2 0 11 2 0 12 M I H S A n n u A l r e p o r t

M A R icopA cou n t y Speci A l H e A lt H cA R e DiSt R ict BoA R D of Di R ectoR S

Susan Gerard Chairman - District 3

Alice Lara Vice Chairman - District 5

Bil Bruno District 1

Donald Rumer-Rivera District 2

Elbert Bicknell District 4

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De A R f R i en DS
For many residents of Maricopa County, the Maricopa Medical Center is just a towering edifice they zoom past while driving by on the interstate. As Chairman of the Special Health Care District Board of Directors, it is my distinct pleasure to invite you to step into the hospital and learn about the remarkable transformation taking place in the states only public health care system. I am honored to work with other publicly elected members of the MIHS Board, President and CEO Betsey Bayless, the MIHS staff and the doctors, nurses and technicians at Maricopa Medical Center, Desert Vista Behavioral Health Center, the 11 neighborhood clinics and other medical facilities that make up the states only safety net system. Together, they play a vital role in keeping our communities, our county, our state and our region healthy. Maricopa is the only hospital in Arizona with Adult and Pediatric trauma centers verified by the American College of Surgeons. It is also a nationally recognized teaching hospital now formally affiliated with the University of Arizona College of Medicine Phoenix. Maricopa houses the internationally acclaimed Arizona Burn Center, the only Burn Center in Arizona verified by the American Burn Association and The American College of Surgeons. In addition, MIHS operates the McDowell Healthcare Center, the largest provider of comprehensive and coordinated HIV-related medical care for adults in Maricopa County. Maricopa is also the place that thinks about the unthinkable, standing ready to care for the community in the event of a natural or man-made disaster. This success can only be achieved with the partnership of you and other members of the community. We are fortunate to live in a community with residents who support a health care system that is a safety net and a center of education. I invite you to stay informed of our system by following us on Facebook, attending one of our monthly board meeting and by visiting our web site, www.mihs.org. Or, please find out for yourself about the amazing things happening at MIHS by getting your comprehensive, patientcentered health care from one of our neighborhood clinics. You wont be disappointed. Susan Gerard Chairman - District 3

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HiStoRy
A strong public hospital has always been part of Maricopa County even before Arizona statehood. The first site -- 160 acres at Durango and 35th Avenue -- was purchased in 1898 for $5,650 for a "poor farm and convalescent hospital. It was more than four miles from downtown Phoenix. The old county hospital was developed and licensed over the next 70 years until Maricopa Medical Center opened in 1971 at 24th Street and Roosevelt. By the 1990s, the hospital was in financial distress and in danger of closing. In 2003, Maricopa County voters approved creation of a special health care district and an elected five-member Board of Directors to save the system. The new board believed Maricopa could move from survival to sustainability to success. Working with President and CEO Betsey Bayless, they began a turnaround that surprised naysayers who had predicted the states only public hospital would disappear. With the dedication and hard work of MIHS management, our physician partners, District Medical Group, and administrative teams, Maricopa has been restored to financial health. This remarkable turnaround has allowed Maricopa to counter decades of disinvestment and rebuild itself into a modern health system, including a new state of the art electronic patient medical record and financial database. Much has changed around Maricopa, but one constant is the dedication of the staff. Our physicians are among the best in the region and theyre part of a team that includes great nurses and support staff. MIHS leadership is striving to provide them with all facilities, equipment and support they need so that Maricopa can continue to provide better, more efficient patient care for years to come.

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A M e SSAge f RoM pR e Si Den t A n D ceo BetSe y BAy l e SS

The last year has brought dramatic change and improvement to our health care system. Just walk around any MIHS facility these days and you can see and feel the difference. Take Epic, the new electronic medical record and finance system that gives our medical staff access to nearly 300,000 patient records, including up-tothe-minute test results. We opened a new state of the art Pediatric Emergency Department, nearly doubling its size. There are newly renovated Labor and Delivery Rooms, a new cardiac facility and new imaging equipment. Nearly 300 patient rooms have been upgraded. Patient satisfaction scores are up and public perceptions are changing of a system that suffered from neglect for decades. In 2011, we signed a historic agreement with the University of Arizona College of Medicine-Phoenix to become the colleges primary teaching partner. It is a role clearly suited for MIHS because we have trained the greatest number of health professionals in Arizona. Working together with our medical staff partner, District Medical Group, and our medical school partner, UA College of Medicine-Phoenix, we are creating a health system for the future. Our growth plans include: a. Expanding a robust primary care network of geographically convenient clinics. b. Expanding our network of Integrated Health Homes, designed to treat the whole health mind, body and spirit of persons with serious mental illness. c. Implementing medical home models for preventive care and chronic disease management; and d. Investing in a state-of-the-art hospital. We continue to face challenges, including big cuts in the Arizona Health Care Cost Containment System. While these cuts are hurting all safety net providers, MIHS has been uniquely impacted because we have a large Medicaid population. In 2011, MIHS provided $54.6 million in charity care and had a Medicaid/ AHCCCS cost shortfall of $65.9 million. The total of these uncovered expenses for indigent care was $120.5 million. We are working hard to improve efficiencies and ensure fiscal responsibility so that MIHS will be able to provide top quality care for generations to come. All these improvements benefit the entire community, including those who never step foot in the door of our facilities. Maricopa is truly reinventing itself and I want to thank those visionaries who believed in us all along the way. Betsey Bayless President and CEO

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MiHS MiSSion / v iSion

Mission:
Maricopa Integrated Health System is committed to offering comprehensive and safe care to all of those who live in Maricopa County, including the underserved and medically needy, through a seamless continuum of care that keeps our community healthy and self-sufficient and effectively treats illness. We are committed to fostering academic programs that train physicians for the community and conduct clinical research to improve health care outcomes.

Vision:
Maricopa Integrated Health System will be a preferred health care provider available to all people of Maricopa County, an effective financial steward of resources, and a nationally-recognized leader in creating new partnerships and collaborations that will be models of excellent health care delivery.

Values:
Respect Compassion Collaboration Excellence Stewardship Leadership Integrity Education Innovation Accountability

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coM M it t eD to ou R coM M u n it y
The mission of Maricopa Integrated Health System (MIHS) is a vital one. For more than 100 years, our health care system has had a strong legacy of delivering high quality care in a top-notch health setting to the citizens of Maricopa County and beyond. As the Valleys premier teaching hospital, MIHS remains at the forefront of training physicians for our future. As the States only Public Health Care System, we are committed to providing quality health care outcomes to all members of our community regardless of their ability to pay. We provide leadership in patient care, education and research throughout Maricopa County, and have recently become the principal academic affiliate of the University of Arizona College of Medicine Phoenix in providing excellent training in a variety of residency and fellowship programs under the guidance of a highly-experienced physician staff. We have a long tradition of providing community-focused health care services to our diverse patient population. Our hospital understands your needs and has responded to them with a team of highly-skilled physicians, nurses, and allied health staff within a state of the art, family friendly environment that is both welcoming and efficient. Our flagship campus features Maricopa Medical Center which has been recognized by U.S. News and World Report in its report on "America's Best Hospitals" for excellence in respiratory disorders, urology, medical care, education and research. We are also home to the Arizona Burn Center, the second busiest burn center in the United States. Our focus is in serving the medical needs of entire families through our diverse medical services and physician specialists. We are committed to providing compassionate care, outstanding medical services, and preparing doctors to meet your future medical needs. Its at the core of what we do each day.

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HigH l igH tS
Academic Affiliation with the University of Arizona College of Medicine - Phoenix
In June 2011, Maricopa Integrated Health System, District Medical Group, and the University of Arizona College of Medicine Phoenix embarked on an affiliation agreement that strengthens medical education for Arizonas future. The collaboration will ensure that UA medical students will receive a rich, world-class education experience from MIHS, which has trained thousands of doctors since the 1950s. Under the agreement, Maricopa Integrated Health System and District Medical Group designate the UA College of Medicine Phoenix as their primary academic affiliate in the Phoenix metropolitan area, and the College of Medicine Phoenix designates MIHS as the primary academic medical center and DMG as a primary faculty practice plan. This affiliation agreement will not only enhance the mission of each of our organizations but also promises tremendous rewards for our entire community. Our missions align well. We are each committed to superior patient care and providing the best training to the next generation of physicians who will serve the future health care needs of the people of Arizona for decades to come.

Partners in Excellence

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the uA is seeking clinical environments where patient care is personalized, team-based, technologically advanced and applied from clinical research. MiHS will be the place where that happens.
- Betsey Bayless, President and CEO, Maricopa Integrated Health System

"We have had students and residents in the Maricopa integrated Health System for four decades. now, as we prepare to expand our class size, the need for quality medical education also increases and MiHS is critical to that progression."
- Stuart D. Flynn, M.D., Dean of UA College of Medicine - Phoenix

this affiliation will enhance the medical schools reputation and its top-tier status and helps us further address the physician shortage in our state while improving health care delivery in the community.
- Fred DuVal, Former Chair-elect of the Arizona Board of Regents.

the affiliation positions us to collaboratively train and retain primary care providers and specialists in Arizona to meet future medical care needs.
- Kote Chundu, M.D., President and CEO of District Medical Group

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peDi At R ic eM eRgenc y DepA Rt M en t ex pA nSion

In August 2011 we held the official grand opening celebration of our new Arizona Childrens Center Pediatric Emergency Department at Maricopa Medical Center with many of our former pediatric emergency department patients joining us to celebrate. The $4.6 million dollar renovation and expansion dramatically improves the space in which care is provided to our youngest patients. The renovation nearly doubles the physical size of the department to 11,000 square feet from 6,000 square feet. Our improved Pediatric ED includes 12 newly designed exam rooms, a two-bed critical care room, six holding rooms and a room for special procedures. In addition to being family friendly and state of the art, all ED beds are centrally monitored with staff equipped to handle any emergency. Each family-friendly patient room is designed and configured to provide maximum privacy and comfort. A new nursing station allows for direct line of sight to patient rooms as well as improved staff efficiency. The new pediatric ED also includes the latest emergency medical equipment and a new west entrance circular drive providing convenient patient pickup and drop off. Under the leadership of Alan Frechette, M.D., Medical Director of the Pediatric Emergency Department, our pediatric emergency department is staffed with specially trained pediatric emergency physicians and nurses ready to treat seriously injured children and teens 24 hours a day, seven days a week. Able to accommodate over 20,000 visits per year, the improved patient flow continues to ensure one of the lowest pediatric door-to-doctor and door-to-discharge times in the Valley.

2011-2012 StatS :
13,780 Pediatric Emergency Department Visits 38 Pediatric Emergency Department Visits per day

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M i k A el A'S StoRy...
On August 5, 2002, a fire broke out in the Rivera-Prieto household. Mikaela Rivera-Prieto, a 14-month old toddler, arrived at the Arizona Burn Center at Maricopa Medical Center with second and third degree burns to 90 percent of her body. Mikaelas first few weeks at Maricopa Medical Center involved many surgeries at her bedside, as she was too sick from her injuries to leave her room. Within her first few weeks of admission, Mikaelas entire left leg had to be amputated, due to the severity of her burn. Seven years later, the amputation of her right foot would follow. Over a total of nine years, Mikaela endured hospital stays, from weeks to months with close to 100 surgeries and extensive physical therapy. Additionally, due to the inability of her severely burned skin to grow along with her body, ongoing skin graft surgeries and therapy were needed during her growing years. Thanks to the outstanding treatment she received at the Arizona Burn Center, along with the love and support of her caring family, Mikaela is now a preteen and in a word amazing! She has learned to adapt and move her body and is now able to dress herself, attend school, write, and play. She has even begun attending the Arizona Burn Centers annual summer camp for burn survivors where her latest adventures include horseback riding and flying down a zip line. Mikaelas story proves that with loving family support, a childs determination to improve despite all the odds and the Arizona Burn Center's commitment to outstanding care virtually nothing in the realm of healing is impossible.

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t H e A R izonA Bu R n cen t eR At M A R icopA M eDicA l cen t eR

The Arizona Burn Center at Maricopa Medical Center is an internationally recognized center of excellence providing comprehensive and individualized care for adult and pediatric patients suffering from burn injuries. The center is licensed for 37 beds, making the Arizona Burn Center the second largest in North America. Now burn specialists at the Arizona Burn Center are able to offer help beyond our walls. After the September 11th attack, one of the critical benchmarks within the National Bioterrorism Hospital Preparedness Grant from the Health Resources and Services Administration (HRSA) was the enhancement of statewide trauma and burn care capacity to respond to a mass casualty incident due to terrorism. The Arizona Burn Disaster Network: The State of Arizona tasked the Arizona Department of Health Services (ADHS) along with its only verified burn center, the Arizona Burn Center at Maricopa Medical Center, to develop a plan to create additional bed capacity in the event of a large scale, mass casualty burn event. What came about was the development of a network across the entire State of Arizona consisting of 11 hospitals with existing critical care units and critical care staff to provide care for burn patients during the first 72 hours after a mass casualty event. Conceptually, if an event occurs resulting in multiple or mass casualties that overwhelms the resources at the Arizona Burn Center, burn victims will be triaged to each of the 11 participating network hospitals. The Arizona Burn Center will be the point of central control and through the use of telemedicine will provide immediate consultation and triage to patients at each network hospital. When possible, appropriate patients will be transferred from network hospitals to either the Arizona Burn Center or other Verified Burn Centers across the Southwestern U.S. Beyond its critical role in a mass casualty event, the telemedicine network provides access to burn center expertise to hospitals, clinics and emergency technicians, particularly those in rural areas. It is another example of the ability of our burn center to offer remote care throughout Arizona as well as the Southwestern United States (to those with telemedicine access) to negate the need for unnecessary transport, thereby increasing patient safety and overall patient survival.

Burn survivors Stephanie and Christian Nielson returned to Phoenix to speak at the Arizona Burn Center's 2011 annual conference. They were brought to the burn center in 2008 after their small plane crashed and burst into flames near St. Johns, Arizona. Their courageous story of survival and recovery has captivated the entire nation and brought national acclaim and attention to the Arizona Burn Center at Maricopa Medical Center.

2011-2012 Burn StatS:

30 Average Daily Census 1,834 Burn Emergency Department visits 4,652 Burn Clinic visits

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DoctoR MooR e'S StoRy...

In 2008, Dr. Dominic Moore headed cross-country from New York to the desert southwest to begin his pediatric residency training program at Maricopa Medical Center. In our Neonatal ICU, Dr. Moore learned to care for babies that might not have survived years ago. Dr. Moore also quickly learned firsthand that beyond the books, lectures and simulations of medical school, the lessons become very real when a new doctor begins to care for actual patients, particularly the smallest among us. The care of newborns, however, is just one setting where our residents are trained. All residents have the opportunity to develop diverse medical skills amid a rich educational environment within one of our 10 residency training programs offered at Maricopa Medical Center. As the premier academic residency training program in the Valley, our residents care for a diverse patient population with a variety of medical and social needs. In our pediatric residency program, Dr. Moore is able to experience several medical settings as he begins the next chapter of his career. Since that time, Dr. Moore has made the decision to study Palliative Care and Hospice Medicine in his fellowship. Also, during 2011 he continued his own efforts to educate the next generation of physicians as Chief Resident. Maricopa Medical Center continues to play a pivotal role in Maricopa County in training highly-skilled physicians to meet the medical needs of today and tomorrow.

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t R A i n i ng t H e n ext gen eR At ion of pH ySici A nS

As the largest physician training hospital in Maricopa County, Maricopa Medical Center plays a key role in teaching the next generation of Arizonas medical professionals. With an impending physician shortage, Maricopa Medical Center is at the forefront of training physicians to meet the medical needs of tomorrow. While at Maricopa Medical Center, medical residents are exposed to a rigorous medical education experience with supervising physicians available around the clock. Maricopa Medical Center cares for some of the communitys sickest and most vulnerable patient populations throughout the Valley and state. With one of the busiest Adult Level I trauma centers and emergency departments, residents are exposed to a variety of injuries and conditions. Under the recent affiliation agreement with the University of Arizona College of Medicine Phoenix, the groundwork has been laid for Maricopa Medical Center to become the principal academic affiliate of the University of Arizona College of Medicine - Phoenix. We are excited about this new opportunity as we seek to expand our role in training the next generation of physicians to meet the demands of the future.

2011-2012 StatS :
228 MIHS residents 231 Rotating residents 447 Medical School Students

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R e Se A RcH
MIHS reached a new milestone in research in 2011 with $8.25 million in sponsored research, representing 120 studies with $4.48 million in academic research funding and nearly $4 million in industry-sponsored research contracts. With 67 clinical trials involving 129 investigators at MIHS, we reach hundreds of patients each year. In 2011, our clinician-investigators published their research findings in more than 50 scientific and medical journals. Our resident-led research team also conducted 126 individual research projects, with 43 poster presentations during Academic Excellence Day 2011. MIHS is also proud to partner with local universities as part of training outstanding physician researchers for our future. In 2011, 40 medical graduate and undergraduate students from the University of Arizona, Arizona State University, Midwestern University and other institutions were involved in research projects under MIHS-DMG physician mentorship. Other major research studies include funding from the Arizona Biomedical Research Commission to research Public Health Interventions for MRSA in pediatric patients. The Federal Agency for Healthcare Research and Quality has also provided funds to study the use of a self-triage kiosk in the Pediatric Emergency Department. Our Department of Emergency Medicine is a leader in collaborative multi-site investigations of the causes and treatment for skin and soft tissue infections, including STOP MRSA, which studies antibiotic use in uncomplicated soft tissue infections. The department is also involved in a multi-site study for suicide detection and prevention in the Emergency Room setting. Our Arizona Burn Center also continues cuttingedge research in improving burn wound treatment in collaboration with Translational Genomics Research Institute (TGen). In addition to several ongoing collaborative studies with ASU to better understand depression and obesity in pregnant women, the Department of Obstetrics and Gynecology also began a significant new project in 2011 to obtain cord blood from new mothers during the delivery process. The cord blood is then sent to the University of Colorado Cord Blood Bank in Denver where it is banked and made available for transplantation and future medical research projects. These are just some of the innovative ways our MIHS-DMG Research Team is working hard each day to create front-line outcomes for patients at MIHS as well as across the United States.

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t H e A R k pRoj ect
Technology at Maricopa has undergone an upgrade of epic proportions with the advent of the ARK electronic medical record project. The Maricopa Special Health Care District Board of Directors approved the five-year, threephased project in 2008 that included installation of Epic Systems Electronic Medical Record (EMR) and Computerized Physician Orders Management (CPOM). In October of 2009, Phase I of the ARK Project was successfully launched in the Ambulatory, Emergency, and Surgery areas. Work on Phase II began in October of 2010 and concludes in 2012 with the launching of the integrated EMR and CPOM for the inpatient settings. During 2011, a vast majority of the ARK Projects resources were devoted to building and testing the Phase II integrated inpatient applications, developing training for the entire MIHS inpatient staff, and preparing for the Epic Go-live installation. In addition to inpatient documentation and integration with operational Epic systems launched in Phase I, Phase II also includes a new integrated clinical laboratory system, a radiology system, and inpatient pharmacy system. The Epic System will further improve patient care and enhance clinical decision support. The ARK Project paves the way for marked improvements in medication management, streamlining clinical documentation and health information portability. Quality and patient safety will be enhanced with increased efficiencies in support of best practices across the continuum of care in a customer-oriented, cost-sensitive academic environment.

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f Ron t l i n e DiSA St eR pR epA R eDn e SS

MIHS stands ready to handle any type of disaster or emergency situation that may have an impact on the citizens of Maricopa County and beyond. As a Level I trauma hospital with a nationally known Burn Center, we stand on the frontlines of disaster readiness in order to triage and treat any number of individuals who may be directly affected by a variety of natural or man made disaster situations. Since 9/11, MIHS has made a commitment to our community to be at the forefront of disaster preparedness for our patients and our community, and to ensure the best patient care is available during any type of emergency. Throughout the year, MIHS conducts staff-wide disaster drills and exercises to ensure we are ready to mobilize at any moment. In 2011, MIHS took part in an extensive state-wide disaster drill known as Operation Vigilant Guard. The drill simulated what would happen if a nuclear device was detonated in downtown Phoenix. Known for our rapid-response and Arizona Burn Center, Maricopa Medical Center played a pivotal role in the drill in handling hundreds of mock patients, many of which were flown in on a Blackhawk helicopter. In disaster and emergency situations, you can be assured our highly-skilled disaster teams, decon unit, and disaster trained medical staff, including MIHS physicians and nurses, are ready to respond at a moment's notice.

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Key Facts Regarding MIHS Disaster Preparedness: Hospitals like Maricopa Medical Center are the backbone of the healthcare response to medical disasters, such as an influenza pandemic or a chemical or biological accident or attack. Our leaders have recognized this need and made disaster preparedness a top priority. Here are some key facts regarding MIHS disaster preparedness: Our Internal Emergency Management Committee meets monthly and includes external partners in planning a variety of responses to disaster/emergency situations. We have adopted an all hazards approach which allows a flexible response no matter what type of incident. MIHS is a designated training site for chemical, biological, radiological, nuclear and explosive decontamination. MIHS participates in Hospital Preparedness Program grant funding projects administered by the Arizona Department of Health Services. MIHS is a member of the Arizona Coalition for Healthcare Emergency Response Central Region, the Coyote Crisis Collaborative and the Maricopa County Department of Public Health Points of Distribution program. MIHS has been a key player in community-based disaster response exercises, including: 2011 Statewide Operation Vigilant Guard exercise 2011 Arizona Department of Health Services The Surge After exercise 2010 National Disaster Medical System reception exercise

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BR A n Don'S StoRy...
If asked to describe Brandon Davis, hospital staff would call him strong and courageous. These two traits have shown through times of trauma and uncertainty starting at the age of five, when Brandon was in an auto accident. On December 9, 2008, Brandon was a front seat passenger restrained by an adult lap and shoulder belt in a van that collided with another vehicle. The passenger airbag deployed and Brandon suffered critical injuries to his cervical spine. Paramedics on scene recognized the life threatening nature of Brandons injuries and dispatched a medical helicopter with rapid air transport to Maricopa Medical Center. Brandon was alert, but had no sensation from his chest to his feet. The first evaluation of Brandons condition revealed the complete transection of his cervical spine, quadriplegia (paralysis of all limbs). Brandon was admitted to the Pediatric Intensive Care Unit (PICU) in respiratory failure. He was also facing neurogenic shock, a life threatening condition that occurs after acute cervical spine injuries, wherein the patient loses the ability to breathe and to control blood pressure and heart rate. The next day, Brandon required multiple episodes of CPR and medications to increase his blood pressure and heart rate to sustain his life. Our highly trained, coordinated team consisting of trauma surgeons, pediatric and adult emergency medicine physicians and nurses, pediatric trained respiratory therapists, neurologists, clinical pharmacists, plastic surgery teams, and Pediatric ICU staff worked to ensure Brandons care. Our pediatric trained clinical pharmacists, nutritionists, child life specialists, social workers and physical therapists consulted on Brandons care and assisted his mother on a daily basis. All of this hard work was just the beginning for Brandon. With the love and dedication of his mother, Tina, he was able to start second grade on time. He is an excellent student and can write with a pencil. At 8 years old, he went skiing for the first time in a specially adapted ski chair. The strength and courage of Brandon and his family allow him to be a happy and normal young man.

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A R izonA cHil DR enS cen t eR

The Arizona Childrens Center at Maricopa Medical Center is proud of its accomplishments in 2011 and the services provided to the residents of Maricopa County. Our outstanding pediatric emergency department is staffed with pediatric specialists trained as emergency physicians and nurses who have been assembled to treat the most medically complex cases. Our newly renovated space accommodates over 20,000 visits per year. The Arizona Childrens Center includes a 34-bed Inpatient Pediatric Unit, a seven-bed Pediatric Intensive Care Unit (PICU), a 31-bed Neonatal Intensive Care Unit (NICU), Neonatal Nursery, Level II Pediatric Trauma Services, general pediatric clinic, subspecialty pediatric clinic which includes gastroenterology, pulmonology, neurology, cardiology, endocrinology, adolescent medicine, infectious disease, nephrology, and rheumatology. The Arizona Childrens Center also collaborates with the Arizona Burn Center at Maricopa Medical Center in the treatment of pediatric burn patients. Established in 2007 at Maricopa Medical Center, the Arizona Childrens Center is certified by the Children's Hospital Association. The Arizona Childrens Center is committed to offering the highest level of advanced medical care to all children who live in Arizona, including the underserved.

2011-2012 StatS:
Provided care for 36,000 pediatric patients 104,000 inpatient/outpatient services 13,780 Pediatric Emergency Department patients 21,045 Pediatric Clinic visits

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A Du lt l e v el on e t R Au M A / eD
Each year, our Trauma Center sees a wide variety of injuries including everything from motor vehicle crashes to falls to gunshot wounds to sports-related accidents. Each trauma patient who comes through our doors faces critical and potentially life-threatening or disabling injuries sometimes with only a short time to spare before critical care and treatment must take place. Each patient is treated by our highly skilled trauma staff comprised of trauma surgeons, emergency medicine physicians, nurses and other health care professional who provide an immediate team approach to caring for our most critical patients. As the only verified Trauma Center by the American College of Surgeons in providing Adult and Pediatric Trauma Care in Arizona, our trauma services team is also supported by specialists such as orthopedic surgeons, hand surgeons and burn surgeons. Additional support services include diagnostic radiology and imaging, anesthesiologists and blood and laboratory services. Our Trauma Center provides state-ofthe-art equipment to resuscitate and stabilize the most critically injured patients. Our trauma program is also at the forefront of providing injuryprevention education programs throughout our community. As a highly respected Level One Trauma Center, we are proud of playing a vital role in the survival and healing of severely injured people throughout Maricopa County and beyond.

2011-2012 StatS :
2,000 annual trauma activations 6 trauma activations per day

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fA Mily H e A lt H cen t eR S SeRv i ng you R coM M u n it y

MIHS operates 11 Family Health Centers across Maricopa County, as well as the McDowell Healthcare Center, the countrys largest provider of comprehensive and coordinated HIVrelated medical care for adults. Conveniently located throughout Maricopa County, patients can receive expert primary, preventative, prenatal and pediatrics screenings and treatments, including dental care, all in one place. Additionally, a Comprehensive Healthcare Center (CHC) is located on-site at the Maricopa Medical Center campus in Phoenix. The center treats both adult and pediatric populations by providing primary care services including family and internal medicine, pediatric care, and obstetrics/gynecology. The Center also provides dental care for children and adults. Other available services at the center include antepartum testing, a breast clinic, cardiopulmonary clinic, dental clinic, dialysis center, ear-nose-throat clinic, internal medicine, medical subspecialty clinics, oncology, orthopedics, ophthalmology, pediatrics, pharmacy, radiology, a surgical vascular clinic, and women's care clinic. The Comprehensive Healthcare Center is also home to the Phoenix Cancer Center. The cancer center is Maricopa County's resource for physicians, cancer patients, cancer survivors, and individuals in need of information on the prevention and treatment of all types of cancer. Outpatient care, including surgical diagnoses, biopsies, mammograms, and chemotherapy are also delivered in the Comprehensive Healthcare Center. Phoenix Cancer Center collaborates with Integrated Medical Services, Inc. to provide a comfortable outpatient setting for our patients requiring radiation therapy. Phoenix Cancer Center's Breast Clinic offers a full range of clinical and support services, from screening and diagnosis to treatment and counseling.

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R e AcHi ng ou t to ou R coM M u n it y
Many people do not see past the Maricopa Medical Center tower at 24th Street and Roosevelt when they think of MIHS. But keeping people out of the hospital through prevention is one of our primary objectives. In addition to 11 neighborhood health centers and the regions only HIV/AIDS clinic, MIHS reaches out to the community through health fairs, schools, churches, community based organizations and others. In 2011, MIHS participated in 344 community presentations and events, reaching nearly 32,000 residents. Our outreach efforts provided thousands of clinical screenings, including about 2,000 diabetes tests, and referrals to our Family Health Centers. These neighborhood clinics become a medical home for patients, a place to see a doctor before a medical issue requires hospitalization. These outreach efforts are successful thanks to the support from senior management, volunteers and staff and because of the dedication of an outstanding community outreach team.

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ou R BeH Av ioR A l H e A lt H cen t eR S

Maricopa Integrated Health System's Behavioral Health Centers provides a safe and comfortable environment for adults in need of inpatient psychiatric services. We operate a Level 1 Acute Psychiatric Hospital with beds located on two campuses: the Desert Vista Behavioral Health Center in Mesa and the Behavioral Health Annex of the Maricopa Medical Center in Phoenix. Our Inpatient Psychiatric Hospital has a total capacity of 189 beds with distinct units dedicated to serving psychiatric patients requiring intensive inpatient care. Our program serves individuals seeking care on a voluntary basis as well as those who have been courtordered to receive mental health evaluation and treatment. One of our units has the unique focus of serving the geriatric population and those with significant medical conditions. Each patient is cared for by a multi-disciplinary treatment team, consisting of a psychiatrist, social worker, registered nurse, and often a psychiatric resident physician. Psychologists and recreational therapists also participate in treatment planning. Our psychiatrists, nurse practitioners, social workers, and nursing staff take a multi-disciplinary team approach to treatment while collaborating closely with referring physicians, behavioral health agency outpatient treatment teams, primary care physicians, and other health care professionals. Outpatient psychiatric services are also available at our Desert Vista Campus in Mesa. The Desert Vista Outpatient Clinic provides individual, group and family counseling for adults, adolescents and children along with a full range of psychiatric assessment, evaluation, testing and medication monitoring. Services in the outpatient clinic are provided by psychiatric resident physicians in our residency training program under the direct supervision of attending psychiatrists.

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R ef ugee WoM enS H e A lt H cl i n ic

The Refugee Womens Health Clinic (RWHC) is a patient-centered medical home for the Valleys refugee population. The overarching purpose of the RWHC is to provide culturally grounded and linguistically appropriate health services to the growing refugee and immigrant community in the Phoenix metropolitan area while seeking to reduce/eliminate health disparities and cultural barriers to care. At its core, the RWHC is a safe haven where women can feel empowered, communicate, and be understood in their native language. Since the clinic has been in existence, significant strides in improving patient trust, building community capacity, and training health care professionals have been made. As a result, more refugee women are taking the initiative in seeking health care when they need it. As one of only two Refugee Women Health Clinics in the United States, our RWHC has thus far served more than 1,000 refugee women from 28 countries and has delivered close to 250 babies since its inception in 2008. The RWHC staff members, who are refugees themselves, understand and respect the specific cultural and health needs of our RWHC patients. Some of those services include patient education, coordination of transportation for clinic visits, diapers for children 0-2 years of age, new mom packages for women who deliver at Maricopa Medical Center, and mental health services and evaluations provided by a culturally competent psychiatrist. By empowering and mentoring refugee women, the RWHC influences their ability to make informed medical decisions for themselves and their families, and increases health seeking behaviors. Partnering with various refugee resettlement agencies as well as research partners and universities, the clinic continues to advance in the arena of cross- cultural healthcare. After three years of service to Phoenixs refugee community, the RWHC remains a safe haven for many women seeking medical attention for themselves and their families to begin anew.

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ou R Di v eR Sif i eD M eDicA l SeRv iceS

pulmonary: 3% other outpatient services: 8%

Burn, trauma & emergency: 23%

family health & specialty clinics: 16%

psychiatry: 8% Women & infants: 6%

general Medicine: 13%

general surgery: 20%

cardiology: 3%

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2011-2012 f i nA nci A lS
net patient Service revenue: total operating revenues: total operating expenses: loss from operations: loss from operations %: District tax Subsidy: other non-operating revenues/expenses: net Income: Salaries, Wages and Benefits: Charity and uncompensated Care Costs: $343,500,000 $607,700,000 $642,500,000 $34,800,000 -5.7% $55,700,000

2011-2012 v itA l StAtS

total Inpatient Admissions: Acute: Behavioral Health: FHC, CHC, 7th Avenue Walk-in Clinic Visits: Dental Visits: emergency Visits: total Surgeries: 18, 374 15,164 3,210

331,666 22,032 55,572 7,855 3,757 228 525

$8,700,000 $29,600,000 $253,900,000

employees: Medical residents: physicians & Mid levels on Staff: Maricopa Health plan Members:

$54,600,000

60,000

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RoSe'S StoRy...
A few years ago, Rose Rivers was having pain and knew something was wrong. Being out of work, and with her COBRA coverage expired, she was without insurance and had limited access to medical care. After an appointment at the Maricopa Integrated Health System Breast Center Clinic, Rose found out she had a rare form of breast cancer. Although she was enrolled in the MIHS ability-to-pay program, she knew the cost of her cancer treatment would quickly escalate and potentially become unmanageable. This is where the Maricopa Health Foundation was able to step in and lend a much needing helping hand. The Foundation is in the unique position to help women like Rose. With funding from the Foundation, Rose and other women who need help and have nowhere else to turn, are able to receive financial funding to fight their breast cancer diagnosis so they can focus on getting better. An integral part of the mission of the Foundation is to support patient care. Significantly, this includes assisting patients with cancer because these patients have an especially difficult and expensive battle to face. Despite the devastating news and the subsequent financial hardship, Rose chose to rejoice saying, I was well enough to go to battle with cancer. Today, Rose has won that battle and is a breast cancer survivor and inspiration to countless women in helping them remain optimistic as they also fight to regain their own health.

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M A R icopA H e A lt H fou n DAtion

In 2011, the Maricopa Health Foundation (MHF) gave a helping hand to more than 130 patients in supporting their specific needs during medically challenging times in their lives. As the philanthropic arm of Maricopa Integrated Health System, we are very proud of the progress Maricopa Health Foundation has made over the past few years in helping our community access quality healthcare through medical services, outreach, education and research. We are grateful for the support and commitment of MIHS and our physician partners from District Medical Group as well as our donors and volunteers who have given so generously throughout this year. Maricopa Health Foundation is additionally involved in improving the overall patient experience at MIHS. This year, MHF supported various refresh and renovation projects throughout the Maricopa Medical Center Campus. MHF purchased colorful murals for the Arizona Childrens Center, MRI and Ultrasound Suites, as well as our Pediatric Burn Unit, and artwork for our Comprehensive Health Care Center. Additionally, the foundation was also part of installing 43 Xbox 360 Kinect Game Systems for the Arizona Childrens Center as well as equipping our Child Life Specialists with iPads to help our youngest patients understand their medical treatments and be more at ease in the hospital setting. This years Annual CopaBall raised more than $100,000 which helped us supply cutting-edge equipment for our Arizona Childrens Center including Cinemavision MRI Goggles, Accuvein Vein Finders, Waterless Breast Milk Warmers, Vecta Sensory Distraction Machines, and Giraffe Incubator Accessories. Additionally, our foundation sponsored dozens of continuing medical education opportunities for our nurses as well as provided community education materials including burn prevention books for children and Code Cards for frontline emergency medical personnel. The foundation funded two major research projects the Community Health Worker Pilot Project and Head Injury Intervention Project at 10 Valley High Schools. We also continue to support two crucial outreach programs at Maricopa Medical Center Maricopa Medical Centers New Hope for Teen Pregnancy and our Wings to Safety Domestic Violence Program, the only hospital based domestic violence program in the State of Arizona. Continued support from our donors and community have allowed us to help our adult and pediatric patients get the necessary medical help they need as well as improve the patient amenities we are able to provide. Maricopa Health Foundation extends a heartfelt thank you to our donors who make this possible. The Maricopa Health Foundation is a 501 (c)(3) nonprofit organization and an integral part of the culture, care and service at Maricopa Integrated Health System. Learn more about the Maricopa Health Foundation by visiting our website at www.mihs.org/foundation.

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WADDELL LITCHFIELD

THUNDERBIRD EL MIRAGE

EL MIRAGE

DUNLAP

13
PKWY.

CAVE CREEK

GLENDALE

THOMAS MCDOWELL

43RD AVE.

9
ROOSEVELT

BUCKEYE LITCHFIELD EL MIRAGE

PHOENIX

MESA DR. MCQUEEN

RURAL

RD.

PIMA RD.

INDIAN SCHOOL

32ND ST.

SCOTTSDALE

PIESTEWWA

GLENDALE

6
G N RA D E AV .

RD.

SCOTTSDALE

11 12
7TH ST.

3
BROADWAY

H
APACHE

4 10

MESA
MAIN

19TH AVE.

MIHS FAMILY HEALTH CENTERS AND MARICOPA MEDICAL CENTER

H. Maricopa Medical Center 2601 E. Roosevelt, Phoenix 85008 P. 602.344.5011 1. Avondale Family Health Center 950 E. Van Buren, Avondale 85323 P. 623.344.6800 2. Chandler Family Health Center 8811 S. Hamilton, Chandler 85225 P. 480.344.6100 3. Comprehensive Healthcare Center 2525 E. Roosevelt, Phoenix 85008 P. 602.344.1015 4. Desert Vista Behavioral Health Center 570 W. Brown Rd., Mesa 85201 P. 480.344.2000

7TH AVE.

GUADALUPE

48TH ST.

AVONDALE

TEMPE

7
RURAL RD.

GUADALUPE ALMA SCHOOL

GILBERT

6. Glendale Family Health Center 5141 W. Lamar, Glendale 85301 P. 623.344.6700 7. Guadalupe Family Health Center 5825 E. Calle Guadalupe Guadalupe 85283 P. 480.344.6000 8. Maryvale Family Health Center 4011 N. 51st Ave., Phoenix 85031 P. 623.344.6900 9. McDowell Family Health Center 1144 E McDowell Rd, #300 Phoenix 85006 P. 602.344.6550 10. Mesa Family Health Center 59 S. Hibbert, Mesa 85210 P. 480.344.6200

CHANDLER BLVD. PECOS

CHANDLER
11. 7th Ave Family Health Center/ MIHS Urgent Care Center 1201 S. 7th Ave., Phoenix 85007 P. 602.344.6600 / 602.344.6655 12. South Central Family Health Center 33 W. Tamarisk, Phoenix 85041 P. 602.344.6400 13. Sunnyslope Family Health Center 934 W. Hatcher, Phoenix 85021 P. 602.344.6300

www.mihs.org

5. El Mirage Family Health Center 12428 W. Thunderbird El Mirage 85335 P. 623.344.6500