Our Journey

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Our Journey
Lisa MichaelisHeartland Regional Medical Center
Administrator
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Overview

• Why we do what we do
• Our Journey to Quality - Baldrige
• Voice Of Customers (VOC)
• Connection to Purpose
• Customer Engagement
• Workforce Engagement

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Heartland Health, St. Joseph, Mo.
Heartland is a fully integrated health-care
delivery system, located in the heart of America
and comprised of four entities

• Heartland Regional Medical Center
• Heartland Clinic
• Heartland Foundation
• Community Health Improvement Solutions

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Heartland Health, St. Joseph, Mo.
To make Heartland Health and our service area the
best and safest place in America to receive
health care and live a healthy and productive
life. Heartland Healths vision
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Why We Do what we do
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• 65 percent overweight or obese
• School district reports an alarming increase in
  obesity
• Direct connection between poverty and obesity

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• Nine percent of people in St. Joseph live with
  diabetes
• In the under 15,000 bracket, rate soars to
  nearly 21 percent

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1 out of 4 people in St. Joseph smoke Under
15,000 income bracket, the smoking rate doubles!
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Our community needs more than a hospital
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• Included in Strategic Planning Process
• Community health needs assessment
• Listen to the voice of the customer

because we care
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89 percent of students say they can makea
difference
The emPower Plant program provides a handson
experience for students on the brink of adulthood
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• Youth Health Partnership
• Increase childhood immunizations andwellchild
  exams
• Reduce teen pregnancy
• Improve oral health care

The Health Express
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• Pound Plunge 12week, team approach, weight
  loss challenge
• National model for community health improvement
  events

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Community Health Improvement Solutions Wellness
Connections program creates health and wellness
plans for individual businesses
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Innovation putting the needs of the patient
first
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Why Baldrige
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• Recognition
• Change course

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• CEO support
• Few key leaders spearheaded efforts
• Small group assisted

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• Organizational Structure
• Measurement
• Quality focus
• Growth
• Leadership Changes

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• Excellence in Missouri Foundation
• Balanced scorecards
• Processes
• Customers
• Leadership
• Performance Improvement
• Across entire organization

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• Needed to enhance knowledge of the criteria
• Trained eight employees as examiners
• Deep understanding of customers
• Success with performance improvement

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• Shifted to more of a team approach
• Category leads and teams formed
• Focus on integration and learning

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Voice of our Customers
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Hospital and Clinic Inpatients Outpatients ER Clin
ics Community Health Improvement
Solutions Members Community Heartland
Foundation Community Region
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(2)
(3)
(5)
(1)
(4)
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If its important to them,its important to us.
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Key Customer Requirements Satisfaction Priorities/ Examples Customer Segment Listening and Input Methods
Patients Inpatient Satisfiers/Priorities
Comfort Pain Personal needs Compassion Response to concerns/complaints Address emotional needs Includes you in decisions Addresses Pain Patient Surveys D, M Discharge Calls D Key Words D Rounding - D
Key Frequency AAnnual, B-Biennial, D-Daily, M-Monthly, P-Periodic, ANAs Needed Key Frequency AAnnual, B-Biennial, D-Daily, M-Monthly, P-Periodic, ANAs Needed Key Frequency AAnnual, B-Biennial, D-Daily, M-Monthly, P-Periodic, ANAs Needed

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• Collect, review and assess voice of the customer
  data and inputs
• Performance improvement

Listening to their concerns
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• Multiple Methods (Figure 6.1-1)
• Problem, Analysis, Solution, Transition,
  Evaluation (PASTE) continuous improvement
• PASTEplus with Black Belt support
• PASTEplus for Design design or redesign with
  Black Belt Support

Continuous
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• 90-Day action plans, Balanced Scorecard (BSC) and
  goals
• Requirements shared with the caregivers, medical
  staff, board

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• Opportunities for improvement
• Cycles of improvement

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Connection to Purpose Customer Engagement
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• Patient
• Member
• Community
• Region

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• Rounding
• Satisfaction surveys
• Community perception survey
• Focus groups

Voice of the Customer
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• Leader action plan
• Rounding with patients, members and caregivers
• Service recovery
• Thank you notes
• Coaching and teaching

• Keywords
• Discharge calls
• Behavioral standards
• Individual care plan
• Leader goals

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• Health improvement programs
• Community forumssummits
• Community Alliance
• Corporate citizenship
• Youth health
• Senior health
• Employee health

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• Heartland Foundation regional development
• Regional electronic medical record
• Specialty clinics

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PG Press Ganey
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Key Drivers
PG Press Ganey
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Connection to Purpose - Workforce Engagement
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Employees
Physicians
Volunteers
Everyone is a caregiver at Heartland
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Our Aspiration Creating an engaging workplace
culture for our patients to receive care, for our
caregivers to work, for our physicians to
practice and for our community members to
volunteer.
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Heartlands People Plan Workforce Alignment
ENGAGEMENT OF Leadership Caregivers Physicians Volunteers INTEGRATION OF HRMC HC CHIS HF ROLE CAPABILITIES Skills Competencies Education Certifications Licensures Essential Requirements Physical capacity BEHAVIOR STANDARDS Respect Counts HEART Hear Excellence Appearance Responsibility Teamwork
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• Employer of Choice, a strategic goal
• Aligned to organizational needs relative to
• Capacity
• Capability
• The safety and security of our workforce is
  essential to our workforce plans
• HEART behaviors set common standard for
  caregivers, physicians, volunteers and leaders

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Behaviors HOW You Do It
HEART behaviors lay a foundation for our
culture H Hear Voice of the Customer E
Excellence Life long learning A Appearance
Creating a positive impression R
Responsibility Adhering to standards T
Teamwork Collaborating with others
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Hire the right people a servants heart
combined with the skills and competencies to
achieve our strategic priorities.
Engagement begins day one. Expectations and
enculturation vital
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• Development and Learning
• Aligned to Strategic Planning Process
• Leadership effectiveness a clear differentiator
• New expectations for formal education completion
• Specific focus on our high performers

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Investment in Leadership

• Leadership Development Institutes
• Highly inclusive
• Partnership with Advisory Board Company
• Themes and seating arrangements encourage
  relationship building
• Accountability Teamwork Developing Staff
  Critical Conversations Influence Conflict
  Management Leading Change
• Fellowship of the Advisory Board Company
• Mini-MBA
• National Track for High Potential Front-Line
  Leaders
• Local Cohort with Administrators/Physician
  Leaders
• Physician Leadership Academy
• Topics aligned to the rest of our Leadership
  Curriculum
• Introduced by CEO Dr. Laney
• Employed and independent physicians invited
• Leverages physicians voice in strategic
  conversations

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AFR A BIG Breakthrough for Us

• Critical Conversations and AFR Strategy
• SIX LDIs across eighteen months focused on
  leader skill-building, practice and stories
• Dr. Mark Laney, CEO (hired in summer, 2009)
  unconditionally supported full implementation
• Human Resources on Deck

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HEART Behavior Standards
RARELY
FREQUENTLY
ALWAYS
ALWAYS Caregivers go to Staff Development
Institutes are offered stretch assignments and
wear an Always Badge
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• Many ways to reward and
• recognize
• Competitive benefits/compensation
• Sharing Success
• Wellness programs (walking the talk)
• Touchstone
• All designed to reinforce
• Heartlands strategic priorities
• and align to organizational
• core competencies

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Physician Engagement

• A key priority
• Selection of Physician CEO in 2009
• Leadership Structure Dyads
• Quality Management Committee leading quality,
  PI and capital expenditures
• Physician Leadership Development aligned with the
  rest of our leadership offerings

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• A critical extension of our workforce
• HEART expectations aligned
• Assignments based upon organizational Fit and
  interests
• Involvement in operational value activities
• Patient visitors
• Guest Services
• Discharge Transport

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Auxiliary of the Year
(Missouri Hospital Association)
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Caregiver Satisfaction Results
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Goal 80th Percentile Goal 80th Percentile Goal 80th Percentile COMPARISON COMPARISON COMPARISON
Organization 2010 Organization Mean 2010 Percentile 2010 All Hospital DB (393) 2010 2001-3000 FTE DB (22) Baldrige Facilities (12)
HH 76.2 83rd 83rd 95th 82nd
HRMC 75.5 80th 80th 90th 78th
HC 79.3 94th 94th 99th 90th
CHP/CHIS 80.0 95th 95th 99th 99th
LTACH 66.5 20th 20th 16th 1st
HF 71.6 52nd 52nd 49th 21st
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Percentile performance improved from the 23rd
Decile in 2008 to 81st Decile in 2010!
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• Focus on behavior to drive engagement/
  satisfaction
• Engagement of physicians in robust leadership
  learning
• Quarterly LDIs and our Fellowships build
  leadership skill with demonstrable improvement in
  engagement and patient satisfaction
• SDIs develop informal leaders and contribute to
  succession management

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• Transition from satisfaction to a Patient
  Experience focus
• Improve engagement and partnerships with medical
  staff and physician leadership
• Improve linkage of learning initiatives to
  application in day to day work
• Accelerate leadership learning to assure
  caregivers, medical staff are ready for
  health-care reform

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• Every element of our People Plan is with an eye
  on supporting the strategic priorities of
  Heartland
• Engaging all members of our workforce
  caregivers, physicians and volunteers assures
  we meet our service areas health-care needs now
  and in the future
• Our strong focus on leadership development at all
  levels will help us navigate uncertainties posed
  by healthcare reform and a shift toward more
  value for health care dollars spent

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Engaged in the community Demonstrates
performance excellence Provides patient
safety Best in value
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• Balance process and customer relationships
• Longterm health improvement and illness
  prevention is the model for health-care reform
• It takes a team
• Lead with a servants heart
• What is best for the customer

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• Transparency
• Develop systems and key processes
• Listen Engage
• Link strategy, customer, workforce and
• performance improvement

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November 11 12, 2010 January 13 14,
2011 March 3 - 4, 2011
Register at www.heartland-health.com/baldrige