Jackson Health System - 2013 Report To The Community

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Making Miracles 2013 Report To The Community

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From The President & Chief Executive Officer, Carlos A. Migoya More than 35 years ago, my younger son was born at Jackson Memorial Hospital weighing just over a pound, given only a whisper of a chance to survive. At any other facility, he would have been lost, but thanks to the doctors, nurses and other caregivers at our public hospital, he has grown into a happy, healthy and successful young man.

Our entire team is deeply committed to carrying that work forward.

The industry we represent and the community we serve will change substantially in the years ahead – Jackson must be strong enough, nimble enough and smart enough to change with them while still pushing ourselves to deliver the world’s best medical care.

At any other hospital, they would call it a miracle. At Jackson, we call it a Monday.

In the year to come, we will continue this journey of transformation.

Jackson will continue to focus on those signature services that make us famous: transplant, trauma, neurosurgery and neurology, fetal medicine, maternity, bariatrics, and pediatrics, particularly for the smallest and sickest children.

Stories like these take place at our hospitals every day, and they are the inspiration for our new identity: Miracles made daily.

From Ryder Trauma Center, which trains every one of the U.S. Army’s forward surgical teams and treats our most seriously injured neighbors, to Jackson Rehabilitation Hospital, where patients work toward a second chance at independent lives, Jackson Health System makes miracles.

Just a few years from now, Jackson will celebrate its 100th anniversary, so today we are building the framework for a second century of making miracles.

Sincerely,

Dr. James M. Jackson, Miami’s first resident physician and Jackson Memorial Hospital’s namesake.

Carlos A. Migoya President & Chief Executive Officer

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From The President & Chief Executive Officer, Carlos A. Migoya More than 35 years ago, my younger son was born at Jackson Memorial Hospital weighing just over a pound, given only a whisper of a chance to survive. At any other facility, he would have been lost, but thanks to the doctors, nurses and other caregivers at our public hospital, he has grown into a happy, healthy and successful young man.

Our entire team is deeply committed to carrying that work forward.

The industry we represent and the community we serve will change substantially in the years ahead – Jackson must be strong enough, nimble enough and smart enough to change with them while still pushing ourselves to deliver the world’s best medical care.

At any other hospital, they would call it a miracle. At Jackson, we call it a Monday.

In the year to come, we will continue this journey of transformation.

Jackson will continue to focus on those signature services that make us famous: transplant, trauma, neurosurgery and neurology, fetal medicine, maternity, bariatrics, and pediatrics, particularly for the smallest and sickest children.

Stories like these take place at our hospitals every day, and they are the inspiration for our new identity: Miracles made daily.

From Ryder Trauma Center, which trains every one of the U.S. Army’s forward surgical teams and treats our most seriously injured neighbors, to Jackson Rehabilitation Hospital, where patients work toward a second chance at independent lives, Jackson Health System makes miracles.

Just a few years from now, Jackson will celebrate its 100th anniversary, so today we are building the framework for a second century of making miracles.

Sincerely,

Dr. James M. Jackson, Miami’s first resident physician and Jackson Memorial Hospital’s namesake.

Carlos A. Migoya President & Chief Executive Officer

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From The Chairman Of The Public Health Trust Board Of Trustees, Darryl K. Sharpton Jackson Health System is an institution like no other. We combine world-class clinical care, famed academic partners and a community promise to deliver a single high standard of care to every Miami-Dade County resident, regardless of their financial circumstances.

With the support of our elected leaders, our stellar staff of caregivers, and our proud taxpayer-owners, we chose transformation. By the end of 2012, our community’s faith was validated: clinical care continued to improve, while business and service standards have begun catching up.

Not long ago, that mission was in peril. Even as our medical work remained cutting-edge, our operations and finances were a generation out of date.

Our community was left confronting a difficult choice: disassemble Jackson’s signature services, seek ever-larger public subsidies or undergo a radical transformation to become a next-generation healthcare system.

Certainly Jackson is not satisfied. With the sunset of the Public Health Trust Financial Recovery Board and the reinvention of the Board of Trustees, Jackson is poised to execute a sophisticated set of strategies to grow into the new American healthcare environment. Through it all, our mission statement remains our guiding principle and our proudest legacy.

Sincerely,

Darryl K. Sharpton Chairman Public Health Trust Board of Trustees

Jackson Then & Now

Miami City Hospital couldn’t have opened at a more important time – June 1918 was plagued by an influenza epidemic that quickly filled the hospital to capacity. Now, almost 100 years later, the hospital, created by physician and civic leader Dr. James M. Jackson, has grown from a 13-bed, small-town hospital to Jackson Memorial Hospital, the crown jewel of Jackson Health System, and the largest public hospital in the nation.*

Over the years, Jackson has been home to many firsts, despite obstacles including polio and influenza epidemics, devastating hurricanes and seemingly insurmountable budget challenges. All the while, our hardworking clinical and administrative staff have met their responsibilities to the community and positioned the organization as a national healthcare leader. *Becker’s Hospital Review, June 2013

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From The Chairman Of The Public Health Trust Board Of Trustees, Darryl K. Sharpton Jackson Health System is an institution like no other. We combine world-class clinical care, famed academic partners and a community promise to deliver a single high standard of care to every Miami-Dade County resident, regardless of their financial circumstances.

With the support of our elected leaders, our stellar staff of caregivers, and our proud taxpayer-owners, we chose transformation. By the end of 2012, our community’s faith was validated: clinical care continued to improve, while business and service standards have begun catching up.

Not long ago, that mission was in peril. Even as our medical work remained cutting-edge, our operations and finances were a generation out of date.

Our community was left confronting a difficult choice: disassemble Jackson’s signature services, seek ever-larger public subsidies or undergo a radical transformation to become a next-generation healthcare system.

Certainly Jackson is not satisfied. With the sunset of the Public Health Trust Financial Recovery Board and the reinvention of the Board of Trustees, Jackson is poised to execute a sophisticated set of strategies to grow into the new American healthcare environment. Through it all, our mission statement remains our guiding principle and our proudest legacy.

Sincerely,

Darryl K. Sharpton Chairman Public Health Trust Board of Trustees

Jackson Then & Now

Miami City Hospital couldn’t have opened at a more important time – June 1918 was plagued by an influenza epidemic that quickly filled the hospital to capacity. Now, almost 100 years later, the hospital, created by physician and civic leader Dr. James M. Jackson, has grown from a 13-bed, small-town hospital to Jackson Memorial Hospital, the crown jewel of Jackson Health System, and the largest public hospital in the nation.*

Over the years, Jackson has been home to many firsts, despite obstacles including polio and influenza epidemics, devastating hurricanes and seemingly insurmountable budget challenges. All the while, our hardworking clinical and administrative staff have met their responsibilities to the community and positioned the organization as a national healthcare leader. *Becker’s Hospital Review, June 2013

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A Century Of Milestones 1926: Miami City Hospital treats more than 700 victims after a major hurricane and operates relief stations throughout the city.

1946: Jackson becomes the only hospital in the region to offer radium treatment for cancer.

1952: The University of Miami School of Medicine opens, beginning Jackson’s longtime affiliation with UM.

1956: Dr. Robert S. Litwak, chief of thoracic surgery at Jackson, performs the first open-heart surgery in Florida.

1960: The hospital performs cardiopulmonary bypass using a new heart-lung machine.

1965: Jackson makes headlines by treating burn patients with an innovative silver nitrate treatment after the cruise ship Yarmouth Castle catches fire.

Mission To build the health of the community by providing a single, high standard of quality care for the residents of Miami-Dade County.

1973: The National Cancer Institute chooses Jackson as the Florida site for a Comprehensive Cancer Center, then one of only 20 in the nation.

1977: Jackson’s Kidney Transplantation

Vision

Center opens and performs 24 transplants in its first year.

To be a nationally and internationally recognized, world-class academic medical system and to be the provider of choice for quality care.

1986: The Best in Medicine names Jackson Memorial Hospital one of the top 25 medical facilities in the U.S. – the only public hospital to make the list.

1992: Ryder Trauma Center opens just weeks before Hurricane Andrew devastates Miami-Dade.

Values

2001: The Public Health Trust creates Jackson

Service Excellence and Quality Commitment Compassion Teamwork and Communication Respect Confidentiality Integrity and Stewardship Inclusion

Health System, an integrated public health system, and acquires Deering Hospital, which is renamed Jackson South Community Hospital.

2006: Jackson Health System adds Parkway Regional Medical Center, which becomes Jackson North Medical Center.

Jackson South Community Hospital

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A Century Of Milestones 1926: Miami City Hospital treats more than 700 victims after a major hurricane and operates relief stations throughout the city.

1946: Jackson becomes the only hospital in the region to offer radium treatment for cancer.

1952: The University of Miami School of Medicine opens, beginning Jackson’s longtime affiliation with UM.

1956: Dr. Robert S. Litwak, chief of thoracic surgery at Jackson, performs the first open-heart surgery in Florida.

1960: The hospital performs cardiopulmonary bypass using a new heart-lung machine.

1965: Jackson makes headlines by treating burn patients with an innovative silver nitrate treatment after the cruise ship Yarmouth Castle catches fire.

Mission To build the health of the community by providing a single, high standard of quality care for the residents of Miami-Dade County.

1973: The National Cancer Institute chooses Jackson as the Florida site for a Comprehensive Cancer Center, then one of only 20 in the nation.

1977: Jackson’s Kidney Transplantation

Vision

Center opens and performs 24 transplants in its first year.

To be a nationally and internationally recognized, world-class academic medical system and to be the provider of choice for quality care.

1986: The Best in Medicine names Jackson Memorial Hospital one of the top 25 medical facilities in the U.S. – the only public hospital to make the list.

1992: Ryder Trauma Center opens just weeks before Hurricane Andrew devastates Miami-Dade.

Values

2001: The Public Health Trust creates Jackson

Service Excellence and Quality Commitment Compassion Teamwork and Communication Respect Confidentiality Integrity and Stewardship Inclusion

Health System, an integrated public health system, and acquires Deering Hospital, which is renamed Jackson South Community Hospital.

2006: Jackson Health System adds Parkway Regional Medical Center, which becomes Jackson North Medical Center.

Jackson South Community Hospital

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Jackson South Community Hospital

Jackson Rehabilitation Hospital

9333 S.W. 152nd Street, Miami, FL 33157

Jackson Rehabilitation Hospital provides comprehensive rehabilitative care to adults, adolescents and children, while helping patients and their families through the recovery process.

Led by a multidisciplinary team, Jackson Rehabilitation Hospital delivers inpatient and outpatient care, as well as support services for patients with spinal cord injuries, brain injuries, and a broad spectrum of medical and physical conditions.

Jackson South Community Hospital offers a full spectrum of services and is staffed by nationally recognized, board-certified physicians and allied healthcare professionals who practice a wide array of specialties and subspecialties. It’s also home to the Urology Center of Excellence and Bariatric Surgery Center of Excellence.

1611 N.W. 12th Avenue, Miami, FL 33136

Jackson Memorial Hospital

Holtz Children’s Hospital 1611 N.W. 12th Avenue, Miami, FL 33136

Your Jackson Health System

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Jackson Memorial Hospital

Jackson North Medical Center

1611 N.W. 12th Avenue, Miami, FL 33136

160 N.W. 170th Street, North Miami Beach, FL 33169

Jackson Memorial Hospital is an accredited, non-profit, tertiary care hospital and the major teaching facility for the University of Miami Miller School of Medicine. With nearly 1,000 licensed beds, it’s a magnet for medical research and home to Ryder Trauma Center – the only adult and pediatric Level I trauma center in Miami-Dade County – and the Miami Transplant Institute, one of the nation’s top transplant programs.

Jackson North Medical Center is home to specialized centers for endovascular disease, fibroids, pain management, back pain, women’s health, wound care and weight-loss surgery. In addition, Jackson North hosts the medical school professors, interns and residents from Florida International University’s Herbert Wertheim College of Medicine.

Holtz Children’s Hospital is one of the largest children’s hospitals in the Southeast and is the exclusive home to the pediatric specialists who serve on the faculty of the University of Miami Miller School of Medicine. Patients here can access breakthrough treatment for complex medical problems often considered untreatable.

Jackson Behavioral Health Hospital 1695 N.W. 9th Avenue, Miami, FL 33136

Jackson Behavioral Health Hospital provides a full continuum of mental health care for children, adolescents, adults and seniors including innovative residential and outpatient programs.

Jackson Behavioral Health Hospital

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Jackson South Community Hospital

Jackson Rehabilitation Hospital

9333 S.W. 152nd Street, Miami, FL 33157

Jackson Rehabilitation Hospital provides comprehensive rehabilitative care to adults, adolescents and children, while helping patients and their families through the recovery process.

Led by a multidisciplinary team, Jackson Rehabilitation Hospital delivers inpatient and outpatient care, as well as support services for patients with spinal cord injuries, brain injuries, and a broad spectrum of medical and physical conditions.

Jackson South Community Hospital offers a full spectrum of services and is staffed by nationally recognized, board-certified physicians and allied healthcare professionals who practice a wide array of specialties and subspecialties. It’s also home to the Urology Center of Excellence and Bariatric Surgery Center of Excellence.

1611 N.W. 12th Avenue, Miami, FL 33136

Jackson Memorial Hospital

Holtz Children’s Hospital 1611 N.W. 12th Avenue, Miami, FL 33136

Your Jackson Health System

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Jackson Memorial Hospital

Jackson North Medical Center

1611 N.W. 12th Avenue, Miami, FL 33136

160 N.W. 170th Street, North Miami Beach, FL 33169

Jackson Memorial Hospital is an accredited, non-profit, tertiary care hospital and the major teaching facility for the University of Miami Miller School of Medicine. With nearly 1,000 licensed beds, it’s a magnet for medical research and home to Ryder Trauma Center – the only adult and pediatric Level I trauma center in Miami-Dade County – and the Miami Transplant Institute, one of the nation’s top transplant programs.

Jackson North Medical Center is home to specialized centers for endovascular disease, fibroids, pain management, back pain, women’s health, wound care and weight-loss surgery. In addition, Jackson North hosts the medical school professors, interns and residents from Florida International University’s Herbert Wertheim College of Medicine.

Holtz Children’s Hospital is one of the largest children’s hospitals in the Southeast and is the exclusive home to the pediatric specialists who serve on the faculty of the University of Miami Miller School of Medicine. Patients here can access breakthrough treatment for complex medical problems often considered untreatable.

Jackson Behavioral Health Hospital 1695 N.W. 9th Avenue, Miami, FL 33136

Jackson Behavioral Health Hospital provides a full continuum of mental health care for children, adolescents, adults and seniors including innovative residential and outpatient programs.

Jackson Behavioral Health Hospital

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Our Locations 1

2

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Jackson Memorial Perdue Medical Center

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Jackson South Community Hospital

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Rosie Lee Wesley Health Center

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Prevention, Education & Treatment (PET) Center

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Downtown Medical Center

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Dr. Rafael A. Peñalver Clinic

Jefferson Reaves, Sr. Health Center

14 Jackson Pediatric Center

Jackson Rehabilitation Hospital

15 Jackson Memorial Long

Jackson Memorial Hospital

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North Dade Health Center

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Jackson North Medical Center

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Jackson North Community Mental Health Center & Crisis Stabilization Unit

(PPEC facility)

Term Care Center

10 Holtz Children’s Hospital 11 Ryder Trauma Center 12

Miami Transplant Institute

13 Jackson Behavioral

Health Hospital

Call 305-585-4DOC to find a Jackson physician.

Welcome To Miami’s Health District Jackson Memorial Hospital is the crown jewel of Jackson Health System and the centerpiece of Miami’s health district.

A short distance from downtown Miami and accessible by Metrorail, bus and car, visitors can walk to dozens of important healthcare resources, including Jackson Memorial Hospital, Holtz Children’s Hospital, Ryder Trauma Center, Bascom Palmer Eye Institute, University of Miami Hospital, the Miami VA Medical Center, Miami-Dade County Health Department, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine’s teaching and research facilities.

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Our Locations 1

2

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Jackson Memorial Perdue Medical Center

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Jackson South Community Hospital

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Rosie Lee Wesley Health Center

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4

Prevention, Education & Treatment (PET) Center

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Downtown Medical Center

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Dr. Rafael A. Peñalver Clinic

Jefferson Reaves, Sr. Health Center

14 Jackson Pediatric Center

Jackson Rehabilitation Hospital

15 Jackson Memorial Long

Jackson Memorial Hospital

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North Dade Health Center

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Jackson North Medical Center

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Jackson North Community Mental Health Center & Crisis Stabilization Unit

(PPEC facility)

Term Care Center

10 Holtz Children’s Hospital 11 Ryder Trauma Center 12

Miami Transplant Institute

13 Jackson Behavioral

Health Hospital

Call 305-585-4DOC to find a Jackson physician.

Welcome To Miami’s Health District Jackson Memorial Hospital is the crown jewel of Jackson Health System and the centerpiece of Miami’s health district.

A short distance from downtown Miami and accessible by Metrorail, bus and car, visitors can walk to dozens of important healthcare resources, including Jackson Memorial Hospital, Holtz Children’s Hospital, Ryder Trauma Center, Bascom Palmer Eye Institute, University of Miami Hospital, the Miami VA Medical Center, Miami-Dade County Health Department, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine’s teaching and research facilities.

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Partnerships That Make A Difference

Awards & Honors For more than a half-century, the University of Miami Miller School of Medicine has worked in tandem with Jackson Health System to provide world-class medical care to patients from South Florida and around the globe. Nearly 90 percent of the physicians practicing at Jackson Memorial Hospital are faculty members of the medical school – doctors who are training the doctors of tomorrow.

This unique relationship offers patients access to up-to-the-minute, breakthrough treatments and the world-renowned physician-scientists involved in the development of these innovations. It also gives our patients access to clinical trials that test new treatments or new approaches to existing therapies.

Most recently, Jackson has welcomed another academic powerhouse, Florida International University and its Herbert Wertheim College of Medicine. FIU faculty practice at Jackson North Medical Center and Jackson Memorial.

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• UM/Jackson Memorial: Named #1 hospital in Miami/ Ft. Lauderdale by U.S. News & World Report in its 2013 rankings.

• Holtz Children’s Hospital: Among the nation’s top children’s hospitals according to U.S. News & World Report’s 2013-14 specialty rankings.

• Miami Transplant Institute: Earned silver-level status for three transplant types and one bronze-level status from the U.S. Department of Health and Human Services’ Division of Transplantation. No transplant program in the U.S. received more honors.

• Jackson Health System: Recognized by the Human Rights Campaign as a “Leader In Healthcare Equality” for policies and practices related to lesbian, gay, bisexual and transgender (LGBT) patients and their families.

• Jackson North Medical Center: Recipient of the 2012 U.S. Environmental Protection Agency’s (EPA) Energy Star® certification – one of only three hospitals in Florida to earn the recognition.

• UM/Jackson Memorial Burn Center at Ryder Trauma Center: Certified as the only burn center in South Florida and one of just 65 in the nation.

• Jackson Memorial Hospital: Recipient of “Get With The Guidelines” Stroke Gold Plus Award from the American Heart Association.

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Partnerships That Make A Difference

Awards & Honors For more than a half-century, the University of Miami Miller School of Medicine has worked in tandem with Jackson Health System to provide world-class medical care to patients from South Florida and around the globe. Nearly 90 percent of the physicians practicing at Jackson Memorial Hospital are faculty members of the medical school – doctors who are training the doctors of tomorrow.

This unique relationship offers patients access to up-to-the-minute, breakthrough treatments and the world-renowned physician-scientists involved in the development of these innovations. It also gives our patients access to clinical trials that test new treatments or new approaches to existing therapies.

Most recently, Jackson has welcomed another academic powerhouse, Florida International University and its Herbert Wertheim College of Medicine. FIU faculty practice at Jackson North Medical Center and Jackson Memorial.

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• UM/Jackson Memorial: Named #1 hospital in Miami/ Ft. Lauderdale by U.S. News & World Report in its 2013 rankings.

• Holtz Children’s Hospital: Among the nation’s top children’s hospitals according to U.S. News & World Report’s 2013-14 specialty rankings.

• Miami Transplant Institute: Earned silver-level status for three transplant types and one bronze-level status from the U.S. Department of Health and Human Services’ Division of Transplantation. No transplant program in the U.S. received more honors.

• Jackson Health System: Recognized by the Human Rights Campaign as a “Leader In Healthcare Equality” for policies and practices related to lesbian, gay, bisexual and transgender (LGBT) patients and their families.

• Jackson North Medical Center: Recipient of the 2012 U.S. Environmental Protection Agency’s (EPA) Energy Star® certification – one of only three hospitals in Florida to earn the recognition.

• UM/Jackson Memorial Burn Center at Ryder Trauma Center: Certified as the only burn center in South Florida and one of just 65 in the nation.

• Jackson Memorial Hospital: Recipient of “Get With The Guidelines” Stroke Gold Plus Award from the American Heart Association.

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Babies In The Most Capable Hands Our neonatal specialists treat infants from the moment they enter the world. For new parents facing complications, Holtz Children’s provides the highest level neonatal care available, seamlessly integrated with Jackson’s maternity services. Our 126-bed Schatzi Kassal Project: New Born Neonatal Intensive Care Unit (NICU), including the largest Level III unit in Florida, provides care for the most critically ill newborns. And our neonatologists and neonatal nursing team address a wide range of complications from premature birth, to congenital defects, to life-threatening illness.

Yasser’s Miracle

Care For The Next Generation Every child deserves a miracle. From preventive care to emergency services, Holtz Children’s Hospital offers exceptional care along with expertise in handling the most complex cases. Our world-class team – comprised of doctors from the University of Miami Miller School of Medicine – addresses patient needs from infancy through young adulthood. In fact, more of Holtz Children’s physicians appear on the 2013 Best Doctors in America® List than any other children’s hospital in South Florida.

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In addition, Holtz Children’s is ranked among the nation’s top children’s hospitals, according to U.S. News & World Report. It was ranked in six specialties: cardiology and heart surgery, diabetes and endocrinology, gastroenterology and GI surgery, neonatology, nephrology and urology.

Holtz Children’s Hospital

Different Because Kids Are Different Children receive care at Holtz Children’s in an environment created just for kids. It promotes health and healing, featuring a colorful, welcoming setting to help children feel safe and stimulate their imaginations.

Waiting areas and patient rooms feature fun décor, kid-friendly artwork and inspiring themes from space travel to jungle adventure.

When 16-year-old Yasser Lopez went fishing with friends, a spear gun accidentally fired and hit him in the head, leaving approximately three feet of the spear protruding from his forehead. Conscious and talking, he was transported to Ryder Trauma Center where he was rushed to surgery. Trauma surgeons and neurosurgeons successfully removed the spear from his skull and brain. Today, Yasser is back to enjoying his active lifestyle.

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Babies In The Most Capable Hands Our neonatal specialists treat infants from the moment they enter the world. For new parents facing complications, Holtz Children’s provides the highest level neonatal care available, seamlessly integrated with Jackson’s maternity services. Our 126-bed Schatzi Kassal Project: New Born Neonatal Intensive Care Unit (NICU), including the largest Level III unit in Florida, provides care for the most critically ill newborns. And our neonatologists and neonatal nursing team address a wide range of complications from premature birth, to congenital defects, to life-threatening illness.

Yasser’s Miracle

Care For The Next Generation Every child deserves a miracle. From preventive care to emergency services, Holtz Children’s Hospital offers exceptional care along with expertise in handling the most complex cases. Our world-class team – comprised of doctors from the University of Miami Miller School of Medicine – addresses patient needs from infancy through young adulthood. In fact, more of Holtz Children’s physicians appear on the 2013 Best Doctors in America® List than any other children’s hospital in South Florida.

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In addition, Holtz Children’s is ranked among the nation’s top children’s hospitals, according to U.S. News & World Report. It was ranked in six specialties: cardiology and heart surgery, diabetes and endocrinology, gastroenterology and GI surgery, neonatology, nephrology and urology.

Holtz Children’s Hospital

Different Because Kids Are Different Children receive care at Holtz Children’s in an environment created just for kids. It promotes health and healing, featuring a colorful, welcoming setting to help children feel safe and stimulate their imaginations.

Waiting areas and patient rooms feature fun décor, kid-friendly artwork and inspiring themes from space travel to jungle adventure.

When 16-year-old Yasser Lopez went fishing with friends, a spear gun accidentally fired and hit him in the head, leaving approximately three feet of the spear protruding from his forehead. Conscious and talking, he was transported to Ryder Trauma Center where he was rushed to surgery. Trauma surgeons and neurosurgeons successfully removed the spear from his skull and brain. Today, Yasser is back to enjoying his active lifestyle.

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Child Life Services Creating a unique environment for kids goes beyond child-friendly décor.

Holtz Children’s boasts a leading Child Life Services program to provide emotional support for patients and their families. The program includes: • Professional support from child life specialists • Recreational and pet therapy • Availability of “safe” playrooms where no medical procedures take place • Special visitors, including a Foster Grandparent program, volunteers, artists, musicians and professional athletes

Making Miracles Inside The Womb

Miracles For The Tiniest Patients

The Jackson Fetal Therapy Institute handles some of the most complex cases in the world. As the only fetal therapy center in the southeastern United States, our team manages dozens of rare conditions for hundreds of expectant parents each year. In addition, the Jackson Fetal Therapy Institute is part of the U.S. Fetus consortium, which conducts breakthrough research and provides our patients with access to the newest, most cutting-edge treatments available.

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Photo by Jenn Hopkins Photography

When serious complications arise during pregnancy, expectant parents from around the world turn to the unique expertise of the Jackson Fetal Therapy Institute at Jackson Memorial Hospital. Here, the team of obstetric surgeons, nurses, sonographers and pediatric subspecialists focus on diagnosing and treating birth defects and high-risk conditions during pregnancy – while the baby is still inside the mother’s womb.

Midway through her pregnancy, Tammy Gonzalez learned the daughter in her womb had a tennis-ball-sized tumor growing from her mouth and that the baby would likely not survive. That’s when she sought help from Dr. Rubén Quintero and Dr. Eftichia Kontopoulos at the Jackson Fetal Therapy Institute. They surgically removed the tumor during pregnancy – the first such surgery in history – and little Leyna was born healthy with just a tiny scar on her mouth.

The Tattersall twins, treated for twin-twin transfusion syndrome.

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Child Life Services Creating a unique environment for kids goes beyond child-friendly décor.

Holtz Children’s boasts a leading Child Life Services program to provide emotional support for patients and their families. The program includes: • Professional support from child life specialists • Recreational and pet therapy • Availability of “safe” playrooms where no medical procedures take place • Special visitors, including a Foster Grandparent program, volunteers, artists, musicians and professional athletes

Making Miracles Inside The Womb

Miracles For The Tiniest Patients

The Jackson Fetal Therapy Institute handles some of the most complex cases in the world. As the only fetal therapy center in the southeastern United States, our team manages dozens of rare conditions for hundreds of expectant parents each year. In addition, the Jackson Fetal Therapy Institute is part of the U.S. Fetus consortium, which conducts breakthrough research and provides our patients with access to the newest, most cutting-edge treatments available.

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Photo by Jenn Hopkins Photography

When serious complications arise during pregnancy, expectant parents from around the world turn to the unique expertise of the Jackson Fetal Therapy Institute at Jackson Memorial Hospital. Here, the team of obstetric surgeons, nurses, sonographers and pediatric subspecialists focus on diagnosing and treating birth defects and high-risk conditions during pregnancy – while the baby is still inside the mother’s womb.

Midway through her pregnancy, Tammy Gonzalez learned the daughter in her womb had a tennis-ball-sized tumor growing from her mouth and that the baby would likely not survive. That’s when she sought help from Dr. Rubén Quintero and Dr. Eftichia Kontopoulos at the Jackson Fetal Therapy Institute. They surgically removed the tumor during pregnancy – the first such surgery in history – and little Leyna was born healthy with just a tiny scar on her mouth.

The Tattersall twins, treated for twin-twin transfusion syndrome.

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More Than 20 Years Of Saving Lives A Cool Miracle For Spinal Cord Injuries Champion gymnast Jorge Valdes was practicing for a Cirque du Soleil audition when he landed on his head. Unable to feel his legs and chest, the 21-year-old was airlifted to Ryder. The trauma team administered hypothermia treatment, cooling his body to reduce swelling on his spinal cord. A week after surgery and treatment at Ryder, Jorge walked out of the hospital. He’s now fully recovered and continuing to pursue his goals.

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Since 1992, the doctors, nurses and staff at Ryder Trauma Center have been saving the lives of people with critical injuries. Ryder is the only adult and pediatric Level I trauma center in Miami-Dade County, which means it provides the highest level of trauma care possible. It also means that when someone is seriously hurt, the only place to go is Ryder.

Trauma Training For The Front Lines The trauma team at Ryder sees patients with injuries unimaginable to most of us. It’s why the U.S. Department of Defense selected the center as the only surgical facility up to the task of training its military surgeons.

For more than a decade, the U.S. Army’s forward surgical teams have trained at Ryder before deployment to war zones. And now the U.S. Air Force has joined them as well.

Ryder also conducts specialized education and training, extensive injury research, clinical trials, and telemedicine programs to share life-saving techniques with hospitals worldwide. This expertise is what makes Ryder the most experienced trauma center in South Florida.

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More Than 20 Years Of Saving Lives A Cool Miracle For Spinal Cord Injuries Champion gymnast Jorge Valdes was practicing for a Cirque du Soleil audition when he landed on his head. Unable to feel his legs and chest, the 21-year-old was airlifted to Ryder. The trauma team administered hypothermia treatment, cooling his body to reduce swelling on his spinal cord. A week after surgery and treatment at Ryder, Jorge walked out of the hospital. He’s now fully recovered and continuing to pursue his goals.

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Since 1992, the doctors, nurses and staff at Ryder Trauma Center have been saving the lives of people with critical injuries. Ryder is the only adult and pediatric Level I trauma center in Miami-Dade County, which means it provides the highest level of trauma care possible. It also means that when someone is seriously hurt, the only place to go is Ryder.

Trauma Training For The Front Lines The trauma team at Ryder sees patients with injuries unimaginable to most of us. It’s why the U.S. Department of Defense selected the center as the only surgical facility up to the task of training its military surgeons.

For more than a decade, the U.S. Army’s forward surgical teams have trained at Ryder before deployment to war zones. And now the U.S. Air Force has joined them as well.

Ryder also conducts specialized education and training, extensive injury research, clinical trials, and telemedicine programs to share life-saving techniques with hospitals worldwide. This expertise is what makes Ryder the most experienced trauma center in South Florida.

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Tipping The Scales Toward Better Health Finding Balance After WeightLoss Surgery Ozabeth Sheffield weighed 300 pounds at her heaviest and suffered from diabetes, hypertension, asthma and knee pain. After her gastric bypass procedure at Jackson North Medical Center, she lost 20 pounds in the first week. Now 150 pounds lighter, Ozabeth says that having bariatric surgery was the best decision she ever made. “While you have to do your part, weight-loss surgery can do so much for your outlook, relationships and health. The surgery saved me. It added years to my life and changed my marriage, and I’m happier now.”

When diet and exercise don’t help people shed excess weight, many turn to the world-class teams at our ASMBS Bariatric Surgery Centers of Excellence at Jackson North Medical Center and Jackson South Community Hospital.

The ASMBS Bariatric Surgery Center of Excellence designation by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program was awarded to Jackson North in March 2012 and to Jackson South soon thereafter. Centers that earn the designation must provide superior patient care, promote optimal levels of performance, and advance the safety, efficacy and efficiency of bariatric and metabolic surgical care.

Our surgeons are pioneers in the field of bariatric surgery and have patented instruments to use in bariatric procedures. They have also led international studies and authored numerous articles. Jackson South’s Center of Excellence specializes in laparoscopic sleeve gastrectomy, also known as “gastric sleeve,” one of the newest bariatric procedures available.

At Jackson North, patients can also select the gastric sleeve procedure, as well as Roux-en-Y gastric bypass or gastric banding, which sometimes uses the Lapband® device. In addition to surgery, patients receive support for psychological issues associated with surgical weight loss, diet and fitness, and recovery.

Read these patients’ weight-loss success stories and others’ at JacksonCanHelp.org.

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Tipping The Scales Toward Better Health Finding Balance After WeightLoss Surgery Ozabeth Sheffield weighed 300 pounds at her heaviest and suffered from diabetes, hypertension, asthma and knee pain. After her gastric bypass procedure at Jackson North Medical Center, she lost 20 pounds in the first week. Now 150 pounds lighter, Ozabeth says that having bariatric surgery was the best decision she ever made. “While you have to do your part, weight-loss surgery can do so much for your outlook, relationships and health. The surgery saved me. It added years to my life and changed my marriage, and I’m happier now.”

When diet and exercise don’t help people shed excess weight, many turn to the world-class teams at our ASMBS Bariatric Surgery Centers of Excellence at Jackson North Medical Center and Jackson South Community Hospital.

The ASMBS Bariatric Surgery Center of Excellence designation by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program was awarded to Jackson North in March 2012 and to Jackson South soon thereafter. Centers that earn the designation must provide superior patient care, promote optimal levels of performance, and advance the safety, efficacy and efficiency of bariatric and metabolic surgical care.

Our surgeons are pioneers in the field of bariatric surgery and have patented instruments to use in bariatric procedures. They have also led international studies and authored numerous articles. Jackson South’s Center of Excellence specializes in laparoscopic sleeve gastrectomy, also known as “gastric sleeve,” one of the newest bariatric procedures available.

At Jackson North, patients can also select the gastric sleeve procedure, as well as Roux-en-Y gastric bypass or gastric banding, which sometimes uses the Lapband® device. In addition to surgery, patients receive support for psychological issues associated with surgical weight loss, diet and fitness, and recovery.

Read these patients’ weight-loss success stories and others’ at JacksonCanHelp.org.

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A Transplant Leader Established more than 40 years ago, the Miami Transplant Institute has grown to become one of the largest and most comprehensive transplant centers in the world. Here, our surgeons perform more than 450 organ transplant procedures each year. Moreover, ours is the only program in Florida to perform every type of organ transplant, including: • Heart Transplants • Intestinal and Multivisceral Transplants • Kidney Transplants

A Big Miracle For A Little Girl

• Liver Transplants • Living Donor Kidney Transplants • Lung Transplants • Pancreas Transplants and Combination Pancreas-Kidney Transplants

Transplant Trifecta

Six-year-old Angela Bushi, diagnosed with Wolcott-Rallison Syndrome, was treated with an innovative plan that included a life-saving transplant – the first combined liver, kidney and pancreas transplant ever performed on a child and the first time in history that transplantation was used to treat WRS.

This past year, the Miami Transplant Institute earned silver-level awards from the U.S. Department of Health and Human Services’ Division of Transplantation for its kidney, kidney-pancreas and lung transplant programs.

The institute also received a bronze-level award for its heart transplant program. No transplant program in the U.S. has received more awards.

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A Transplant Leader Established more than 40 years ago, the Miami Transplant Institute has grown to become one of the largest and most comprehensive transplant centers in the world. Here, our surgeons perform more than 450 organ transplant procedures each year. Moreover, ours is the only program in Florida to perform every type of organ transplant, including: • Heart Transplants • Intestinal and Multivisceral Transplants • Kidney Transplants

A Big Miracle For A Little Girl

• Liver Transplants • Living Donor Kidney Transplants • Lung Transplants • Pancreas Transplants and Combination Pancreas-Kidney Transplants

Transplant Trifecta

Six-year-old Angela Bushi, diagnosed with Wolcott-Rallison Syndrome, was treated with an innovative plan that included a life-saving transplant – the first combined liver, kidney and pancreas transplant ever performed on a child and the first time in history that transplantation was used to treat WRS.

This past year, the Miami Transplant Institute earned silver-level awards from the U.S. Department of Health and Human Services’ Division of Transplantation for its kidney, kidney-pancreas and lung transplant programs.

The institute also received a bronze-level award for its heart transplant program. No transplant program in the U.S. has received more awards.

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Making Miracles For International Patients Jackson International connects patients from around the globe with expert treatment for complex medical care. In addition, Jackson International’s team provides these patients and their families with attentive, detail-oriented service to eliminate stress and worry.

An International “Frequent Flyer�

In 2007, Fatema Al Ansara flew halfway around the globe from her home in Quatar to receive a life-saving five-organ transplant at Jackson Memorial. Then in 2011, when she became pregnant through in vitro fertilization, Fatema knew there was only one place she felt comfortable giving birth. She returned to Jackson and made history as the first five-organ transplant patient to conceive and deliver a child.

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Because it can be challenging to travel to a new country for care, Jackson International patients have access to our medical concierge and hospitality program. The program assigns a hospitality coordinator who provides compassionate, professional and personal assistance 24 hours a day.

Recognizing the unique needs of international patients and their families, Jackson International developed the BUPA International Patient Reception Center at Jackson Memorial Hospital, an upscale oasis. The center features first-class hospital amenities in addition to luxurious waiting areas, examination rooms and a full-service business center.

The center assists with every aspect of the process from inpatient and outpatient referrals to emergency and trauma care.

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Making Miracles For International Patients Jackson International connects patients from around the globe with expert treatment for complex medical care. In addition, Jackson International’s team provides these patients and their families with attentive, detail-oriented service to eliminate stress and worry.

An International “Frequent Flyer�

In 2007, Fatema Al Ansara flew halfway around the globe from her home in Quatar to receive a life-saving five-organ transplant at Jackson Memorial. Then in 2011, when she became pregnant through in vitro fertilization, Fatema knew there was only one place she felt comfortable giving birth. She returned to Jackson and made history as the first five-organ transplant patient to conceive and deliver a child.

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Because it can be challenging to travel to a new country for care, Jackson International patients have access to our medical concierge and hospitality program. The program assigns a hospitality coordinator who provides compassionate, professional and personal assistance 24 hours a day.

Recognizing the unique needs of international patients and their families, Jackson International developed the BUPA International Patient Reception Center at Jackson Memorial Hospital, an upscale oasis. The center features first-class hospital amenities in addition to luxurious waiting areas, examination rooms and a full-service business center.

The center assists with every aspect of the process from inpatient and outpatient referrals to emergency and trauma care.

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Miracles For Every Member Of Our Community

Jackson Health System also delivers preventive care to adults and children. Holtz Children’s supports outreach, delivers free or low-cost services, and operates grant-funded education programs for children who need help. Initiatives include: • School-Based Health Clinics: Through The Children’s Trust, Holtz Children’s and Jackson Health System provide health care in 18 elementary, middle and high schools in Miami-Dade County.

• Injury Prevention: Holtz Children’s offers age-specific, free programs throughout the county on topics such as bike safety, fire safety, water safety, home safety,

As Miami-Dade County’s only public health system, Jackson’s responsibility includes delivering care to all members of our community oftentimes by literally bringing care to populations who cannot easily access our facilities.

passenger safety and poison prevention.

• Health Education Materials: Holtz Children’s develops and distributes more than 300,000 informational brochures four times a year to all Miami-Dade County

That’s why Jackson unveiled a new mobile mammogram screening unit – Miami-Dade County’s first mobile mammogram unit equipped with digital mammography technology. The mobile unit visits wellness events and health fairs, as well as primary healthcare providers to ensure that women have reduced-cost or free access to screening mammography.

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public school children to share seasonally relevant health information.

In addition, we hold health fairs and clinics to improve awareness about health – and to keep our neighbors healthy.

Jackson Primary Care Centers Dr. Rafael A. Peñalver Clinic 971 N.W. 2nd Street Miami, FL 33128 Jefferson Reaves, Sr. Health Center 1009 N.W. 5th Avenue Miami, FL 33136 North Dade Health Center 16555 N.W. 25th Avenue Miami Gardens, FL 33054 Rosie Lee Wesley Health Center 6601 S.W. 62nd Avenue South Miami, FL 33143 Prevention, Education & Treatment (PET) Center 615 Collins Avenue Miami Beach, FL 33139 Call 305-585-6000 to schedule an appointment at one of our primary care centers.

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Miracles For Every Member Of Our Community

Jackson Health System also delivers preventive care to adults and children. Holtz Children’s supports outreach, delivers free or low-cost services, and operates grant-funded education programs for children who need help. Initiatives include: • School-Based Health Clinics: Through The Children’s Trust, Holtz Children’s and Jackson Health System provide health care in 18 elementary, middle and high schools in Miami-Dade County.

• Injury Prevention: Holtz Children’s offers age-specific, free programs throughout the county on topics such as bike safety, fire safety, water safety, home safety,

As Miami-Dade County’s only public health system, Jackson’s responsibility includes delivering care to all members of our community oftentimes by literally bringing care to populations who cannot easily access our facilities.

passenger safety and poison prevention.

• Health Education Materials: Holtz Children’s develops and distributes more than 300,000 informational brochures four times a year to all Miami-Dade County

That’s why Jackson unveiled a new mobile mammogram screening unit – Miami-Dade County’s first mobile mammogram unit equipped with digital mammography technology. The mobile unit visits wellness events and health fairs, as well as primary healthcare providers to ensure that women have reduced-cost or free access to screening mammography.

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public school children to share seasonally relevant health information.

In addition, we hold health fairs and clinics to improve awareness about health – and to keep our neighbors healthy.

Jackson Primary Care Centers Dr. Rafael A. Peñalver Clinic 971 N.W. 2nd Street Miami, FL 33128 Jefferson Reaves, Sr. Health Center 1009 N.W. 5th Avenue Miami, FL 33136 North Dade Health Center 16555 N.W. 25th Avenue Miami Gardens, FL 33054 Rosie Lee Wesley Health Center 6601 S.W. 62nd Avenue South Miami, FL 33143 Prevention, Education & Treatment (PET) Center 615 Collins Avenue Miami Beach, FL 33139 Call 305-585-6000 to schedule an appointment at one of our primary care centers.

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Facts & Statistics (Oct. 1, 2011 - Sept. 30, 2012) Jackson Memorial Hospital

Jackson North Medical Center

Jackson Rehabilitation Hospital

Ambulatory Care Services

Inpatient Services Number of Licensed Beds: 961 Hospital Admissions (excluding newborn): 32,773 Births: 3,699

Inpatient Services Number of Licensed Beds: 382 Hospital Admissions (excluding newborn): 9,583 Births: 1,744

Inpatient Services Number of Licensed Beds: 80 Hospital Admissions (adult & pediatric): 875

Emergency Services Visits to Emergency Department (adult): 81,593 Ryder Trauma Center Cases (adult & pediatric): 3,788

Outpatient Services Visits to Emergency Services (adult & pediatric): 45,878

Health Clinic Visits Ambulatory Care Center (East & West): 118,288 North Dade Health Center: 23,117 Jefferson Reaves, Sr. Health Center: 21,121 Rosie Lee Wesley Health Center: 14,874 Prevention, Education & Treatment (PET) Center: 3,497 Downtown Medical Center: 3,533

Holtz Children’s Hospital Inpatient Services Number of Licensed Beds: 218 Hospital Admissions: 10,956 Outpatient Services Visits to Emergency Services (pediatric): 21,470 Visits to Outpatient Clinics (pediatric): 15,607

Jackson South Community Hospital Inpatient Services Number of Licensed Beds: 226 Hospital Admissions (excluding newborn): 9,394 Births: 968 Outpatient Services Visits to Emergency Services (adult & pediatric): 42,439

Outpatient Services Rehabilitation Clinic Visits (adult & pediatric): 550

Jackson Behavioral Health Hospital Inpatient Services Number of Licensed Beds: 239 Hospital Admissions (adult & pediatric): 6,201 Outpatient Services Visits to Outpatient Clinics (adult & pediatric): 206,358

Jackson Memorial Long Term Care Center Number of Licensed Beds: 180 Average Daily Census: 176

Jackson Memorial Perdue Medical Center Number of Licensed Beds: 163 Average Daily Census: 136

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Facts & Statistics (Oct. 1, 2011 - Sept. 30, 2012) Jackson Memorial Hospital

Jackson North Medical Center

Jackson Rehabilitation Hospital

Ambulatory Care Services

Inpatient Services Number of Licensed Beds: 961 Hospital Admissions (excluding newborn): 32,773 Births: 3,699

Inpatient Services Number of Licensed Beds: 382 Hospital Admissions (excluding newborn): 9,583 Births: 1,744

Inpatient Services Number of Licensed Beds: 80 Hospital Admissions (adult & pediatric): 875

Emergency Services Visits to Emergency Department (adult): 81,593 Ryder Trauma Center Cases (adult & pediatric): 3,788

Outpatient Services Visits to Emergency Services (adult & pediatric): 45,878

Health Clinic Visits Ambulatory Care Center (East & West): 118,288 North Dade Health Center: 23,117 Jefferson Reaves, Sr. Health Center: 21,121 Rosie Lee Wesley Health Center: 14,874 Prevention, Education & Treatment (PET) Center: 3,497 Downtown Medical Center: 3,533

Holtz Children’s Hospital Inpatient Services Number of Licensed Beds: 218 Hospital Admissions: 10,956 Outpatient Services Visits to Emergency Services (pediatric): 21,470 Visits to Outpatient Clinics (pediatric): 15,607

Jackson South Community Hospital Inpatient Services Number of Licensed Beds: 226 Hospital Admissions (excluding newborn): 9,394 Births: 968 Outpatient Services Visits to Emergency Services (adult & pediatric): 42,439

Outpatient Services Rehabilitation Clinic Visits (adult & pediatric): 550

Jackson Behavioral Health Hospital Inpatient Services Number of Licensed Beds: 239 Hospital Admissions (adult & pediatric): 6,201 Outpatient Services Visits to Outpatient Clinics (adult & pediatric): 206,358

Jackson Memorial Long Term Care Center Number of Licensed Beds: 180 Average Daily Census: 176

Jackson Memorial Perdue Medical Center Number of Licensed Beds: 163 Average Daily Census: 136

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Financial Information FY 2012

Leadership 2013

When the current leadership team came to Jackson Health System in 2011, the system risked losing $415 million by the close of the fiscal year 2012. Instead, Jackson showed a miraculous surplus of nearly $8.2 million.

Public Health Trust Board of Trustees

Miami-Dade County Mayor Carlos A. Gimenez

Darryl K. Sharpton, Chairman Joe Arriola, Vice Chairman Irene Lipof, Ed.D., Secretary Mojdeh L. Khaghan, Treasurer Marcos José Lapciuc, Member Michael Bileca, Member

Board of County Commissioners Miami-Dade County, Florida

Total Revenue....................................................$1,558,973,791 Patient Services....................................................$797,723,708 1/2 Cent Sales Tax...............................................$202,479,726 County Tax Support............................................$133,361,996 JMH Health Plan................................................$105,304,844 Other Revenue....................................................$320,103,517 Total Expenses...................................................$1,550,774,033 Compensation & Benefits....................................$828,206,429 Operational Expenses...........................................$535,913,812 Pharmaceutical & Other......................................$186,653,792 Excess Revenue..................................................$8,199,758

Charity Care......................................................$392,534,945

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Rebeca Sosa, Chairwoman, District 6 Lynda Bell, Vice Chair, District 8 Barbara J. Jordan, District 1 Jean Monestime, District 2 Audrey Edmonson, District 3 Sally A. Heyman, District 4 Bruno A. Barreiro, District 5 Xavier L. Suarez, District 7 Dennis C. Moss, District 9 Javier D. Souto, District 10 Juan C. Zapata, District 11 José “Pepe” Diaz, District 12 Esteban Bovo, Jr., District 13

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Financial Information FY 2012

Leadership 2013

When the current leadership team came to Jackson Health System in 2011, the system risked losing $415 million by the close of the fiscal year 2012. Instead, Jackson showed a miraculous surplus of nearly $8.2 million.

Public Health Trust Board of Trustees

Miami-Dade County Mayor Carlos A. Gimenez

Darryl K. Sharpton, Chairman Joe Arriola, Vice Chairman Irene Lipof, Ed.D., Secretary Mojdeh L. Khaghan, Treasurer Marcos José Lapciuc, Member Michael Bileca, Member

Board of County Commissioners Miami-Dade County, Florida

Total Revenue....................................................$1,558,973,791 Patient Services....................................................$797,723,708 1/2 Cent Sales Tax...............................................$202,479,726 County Tax Support............................................$133,361,996 JMH Health Plan................................................$105,304,844 Other Revenue....................................................$320,103,517 Total Expenses...................................................$1,550,774,033 Compensation & Benefits....................................$828,206,429 Operational Expenses...........................................$535,913,812 Pharmaceutical & Other......................................$186,653,792 Excess Revenue..................................................$8,199,758

Charity Care......................................................$392,534,945

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Rebeca Sosa, Chairwoman, District 6 Lynda Bell, Vice Chair, District 8 Barbara J. Jordan, District 1 Jean Monestime, District 2 Audrey Edmonson, District 3 Sally A. Heyman, District 4 Bruno A. Barreiro, District 5 Xavier L. Suarez, District 7 Dennis C. Moss, District 9 Javier D. Souto, District 10 Juan C. Zapata, District 11 José “Pepe” Diaz, District 12 Esteban Bovo, Jr., District 13

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Making Miracles 2013 Report To The Community 1611 N.W. 12th Avenue Miami, FL 33136

www.JacksonHealth.org

Facebook: Jackson Health System

Get To Know

Jackson

Twitter: @jacksonhealth

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Jackson Memorial Hospital • Jackson North Medical Center • Jackson South Community Hospital Holtz Children’s Hospital • Jackson Behavioral Health Hospital • Jackson Rehabilitation Hospital