Hawaii PSP 2012 Understanding the Performance Sharing Program

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Reward for Results

• New incentive programs

Performance Sharing Program (PSP): LMP bargaining

Variable Pay Program (VPP): leaders and non-bargaining

• Important component of Total Compensation

• Help region achieve goals and you earn extra money

• Reward is earned for results you help us achieve

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Why Reward for Results

“We’ve been providing high quality care and service to Hawaii for over 50 years.

Reward for Results is an incentive for each of us to

work together to become a successful and sustainable

organization for the next 50!”

Thomas Risse

Chief Financial Officer

Winona White

V.P. of Human Resources

Eligibility

• Hawaii Nurses Association, OPEIU Local 50 employees

• Part of the Labor Management Partnership (LMP) and party to the National Agreement

Benefits of the PSP

• Enhanced Line of Sight for employees

• Improvements aligned with regional goals

• Reward and recognition based on where employees directly affect members’ care and service experiences

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How does the PSP work?

Step 1: You help us deliver on regional financial goal

Step 2: You help us achieve our PSP goals

Step 3: You receive your reward

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Step 1: What you can do

Regional Financial Goal – Operating Margin Turn of lights when you leave a room

Ask yourself if you really need to print that document

Watch for waste in your department

Actively manage expenses

Commit to actions that help us improve Point-of-Service collections

Encourage your friends to join KP – more commercial members means better financial results!

Financial Goal for PSP is the higher of…

A) Operating margin goal for the program year

OR

B) Positive operating margin

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Step 1: How funding works

SCENARIO 2 NO PAYOUT

Maximum Funding Operating Margin

SCENARIO 1

Partial Funding

SCENARIO 3 Full Funding

Minimum Funding Operating Margin A) Above goal or B) positive -- whichever is higher

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Step 2: What You Can Do

Service35%

Quality30%

People20%

Affordability15%

2012 PSP Goals

Service

Quality

People

Affordability

Our 2012 Performance Goals metrics

Quality • TJC composite score • patient falls—1K patient days • clinic immunization medication errors

Service • nurse communications—HCAHPS • pain management—HCAHPS • satisfaction with nursing team

People • number of injuries • completion of THA

Affordability • Common Lost Time days

Service 2012 tips: HCAHPS nurse communication

Improve scores of positive member responses to “nurse communications” questions on HCAHPS survey, from 76.9% to:

Minimum: 77.9%

Target: 79.9%

Maximum: 81.0%

What you can do • Engage staff nurses in rounding on patients every hour. • Use the four Ps of hourly rounding: Positioning, Pain,

Personal hygiene, and Physical environment. • Listen carefully to patient and member needs,

requests, and concerns; address them clearly and thoroughly.

• Give your name when entering a patient’s room or addressing family members; always ask patients and family whether they need anything before you leave.

• Before patients are discharged, discuss after care instructions and give care-gap summaries to steer patients to preventive screenings.

• Use service techniques based on the AIDET model: Acknowledge, Introduce, Duration, Explanation and Thank you.

Service 2012 tips: HCAHPS pain management

Improve scores of positive member responses to “pain management” questions on HCAHPS survey, from 70th percentile to:

Minimum: 75th

Target: 80th

Maximum: 90th

What you can do • Use the four Ps of hourly rounding: Positioning,

Pain, Personal hygiene, and Physical environment. • Establish patients’ expectations concerning the

pain that they may feel and how it can be handled.

• Monitor patient pain levels consistently using pain scales.

• Reassess patients pain level one hour after medication. Communicate verbally and on care board when next pain medication will be given.

• Work with your unit-based team to research how to improve pain management

Service 2012 tips: PSAT satisfaction with nursing team

Increase scores on the PSAT measure of satisfaction with the nursing team from 90% to:

Minimum: 90%

Target: 91%

Maximum: 92%

What you can do • Engage staff nurses in rounding on patients every

hour. • Practice AIDET • Demonstrate understanding and personalize your

care • Express confidence in the clinician and your

nursing team • Be warm and caring in your interactions and

SMILE (even on the phone)—it makes a difference • Work with your teams to understand service

scores and find ways your team can improve

Quality 2012 tips: TJC composite

Increase TJC Composite score from 98.7 to:

Minimum: 98.8 score

Target: 99.0 score

Maximum: 99.6 score

What you can do • Emphasize the importance of taking needed

medication and reporting or addressing pain levels.

• Identify missing labs and screenings; flag for practitioners.

• Try tests of change to reduce surgery related complications such as the use of clippers on surgical sites, rather than shaving, which can lead to nicks ripe for infection.

Quality 2012 tips: Patient falls

Reduce patient fall rate, calculated as the number of falls per 1000 patient days from 2.8 to:

Minimum: 2.7

Target: 2.6

Maximum: 2.5

What you can do • Use huddles to identify and coordinate care of

fall-risk patients and hourly rounding to assess patient needs.

• Give patients who are high-risks for falling color-coded identifiers such as yellow arm-bands or red socks.

• Place call lights within patients’ reach; have them demonstrate use upon admission to unit.

• Turn on bed alarms to alert staff to patients who are trying to get out of bed or sit up.

• Keep path to patient’s bathroom clear and free of clutter and spills.

Quality 2012 tips: Medication errors

Reduce the percentage of medication errors in clinic immunizations from the baseline of 17 to:

Minimum: 20% reduction

Target: 40% reduction

Maximum: 60% reduction

What you can do • Maintain current immunization knowledge of

vaccines and recommended immunization schedule by the Centers for Disease Control and Prevention.

• Verify correct patients and orders using immunization history, pre-visit summary, or other tools.

• Consult with physician for any needed follow up instructions for patient; contact patient or parent/guardian to carry out instructions.

• Avoid distractions when giving medication.

People 2012 tips: Workplace injuries

Reduce number of workplace injuries among HNA staff from 93 to:

Minimum: 84 (10% reduction)

Target: 74

(20% reduction)

Maximum: 65

(30% reduction)

What you can do • Use sliders and other lift aids, and ask others for

help when handling patients. • Eliminate clutter and tripping hazards from your

work area. • Get an assessment of your work station to make

sure it’s ergonomically sound. • Make sure your computer monitor is at eye level;

make sure your wrists are horizontal (not bent) while using the keyboard or mouse.

• Have safety conversations with your co-workers, and record them at kphirewards.com to receive Mahalo Points

• Speak up if you see something unsafe.

People 2012 tips: Total Health Assessment

Increase the percentage of HNA staff who complete the Total Health Assessment from 9.6% to:

Minimum: 40%

Target: 50%

Maximum: 75%

What you can do • If you haven’t already in 2012, take the THA

yourself: kp.org/hwf • Take time to assist team members who are less

computer savvy with completing the online assessment.

• Organize a healthy walk, salad potluck, or lunchtime exercise activity for your unit and hand out instructions on how to take the THA.

• Keep your numbers handy: correct height, weight, blood pressure, etc.

Affordability 2012 tips: Common Lost Time

Reduce Common Lost Time from 12.3 days to:

Minimum: 12.2 days

Target: 11.3 days

Maximum: 10.3 days

What you can do • Understanding sick leave and time-off policies,

improving work relationships, and committing to the best patient care and service will lead to wise use of sick time.

• Survey team members to check staff understanding of sick leave or confusion about leave eligibility.

• Encourage colleagues to plan time off in advance and talk to supervisors about scheduling needs.

• Keep a calendar so you’re aware of how often you call in sick.

• Experiment with trading shifts, but check the union contract first.

Potential payouts for minimum and target goals

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Step 2: Impact of Regional Strategic Goals

Minimum:

Level of Each Goal Achievement

Target:

Maximum:

QUALITY

PEOPLE

SERVICE

AFFORDABILITY

= payout level is based on goal achievement

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Step 3: Your payout

WHAT WE WANT! WHAT WE DON’T WANT!

Good Financial Results

Financial performance funding

and

2012 Strategic goal results

and

Incentive opportunity =

Reward amount paid in 2013

Poor Financial Results

No funding

=

Improve in 2013 so we can earn a 2014

payout

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Next Steps

Understand the PSP goals and measures

Meet with your UBTs

Research ways to reach goals on lmpartnership.org website

Discuss these goals with your manager

Help the region achieve our goals so you can maximize your potential reward!

You can make a difference!

Questions?