Welcome to our…

Journey to Excellence…An overview

Barbara Dumont, RN, VPSS, QRM

CAH QI ShowcaseFairmont Hot Springs, MTWednesday, April 21, 2010

AgendaAgenda

• Why did we pursue this initiative?• A brief introduction to the Studer

Groupo The Healthcare Flywheelo The Six Pillarso The Nine Principleso The Must-Haves

• What is next on this Journey?

We will provide Excellent Healthcare Close to Home

by creating a great place for employees to work, physicians to practice, and patients to receive care.

Common ComplaintsCommon Complaints

Courtesy of Care Givers Waiting Times Privacy Explanations of Tests Courtesy Towards Family Arrangements for Home Care Discharge Instructions Personal Needs

Why…Why…

“If you do what you’ve always done,

you’ll get what you’ve always got!”

Seems like the rules Seems like the rules are always changingare always changing

Our old methods Our old methods won’t work anymorewon’t work anymore

Do more with less…Do more with less…

faster… better…faster… better…

Revenues down… Revenues down… Expectations up…Expectations up…

And our competition is And our competition is different than beforedifferent than before

The Game Has The Game Has Changed!Changed!

Word of MouthWord of Mouth

66% of healthcare choice decisions are based on word of mouth

Can’t con the community Can’t con the employees

AHA Reality Check II, AHA, 1998

1Very Poor

Patient Satisfaction Scores

2Poor

4Goo

d

5Very Good

1%1% 1%1% 5%5% 19%19% 74%74%

3Fair

99th Percentile Hospital

* Press Ganey Report

What percentile would this hospital be in if responses were 74% Good and 19% Very Good?

What percentile would this hospital be in if responses were 74% Good and 19% Very Good?

The customer “will” return• “Very good care”, “WOW” service.• Will recommend to friends and family.• Increased market share.

The customer “might” return

• “Good care” “Okay”, “Some were nice.” • May or may not tell others.• No gain in market share –stays the same!

The customer “might not” return • “Fair Care”, “Average”, “Could be better”• The customer may be complaining about their experience.• If another hospital is suggested, the patient may go.

The customer “will not” return • “Poor”, “Dissatisfied”, “They didn’t care about me.”• They are telling others about their poor experience. • Customer would go elsewhere if they could.• Losing market share.

The customer is “gone”• “Very Poor”, “Very Dissatisfied”, “I’m not going back there!”• The customer takes 10 customers with them!• Losing lots of market share.

5

4

3

2

1

PRESS GANEY SCORESPRESS GANEY SCORES“What do they really mean?“What do they really mean?

Hardwiring ExcellenceHardwiring Excellence

The book!The book!

Quint StuderQuint Studer

• B.A. in EducationB.A. in Education

• M.S. in Education from University of M.S. in Education from University of Wisconsin, WhitewaterWisconsin, Whitewater

• Special Education TeacherSpecial Education Teacher

• Began healthcare career in a staff Began healthcare career in a staff positionposition

• COO of Holy Cross Hospital in COO of Holy Cross Hospital in ChicagoChicago

• President of the Baptist Hospital in President of the Baptist Hospital in Pensacola, FL, Pensacola, FL,

• At Holy Cross and Baptist, led both At Holy Cross and Baptist, led both organizations to the top one percent in organizations to the top one percent in employee and patient satisfaction employee and patient satisfaction compared to hospitals nationwide, as compared to hospitals nationwide, as ranked by independent health care ranked by independent health care survey organizations.survey organizations.

The Studer Group The Studer Group

Q.Q. Can we do this change process without Studer Can we do this change process without Studer Group?Group?

A.A. Yes, organizations throughout the country are striving Yes, organizations throughout the country are striving for service excellence. for service excellence.

However, most organizations Studer works with However, most organizations Studer works with

1.1. Felt they have gone as far as they can on their own Felt they have gone as far as they can on their own and want to see further progress; orand want to see further progress; or

2.2. Want to speed up the process and hardwire the Want to speed up the process and hardwire the changes; orchanges; or

3.3. Do not want this to be just another program. Do not want this to be just another program.

The Studer Group The Studer Group

Q.Q. Why do hospitals choose to work with the Studer Why do hospitals choose to work with the Studer Group?Group?

A.A. Hospitals have found find that they can accelerate Hospitals have found find that they can accelerate organizational change to achieve results faster and organizational change to achieve results faster and systems are systems are hardwiredhardwired sooner to ensure the gains are sooner to ensure the gains are not lost but built on for even greater results. not lost but built on for even greater results.

Hardwiring Hardwiring ExcellenceExcellence

Definition: A task or process is considered to be “hardwired” when 90% of the organization consistently

performs the task or process correctly.

Healthcare FlywheelHealthcare Flywheel

- Must Haves- Must Haves

- Nine Principles- Nine Principles

- Six Pillars- Six Pillars

Committo Excellence

Build a CultureAround Service

Measure theImportant Things

Create and DevelopGreat Leaders

Focus on EmployeeSatisfaction

Build IndividualAccountability

Recognize andReward Success

Communicateat All Levels

Align Behaviorswith Goals and Values

Nine PrinciplesNine Principles

SJLH SJLH Journey toJourney toExcellenceExcellence Pillars Pillars

Service PeopleQuality Finance GrowthCommunity

•Achieve a community benefit amount of 3% of net revenue

•Exceed budgeted net revenue by 3%

•10% EBIDA

•Days cash on hand of 70

•Improve employee & medical staff satisfaction

•Improve quality indicators

•Improve safety for employees and patients

•Improve patient satisfaction

•Increase patient loyalty

25% 25% 15% 20% 5% 10%

1. Rounding for Outcomes

2. Employee Thank you notes

3. Pre and Post Phone calls

4. Key Words at Key Times / AIDET

5. Selection and the First 90 Days

6. Aligning Leader Evaluations with Desired Behaviors – LEM Module

Must HavesMust Haves

Behavior StandardsBehavior Standards

Accountability Ambassador Appearance

CommunicationConfidentiality & Dignity

Ethics

Patient-Centered Care

Safety & Security

Teamwork

LDI’s…LDI’s…

“Leadership Development Institute”Teach managers new ways of managing their department

Raise the bar for leader behaviorConsistently reinforce where we are going

Communication Communication BoardsBoards

Key Words at Key Words at Key TimesKey Times

Things said and done to “connect the dots” and help patients, staff, and physicians understand why we do things and what is going on.

AIDETAIDET

AA AcknowledgeAcknowledge

II IntroduceIntroduce

DD DurationDuration

EE ExplanationExplanation

TT Thank YouThank You

Discharge Phone CallsDischarge Phone Calls

Demonstrate empathy Improve clinical outcomes Harvest reward and

recognition of the staff Learn about the patient’s

perception of service Gather process

improvement suggestions

Define Desired AttributesCommit to StandardsLeader Screens CandidatesPeers Interview Those OK’d by LeaderUse Behavior Based QuestionsMake an Offer Assign a Preceptor

Team InterviewingTeam Interviewing

Decision Matrix Decision Matrix

Desired Wt

1-3

Candidate #1

Candidate #2

Candidate #3

Experience: Minimum 3 years experience in accounting, finance or health care

3 3/9 2/6 4/12

Diligence: Tell me about a time when you had to work on a project that did not work out the way it should?

3 5/15 3/9 3/9

Integrity: Describe a situation in which you felt it might be justifiable to break company policy or alter a standard procedure?

3 4/12 3/9 4/12

Totals 36 24 33

Weights 1- Preferred, but not necessary 2- Moderately necessary 3- Essential

Score:1: Very Poor 2: Poor 3: Fair 4: Good 5: Excellent

30 and 90-Day 30 and 90-Day MeetingsMeetings

Supervisor asks the following:1. How do we compare with what we said?2. What’s working well? Have there been

any individuals who have been helpful to you?

3. Based on your prior work, what ideas for improvement do you have?

4. Is there any reason that you feel this is not the right place for you?

The Journey means…The Journey means…

We will live our Mission.

As measured by:o Patient Satisfaction scores

o Physician Satisfaction scores

o Employee Satisfaction scores

The Journey means…The Journey means…

We will fine tune our operations.

As measured by:o Our Quality Program

o Our Safety/Risk Management Programs

o Creation/revision of our P&Ps

The Journey means…The Journey means…

We will build a solid financial foundation.

As measured by:o The Bottom lineo Our Days Cash on Hando Our Savingso The Ability to Borrow

The Journey means…The Journey means…

We will prepare for the future. As measured by:

o Development of a Facility Master Plan and Replacement Plan

o Completing needed renovation and remodeling of our physical plant

o Our investment in capital equipment

Those who say it cannot be done

should not interrupt the person doing it.

--Chinese ProverbChinese Proverb

The road is long…The road is long…

“It isn’t hard to be good from time to time, what’s tough is being good every day.”

- Willie Mays

Hardwiring

Questions?Thank you!