Hospital Demonstrates Good Care Not About Size

Tulare - Shawn Bolouki, Tulare District Hospital's new chief executive officer, said he doesn't buy the notion larger hospitals mean better patient care

“Size is not equal to quality,” Bolouki said as he grabbed results from two recent reports on quality of care and patient satisfaction to support his position.

The reports, Hospital Compare and the 2007 Annual Report on Quality and Safety, were prepared by the Center for Medicare and Medicaid Services and The Joint Commission on Accreditation of Hospitals, respectively. Each allows consumers to compare Tulare District's results with other hospitals in the county, state and nation.
The Joint Commission's annual quality and safety report found Tulare District's performance between July 2006 and June 2007 was:

• Better than most accredited organizations in caring for patients with heart failure. Larger Kaweah Delta Hospital's overall performance is below that of most accredited organizations, as is Sierra View District Hospital.

• Better than most accredited organizations in caring for pneumonia patients. Kaweah Delta's performance is similar to most accredited organizations, while Sierra View's is below.

• Similar to most accredited organizations in caring for heart attack victims. Kaweah Delta's and Sierra View’s were similar as well.

Bolouki said he hopes the findings will bolster the public's confidence in Tulare District's ability to provide quality care.

He believes complaints about the emergency room have erroneously led people to believe the care is bad, which is not the case.

“We are doing better than any other hospital around here,” Bolouki said.
The problem with the emergency room is its capacity, not quality of care, he said.
He equated the situation to trying to squeeze 20 people inside a passenger car built for five. Complaints will result, no matter how good the car is.

“We are in the process of building a bus and, unfortunately, it's not going to be available until 2012,” he said.

Hospital Compare also reported on patient satisfaction, another area in which the hospital did well. The study found:

· 77 percent of Tulare District patients reported nurses communicated well with them. That is the highest percentage logged in the county and well above the 67 percent state average and 73 percent national average.

· 86 percent of Tulare District patients reported doctors communicated well with them, again the highest percentage in the county and above the 76 percent state average and 79 percent national average.

· 62 percent of Tulare District patients reported they received help quickly from hospital staff, the highest percentage in the county and above the 54 percent state average and 60 percent national average.

· 72 percent of Tulare District patients said their pain was well controlled, the highest percentage in the county and above the 64 percent state average and 67 percent national average.

· 57 percent of Tulare District patients said staff explained their medications before administering them, which was slightly higher than what Kaweah Delta patients reported and above the 54 percent state average. The national average is 58 percent.

· 77 percent of Tulare District's patients said they were given information about what to do during their recovery at home. This was less than the 81 percent logged by Kaweah Delta. The state average was 76 percent and the national was 79 percent.

· 66 percent of Tulare District's patients rated the hospital a 9 or a 10 on a scale that ranged from 0 (the lowest) to 10 (the highest). This was the highest in the county and above the 60 percent state average and 63 percent national average.

· 63 percent of patients said they would recommend the hospital to friends and family, which was below Kaweah Delta's 65 percent, which met the state average, and below the 67 percent national average.

More detailed reports on hospital performance and patient satisfaction can be found at www.hospitalcompare.hhs.gov/hospital and at www.jointcommission.org

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Best of Valley's Featured Artist
Likes to Add 'Bling' to Quilts

Tulare - Although she only started making quilts about six years ago, Debbie Van Fossen's style and imagination has caught the attention of organizers of the Best of the Valley Quilt Show, which opens Friday at the Heritage Complex at the International Agri-Center.

The show is held in conjunction with the Antique Farm Show at the Agri-Center Saturday and Sunday. (See story on Antique Show below right.)

Van Fossen, who grew up in Tulare and now lives in Visalia, is the featured artist at the three-day regional show of quilts and wearable arts, which will start daily at 9 a.m. and run to 5 p.m. Friday and Saturday and to 4 p.m. Sunday.

“I love her sense of color,” show Chairwoman Bobbi Moore said, adding her favorite Van Fossen creation is a rose-colored velvet quilt stitched with metallic thread.

The thread gives the quilt “the little bling bling” Van Fossen said she loves to add to her traditional quilts.

Visitors to the 13th annual show will get to see not only Van Fossen's quilts, but her vests as well. “I'm going to wear something every day that I've made,” she said.
An account clerk for 31 years with the Tulare City School District, Van Fossen said she always has needed a creative outlet to balance the numbers and papers she works with all day.

“It was tole painting for awhile, rubber stamping…I've gone through them all,” she said.

Hasn't Stopped

While she has long been attracted to the colors used in quilting, she said she was reluctant to go down that road until she learned you can quilt with a sewing machine.After that, the rest is history.

She took classes at Thimble Town with Barbara Phillips and began making quilts on her small home sewing machine, which she continues to use today.
“I absolutely loved it and haven't stopped,” she said.

She made new friends in the Orange Blossom and Common Threads quilters' guilds, in Visalia and Hanford, respectively, and together they have traveled to classes and retreats.

Her awards have included Best of Show and Best Machine Quilting at the Best of the Valley. She also has won Best of Show at the Tulare County Fair and a third place at the Road to California Quilt Show in Ontario. She was also juried into the American Quilting Society's Nashville Quilt Show and the Pacific International Quilt Festival in Santa Clara.

In addition to her award-winning work, visitors will get to see a special quilt she finished in August and which normally hangs in the city school district board room. The quilt, made of T-shirts from each of the district's elementary and middle school campuses, is called “Cool Schools.”

Admission to the Best of the Valley is $8 with children under 12 free.

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New Hospital CEO on a Mission

By Julie Fernandez

Tulare - Shawn Bolouki has one file on his desk that has grown larger almost daily since he took over March 1 as Tulare District Hospital's new chief executive officer.

Odds are excellent that file will continue to expand.
Bolouki is doing what organizational experts call a SWOT analysis. That is he is conducting interviews and doing research to identify the strengths, weaknesses, opportunities and threats related to the Tulare Local HealthCare District.

So far he has interviewed all five members of the district's board of directors individually and is continuing to meet with doctors, hospital employees, community members and vendors, he said during an interview last week.

“It's been absolutely fascinating and eye-opening to me,” Bolouki said, explaining he will use what he learns to help build a road map for the hospital's future.

Although he has not completed his study, the new chief executive officer has done enough research that he is confident in saying the hospital is providing good care.
Bolouki cited two recent reports to back up this statement: Hospital Compare, prepared by the U.S. Department of Health and Human Services in conjunction with the Centers for Medicare and Medicaid Services; and the 2007 Annual Report on Quality and Safety from The Joint Commission on the Accreditation of Hospitals.

The problem, he said, is the hospital has not done a good job communicating its successes and contributions to the community and that is something he hopes to change.

Many Challenges

Bolouki steps into the CEO role at a time Tulare District Hospital faces many challenges, including the building of a four-story hospital tower that is expected to cost $120 million--$35 million more than the $85 million in bonds voters approved three years ago--a divided medical staff, and a board of directors that is not always of one mind.

Bolouki appears undaunted by the situation, saying he took the CEO job because of the challenges it presents.

“This is an excellent chance to practice the skills I've learned,” he said.
At this point, he said he is not overly concerned about the cost of the hospital's expansion, because the architect is still working on the design drawings, he said. “If it comes to the point we need help from the community I will go back to the community.”

He also urged the community to watch the hospital's Web site, which currently offers a virtual tour of the exterior of the new tower and is soon expected to add an interior tour so residents can see, for example, what the new emergency room will look like.

“We are trying to do something that I think is very unique,” he said.
As for the board members and the physicians who have been concerned about various matters, Bolouki said he has meet with them and they all share a common goal—quality care.

“The destination is fixed, but how you want to get there is flexible,” Bolouki said. “My hope is to bring them all together. You basically encourage a dialogue and you build consensus.”

Building a Team

Bolouki said he sees his role inside the hospital as that of a coach, who makes sure he understands the organization and puts the right person in the right place, and he is well along in building his management team.

Pat Mathewson, who joined the hospital staff on an interim basis last year, has agreed to continue as chief clinical officer, he said, and Victoria Myers, whom he worked with at another hospital, has been hired as vice president of business development. He expects to hire a chief financial officer soon.

Bolouki will not fill the chief operations officer position, because that is a job he also is qualified to do. “My issue too is to reduce costs,” he added.

As CEO, Bolouki said two things are “non-negotiable in my book—quality of care and compliance (with state and federal regulations).” To promote both, he has appointed Julie Gresham, a registered nurse, as chief compliance and quality officer.
Prior to coming to Tulare, Bolouki, 51, worked at CHA Hollywood Presbyterian Medical Center in Los Angeles, where he served as executive vice president/chief operating officer from 2001 until 2005, when he became chief executive officer. He served in the CEO capacity until Jan. 2, 2007, and remained available for consulting until May.

Skid Row

He was not the CEO when that medical center was accused in February 2007 of dumping a patient in Los Angeles' skid row, although several Internet bloggers, upset about the incident, mistakenly identified him as the CEO.

The interview he did with National Public Radio on patient dumping—which is also easily accessible on the Internet-- was done in December 2005, which was 14 months before the Hollywood Presbyterian incident and shortly after two other Los Angeles hospitals were accused of dumping patients.

“From my point of view, health care is a right, not a privilege,” Bolouki said last week.

Bolouki, who is of Persian and German ethnicity, was born and raised in Germany and came to the U.S. in 1977 to attend a language school in Washington D.C. before heading to Miami Dade Community College, where he studied architectural engineering for two years.

He returned to Germany, where he studied hospital engineering, earning a master's degree. In 1986 he returned to the U.S., where his wife, whom he had met while she studied in Germany, lived. He went to Pennsylvania first, but later moved to California.

His first job was at St. Paul's Manor and Health Care Center in San Diego, where he was director of engineering and security from 1987 to 1989. He then went to Sharp memorial Hospital, also in San Diego, where he was manager of maintenance and operations from 1989 to 1992.

From 1992 to 1993, he was acting director for facilities engineering at the University of California San Diego Medical Center. He then went to another UCSD hospital in LaJolla, where he was director of facilities, engineering support services for four years.

From 1997 to 2000 he worked for the Tenet California Health system's Community and Mission Hospitals in Huntington Park, serving as assistant chief operating officer for both facilities.

He then moved to Tenet's St. Luke Medical Center, where he worked until 2001, when he left to become the COO and CEO at Los Angeles County/USC HealthCare Network, a huge operation with 8,000 employees and 820 interns and residents.

He said he chose to leave that job nine months later.

“I came to the point I realized I couldn't really make a difference,” he said. “I was not able to do the right thing for the patient.”

Bolouki has a one-year renewable contract with the district, which is paying him a $250,000 annual salary. He also can receive an additional $25,000 every six months if performance and objective goals established by the board are met.
If he stays with the district for five years, he will receive a $200,000 retention bonus.

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Antique Farm Equipment Show Will Have Orange Look

Tulare - People attending the 16th California Antique Farm Equipment Show this weekend at the International Agri-Center may see a lot of orange.

This is the 25th anniversary year of the Allis-Chalmers “Gathering of the Orange,” and the Tulare antique show will be the first of many national gatherings of Allis-Chalmers collectors.

A theme of this year's show and the featured tractor is the Allis-Chalmers. The “Gathering of the Orange” is a symbol of the annual gathering held around the U.S. and Canada for all those people who are collectors and/or enthusiasts of the Allis-Chalmers line of tractors, equipment, scale models and memorabilia.

Although the “Gathering of the Orange” wasn't the symbol of this event until 1988, it was in 1983 that a group of Allis-Chalmers enthusiasts gathered in Freeport, Ill., to show off the “orange” of the line. The show proved to be a success and plans were made for the following year with the group meeting at Dalton, Minn. The enthusiasm of the group has only grown over the years.

The shows are held every year in different locations around the U.S. and Canada.
The shows are coordinated through the Allis-Chalmers magazine “Old Allis News,” as there is no formal membership or organization.

Chairman Joe Raney

Long time volunteer and Tulare resident Joe Raney will chair the 2008 antique farm equipment show. Raney was born in Oklahoma, but set his roots in Tulare at age six. A Tulare Union and College of the Sequoias graduate, Raney worked for 30 years with the Tulare Fire Department.

Following his retirement in 1995, he began volunteering at the Agri-Center.
This year, Raney will lead the charge of the Antique Show planning. He looks forward to putting his own firefighter twist on the antiques displayed.

“I hope to have several antique fire engines at the show. Fingers crossed, they'll make it,” Raney said.

The 2008 event will again be a community and family event to experience. The two-day show will showcase antique farm equipment, special daily events and great food.

“These days it's hard to get the whole family together for good, wholesome fun,” Raney said. “The Antique Show is just the place for families to spend the day together. You can appreciate some great antique farm equipment and experience the special events in the afternoon.”

Another feature of the show will be the 5th Annual Rib Cook-off, starting at 10 a.m., Sunday.

“I always hear people say they can BBQ-up the best ribs,” said Kent Foreman, Rib Cook-off chairman. “We're going to test those cooking abilities and let some rib-hungry judges decide who truly makes the ultimate beef and pork ribs.”

To purchase tickets or for more information on the 16 the Annual California Antique Farm Equipment Show visit www.farmshow.org, email antique@farmshow.org or call (800) 999-9186.

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Gerald Benton Injured in Motorcycle Crash

Tulare - Retired Tulare Joint Union High School District Superintendent Gerald Benton is recovering in South Africa from injuries he suffered in a motorcycle accident there last week.

Benton's daughter, Amy Benton-Hermann, said her dad suffered many injuries and was in a hospital in Johannesburg, South Africa. “He's got a long road ahead,” she said. “He is improving daily.”

Gerald's son and son-in-law left this week to stay with him in Johannesburg. There is no word yet on when he will be able to fly home, but he's getting stronger every day, she added.

Benton had just begun a three-week motorcycle tour of South Africa when he had the crash April 7, said his daughter. He and friend Mike Shaffer had traveled to South Africa for the tour. They were to meet up with about 25 other people, rent motorcycles and travel around the country by motorcycle.

Shaffer is with his friend. “He's been like an angel,” said Benton-Hermann.
Benton served as superintendent of the high school district for eight years before retiring two years ago. He grew up in Tulare, attending Tulare Western High School. After college he returned to Tulare as a teacher and eventually administrator, serving in numerous capacities in the district before being named superintendent. He is the immediate past president of the Tulare Chamber of Commerce.

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