Welcome to Banner Estrella Medical Center

1. Welcome to Banner Estrella Medical Center!

3. Healing Environment Non-smoking campus Healing gardens Natural light within interior spaces Open space, walkways Therapeutic art and music Living area for loved ones in each patient room Complementary programs and services Meditation Chapel

5. Medical Executive Committee Back row (left to right) James Hawkins, MD, Orthopedic Surgery Chair, Lawrence Kline, DO, Vice Chief of Staff, James Ferraro, DO, Medicine Chair, Ken Welch, MD, Chief Medical Officer, Jon King, MD, Immediate Past Chief of Staff, Del Black, MD Anesthesia Chair, Kevin Brady, MD, Cardiology/CVT Chair, David Cohen, MD, Emergency Medicine Chair, Florian Walter, DO, OB/Gyn Chair Front row (left to right) Kent Johnson, MD, Chief of Staff , Sandy Gladding, MD, Surgery Chair, Robert Gould, CEO, Mystie Johnson, MD, Secretary/Treasurer, Brijesh Bobba, MD, Hospitalist Representative, Lisa Ring, MD, Pediatrics Chair Not pictured: Cecil Vaughn, MD, Endovascular Committee Chair, Threasa Frouge, MD, Radiology/Radiation Oncology Chair, Gavin Parisi, MD, Member-At-Large

6. Hospital LeadershipSenior Operations Staff Rob Gould � Chief Executive Officer Gary Foster � Associate Administrator Scott Leckey � Chief Financial Officer Ken Welch, MD � Chief Medical Officer Karin Toci, RN � Chief Nursing Officer Dina Steinberg � Chief Human Resources Officer Other Administrative Team Members: Leslie Cox � Director, Medical Staff Services Cheryl Poland � Director, Physician Resources Tiffany Tcheng � Public Relations

7. Chief Medical Officer Goals Collegiality of Medical Staff Operate in highly collaborative manner Team approach Address Disruptive Behavior Advanced Clinical Information System CPOE/EMR Clinical Connectivity Power Notes (PNED and PN2G) PRC (Professional Review Committee) Effective/Efficient Peer Review Process

8. Medical Staff Services Office Medical Staff Services provides administrative support to the Medical Staff organization and acts as a liaison between you and administration. Responsibilities include: Medical Staff Bylaws, Rules and Regulations, regulatory compliance, ensuring appropriate credentialing and peer review mechanisms to provide for a high quality medical staff, and administration of student/resident rotations and Continuing Medical Education programs. We are located behind Administration on the first floor in the Diagnostic & Treatment building. Monday � Thursday 8:00a.m. � 5:00p.m. Friday 8:00a.m. � 4:30p.m. Phone: 623-327-3227 Fax: 623-327-5488 Director: Leslie Cox, CPMSM, CPCS 623-327-5048 Medical Staff Coordinator Sr.: Kelly Brillhart, CPCS 623-327-5029 Medical Staff Coordinators: Monique Benavidez 623-327-5164 Leslee DuFrain, CPCS 623-327-5228 Susy Power, CPCS 623-327-5049 Administrative Assistant: Traci Jones 623-327-5047

9. Physician Resources Cheryl Poland, Director, Physician Resources Phone: 623-327-5006 Networking Patient Referral Physician Directory Social Events Office Staff & Local Resources Problem Resolution Information on Hospital Services Physician Recruitment

10. Physician Referral Program 230-CARE (602-230-2273) Free service for Banner physicians who meet criteria: �Active� or �Community Based� physicians In good standing at Banner facility where practicing Must be accepting new patients Application is available via the telephone or over the internet at www.bannerhealth.com/physicianprofile Complete Physician Profile; Update annually

11. Clinical Informatics Coordinator Provides training and assistance for Computer Physician Order Entry/Electronic Medical Record (CPOE/EMR) Please contact Carol Ricketts, RN, Clinical Informatics Coordinator (CIC), at Phone No. 623-327-5134 or Pager No. 602-250-0966 to schedule CPOE/EMR training. It is recommended you complete this 4-5 hour training session prior to Medical Staff appointment to avoid delays in exercising privileges as it may take several business days to obtain sign-on credentials. You will receive a password for access to the electronic medical record once membership and privileges are approved by the Banner Health Board.

12. Quality Management Quality Management oversees the Performance Improvement Program, ensures BEMC compliance with accrediting and regulatory organizations, utilizes department specific and Quality Departmental data to implement evidenced based solutions to improve specific departmental and overall hospital quality, increases visibility of BEMC positive quality outcomes both internally and externally to achieve quality recognition, Proactively implements Banner franchise model/best practices and hospital wide solutions in anticipation of Quality and risk issues that may impact patient care, implements solutions to ensure compliance with the 2010 National Patient Safety Goals. Located on the second floor Monday � Friday / 7:30a.m. � 4:30p.m. Quality Management Clinical Specialists are assigned to every medical staff committee and attend all meetings. Facilitate the peer review process. (Please see the peer review committee slide) Contact information: Tom Snyder, RN, BSN, MBA Quality Director 623-327-5122 Ruth Hoskins, RN, BSN, CPHQ, Quality Specialist 623-327-5042 Brenda Bassett, BS, MLS (ASCP) Quality Specialist 623-327-4125 Lori Buffington, BSHS, RHIT, Systems Consult 623-327-5311

13. 2010 National Patient Safety Goals Accuracy of patient identification Effective communication among caregivers Safety of using medications Reduce risk of health care-associated infections Reconcile medications across continuum of care Reduce risk of patient harm resulting from falls Prevent health care associated pressure ulcers (decubitus ulcers) Identify safety risks inherent in patient population Universal Protocol for preventing wrong site, wrong procedure, and wrong person surgery

14.  Professional Review Committee  The Professional Review Committee (PRC) is a diverse group of physicians charged with evaluating cases and processes that come to the attention of Quality Management and/or Medical Staff Services departments. The PRC serves as a non-biased link between hospital quality review and the medical staff. In most hospitals, peer review often goes on behind the scenes. However, the philosophy at BEMC is to bring this function to light so that all can benefit from thoughtful analysis and constructive thinking. The committee gives input into this confidential process designed to improve the quality of care from the perspectives of the individual practitioner and the hospital system. The PRC identifies concerns about hospital and nursing processes which are referred to the appropriate committee or department for review and feedback. External reviewers are utilized when warranted and cases are discussed with the physicians involved who are encouraged to participate in peer review.

15. HIMS (General) 623-327-5330 Dictation/Transcription Sally Gamez 623-327-5316 Record Completion Gloria Varney 623-327-5323 Record Completion (OB) Terri Rhoades 623-327-5312 Coding Marla Hackett 623-327-5326 ROI (Release of Information) Tammy Alexander 623-327-5320 Oncology Registry Danielle Fuller, Cancer Registrar 623-327-5246 Health Information Management Services (HIMS)

16. HIPAA: Patient Confidentiality Confidentiality of Patients� Medical Records: Property of Hospital Confidential Written authorization required for release in accordance with law and Banner policies Safeguarded against unauthorized disclosure, use, loss, defacement and tampering HIMS logs all requests for access to medical record information Extremely Sensitive Patient Information: Requires additional protection from disclosure Hospital requires special consent for release �HIV-related� and �communicable disease- related� information includes positive and negative information Faxing Medical Records: Fax number and recipient are verified prior to transmission Confidential information noted on cover sheet Medical records access to confidential materials is only permissible when the person seeking access is involved in the care of the patient or is involved in some other appropriate authorized activity. All access to electronic records is tracked and unauthorized access to a patient�s record will not be tolerated.

17. Clinical Documentation Specialists CDMP is a method to assist the physician, via the documentation clarification and coding process, with the help of Clinical Documentation Specialists (CDSs) to provide the most accurate and compliant documentation for each patient. The role of the CDSs is to have clinical knowledge and be well versed in the Medicare rules as well as documentation options and the impact these options can have on severity ratings. CDSs will be utilized concurrently on the floors and will assist the physicians in using "compliant" language in addition to helping with communication to the hospital coders. Compliant Documentation Management Program (CDMP) Dedicated team of coding / nursing professionals BEMC Team: Cheryl Megaro, RN 623-327-5157 Bridget Evans, RN 623-327-5110

18. Hospitalist Service Banner Arizona Medical Clinic Phone: 623-327-7313; Fax: 623-327-5437 Acute Inpatient Care Coverage 24/7 Admission and Discharge Care coordination Arrange transition to outpatient setting Improve hospital systems

20. BEMC Offers: Emergency Care Medical/Surgical Care Cardiovascular Interventions Open Heart Surgery Women�s Care Inpatient/Outpatient Diagnostic Imaging Bariatric Surgery Intensive Care and e-ICU 214 beds 84 Med/Surg 24 Orthopedic 12 Oncology 12 Med/Surg ICU 12 Cardiac ICU 60 Telemetry 33 Antepartum/ Postpartum 13 NICU 11 L&D Suites Level II EQ Nursery

21. Flexible and Adaptable Interventional Suites Operating rooms, cath labs and interventional radiology suites with common support space Large operating suites to accommodate robotics and changing technologies Close proximity to Diagnostic Imaging

22. Online Pre-Registration Patients may pre-register for scheduled visits in advance, at their convenience, from home or office, using a secure, online system. Located at: www.bannerhealth.com, keyword �pre-registration� Must be submitted 48 hours prior to visit Contact is Patient Registration Department: 623-327-4010

23. Procedure and Surgery Scheduling Cardiac Catheterization Lab & Special Procedures: Scheduler is Cocoa Magana (623) 327-5444; hours are 8:00 a.m. to 4:30 p.m. Monday - Friday. To schedule after-hours, call the team leader at (623) 826-8777. OB procedures, C-sections, i.e. NST�s, Amniocentesis, Versions and labor inductions (623) 327-5871 Surginet (602-327-5448) handles: Surgical cases in our Main operating rooms (General Surgery, Endovascular, CVOR) Endoscopy procedures For procedures the day of, please call (623) 327-5990

24. Estrella Surgery Center Separately-licensed, free-standing ambulatory surgery center Located on BEMC campus, directly west of the hospital Four operating suites, two GI suites, 14-bed recovery area Operates 5 days/wk, same-day surgery, no overnight stays Equipped for ENT, GI, Gynecology, Vascular, Urology, Ophthalmology and General Surgery, Orthopedics, Plastic Surgery, Podiatry and Pain Procedures Partnership opportunities available

25. Medical Interpreters Title VI of the federal Civil Rights Act requires that hospitals provide interpreting services to Limited English Proficients. It is Banner Estrella policy to use ONLY a hospital Medical interpreter or telephone service contracted by Banner Health for interpreting to patients, patients� family members and physicians. Interpretation by family, friends, or untrained staff members is prohibited. Hours of service are: 7a.m. � Midnight Monday through Friday 7a.m. � 5:30 p.m. Saturday and Sunday To contact a Spanish Interpreter during business hours, you can use Vocera at (602) 747-2255 and Ask for �Interpreter.� Or, you can page an interpreter at (602) 223-5466. For assistance with American Sign Language for our Hearing Impaired or Deaf patients please contact: Arizona Interpreting Services Office: 480-961-7331 Fax: 480-961-8130 Pager: 602-851-7635 After Hours: For Cyracom dial 1-3700 from any phone Enter account Number: 501015193 Pin Number: 7000

26. If you observe suspicious conduct or behavior while on hospital property or if you or someone else is the victim of a crime, call security dispatch at: 1-4400 (internal non-emergent) 1-6666 (internal emergency) 602-747-4400 (external) ID Badge: Please stop by the Medical Staff Services Department to obtain your ID Badge and parking pass. You will need to provide a legible government issued ID card (current driver�s license, military ID or passport). Physicians, allied health practitioners, residents and students must wear BEMC identification badge while on campus for: Access to restricted areas Identity verification for patients, staff and others Parking: Covered parking is located on the southeast side of the campus. Vehicle information such as make/model, color, year, state and license plate number is required to obtain your parking pass. Physician Lounge: The physician lounge is located on the first floor south of the Emergency Department. Hot breakfast is available, and lunch is served Monday � Friday from 11am � 2pm. BEMC Security/ID Badge/Parking/Physicians Lounge

27. After Hours Assistance Administrative Supervisor Coverage from 7:00 p.m. to 7:30 a.m., Monday-Friday, and 24-hours/day on week-ends. BEMC Main Phone: 623-327-4000 Vocera: Dial 602-747-2255 and ask for �Administrative Supervisor at Estrella� Pager: 602-223-1878 If unable to reach an Administrative Supervisor, call Bed Placement at 623-327-4013. This number is staffed 24-hours/day, 7 days/week.

28. Patient Experience Major focus for BEMC HCAHPS Patient Survey Patient satisfaction scores measured and reported weekly Keri Hackendahl, Director, Service Excellence: 623-327-4015 Kaaren DeShay, Manager, Patient Relations: 623-327-5230 Patient Experience: Helpful Hints Introduce yourself. Greet the patient with a touch. Ask if you may sit down. Finish by asking: �Have I answered all your questions, and is there anything else I can do for you?�

29. What physician-related questions are patients asked on the patient experience survey? During this hospital stay, how often did doctors treat you with courtesy and respect? During this hospital stay, how often did doctors listen carefully to you? During this hospital stay, how often did doctors explain things in a way you could understand? Patients are provided with the following response options: Never, Sometimes, Usually, Always How will your patients answer these questions? (To obtain your individual patient experience scores, contact Service Excellence at (623) 327-4015)

30. Medical Staff Expectations Physician-to-Physician Communication Initial patient visit within 24 hours of admission and daily visits thereafter H&P dictated within 24 hours of admission Documentation of daily visits Consultations rendered and electronically recorded or dictated within 24 hours of notification. 20 minute call back Professional Conduct and Ethical Behavior Effective and timely communication with patients/families/staff Participation in Peer Review and Quality Improvement Activities Completion of Medical Records in accordance with Medical Staff Rules and Regulations

31. What is Throughput? Direct admits: Call Bed Placement (623) 327-4013 for direct admits. Discharge time: 11:00a.m. goal. Focus on complete and accurate discharge instructions and medication reconciliation. Clinical conditions and referrals to Case Management and Social Work identified early to ensure appropriate, safe and timely discharge. Inform patient and family of goals for discharge.

32. Disclosure of Unanticipated Patient Outcomes No blame culture Provide timely information to patient or family regarding an unanticipated outcome Physician�s responsibility with staff support Maintain ongoing communication & follow-up Document in the Medical Record Refer to Banner Policy #9063 � Disclosure of Unanticipated Outcomes

33. Safe Prescribing Standards Write legibly Curtail abbreviations, especially guard against: �U� for Units �qD� for Daily DO NOT USE� Trailing zeros ALWAYS use a Leading ZERO when using decimals PRN orders need to have an indication Verbal orders only in an emergency Expect �read-back� for telephone orders

34. Infection ControlValley Fever � What is it? Valley Fever (Coccidioidomycosis) is a disease caused by inhaling spores of two fungi, Coccidioides immitis or Coccidioides posadasii.� The disease was originally named �Valley Fever� because of its discovery in California�s San Joaquin Valley, and is prevalent in Mexico, Texas, Nevada, Arizona and the Desert Southwest.� New cases in AZ - In 2008 - 4768, in 2009 � 10, 279 2009 BEMC � 72 cases Signs & Symptoms Most people (about 60%) who become infected with Valley Fever have no apparent symptoms. If symptoms do develop, they occur within 3 weeks after inhaling the spores.�Of the ones who have symptoms, some have mild disease where the disease appears like a persistent mild community acquired pneumonia. The most common symptoms are cough, chest pain, fatigue, headache, and fever.� After recovery, most people develop a lifelong immunity�against re-infection.� Five to ten percent of those infected experience more severe complications. In the 1%-2% of�patients whose Valley Fever becomes disseminated, the fungal infection may spread from the lungs to the skin, joints, bones, and -in the most serious and potentially fatal complication- to�the brain�s protective membranes. Contact information: John Po, MD, Medical Director, Infectious Disease 623-327-4144 Toni Lee, RN, Sr. Infection Preventionist Supervisor 623-327-5213

35. Banner Estrella Medical Center�Transforming the Healthcare Experience Our Mission: We exist to make a difference in people�s lives through excellent patient care. We Value: People Above All �by treating those we serve and each other with compassion, dignity and respect. Excellence �by acting with integrity and striving for the highest quality care and service. Results �We show we value results by exceeding the expectations of the people we serve,as well as the expectations we set for ourselves.