Our Journey to Excellence Sustaining Excellence in Execution when Collaborating with Academic Partners
LafayetteGeneral.com
Our beginning… Start of J2E
Progress
People
EMPLOYEE Satisfaction 38th percentile
84th percentile
Service
INPT 38th percentile ED 15th percentile OUTPT n/a Physician Sat n/a
FY14 to date: INPT 99th percentile ED 82nd percentile Outpatient 85th percentile Physician 24th -> 66th
Quality
14 of 25 Indicators
31/35 Indicators
Finance
-0.4%
End of FY13
Growth
2 Hospitals
8 Entities &
(2009)
(as of 2014)
10.2% 6 Clinical Affiliates
PEOPLE: Employee Satisfaction for FY 2010-2013 100 90 80 70 60 50 40 30 20 10 0
FY10
70
77
38
84
FY11 FY12 FY13
Satisfaction (%tile) LafayetteGeneral.com
“System Leaders / Admin Communicate Major Developments” 100 90 80 70 60 50 40 30 20 10 0
97 82
88
70 59
56
FY10 FY11
38
FY12 FY13
7
Attendance
Satisfaction (%tile)
“Adequate Communication Regarding Change” 100 90 80 70 60 50 40 30 20 10 0
96 80
81
70 59 48 38
FY10 FY11 FY12 FY13
7
Attendance
Satisfaction (%tile)
100 90 80 70 60 50 40 30 20 10 0
97 99 96 97 99 99 99 97 99 99 99 Standards of 86 85 87 Behavior Rolled out to Staff 63
67 69
68
54
38
42
1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 3Q10 4Q10 1Q11 2Q11 3Q11 4Q11 1Q12 2Q12 3Q12 4Q12 1Q13 2Q13 3Q13 4Q13 1Q14
Percentile Rank
SERVICE: LGMC Inpatient Satisfaction Results since beginning J2E
Source: Press Ganey Inpatient Satisfaction Report –Large PG Database
LafayetteGeneral.com
Physician Standards of Behavior
LafayetteGeneral.com
It’s VBP for Staff Performance •Value Based Performance •Drives consistency and enhances operational outcomes •Alignment+Actions+Accountability ALIGN expectations + Elevate ACTIONS+ Enhance Individual ACCOUNTABILITY
Our Work + My Work + My Values = SEM Score
(30%) + (50%) + (20%)
= 100%
My Values = 360 ̊Evaluation of Standards of Behavior
Employee Satisfaction Survey Item
Percentile Rank
“Values are evident in our practices”
Employee Satisfaction & Inpatient Survey Item
Percentile Rank
“Staff Worked Together to Care For You” 100 90 80 70 60 50 40 30 20 10 0
91
97
98
84 77 70 FY09 46 38
39
FY10 FY11 FY12
FY13 0
Employee Sat
Inpatient Sat
QUALITY: HCAHPS
LafayetteGeneral.com
What we’ve learned…
Culture trumps strategy.
LafayetteGeneral.com
Three “Must Do’s” for Successful Collaboration… 1. Communicate 2. Educate 3. Validate
Communication “Must Do’s” 1. Cascade behaviors, goals & results 2. Invite to forums & hold leaders accountable for attendance 3. Ensure two-way through External Customer Rounding
FY LGMC Organization Goals People DRAFT 20%
Service 15%
Quality 20%
Funding Our Future 35%
Growth 10%
Goals and Results- EXAMPLE ONLY • ↓ Voluntary Turnover to < 12.3% Current= 13.98% • ↓ First Year Turnover to < 25% Current= 26.2%
•↑ Inpatient Satisfaction to 95th percentile
•30/35 Process of Care Measures at benchmark
Current=98th Current= 33/35 •↑ Outpatient Satisfaction to > 75th percentile Current=83rd
• ↑ Employee Satisfaction > 80th percentile
•↑ ED Patient Satisfaction 80th percentile
Result=84th
Current= 70th •↑ Ambulatory Surgery Satisfaction to 75th percentile
Current= 72nd •↑ Physician Satisfaction to > 50th percentile Result= 66th
• ↑ Operating Margin to > 3.5 % Current=
7.7%
• ↓ AR Days to < 60 Current=
•6/8 HCAHPS Domains ≥ Benchmark (90th percentile) Current=
4/8
51.96
•Acute ALOS < Expected ALOS
•Current= 96.21%
•LGMC Mortality < National Average
• ↓ Labor Expense to < 34.1% of Hospital Net Revenue
Current=5.31%
Current= 29.9%
Less
• ↓ Chargeable & Nonchargeable Supplies to < 17.2% of Hospital Net Revenue Current= 14.95%
• ↑ Net Revenue by 5% Current=
13.4%
• ED/ OR Project will remain on time & on budget Current=
3/5
External Customer Rounding 1.Focus • Share trends, results • Prioritize opportunity 2.Fix 3.Follow-Up
TACTICS & Strategies
IP HVBP
How do scores fit in the dashboard?
HCAHPS COMPOSITES AND QUESTIONS Composite
Nursing Communication Doctor Communication 8 Value Based Purchasing Measures
Responsiveness of Staff Pain Management Communication of Medications Discharge Information Cleanliness and Quietness of Hospital Environment Overall Rating N/A
Taking You and Your Organization to the Next Level © 2011 Studer Group®
Question Summary
Response Scale
Nurse courtesy and respect Nurses listen carefully Nurse explanations are clear Doctor courtesy and respect Doctors listen carefully Doctor explanations are clear Did you need help in getting to bathroom? 2 Staff helped with bathroom needs Call button answered Did you need medicine for pain? 2 Pain well controlled Staff helped patient with pain Were you given any new meds? 2 Staff explained medicine Staff clearly described side effects Did you go home, someone else’s home, or to another facility? 2 Staff discussed help need after discharge Written symptom/health info provided
ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never Yes No (screening question) ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never Yes, No (screening question) ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never Yes, No (screening question) ALWAYS, Usually, Sometimes, Never ALWAYS, Usually, Sometimes, Never Own home, Someone else’s home, Another facility (screening question) YES, No YES, No
Area around room kept quiet at night
ALWAYS, Usually, Sometimes, Never
Room and bathroom kept clean
ALWAYS, Usually, Sometimes, Never
Hospital Rating Question Willingness to Recommend
0 to 10 point scale (percent 9 and 10 reported) DEFINITELY YES, Probably Yes, Probably No, Definitely No
Our Evidenced Based Practice Resource
Practices that Improve QUALITY AND CONSISTENCY in Patient Care Taking You and Your Organization to the Next Level © 2011 Studer Group®
Hourly Rounding “HAPPENS” here H A
Hands
Knock and wash/ foam HANDS
AIDET
Full AIDET for first time; EXPLAIN what you are doing every other time
P
Pain Potty Position
“Let’s go to the bathroom now…” instead of “Do you have to go to the bathroom?”
P E
Possessions
N S
Environmental Scan
Note Say
Are all POSSESSIONS in reach? Perform an ENVIRONMENTAL scan for quietness and cleanliness (e.g. pick up trash or comment about how clean room is, offer quiet kit, ask about door closed/ open)
NOTE changes on the white board SAY when someone will be returning
Hardwire Through Accountability What? Why? How…
Nurse Leader Rounding
LafayetteGeneral.com
Validate, ALWAYS… Objective 1: Identify strategies for developing a shared vision of excellence. Goal / result cascade, forum attendance, Standards of Behavior
Objective 2: Discuss the significance of academic-practice collaboration when establishing a culture of excellence. HCAHPS, Quality
LafayetteGeneral.com
Objective 3: Consider 2 essential leadership practices necessary for promoting stakeholder satisfaction. External Customer Rounding, Nurse Leader Rounding
LafayetteGeneral.com
QUESTIONS/ COMMENTS
Marisa Alack AVP J2E 337-289-8685
[email protected]
LafayetteGeneral.com