All voluntary hospitals in New York State are required to submit a comprehensive Community Service Plan to the Department of Health every three years. An Annual Implementation Report is required the two years in-between. The following Implementation Report describes many of Kingsbrook’s community service initiatives during 2007 and reflects the medical center’s ongoing commitment to providing services that address the unique health care needs of our community.

1. Our Mission

Our mission is to partner with our culturally diverse communities to provide a continuum of outstanding health care services to individuals and families through a caring and trustworthy staff.

Our Vision

Our vision is to be distinguished as a premier hospital and trusted partner that advances the well-being of the individuals, families and communities we serve. We uphold the values of compassion, respect, ethics, excellence and dedication.

2. Public Participation & Notice

Community programs are publicized via direct-mail to community residents, regional newspaper advertisement, on our monthly health and wellness television show “Health News You Can Use” / Brooklyn Community Access Television, institutional wide signage, banner signage around the medical center campus, street promotion throughout the region, on the www.kingsbrook.org site, flyers/signage at our family health centers, community based organizations and our community board offices.

Community Advisory Board

Community residents, local business leaders, clergy and community based organizations also make up our Community Advisory Board (CAB). The purposes of Kingsbrook’s Community Advisory Board are:

• To inform and update CAB members of new and innovative programs and services, so that they may act as ambassadors to the larger community
• To receive the community’s feedback on the level of service offered at Kingsbrook
• To gain insight into the best vehicles of communication to the community
• To survey members about what services are important to them

In 2007 the community advisory board implemented a number of initiatives targeting Domestic Violence.

About Us...

Kingsbrook Jewish Medical Center, celebrating its 83rd year, is dedicated to meeting the health care needs of one of Brooklyn’s most culturally diverse communities. Located in the East Flatbush section of Central Brooklyn, Kingsbrook was founded in 1925 as a chronic care facility to serve the then Jewish Community within a cultural context. As the community evolved and diversified, Kingsbrook expanded its programs and services to meet the needs of the large immigrant and ethnic minority population it now serves.

Kingsbrook is a community hospital, comprised of a 326-bed acute care division with an active medical training program. Kingsbrook shares its campus with Rutland Nursing Home, a 538-bed adult and pediatric skilled nursing long-term care facility. Kingsbrook’s centers of excellence include: The Kingsbrook Rehabilitation Institute, Brooklyn’s only NYS licensed Traumatic Brain Injury and Coma Recovery Unit, a Geriatric Inpatient Psychiatry Service, a Wound Healing and Hyperbaric Center (offering hyperbaric oxygen as one of the treatment modalities for those with diabetes and other individuals with hard-to-heal-wounds), a Non-Invasive Vascular Laboratory, a Caribbean Mental Health Program, a Women’s Wellness Center (featuring gynecological services and laporascopic surgery), Ophthalmology & Neuro-ophthalmology, Orthopedics & Joint replacement and a Vascular Center of Excellence.

Kingsbrook Jewish Medical Center is accredited by the New York State Department of Health, the Joint Commission on Accreditation of Health Care Organizations (JCAHO), the New York State Office of Mental Health (OMH) and the Commission on Accreditation of Rehabilitation Facilities (CARF). The long term-care facility, Rutland Nursing Home, is accredited by the New York State Department of Health.The Medical Center is a voluntary not-for-profit institution and a member of the Greater New York Hospital Association (GNYHA) and the healthcare Association of New York State (HANYS).

In 2007, Kingsbrook provided 252,429 inpatient days of care, more than 25,000 emergency room visits and 170,583 outpatient visits.

3. Needs Assessment

Compared to Kings County as a whole, residents of Kingsbrook’s service area experience significant health disparities; facing higher rates of chronic conditions and mortality rates for HIV/AIDS, diabetes, and other conditions that affect the vascular and circulatory systems, highlighting Kingsbrook service area’s need for sophisticated radiologic services, including effective angiography. Women in Central Brooklyn are more likely to get timely pap tests for cervical cancer than women in Brooklyn and NYC overall, but they are getting mammograms for breast cancer at a rate well below the target of more than 85%. Moreover, women in Central Brooklyn face a mortality rate of 34 deaths per 100,000 from breast cancer, compared with 26 deaths per 100,000 throughout New York City. Furthermore, obesity is more prevalent in Central Brooklyn (30%) compared to the overall geographic Brooklyn region (23%).

Given the prevalence of diabetes and other vascular diseases within our Central Brooklyn community, the enhancement of vascular screening services through the availability of state-of-the-art angiography equipment and services is critical to the improvement of the health of our community; a community identified by the New York City Department of Health as being medically underserved. As a result of the health challenges faced by our residents and the healthcare facility closures which have confronted our community, between 2005 and 2007, Kingsbrook experienced a 29% increase in the demand for its angiography services, a 38% increase in demand for its mammography services, and an increase of 7.7% for its overall radiology services.

4. Strategic Planning

The ability of Kingsbrook to provide the community with access to state-of-the-art radiological services, vascular screening services, HIV/AIDS testing & treatment, diabetic/wound healing services and the access to early detection services for conditions most prevalent in our region, is not merely a component of our Strategic Plan, but is critical to the improvement of the health of our community. As such, Kingsbrook embarked on the following program enhancements in 2007:

Radiology

Kingsbrook’s Radiology Department underwent many technological advancements in 2007. The now state-of-the-art, digital facility offers affiliated and private physicians access to advanced modalities and patient centered services. These advancements also allow the medical center to better accommodate the growing need for advanced radiology services in the community. Advanced modalities include:

• PACS – Completely Filmless Department
• Voice Recognition Transcription System (Powerscribe)
  • Instantaneous TAT for Radiology reports once dictated by a Radiologist
• New 6-Slice CT Scanner

Emergency Department

Kingsbrook's Emergency Department (ED) remains on the cutting edge of advancement and technology with superior information platforms such as an Electronic Medical Records System, which is at the forefront of our national health care agenda and considered to be a critical first step to sharing precise data between practicing physicians, pharmacies and hospitals. Also, Kingsbrook's Emergency Department Information System (EDIS), is an essential component that helps enhance the overall quality of care for patients and decreases wait times. The award-winning system tracks patients through the Emergency Department from triage through to discharge, and provides patients with discharge instructions and prescriptions. The computerized system includes many features to improve patient safety and efficiency such as automatic checking for patient drug/drug and drug/allergy interactions, extensive data collection and reporting, clinical documentation order entry and result reporting. The system also provides complete electronic medical records for Emergency Department patients and allows staff to review old medical records from prior ED visits, including cause for prior admissions, chief complaints, labs and radiology tests. Additionally, the ED utilizes a low frequency cellular phone system,which allows for expanded communication access between the ED team and other key medical center departments. As such, this cellular system encourages minimal loud speaker use in the ED area, a major consideration for the comfort of patients receiving and awaiting treatment.

Kingsbrook’s ED is the only voluntary hospital to establish a clinical affiliation with the Fire Department of New York City (FDNY). This affiliation allows Kingsbrook to offer training to FDNY paramedics in the areas of medication administration, IV insertion, endotrachael intubations, patient assessment and history to name a few.

Pierre Toussaint Family Health Center: Designated HIV / AIDS Center

With HIV/AIDS reaching epidemic proportions in our community, Kingsbrook responded to this with the implementation of a designated AIDS Center, located at its Family Health Center, Pierre Toussaint, 1110 Eastern Parkway, Brooklyn, NY. As a designated AIDS Center, the facility provides comprehensive outpatient care and ensures that each patient receives case management services. The case management services encompass:

• Medical care coordination
• Outpatient case management
• Inpatient case management
• Case management program operations

Non-Invasive Cardiology Diagnostic Suite

Needed advancements were made to the Non-Invasive Cardiology Diagnostic Suite, providing advanced cardiology treatment services to members of our community. This suite is a subdivision of the Division of Cardiology in the Department of Medicine and was implemented to address the community’s increasing battle with heart disease and its many related illnesses. The suite is staffed by highly skilled medical and administrative staff that provides cardiac diagnostic procedures such as:

• Echocardiography, including Transesophageal Echocardiography (TEE)
• Stress Testing including all modalities
• Nuclear Cardiology
• 24-hour ambulatory EKG monitoring (Holter EKG)
• Tilt table testing

Comprehensive Wound Healing & Hyperbaric Center

In response to the growing rate of diabetic amputations, Kingsbrook's instituted its Comprehensive Wound Healing & Hyperbaric Center that integrates state-of-the-art hyperbaric oxygen therapy with more traditional treatments such as antibiotic, physical and nutritional therapies to treat hard-to-heal wounds. By providing the body with 100% pure oxygen under increased pressure, this treatment significantly improves the body’s natural healing abilities, and increases its effectiveness in fighting infection, and promoting the growth of new tissue and blood vessels in the affected areas. The Center's professional staff has specific expertise in treating the non-healing wounds common in persons with diabetes. During 2007, the New York State Assembly and the Empire State Development Corp. supported the advancement of hyperbaric therapy through funding for enhanced wound care services.

Geriatric Psychiatric Unit

The 30-bed Inpatient Geriatric Psychiatry Unit provides comprehensive inpatient treatment to individuals 55 years and older who are experiencing acute psychiatric illness. The unit is staffed to address the accompanying medical needs of older adults and individuals. Utilizing a multidisciplinary team which reflects the ethnic diversity of persons served, the program features an array of services emphasizing diagnosis, assessment, and stabilization. A key element of the program is emotional support for patients, families and other caregivers. The availability of on-site psychiatrists 24-hours a day, 7 days a week allows direct admissions anytime. The Unit accepts voluntary and involuntary admissions. In 2007, the Moses L. Parshelsky Foundation funded the renovation of the common rooms in the Geriatric Psychiatric Unit in support of safety enhancements.

Domestic Violence Programs/Events

Kingsbrook Jewish Medical Center remains committed to protecting the rights of community residents and patients who are the victims of domestic violence. Kingsbrook is also committed to ensuring that all cases of domestic violence are detected, treated and given appropriate follow-up for the victims’ medical and psychological needs. As such, Kingsbrook hosted interdenominational breakfasts for clergy and symposiums for community youngsters to shed further light on this pervasive issue. Kingsbrook’s Emergency Department and Ambulatory Care Centers are key in this ongoing mission for detection and intervention. Safe Horizon also approved funding in 2007, for the support and implementation of the DOVE – Domestic Violence Awareness Program.

Facility Enhancements

The medical center embarked on improvements to several treatment areas in 2007, upgraded divisions include: X-ray Room, Clinic E - dictation room and Pharmacy exam room, ICU - nurse mgrs' office, Briger 3 – classroom, DMRI 1 - transportation/ADC locker room, Katz 1 - existing CT Scan, kitchen - keetle floor, Dialysis - RO installation, computer room - A/C installation, Minkin Basement - renovated old ultrasound room to patient holding area, DMRI 2 – Kingsbrook Rehabilitation Institute face-lift, Masin and DMRI facade repairs, DMRI 3 - Pediatrics lobby face-lift. The New York City Council and the New York City Department of Health helped fund these enhancements.

Also, the following equipment was acquired in 2007: Pulmonary Function System, C-Arms, Echo Cardiology Machine, Cystoscopy Systems, This Prep for Pathology, Documentation System, Portable X-Ray Machine,Ventilators. The New York City Department of Health and Mental Hygiene helped fund these needed technological advancements.

Additionally, KJMC social workers were given upgraded computer equipment with the ability to access “HITE Site”. HITE Site is a GNYHA sponsored internet resource center where social workers are able to locate resources for domestic violence survivors in their own communities. As such, social workers at Kingsbrook are able to give patients clear, printed lists of resources in their region.

Medical Library

Kingsbrook’s library, which is a significant support platform for our many residents, allows the institution to continue its tradition of being an advanced and well equipped medical teaching facility, advancing the scope of medical professionals in our borough. In 2007, the Metropolitan New York Library Association helped fund interlibrary loan activities with the National Library of Medicine.

Brooklyn Health Information Exchange (BHIX)

In 2007, Kingsbrook joined together with other Brooklyn healthcare institutions to form the Brooklyn Health Information Exchange (BHIX). BHIX is a regional health information organization. It’s purpose is to improve the quality of care for Brooklyn’s 2.5 million residents, many of whom are elderly and struggle with chronic and co-morbid conditions through the use of advanced information technology. By advancing the use of a secure,computerized health care information network which empowers patients to grant viewing access to authorized health care providers, BHIX streamlines the flow of health information and improves the delivery and outcomes of healthcare for the Brooklyn community. The data available through BHIX comes from a growing variety of health information sources.

Ambulatory Care Electronic Health Record (EHR)

In 2007, Kingsbrook partnered with the New York City Department of Health to implement an Ambulatory Care Electronic Health Record (EHR), a system that helps Ambulatory Care Physicians manage their patients profiles more proficiently. The system provides the New York City Department of Health and Kingsbook access to improved tracking and response in regard to public health issues that may initially present themselves in the ambulatory care setting. The eClinicalWorks Electronic Health Records (EHR) is structured to enhance Ambulatory operations and the overall patient care at Pierre Toussaint Family Health Center, Crown Heights Family Health Center and the Kingsbrook on-site Ambulatory Center.

This system is intended to help providers manage all aspects of patient care electronically, by providing a full range of functions for data retrieval and capture to support patient review, encounter and follow-up.

Rutland Nursing Home

Rutland Nursing Home, located on the campus of Kingbrook Jewish Medical Center, is a 538- bed, long and short-term care facility offering skilled nursing, physical rehabilitation and a specialty unit for ventilator dependent residents and an array of other sub-acute services. All the resources of the Medical Center, including general medical and subspecialties, surgical, orthopedic, psychiatric, dental services,and the emergency room, are immediately available to the residents. In 2007, the New York State Department of Health helped fund Rutland’s On-time Quality Improvement Initiative.

Early Detection of Disease

Kingsbrook continues to implement programs and services that respond to the vital health needs and concerns of the community at large.As such, all Kingsbrook’s outreach efforts are a direct and targeted response to the health disparities most prevalent in our community.

Free Community Calendar Health Screenings “KJMC Community Screening Calendar”

Kingsbrook provides free screening opportunities all year-round in collaboration with the Foundation for Medical Evaluation and Early Detection. Year-long screenings include: Asthma, HIV/AIDS, Cholesterol, Stroke, Aortic Aneurysm and Diabetes. Screenings are coordinated at three KJMC screening locations within the community:

Kingsbrook Jewish Medical Center
Clinic E • 585 Schenectady Avenue, Brooklyn NY

Pierre Toussaint Family Health Center
1110 Eastern Parkway, Brooklyn, NY

Crown Heights Family Health Center
535 Empire Blvd, Brooklyn, NY

Breast Screenings “KJMC’s Healthy Living Partnership”

Kingsbrook has also partnered with the Brooklyn Healthy Living Program to provide no and low cost mammograms, breast exams and pap smears to women who are uninsured, under-insured or low income. The program is coordinated via our Women’s Wellness Center.

Free “On-Line” Screening Coupon Initiative “Make a Healthy Choice”

For those who visit our web site (www.kingsbrook.org), we provide a free screening coupon that provides early detection testing for prostate, diabetes, glaucoma, breast (examinations) and cholesterol. These screenings are also coordinated at the KJMC screening locations.

PSA Screenings

“Kingsbrook/Daily News PSA Screening Initiative” Kingsbrook partners with The New York Daily News (along with 7 other New York City hospitals) to provide prostate screenings to men 40 and over. Kingsbrook is the only participating Brooklyn hospital in this program and has screened over 1,600 men via this initiative between 2006-2007. Screenings are coordinated at all KJMC screening locations commencing on Father’s Day each year.

HIV/AIDS Screenings

Due to the staggering rise of HIV/AIDS cases in Central Brooklyn, Kingsbrook offers HIV/AIDS “Quick Tests” to all patients entering our Emergency Division. Additionally, HIV/AIDS testing services are also available all year-round at our designated AIDS Center, Pierre Toussaint Family Health Center.

Men’s Health/Screenings “Take Your Man to the Doctor Week”

Kingsbrook partners each year with the office of the Brooklyn Borough President, along with 30 Brooklyn hospitals and health care providers to sponsor a full week of health and wellness screenings geared towards men in our Central Brooklyn community. Take Your Man to the Doctor Week, is a call to action for men of all ages, ethnicities, and social standing to regularly visit a doctor and to take advantage of early detection services.

Education Speaker’s Bureau Program

As part of its community outreach initiatives, Kingsbrook Jewish Medical Center offers this essential program; geared towards providing up-to-date health and wellness information via seminars and discussions to communitybased organizations such as libraries, senior citizen centers, schools, churches and health-based organizations. This traveling program gives community members an opportunity to speak with medical and health education specialists directly about programs and treatments pertinent to their well-being.

Health Seminars “Taking Control of Your Health”

For those who are unable to take part in our day-time education seminars and activities, Kingsbrook devised an evening seminar series “Taking Control of Your Health.” This interactive and intimate seminar allows community residents an opportunity to have discussions with physicians and medical staff on a number health issues most important to them. The session,which includes a light dinner with question and answers at the end, is an added plus to Kingsbrook’s educational outreach services.

Health & Wellness Television “Health News You Can Use”

Kingsbrook Jewish Medical Center’s health and wellness television show “Health News You Can Use” speaks to the unique health care needs of Central Brooklynites and features prominent medical professionals and guests who shed light on treatment options and lifestyle adjustments due to a variety of health conditions. The show’s production crew is comprised of medical and ancillary staff from the medical center.

“Health News You Can Use” airs every fourth Wednesday at 2:00pm on BCAT, Time Warner Cable Channel 35 or Cablevision Channel 68. The show reaches over 500,000 viewers. Health topics featured have been HIV/AIDS, Obesity, Wound Care, Diabetes Part1 & Part 2, Hypertension, Mental Health Part 1 & Part 2, Asthma Part 1 & Part 2.

Health & Wellness Community Newsletter “Health News You Can Use (printed version)”

Keeping the community informed of the health disparities most prevalent in the region is a key factor in our educational outreach. As such, Kingsbrook has joined forces with over 50-60 church partners In an effort to spread the word about these disparities by way of a health and wellness newsletter also entitled “Health News You Can Use.” These pieces, that cover health issues relative to our residents such as: diabetes, stroke, prostate cancer,heart disease, HIV/AIDS, and asthma to name a few, are used as inserts in the Sunday bulletins of these church partners and also used as circulars at our family health centers, local Community Board offices and health fairs.

Mentorship Programs for Youngsters

KJMC’s mentorship program initiatives are designed to expose students to various careers within the medical sphere, providing guidance to information and course study relevant to the pursuit of those fields. The programs encourages research, report production, health media production and hands on special project development that give students an in-depth understanding of how the health industry and its supporting areas work. Over 300 students from our community have participated in our learning & mentorship programs.

5. Charity Care

In 2007, Kingsbrook Jewish Medical Center provided $6,028,236 in charity care. Patients are notified of charity care through posted notices in several patient intake and treatment areas, including our website. It is also available in brochure format via our Public Affairs and Business Departments.

Kingsbrook Jewish Medical Center has implemented a Financial Assistance Program which evaluates those who are underinsured, have exhausted their insurance benefits or are fully uninsured. Kingsbrook Jewish Medical Center’s Financial Assistance Program is based upon up to 300% of the January 2007 Department of Health and Human Services Federal Poverty Guidelines. Current clinic patients without adequate financial resources can receive care in our primary/specialty clinics for fee schedules based on their income and family size. A determination will be made if the patient is eligible for reduced fees. Non-Clinic patients seen in the Emergency Department, Inpatient, or for Outpatient Services can apply for assistance, based on financial need, through the Financial Assistance process in Patient Accounts, Patient Access Services/Financial Counseling or Ambulatory Care.

Anyone in New York State who needs emergency services can receive care and get a discount if they meet the income limits. Any individual residing in Kingsbrook Jewish Medical Center‘s primary service area, which is defined as: East Flatbush, Flatbush, Canarsie, Flatlands, Bedford-Stuyvesant, Crown Heights and/or East New York (zip codes 11203, 11236, 11213, 11226, 11212, 11208, 11207, 11225, 11216), can get a discount on non-emergency, medically necessary services, if they meet the income limits. The amount of the discount varies based on income and the size of the family. Persons may apply regardless of their immigration status. Kingsbrook Jewish Medical Center will never deny medically necessary care because of the need for financial assistance.

6. Corporate Structure

Kingsbrook Jewish Medical Center is governed by an 18 member Board of Trustees. It is a New York not-for-profit corporation, and is a tax exempt organization under Section 501(c)(3) of the United States Internal Revenue Code. The sole voting member of Kingsbrook Jewish Medical Center and its sister corporation, Rutland Nursing Home, Inc., is Kingsbrook Healthcare System, Inc. (which is also a New York not-for-profit corporation and is tax exempt under the United States Internal Revenue Code).