For a man with a nearly impossible task before him, Lindsay Mann is in a rather upbeat mood. With less than two months before he leaves his position as head of the Kaweah Delta Health Care District, Mann says he intends to finish an entire year’s work before he goes.
Yet, he still has time to get excited about the recent rainfall.
“For the record, I am so glad it’s raining in the Central Valley,” Mann said. “Really, I’m thrilled. Aren’t you?”
The Vision
Mann was preparing to launch into a lengthy monologue on the future of the county’s largest heath-care provider and how it will fair once he’s left for Mexico City to pursue a three-year mission for the Mormon Church.
“It’s my duty to cast the vision in the organization, as I have earlier this week with our leadership team, with our board, and, ultimately, the community’s got to have some sense of what’s going on,” Mann said. “Now, this isn’t some kind of valedictory address in any sense, because you know by midyear I’ll be in Mexico.”
But first he wanted to talk about the weather, about how the northern reaches of California are no longer in the grip of drought, and his sense of relief that our area may soon follow.
“Wouldn’t we be thrilled to be out of the drought?” he asked. “That’s been permeating our consciousness for at least five years.”
Seismically Sound
Mann’s consciousness during the last decade has been taken up largely with ensuring Kaweah Delta Medical Center meets the state’s seismic stability requirements before a 2030 deadline, and now most of the payoff for those efforts will come after he departs his job.
Mann leaves KHHCD on March 31, and only after will the fifth and sixth floors of the hospital’s Acequia Wing finally be put to use and the ground broken on an expansion of the ER.
“The fifth floor will be built out for 24 new beds, sixth floor for new NICU (neonatal intensive care unit),” he said, speaking at a near -breakneck pace. “Two new OB ORs that are already approved, interim emergency department expansion is happening within the next six months, and then as soon as the Office of Statewide Health Planning and Development approves it, we’ll build out the expanded emergency department. We’ll literally double our capacities in the ED from 33 spaces to 66 spaces.”
He talks about the renovation and expansion at the Exeter Clinic, the addition of a new urgent care center on Ben Maddox Way and expanding the District’s West Campus on Acres Road.
“This is our board’s vision, to be this valley’s premiere health-care institution, not because we’ve got a big, prideful sense,” he said. “It’s about what we owe to the patient.”
Four-Star Rating
Kaweah Delta has gone a long way toward improving patient outcomes and satisfaction in the last two decades, especially since Mann took over in 2001.
Infection rates at KDMC are down, and the hospital now leads the nation in preventing catheter-associated urinary line and central line-associated infections, two of the 64 metrics used by the federal Center for Medicaid Studies (CMS) in its ratings.
“It’s because we look at the low points and beat the heck out of them,” Mann said. “We are currently the only hospital in the Central Valley, including all of Fresno and Bakersfield, that is at a four-star level by CMS.”
Gaining a four-star rating, then holding it as KDMC has done for two years running, is a difficult feat for any facility. It’s even harder in a poverty-stricken area.
“It’s not a beauty contest,” Mann said. “To do four stars in Tulare County is pretty remarkable, because there is an emergency department attached to this place that’s pretty busy, and it’s an all-comers situation.”
KDMC also holds a 4-A safety score with the Leapfrog Group, an NGO health-care auditor.
Five-Star Context
Mann says the District will continue to seek a five-star rating once he’s gone, but that it will require a team effort and an awareness of the difficulties working in this area present.
“Five (stars) will be a really big challenge because the context of Kaweah Delta in Tulare County and the population we serve and the comorbidities,” Mann said. “What it will take is a very disciplined drive with physicians and hospital staff members to make sure that our following (of) clinical guidelines, national best practices, are perfect, and also that patients and families have great experiences here.”
To further that effort, the District will continue to recruit nurses, doctors and clinicians, as well as working on its sometimes imperfect relationship with the community it serves, Mann said.
So far in 2017, the District has hired 24 new nurses, and it would like to add to its residency programs in the coming months.
Better Care
Key to gaining a five-star rating is satisfying patients and getting the best possible outcomes for them.
In January, the Joint Commission awarded the District a three-year certification for its program of stroke treatment, but Mann says that’s just not good enough. KDMC will add scanning capacity to drive down stroke treatment times, an example of just one of the ways the District is embracing technology, Mann said.
“What it says is we’re not just resting on our laurels,” he said. “We’re moving to very leading-edge procedures.”
In his remaining time, Mann will be sticking to plain hard work.
“I’ve got plenty to do,” he said, “like a year’s worth of work to do just to set the groundwork for the year ahead.”
Part of that groundwork is finding his replacement.
The search is underway, and the District has hired a recruiter to aid its search. KDHCD’s four-star and 4-A ratings should make competition for Mann’s former job tough. Mann seems confident whoever replaces him will have a solid plan to follow into the future.
“As I told the leadership team, it will be a very rich blessing to take this vision and more that will emerge and carry it forward,” he said.