to many people in our community who are in need of treatment. One of our first plans involves implementing evidence-based behavioral health screening tools and services at all points of entry into the hospital and practices. In some cases this may involve web or mobile apps, telehealth, and other technologically sophisticated tools to meet the needs.

We also are looking at the staffing needs. We have begun to invest in recruiting psychiatrists, as well as enlist the services of advanced practice nurses, graduate clinical fellows, and other practitioners such as social workers, to meet demand and enrich existing programs.

Build community partnerships

We cannot meet the community's need for behavioral health services on our own. It is imperative that we work with our community partners and other healthcare institutions and behavioral health agencies.

Establish new programs and services

Particular attention needs to be paid to Asian, Hispanic, and other specific populations. Alzheimer's and other dementias are high on the list of areas where we will focus our attention. Wherever possible, we will also emphasize the value of integrated medicine for whole-body care, such as the services offered by our Graf Center for Integrative Medicine.

Modernize and develop on- and off-campus facilities with community partners

Since establishing our plan, we have completed renovations on our inpatient unit.

Reaching to the Future

Brand

Communicate our brand promise

Two years ago we launched our tagline – Your hospital for life. This tagline was developed to embody everything that our medical center stands for: keeping you and your family healthy, helping you when you are sick, and being a resource when you are well. We must be focused and diligent to ensure that all of our messaging and services reflect that sentiment. We launched a new website, created a new look and feel for our advertisements and communications using the stories of real patients, and have expanded or enhanced community partnerships – all guided by our promise to be your hospital for life. Even initiatives such as a new uniform policy help foster that image and reputation of our professionalism, positive first impressions, teamwork, and patient-centeredness. Branding goes well beyond our logo or advertisements or brochures – it's embodied in every human interaction. Our strategic plan will help take our efforts to the next level by engaging the public in our story and giving them the confidence and trust to choose us for healthcare, for life.

Improve image and reputation as a destination healthcare provider

We have a longstanding and proud history as a community teaching hospital. In recent years we have transformed into a major regionally ranked and nationally recognized medical center. Having exceptional physicians and staff and top safety and quality outcomes is essential to our growth. Our marketing, advertising, and other branding efforts must reinforce our positive attributes and be focused on our clinical and institutional priorities. A good example of our success at being a destination healthcare provider is found in the experience of our bloodless medicine program. We want to support our many key clinical areas to build up our reputation across the board.

Reaching to the Future

Cardiac and Vascular

Re-energize and re-launch the Heart and Vascular Institute

With a focus on goals, outcomes, and key quality metrics, our newly structured Heart and Vascular Institute will drive the expansion of innovative programs supported by research and education. The institute is organized into four main areas:

• Structural Heart Disease
• Coronary Artery Disease
• Arrhythmia Management
• Aortic Disease

Improve access and management of chronic conditions

Improving access to cardiac services may involve co-locating specialists within primary care offices, as well as gym and retail locations. The use of mobile apps and devices, virtual technology, and other telehealth tools can help support the management of chronic heart conditions.

Participate in value-based payment models

We will work to align with efficient partners such as home health agencies, skilled nursing facilities, and hospice and palliative care providers. These partnerships are essential to ensure our success with new cardiac bundled payments for acute myocardial infarction and coronary artery bypass graft patients expected to arrive next year. A comprehensive quality and data management team will monitor performance.

Modernize and develop facilities

We will continue to invest in facilities both on and off campus to support the growth and needs of the cardiac and vascular services. Slated projects include a new cardiothoracic ICU and med/surg ICU.

Reaching to the Future

Charitable Giving

Increase philanthropic gifts to support vision and mission

The EHMC Foundation spearheaded Transforming the Future: Our Campaign for Englewood Hospital and Medical Center, a multiyear $50 million campaign to benefit the largest, most significant modernization program in the medical center's history. Thanks to the visionary leadership and tenacious support of our philanthropic partners, the goal was reached last year. The funds raised included a lead gift from Ronald Lefcourt to name The Lefcourt Family Cancer Treatment and Wellness Center. Other elements of the modernization program made possible by the campaign include a fully expanded and renovated Family Birth Place as well as a full redesign of the main entrance to improve access and traffic flow. Our previous capital campaign raised an impressive $30 million to build the Kaplen Pavilion. Including these large campaigns, over the past decade we have raised $100 million in philanthropic support.

As we look toward the next decade, we will continue to set ambitious fundraising goals to support our ongoing transformation and make a difference for countless patients and families.

Develop leaders to promote philanthropy

The Foundation will develop a robust cadre of volunteer leaders to connect businesses, foundations, and individuals of wealth. Another goal is to develop an identified core of physicians and clinical allies who are fully engaged in promoting a culture of philanthropy.

Reaching to the Future

Musculoskeletal and Neuroscience

Centers of excellence

As part of the new strategic plan, we will work to enhance our neurosurgical, neuroscience, and orthopedic centers of excellence with innovative program expansion, including convenient diagnostics and advanced imaging, supported by research and education.

Areas of specific focus include:

• Joint Replacement
• Spine Surgery
• Acute Musculoskeletal Injury
• Upper Extremity Surgery
• Foot and Ankle
• Acute and Chronic Multimodal Pain Management

Another potential area of expansion is campus- and community-based movement programs for injury prevention, exercise and sports medicine, and management of chronic movement disorders.

Access

By integrating and co-locating preventive, chronic, and complementary rehabilitation and imaging services, a "one-stop shop" for patients will enhance access to care. Physician integration strategies will also provide improved access for patients and their families in the communities we serve.

Reaching to the Future

Oncology

Talent recruitment

Over the past few years, we have recruited key cancer leaders who, along with our other highly skilled fellowship-trained specialists, have developed eight disease management teams. As we work to build up specialized centers of excellence, we will continue to bring on board leading cancer surgeons and other specialists.

Innovation

To support the highest level of diagnosis and treatment, The Lefcourt Family Cancer Treatment and Wellness Center will continue to be a regional leader in introducing technology such as positron emission tomography/magnetic resonance imaging (PET/MRI) as well as the growing field of personalized medicine using molecular pathology advances to create individualized cancer therapy. Innovation also entails a focus on value and cost management, as well as potential partnerships with other providers and institutions to build comprehensive cancer services.

Access to care

Improved access to the cancer center involves streamlining the intake process through a centralized referral center. A new patient access center will help expedite diagnosis, appointments, and care planning and reduce time to treatment. For referring physicians, the decision to refer is influenced by access issues such as having direct access to specialists for consultations and oncology emergencies (including after hours), efficiency and convenience of appointments and the scheduling process, and care coordination including communication among providers and the engagement of specialists and patients as partners in care.

Survivorship

As cancer patients are living longer and longer, more attention needs to be given to survivorship, including on the physical, practical, and emotional concerns facing long-term survivors following treatment.

Reaching to the Future

Physician Partnerships

Access and growth

Over the past several years, our medical staff and physician network have grown, giving patients more options and improved access to care in their home communities. A key component of access is extended hours on evenings and weekends, such as the service offered by our practice in Bergenfield. We will continue to prioritize enhanced access to care, as we explore urgicare, telehealth, and other strategies.

Recruitment and talent

To effectively meet projected shortages in primary care physicians, we will create a recruitment strategy that targets training programs and medical schools. We have a great medical staff, but to maintain our quality, we will need to be more aggressive in recruiting the best and the brightest doctors to begin their career with us. At the same time, we'll be engaged in retaining the talent we are fortunate to have. We will also encourage team-based care with advanced practice nurses and other clinical professionals to meet demand.

Integration and support

Our success in fostering successful partnerships with physicians relies on improved communication and integration between employed and voluntary community-based physicians. Technology tools like Epic and IT infrastructure will be used to facilitate scheduling and continuity of care. We will continue to design and implement a range of structures to align with physicians.

Reaching to the Future

Population Health

Improve patient experience of care

We can engage community members as active partners in their health through the use of innovative strategies that support the patient experience of care. To improve access to care, we will focus on enhancing or opening convenient campus and community-based services. The six dimensions of patient experience as defined by the Institute of Medicine are: safe, effective, patient-centered, timely, efficient, and equitable.

Lower costs

Value-based reimbursement and quality programs such as bundles play an increasingly important role in how we deliver care. Our strategic plan's emphasis on population health management recognizes and responds to these changes to ensure our success.

Improve health outcomes

Our population health strategy puts specific focus on prevention, primary care, mental health, and management of chronic disease. These are areas where we have significant opportunity to improve health outcomes of large populations. The new Epic electronic medical record system will help support care across the continuum by enabling collaborative and seamless delivery of care. The use of quality data, business intelligence, and research are fundamental to supporting and optimizing population health management strategies, and we will be enhancing EHMC departments to engage in these efforts.