Organizational Excellence

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Organizational Excellence

• Wright Medical Center
• Clarion, Iowa

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About Us

• 25 bed rural critical access medical center
• Obstetrics- Approx 200 births per year
• Independent Living facility 45 Units
• Assisted Living- 18 Units
• Family Practice Clinic/Specialty Clinic
• 2 Wellness Centers
• Employs approx. 370 people
• Studer Firestarter of the Month- Feb. 2005
• Summit Award Winner November 2006 and 2007
• Health Leaders Award 2007
• Leadership of Belmond Medical Center, January
  2007
• Bronze IRPE Award 2007, Silver IRPE Award 2008
• Studer Hall of Fame Steve Simonin, CEO 2008

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Quint Studerwww.studergroup.com
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Healthcare Flywheel
SM

• Results tied to each pillar

• Prescriptive To Dos
• Hope, Return to Roots of Healthcare

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WMC Leadership Model
Pillars
Culture
Service
Growth
Core Purpose Mission Vision Values
Continuous Feedback
Organizational Excellence
Family Atmosphere
Quality
Finance
Accountability
People
Community
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WMC Goals and Desires

• The best place for patients to receive care
• The best place for employees to work
• The best place for physicians to practice

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WMC Mission

• Wright Medical Center is committed to providing
  an exceptional healthcare experience.

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WMC Values

• Wright Medical Centers core values of attitude,
  respect, communication, ownership, and
  accountability are defined by our Standards of
  Behavior.

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Wright Medical Center VISION STATEMENT

• Wright Medical Centers vision is to challenge
  ourselves to consistently exceed expectations by
  providing the best healthcare based on a balanced
  pillar approach encompassing service, quality,
  finance, people, and growth. Through teamwork,
  increased profitability, targeted growth, and
  strong leadership, we will create a medical
  center that will be the new standard thus
  achieving the highest level of satisfaction for
  customers, providers, and employees.

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WMC Patient Satisfaction ResultsAccording to the
Press Ganey Measurement Tool

• When we started
• Inpatient- 85.6 mean
• 60
• ER- 90.1 mean
• 90
• Outpat.- 91.0 mean
• 60
• Amb.Surg. 89.2 mean
• 20
• Med.Prac.- 89.2 mean
• 50

• Current Results
• Inpatient- 94.7 mean
• 99
• ER- 92.0 mean
• 98
• Outpat- 95.5 mean
• 99
• Amb.Surg. 94.4 mean
• 94
• Med.Prac.- 94.4 mean
• 95

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WMC Employee Satisfaction Results According to
the Press Ganey Measurement Tool

• When we started
• No national measurement tool
• Culture was negative

• Current Results
• Overall Satisfaction-
• Report received 2008
• 95 National

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Build a championship culture is built around 6
pillars of Excellence

• Service
• Quality
• Financial
• People
• Growth
• Community

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Studer GroupNine Principles

• Commit to Excellence
• Measure the Important Things
• Build a Culture Around Service
• Create and Develop Leaders
• Focus on Employee Satisfaction
• Build Individual Accountability
• Align Behaviors with Goals and Values
• Communicate at All Levels
• Recognize and Reward Success

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Crosswalk between Baldrige Criteria and Studer
Group Principles

• Organizations that have implemented Baldrige
  criteria (systematic), Studer tools
  (prescriptive) and goals by pillars have achieved
  very good results in many of the Baldrige health
  care categories making the preparation for the
  Baldrige a natural crosswalk in your
  Organizational Excellence journey.
• The Baldrige criteria provide a framework for all
  of your improvements efforts in your
  organization.

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Baldrige Health Care CriteriaCategory 1
Leadership

• No secrets
• Effective communication
• Performance expectations
• Ethics
• Community responsibility

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Baldrige Health Care CriteriaCategory 2
Strategic Planning

• Pillars serve as basis for strategic plan
• Measurable goals
• Facility
• Departmental
• Individual
• Progress evaluation

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Baldrige Health Care CriteriaCategory 3
Customer Focus

• Customer expectations
• Individualized patient care
• Standards of Behavior
• Managing for innovation
• Service recovery
• Reward and recognition

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Baldrige Health Care CriteriaCategory 4
Measurement, Analysis and Knowledge Management

• Measure the important things
• Pillars as a means to organize and focus
• Data gathering processes
• LEM, SEM
• Rounding manager
• Discharge call process

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Baldrige Health Care CriteriaCategory 5
Workforce Focus

• Purpose, worthwhile work and making a difference
• Accountability
• Alignment of activities with the People Pillar
• Recruitment and career progression
• Peer interviewing
• 30/90 day evaluation
• H-M-L performer evaluations
• Leadership development

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Baldrige Health Care CriteriaCategory 6 Process
Management

• Cycles of process improvement
• Patient and employee rounding
• Discharge phone calls
• Hardwiring Excellence
• Approaches are well ordered, repeatable and
  continuous improvement is made possible

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Baldrige Health Care CriteriaCategory 7 Results

• Reinforces the ultimate goal of performance
  excellence is to improve results across the
  organization
• The Baldrige results categories and their aligned
  Studer Group Pillars are
• Health Care Outcomes Quality
• Customer Focus Outcomes Service
• Finance and Market Finance and Growth
• Workforce Focus Outcomes People
• Process Effectiveness Outcomes All Pillars
• Leadership Outcomes - Community

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Accountability

• Rounding (Staff and Patients)
• Standards of Behavior
• H-M-L discussions
• Common Evaluation system
• LEM
• Staff appreciation (Thank you notes, Wow bucks,
  etc)
• Mandatory Meetings
• Service Recovery

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Studer GroupMust Haves(In order of sequence)

• Rounding for Outcomes
• Employee Thank-You Notes
• Employee Selection and First 90 Days
• Discharge Phone Calls
• Key Words at Key Times
• Aligning Leader Evaluations with Desired
  Behaviors

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What Employees are Looking For

• To know the organization has purpose and is
  moving in the right direction
• A Good supervisor that will work shoulder to
  shoulder
• Approachability
• Good interdepartmental relationships
• Efficient work systems
• Training and Personal Development
• Tools and equipment to do the job or to know why
  it is not available
• Appreciation
• Not work with low performers

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Where We Were - 2001

• Wright Medical Center in 2000 12 million 2
  bottom line
• Didnt measure Patient or Employee Satisfaction
• 10-12 employee turnover
• 30 of local market utilization
• Didnt employ providers

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Where We Are

• Balanced scorecard, reporting with transparency
  to all employees and medical staff
• Market place dominance in patient satisfaction
• Recognition on State and National level for
  Quality, Service and Leadership

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Balanced Scorecard
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Inpatient Market Share Wright County 2004 - 2007
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WMC Employee Satisfaction Results According to
the Press Ganey Measurement Tool

• When we started
• No national measurement tool
• Culture was negative
• Turnover was High

Current Results

• Overall Satisfaction Report recd Oct/06 98
  National
• Employee Turnover 4

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Potential Bottom-line Results
People
Quality
Growth
Financial
Service

• Reduced claims
• Reduced legal expenses
• Reduced malpractice expense
• Improved patient satisfaction results for public
  reporting

• Improved clinical outcomes - decreased nosocomial
  infections
• Reduced length of stay (MUD)
• Reduced
• re-admits
• Reduced medication errors

• Reduced turnover
• Reduced vacancies
• Reduced agency costs
• Reduced overtime
• Reduced physicals cost to orient

• Higher volume
• Increased revenue
• Decreased left without treatment in the ED
• Reduced outpatient no-shows
• Increased physician activity

• Improved operating income
• Decreased cost per adjusted discharge
• Improved collections
• Reduced accounts receivable days
• Reduced advertising costs

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Pillar Teams

• Someone from each department is on a team and
  they must come back to their department meeting
  and give a Pillar Report
• Pillar teams meet monthly
• A senior leader is in charge of each Pillar
• If the staff person from the department does not
  attend, the department leader is called to attend
• Staff education regarding Service/Operational
  Excellence is now either done at quarterly
  meetings or special meetings are scheduled

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Balanced Pillars- Financial

• The Financial Pillar reviews on a monthly basis
  the income statement, budget deviations, balance
  sheet, statistics and benchmark reports for the
  entire facility
• Keeper of the rules (Medicare Cost Report)
• Bright Ideas Program and Award

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Balanced Pillars- Service

• The Service Pillar comes up with and implements
  ideas that give the patients at WMC World Class
  Service
• Working at boutiquing the medical center
• Follows up on the ideas generated from the
  bright ideas from the Financial Pillar
• Take patient satisfaction results back to their
  departments

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Balanced Pillars- Quality

• The purpose of the Quality Pillar is to monitor
  and insure that the best quality care is given to
  our patients
• Each department reports their quality studies on
  a quarterly basis
• A review of all incident reports is done
• Implement bright ideas submitted through
  financial pillar that deal with quality

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Balanced Pillars- People

• The People Pillar is working to make WMC the
  employer of choice for our service area
• Discuss and educate staff on benefit packages,
  policies etc.
• Provides a venue for an employee forum and input
  in the decision making process
• Helps to initiate the national Employee
  Satisfaction survey tool

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Balanced Pillars- Growth

• Responsible for the future direction and planning
  of the medical center
• Through input of team members researched the
  foundation of what growth looks like
• Outside of the Box thinking
• Works on planning and deploying a plan for those
  departments identified as growth areas of the
  hospital-both short term and long term

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Balanced Pillars - Community

• Improving the health of the communities we serve
• Innovative solutions to community needs though
  community, school, and business teams
• Bringing the community and WMC together through
  the pillar and volunteerism
• Engaging key community members for support and
  invoking the volunteer spirit

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Whats the ROI?

• Patient Satisfaction average of each of the
  five surveys done - 96
• Employee satisfaction 95 nationwide
• Financial margin FYE 2008 6.5
• Quality above quality indicators for Iowa
  Critical Access Hospitals, IRPE bronze award in
  2007, IRPE silver award in 2008
• Growth over 300 since 2006

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Why Organizations Do Not Attain/Sustain
Excellence

• Too many new behaviors introduced at once need
  of sequenced approach
• No process in place to re-recruit the high and
  middle performers and address low performers
  (HML)
• Inability to take best practices and standardize
  across organization
• Failure to have leaders always do desired
  behaviors

• Do not achieve critical mass - Lack of balanced
  approach (Principle 1)
• Leaders do not have the training to be successful
  (Principle 4)
• Absence of an objective accountability
  system(Principle 7)
• Dots are not connected consistently to purpose,
  worthwhile work and making a difference
  (Principle 8)

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Next Steps

• Must sustain results across the balanced
  scorecard
• Continuing a Baldrige journey with focus on
  hardwiring processes with transparent
  communication and strong accountability
• Maintaining passion through constant Sense of
  Urgency focus

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Never Underestimate The Difference You Can Make
Quint Studer