2019 Report to the Community

“
” Greg Anderson
REPORT TO THE
COMMUNITY 2019

HEALTH
IS A STATE OF BODY.
WELLNESS
IS A STATE OF BEING.
“Serving the health and well-being of the area”
A message from CEO Marty Guthmiller
A strategic plan is an important element of any forward-thinking organization. A well-organized strategic plan contains key
areas of direction and focus – namely mission, vision, values, strategic objectives, and action steps. The fundamental
foundation of any strategic plan, though, almost always begins with one’s mission.
An organization rarely changes its mission unless it is undergoing major change or disruption. More frequently –
but still not often – an organization modifies its mission to slightly modify its focus, or to emphasize or clarify its
mission for all to understand and embrace. Such was the case at Orange City Area Health System this past winter
during a Board of Trustees planning session, where the words “well-being” were added to our mission.
This modifcation was to emphasize our commitment to wellness and “well-being” in addition to the quality of
medical/health care we provide. It was also in recognition and acknowledgement of the “Social Determinants of Health”
and the role they play in one’s overall well-being.
The Board was inspired by an American Hospital Association study showing that as much as 80 percent of one’s
health may be attributed to factors other than access to and quality of health care. Key areas include nutrition, fitness,
housing, jobs, social programs, transportation, and community attributes (economic vitality, parks and trails, etc.).
While we always knew and understood the impact of these social determinants, our focus at times may not have
always led us in that direction. With the emphasis placed in our mission statement – and related impact ultimately
in action steps in our strategic plan – you can be assured that we will increasingly be aware of these key determinants.
Where applicable, we may implement services and programs ourselves – or collaborate with other entities – as your
health and well-being partners. To be sure, our mission and strategic plan guide our actions.
Thank you for the trust and confidence you place in us.
We will never take that for granted.
FISCAL 2019: A YEAR IN REVIEW
80 %
PERCENT OF A PERSON’S
WELL-BEING/HEALTH
due to factors outside of
“traditional” health care
LEADERSHIP
Marty Guthmiller, CEO
Dan McCarty, COO
Board of Trustees
Randy Jacobsma, Chair
Tim Zeutenhorst, Vice Chair
Brenda Richardson, Secretary
Russ Adams
Kathy Alons
Chris Immeker
Jerry Henrich
FY 2019 health system expenses by category
Wages
and benefits
59%
Inpatient discharges by payor
Commercial
39%
Medicare
48%
95 th
PERCENTILE
NATIONWIDE PERFORMANCE
FOR PATIENT EXPERIENCE
{Guardian of Excellence Award}
Top 5 %
Contracted
services
19%
Utilities
2% Supplies
and other
12%
Interest and
depreciation
8%
Uninsured
and other
6%
Medicaid
7%
AMONG CLINIC PRACTICES
NATIONWIDE TO achieve largescale
health transformation
{Pinnacle Award: Transforming
Clinical Practice initiative}

Laboratory techs Dara Daynos and Kathleen Gaabucayan,
both from the Philippines, enjoy their studio apartments
and the shared kitchen and great room areas at the
Central Plaza Apartments.
Socioeconomic Factors
40%
10%
30%
20 %
Education Job Status Family/Social
Support
Physical Environment
Health Behaviors
Tobacco Use
Health Care
Diet &
Exercise
Alcohol Use
Access to Care
Quality of Care
Income
Community
Safety
Sexual
Activity
“Health is a state of physical,
mental, and social well-being,
and not merely the absence of
disease or infirmity.”
World Health Organization

WHAT COUNTS
1.5
Orange City Area Health System is committed to caring for
the environment as we care for our patients, employees,
families, and the communities we serve. Every day. MILLION DOLLARS in
“Green” initiatives include recycling (paper, cardboard, COMMUNITY BENEFITS
batteries, plastic), environmentally-sound cleaning products,
including uncompensated
fish-based lawn fertilizer, the elimination of plastic care and free or reduced
straws and Styrofoam in our cafeteria, and “degradable” services provided to the
trash can liners pictured here.
4.5
region last year by Orange
City Area Health System
TONS OF
PAPER RECYCLED
Caring for the environment counts.
Our employees count.
570
$
22,563,344
GROSS ANNUAL WAGES
$8,003,847
BENEFITS COSTS
200
VOLUNTEER PARTNERS
17,268
VOLUNTEER HOURS
SERVED IN 2018
NUMBER OF ORANGE
CITY AREA HEALTH
SYSTEM EMPLOYEES
from 41 communities
93 %
OF PATIENTS INDICATE
THAT THEY WOULD
DEFINITELY RECOMMEND
ORANGE CITY AREA
HEALTH SYSTEM
Economic impact counts.
$
33
MILLION
HEALTH SYSTEM IMPACT
ON LOCAL ECONOMY
As one of the area’s largest employers,
Orange City Area Health System
is a significant economic contributor
to the region. The health system generates
over 730 jobs that add $33
million to Northwest Iowa’s economy.
In addition, the health system annually
contributes nearly $1 million in
charity and uncompensated care and
over $500,000 in community health
improvement services.
Patient satisfaction counts.
top100 NATIONAL
RANKINGS
“Top 100 status is a real indicator of how proactive these hospitals are
when it comes to pushing for performance improvement in areas such
as quality, outcomes, patient safety, market share, and finance.”
-Michael Topchik, National Leader of The Chartis Center for Rural Health

Set aims. Use data. Achieve benchmarks.
In April of this year, Orange City Area Health System’s Family Medicine Clinic in Orange City was recognized as a Pinnacle level practice
in the Transforming Clinical Practice initiative (TCPi) through Compass PTN (Practice Transformation Network). The TCPi is designed to help
clinicians achieve large-scale health transformation in primary and specialty care settings. The Orange City Medical Clinic – one of four
family practice clinics owned and operated by Orange City Area Health System – has successfully adapted and developed its comprehensive
quality improvement strategies to meet these transformation goals. The Orange City Medical Clinic “has merged person and family
engagement (PFE) into their practice, which encourages the patient and their family to partner with the medical staff in their care,”
according to Compass PTN. The Orange City Medical Clinic has also incorporated additional quality metrics and utilization metrics for
national comparison and evaluation.
May 2015
August - September 2016 September 2016 - September 2017
Integration of Behavioral Health into our
Family Medicine Clinic
• Smooth referral process
• Increase in communication between
family practice and behavioral health
• “No-show” rate (to a behavioral health
provider) dropped from an average of
30-50% to 12%
90 %
OF VISION LOSS FROM
DIABETES CAN BE PREVENTED
Relocated Diabetes Care Coordinator into
the Family Medicine Clinic
• Integrated care with family doctors
• Works closely with dieticians
• Implemented: continuous glucose
monitoring, insulin pumps, retinal
scanner to screen for diabetic retinopathy
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Hired our rst and then second Clinical Pharmacists
• Anticoagulation clinics
• Medication reviews for nursing home residents
• Inpatient medication management reviews
• Hospital discharge medication education
• Improved medication safety
• Improved physician and patient satisfaction
Inpatient Discharge Med Reviews by Clinical
Pharmacy
20
PATIENTS IN THE PAST
12 MONTHS
found to have diabetic retinopathy
Aug-18
Sep-18
Oct-18
Nov-18
Dec-18
Jan-19
Percentage of hospital patient discharges for whom our clinical
pharmacists conducted a medication review. This is an important
patient safety initiative to improve outcomes and prevent adverse
events related to medications.
Feb-19
Mar-19
Apr-19
May-19
Jun-19
Jul-19
Aug-19
An integrated approach to pain management
Anesthesiologist James Jeltema, D.O., heads up our new Pain Management Clinic. Integrated
with family medicine, sports medicine, physical therapy, surgical services, and behavioral
health, Dr. Jeltema brings a special skill set to help people deal with their chronic pain
issues. The team uses a multidisciplinary approach to focus on all aspects of a person’s
pain. This includes working with our clinical pharmacists to decide on appropriate
medications that can help decrease pain and inflammation, and working closely with our
clinical psychologist to help patients cope with the mental stress of dealing with chronic
pain. Our Pain Management Clinic offers various injections and procedures aimed at
decreasing a patient’s pain. With this well-rounded approach, a patient is much more likely
to experience a lasting reduction in their pain and return to a level of activity and function
that they desire.
Seated, front to back:
Randy Jacobsma, Chair •Brenda Richardson, Secretary
Russ Adams • Kathy Alons
“Infuse your life with action. Don’t wait for it to happen.
Make it happen. Make your own future. Make your own hope.”
Standing, left to right:
Chris Immeker • Jerry Henrich • Tim Zeutenhorst, Vice Chair
20
OF THE
%
POPULATION
AFFECTED BY
CHRONIC PAIN
Bradley Whitford

LEGACY
IS NOT WHAT I DID FOR MYSELF.
IT'S WHAT I'M DOING FOR THE NEXT GENERATION.
A lifetime of care starts here. (In 1989 in this case)
Alicia Hoffman writes ... “This was my third pregnancy and I had to change my
OB doctor (Dr. Pals is retiring from delivery babies). I was very emotional about
this as I had Dr. Pals my whole life. She delivered me 29 years ago. When I had
my first child in 2012, he was an emergency C-section. Dr. Pals was amazing at
keeping me calm and helping me and my husband understand everything. I then
trusted her for my OB doctor with my second child. When I found out I was expecting
baby number three, Dr. Pals was delivering her last OB in the Spring, and I was
due in June. She suggested Dr. Hanson, and I found out very quickly that I was in
great hands! He was so patient and never made me feel uncomfortable. Through
all of my pregnancies, the quality of care I received has been exceptional. Thank
you for making my pregnancies, births, and hospital stays wonderful!”
We’ve delivered. And we’re expecting.
New (and improved!) labor and delivery rooms.
Upcoming enhancements to our Birth Center.
When it comes to birthcare, you expect safety, security, comfort, and amenities
... in addition to a skilled and compassionate health care team. We want to
deliver on those expections. Every. Single. Time.
That means it was time for us to make some noise.
Vitor Belfort
Two thousand babies.
You heard that right. Cynthia Pals, MD,
has delivered 2,000 babies during
her tenure as a family physician. She
joined Orange City Area Health System
in 1989, and one of the very first
babies she welcomed is this young
woman pictured, who is now a
mother of Levi, Maci, and Nora.
2,000
NUMBER OF BABIES DR. PALS
HAS DELIVERED IN HER PRACTICE
Construction in our birth center consists of three phases. Phase one was
completed in September. It included adding a third labor and delivery room
and upgrading the other two L&D rooms with a fresh style and welcome
features and amenities. Phase two is underway as this Report to the Community
goes to press. Its primary goal is to enhance the security of our Birth Center/OB
WIng. Other important renovations include a new family/visitor bathroom, larger
guest beds and other added-comfort features in the post-partum rooms, and an
enhanced family area and nourishment center.
Thank you for your patience during the renovation. We look forward to delivering
many more babies in the years ahead!
213
BABIES BORN IN (Calendar Year) 2018
from 35 area communities

Pediatric care at Orange City Area Health System. It’s kind of a big deal.
When it comes to kids, parents want to make the very best choice in health care. From a newborn ... to an elementary-age child ... to a teen
athlete ... until they leave the nest. Our team of Family Medicine providers are here to serve your family, through the generations. Your family
physician is your partner at all stages of life. He or she works closely with our Pediatric Care Team to provide personalized approaches to
health and well-being. Integrated pediatric services at Orange City Area Health System include:
• Pediatrician Dr. Megan Meis • Behavioral health provider Dr. DeeJay Donlin • Pediatric physical therapy and occupational therapy
• Speech therapy • Pediatric dental surgery with Dr. Kaitlin Hoogeveen • Ear-nose-throat procedures with Dr. Kurt Korver
Lindsey Kuipers writes ... “When we were preparing to adopt our
daughter out of foster care three years ago, a hospital social
worker sat beside us, detailing a long list of things “she might
never be able to do.” Walk. Talk. Meet developmental milestones.
Eat or drink on her own. Regulate her emotions. Perform academically.
So it continued. Early circumstances had determined she
would be disadvantaged, but the Lord determined she would be a
miracle. Over the next three years, He wrote a story of redemption,
and we feel so lucky to have had many gifted therapists and
doctors be a part of that. Libby Van Bruggen, OT, an occupational
therapist at Orange City Area Health System, was just one of
these – but maybe one of our favorites! When Diamond first
started seeing Libby, her motor skills were nearly two years behind
the “norm” and her emotional regulation was both difficult and
unstable. In less than a year, Libby has helped Diamond to
overcome so many obstacles and anchor into a bravery that was
buried before. When faced with a challenge, Diamond often
repeats to herself what Libby has said to her so many times before,
“This is hard, but I can do hard things!” And she does. She runs and jumps and climbs up ladders and shimmies through tunnels and tries
new things. She tackles sensory input that used to send her into tears and she’s learning to communicate her fears. We’re so thankful for
Libby and Orange City Area Health System, who have worked with our little girl and been a part of the miracle story that is hers.”
Dr. Megan Meis joined our family medicine team this past summer.
She is our first staff Pediatrician, and cares for children from babies
to age 19.
Monica Albers, PT, is one of our Physical Therapists who specializes
in pediatric therapy, from motor delays and balance, to neurological
rehab and orthopedic injuries.
Seated, front to back:
Randy Jacobsma, Chair •Brenda Richardson, Secretary
Russ Adams • Kathy Alons
“Let us be about setting high standards for life, love, creativity, and wisdom. If our expectations in
these areas are low, we are not likely to experience wellness. Setting high standards makes every
Standing, left to right:
Chris Immeker • Jerry Henrich • Tim Zeutenhorst, Vice Chair
day and every decade worth looking forward to.” Greg Anderson

Report to the Community
Sanford’s Mobile Simulation Lab works on site with our hospital and
surgery nurses and paramedics, taking them through various scenarios
to give them the practice and training they need in an event that an
adult or child’s heart were to stop. The sim lab includes an adult and
a pediatric manikin.
Orange City Area Home Health & Hospice achieved “We Honor Veterans”
Partner Level Four, “reflecting their continuing commitment and dedication
to ensuring Veterans have access to quality end-of-life care.” Orange City
Area Hospice is the only Level Four Partner in Northwest Iowa.
The health system Foundation hosted its 24th annual Golf Classic
fundraiser this past June. Thanks to generous sponsors and participants,
nearly $17,000 was raised to help fund equipment and services for our
patients and to fund four $2,000 scholarships for Northwestern College
and Dordt University nursing students.
Our retail pharmacy, located on our
main campus, offers many convenient
services, including “meds to beds” inpatient
prescription delivery, consultation
with your family doc and our clinical
pharmacists, and these FREE weekly
med-packs. Our pharmacists work
directly with your health care provider
to assemble these med-packs to include
all of the oral prescriptions and OTC
medications in convenient weekly pill
packs to help organize your medications
and improve patient compliance.
Our Walk-In Clinic is located at 719 8th Street SE. Hours of operation will be 5-9pm Mon-Fri, and 1-9pm Sat-Sun.
The role of the Walk-In Clinic is to provide care without an appointment for common, non-life-threatening ailments such as
severe cold or flu, serious earache, severe migraine, fever, rash, mild eye injuries, minor cuts and burns, and sprains.
SERVING THE HEALTH & WELL-BEING OF THE REGION
2019 ANNUAL REPORT TO THE COMMUNITY
Medical clinics in Hospers, Orange City, Paullina,
and on the campus of Northwestern College.
Main campus clinic/hospital/birth center/surgical center:
1000 Lincoln Circle SE, Orange CIty Iowa 51041
712.737.4984 • ocHealthSystem.org