How Boards Can Successfully Set Quality and Safety GoalsHow Boards Can Successfully Set Quality and...
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How Boards Can Successfully Set Quality and Safety Goals Harvard Colloquium: August 18, 2010 Dale Lodge, President & CEO Winchester Healthcare Management, Inc., Immediate Past Chair of The Massachusetts Hospital Association, Boston, MA
Transcript of How Boards Can Successfully Set Quality and Safety GoalsHow Boards Can Successfully Set Quality and...
How Boards Can Successfully Set Quality and Safety Goals Harvard Colloquium: August 18, 2010
Dale Lodge, President & CEO Winchester Healthcare Management, Inc.,Immediate Past Chair of The Massachusetts Hospital Association, Boston, MA
Overview
Who we areUnique Hospital Board Characteristics which affect engagement Six Strategies for Board Engagement in Quality and Safety Goals Questions/Comments
Who we are
229 BedsOver 16 Different Sites2,700 Employees800 Volunteers700 Physicians
Who we are
83% Occupancy Rate3% Operating Margin 0-4% Merit Program (3.5% average)8% Turnover Rate2% Nursing Vacancy Rate
Achievements
2009 Premier National Quality AwardMagnet Hospital
95th percentile physician satisfaction
99th percentile for “I would recommend the Hospital to my friends and relatives”96th percentile employee satisfaction
Accomplishments
Accomplishments
Unique Hospital Board Characteristics
Practicing physicians sit on Board Board members actually decide whether or not to credential physicians to practice in Hospital Community based-relatives are often our staff members or patients Hospital Board members are also patients
Strategy #1: Eliminate distractions
Have to have a senior leadership team Board trusts
Must meet financial targetsMust maintain high levels of physician, patient, and employee satisfaction
How to eliminate distractions?It is ALL ABOUT the immediate supervisor Develop your leadersSupervisors need to be leaders and not doersBalance accountability with independence
Strategy #2: Orient Board to need to develop and invest in leaders
Change recruitment focus; recruit for leadership not technical skillsCEO needs to role model; has to allow people to do their job
Strategy #3: Set clear quality and safety goal “Murky aims beget murky accountability”Captive-took Joint Conference Committee from more informational to interactive discussion Institute for Healthcare Improvement (IHI) conference; focusing on cases not enough; need preventable harm goal
Pre-Institute for Healthcare Improvement (IHI) Quality Goal
List of Maryland indicators that were primarily process oriented…like this…
Pneumonia
97.1%98%Blood culture
93.4%95.4%Antibiotic selection
95.5%99.8%Smoking Cessation
100%100%Oxygen Assessment
73.8%93.9%Antibiotics in 4 hours
84.3%97.6%Pneumoccoal Vaccination
76.2%98.6%Flu Vaccine
Our past performanceOur FY 2009 goal Elements to be completed
Our Goal: Eliminate Selected Preventable Harm by Dec. 31, 2011
Patient Safety
Inpatient Falls with Serious
Injury
1
Ventilator Associated
Pneumonia (ICU)
0
Serious Medication
Errors
0
Surgical Site Infections
2
Central Line Associated
Bloodstream Infections (ICU)
0
108
54
0
Baseline 2008
Goal for FY2009
Goal for FY2010
Goal for Q1 FY2012
27
Exceeded our 2009 Goal
Current Score3
38
FY2010 October 2009 through April 30 2010
56.5
3.8
6.5
2.1
4.8
2.2
8.6
2.2
002
468
101214
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Number Annual Rate/1000 Device Days
NHSN Rate 2.7 (Benchmark)
VAP Rate Preventable and Non-Preventable
Hand Hygiene Compliance and Hospital Acquired Infection Rate for selected floor
21.5
72
84
100
9085
90
98 97
90
100
0
10
20
30
40
50
60
70
80
90
100
Dec-08
Jan-10
Feb Mar Jul Aug Dec Jan-10
Feb Mar Apr
2.102.40
1.170.43
0.00
0.50
1.00
1.50
2.00
2.50
2007 2008 2009 Jan-Apr2010
Infection Rate (PPD) (MRSA, C.diff, VRE,ESBL)
Strategy #4: Use stories
Never underestimate the power of storiesThe more personal to your Hospital the better
Strategy #5: Educate, Educate, Educate
Blue Cross GrantsTrustee Education Through Networking DinnersCoaching - David NashValue Capture
Voluntary Education Sessions by Chief Medical Officer after board meetings Patient Safety Rounds Presentations on Investigations (MRSA in Newborn Nursery, Downtime in Information Systems, Sterilization in the Operating Room)
Strategy #6: Be Transparent
“If you’re going to be naked, it’s good to be buff.”
Your own staff will pay great attention to the dataThere’s a high likelihood that your performance will
improve, quicklyYour performance data are going to be public,
anyway, sooner or later
Here is a very visual example of how we have evolved…Former mission statement:
“The Hospital’s mission is the ensure that the highest quality health care continues to be delivered through the coordination of available resources for the purpose of improving the health of the communities we serve.”
And here is our new mission statement…
Questions/Comments
