Title
a. Ratify execution by the Chief Executive Officer for Natividad Medical Center (NMC) of a Hospital Participation Agreement (“Agreement”) with American College of Surgeons (ACS) for participation in the National Surgical Quality Improvement Program (“ACS NSQIP”), for the term of October 1, 2020 through September 30, 2021, and for a total agreement amount of $10,000;
b. Authorize the Interim Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute renewal and amendment No. 1 to the Agreement, extending the agreement an additional one (1) year period (retroactive from October 1, 2021 through September 30, 2022) for a revised full agreement term of October 1, 2020 through September 30, 2022, and adding $12,500 for a revised total agreement amount not to exceed $22,500;
c. Approve the NMC Interim Chief Executive Officer’s recommendation to accept non-standard indemnification, insurance, no warranty, limitations on liability, and governing laws within the agreement.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
a. Ratify execution by the Chief Executive Officer for Natividad Medical Center (NMC) of a Hospital Participation Agreement (“Agreement”) with American College of Surgeons (ACS) for participation in the National Surgical Quality Improvement Program (“ACS NSQIP”), for the term of October 1, 2020 through September 30, 2021, and for a total agreement amount of $10,000;
b. Authorize the Interim Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute renewal and amendment No. 1 to the Agreement, extending the agreement an additional one (1) year period (retroactive from October 1, 2021 through September 30, 2022) for a revised full agreement term of October 1, 2020 through September 30, 2022, and adding $12,500 for a revised total agreement amount not to exceed $22,500;
c. Approve the NMC Interim Chief Executive Officer’s recommendation to accept non-standard indemnification, insurance, no warranty, limitations on liability, and governing laws within the agreement.
SUMMARY/DISCUSSION:
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) is a database and reporting system that provides Natividad Medical Center (NMC) with fact-based information needed to make quick, confident decisions in support of the hospital’s quality improvement initiatives. The database and reporting system allow NMC to: evaluate performance as compared to peer hospitals; and evaluate outcomes, complications, and risk-adjusted mortality. The database and reporting system allow NMC to compare patient-care patterns among physicians and compare expected results to observed results. Participation in ACS NSQIP® satisfies the Centers for Medicare and Medicaid Services (CMS) surgical quality measure requirement (NQF #0493), “Participation in a Systematic Clinical Database Registry for General Surgery.”
Ratification to the original agreement is requested because these types of Participation Agreements have not traditionally gone before the Board for approval in past years, they have been approved internally until recently. These agreements typically have non-standard risk provisions. Natividad has been advised to submit these agreements for approvals as with other service agreements which have non-standard risk provisions.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel previously reviewed and approved this agreement and has reviewed and approved this renewal and amendment No. 1 as to form. The Auditor-Controller previously reviewed and approved this agreement as to payment provisions and has reviewed and approved renewal and amendment No. 1 as to payment provisions. This agreement and renewal and amendment No. 1 have also been reviewed and approved by NMC’s Finance Committee and by its Board of Trustees on November 12, 2021.
FINANCING:
The cost for this agreement was $10,000 of which $10,000 was included in the Fiscal Year 2020-2021 Adopted Budget. The cost for this renewal and amendment No. 1 is $12,500 of which $12,500 is included in the Fiscal Year 2021-22 Adopted Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
ACS NSQIP is the leading nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care in the private and public sector. ACS NSQIP provides participating hospitals with tools, analyses, and reports to make informed decisions about improving quality of care. Further, peer-reviewed studies have shown that ACS NSQIP is effective in improving the quality of surgical care while also reducing complications and costs.
__ Economic Development
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Prepared by: Wally Sayles, Director of Surgical Services, 772-7771
Approved by: Charles R. Harris, Interim Chief Executive Officer, 783-2504
Attachments:
ACS NSQIP Hospital Participation Renewal and Amendment 1
ACS NSQIP Hospital Participation Agreement
Attachments on file with the Clerk of the Board