52
Integrating the Baldrige Business Model in Healthcare: Integrating the Baldrige Integrating the Baldrige Business Model in Healthcare: Business Model in Healthcare: Our Journey To Performance Excellence Our Journey To Performance Excellence Our Journey To Performance Excellence Sherry Marshall, RN Vice President, Quality E. E. Fibuch, MD Professor and Chairman, Department of Anesthesiology University of Missouri-Kansas City School of Medicine Associate Director of Medical Affairs Saint Luke’s Hospital, Kansas City, Missouri The Quality Colloquium August 22 – 25, 2004 Sherry Marshall, RN Sherry Marshall, RN Vice President, Quality Vice President, Quality E. E. E. E. Fibuch Fibuch , MD , MD Professor and Chairman, Department of Anesthesiology Professor and Chairman, Department of Anesthesiology University of Missouri University of Missouri - - Kansas City School of Medicine Kansas City School of Medicine Associate Director of Medical Affairs Associate Director of Medical Affairs Saint Luke’s Hospital, Kansas City, Missouri Saint Luke’s Hospital, Kansas City, Missouri The Quality Colloquium The Quality Colloquium August 22 August 22 25, 2004 25, 2004

Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Embed Size (px)

Citation preview

Page 1: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Integrating the Baldrige Business Model in Healthcare:

Integrating the Baldrige Integrating the Baldrige Business Model in Healthcare:Business Model in Healthcare:

Our Journey To Performance ExcellenceOur Journey To Performance ExcellenceOur Journey To Performance Excellence

Sherry Marshall, RNVice President, Quality

E. E. Fibuch, MDProfessor and Chairman, Department of AnesthesiologyUniversity of Missouri-Kansas City School of Medicine

Associate Director of Medical AffairsSaint Luke’s Hospital, Kansas City, Missouri

The Quality ColloquiumAugust 22 – 25, 2004

Sherry Marshall, RNSherry Marshall, RNVice President, QualityVice President, Quality

E. E. E. E. FibuchFibuch, MD, MDProfessor and Chairman, Department of AnesthesiologyProfessor and Chairman, Department of AnesthesiologyUniversity of MissouriUniversity of Missouri--Kansas City School of MedicineKansas City School of Medicine

Associate Director of Medical AffairsAssociate Director of Medical AffairsSaint Luke’s Hospital, Kansas City, MissouriSaint Luke’s Hospital, Kansas City, Missouri

The Quality ColloquiumThe Quality ColloquiumAugust 22 August 22 –– 25, 200425, 2004

Page 2: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Saint Luke’s HospitalSaint Luke’s HospitalKansas City, MissouriKansas City, Missouri

Page 3: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Where We Came From…Where We Came From…

•• Founded in 1882Founded in 1882•• Reverend Henry David Reverend Henry David JardineJardine•• Articles of Agreement Articles of Agreement –– dated dated

October 3, 1882October 3, 1882•• Charity care was an important Charity care was an important

aspect of the agreementaspect of the agreement•• New hospital was designated New hospital was designated

a teaching institutiona teaching institution

Saint Luke’s HospitalSaint Luke’s Hospital

Page 4: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Who We Are Today…Who We Are Today…•• 582 beds582 beds•• 3186 employees3186 employees•• 500 physicians500 physicians•• Not for profitNot for profit•• Tertiary care referralTertiary care referral•• Protestant Episcopal ChurchProtestant Episcopal Church•• Primary teaching hospital Primary teaching hospital ––

UMKC School of MedicineUMKC School of Medicine•• Level I Trauma CenterLevel I Trauma Center•• Centers of ExcellenceCenters of Excellence•• Level III Neonatal careLevel III Neonatal care

Saint Luke’s HospitalSaint Luke’s Hospital

Page 5: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

MissionMissionCommitted to the highest levels of Committed to the highest levels of

excellence in providing health services excellence in providing health services to all patients in a caring to all patients in a caring

environment…dedicated to medical environment…dedicated to medical research and education.research and education.

Saint Luke’s HospitalSaint Luke’s Hospital

Page 6: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

What We Stand For…What We Stand For…Our Core ValuesOur Core Values

•• Quality/ExcellenceQuality/Excellence

•• Customer FocusCustomer Focus

•• Resource ManagementResource Management

•• Team WorkTeam Work

Be the BestBe the Best

Identify/Analyze ProblemsIdentify/Analyze Problems

High QualityHigh Quality

Corporate ComplianceCorporate Compliance

Courtesy/RespectCourtesy/Respect

Customer SatisfactionCustomer Satisfaction

Ethics/ConfidentialityEthics/Confidentiality

Celebrate DiversityCelebrate Diversity

Cost EffectiveCost Effective

FlexibilityFlexibility

CooperationCooperation

Honest CommunicationHonest Communication

Team CultureTeam Culture

Recognize AchievementRecognize Achievement

OORRGGAANNIIZZAATTIIOONNAALL

EEXXCCEELLLLEENNCCEE

122 YearsServing Kansas City

and the Region

Saint Luke’s HospitalSaint Luke’s Hospital

Page 7: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

LeadershipLeadershipStrategic PlanningStrategic Planning

Focus on Patients, Other Customers, and MarketsFocus on Patients, Other Customers, and MarketsMeasurement, Analysis, and Knowledge ManagementMeasurement, Analysis, and Knowledge Management

Staff FocusStaff FocusProcess ManagementProcess Management

ORGANIZATIONAL PERFORMANCE RESULTSORGANIZATIONAL PERFORMANCE RESULTS

......Because It’s Logical!Because It’s Logical!Why Pursue Baldrige?Why Pursue Baldrige?

ORGANIZATIONAL PERFORMANCE RESULTSORGANIZATIONAL PERFORMANCE RESULTS

Baldrige Business ModelBaldrige Business ModelRationaleRationale

Page 8: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Tailored to each organizationTailored to each organization•• Emphasizes strong leadership in an Emphasizes strong leadership in an

empowered work environmentempowered work environment•• Drives continuous improvementDrives continuous improvement•• Focused on resultsFocused on results

Criteria Provide a FrameworkCriteria Provide a Frameworkfor Organizational Activityfor Organizational Activity

Inpatient Test per Discharge Net Days Accounts Receivable Radiology Turnaround Time

Page 9: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•Manage FinancialPerformance•Manage Customers•Manage Growth

and Development•Manage Clinical

and Administrative Quality•Manage People

• Leadership• Strategic Planning• Patient/Customer

Focus•Measurement and

KnowledgeManagement• Staff Focus• Process Management• Results Focus

Strategic Focus Areas

Level 1 Processes Commitment to ExcellenceAssessment Model

Balanced Scorecard PerspectivesCustomer

SatisfactionFinanceGrowth &

Development PeopleClinical &

AdministrativeQuality

SSCCOORREECCAARRDD

BBAALLAANNCCEEDD

PPMMPP

PROCESSPROCESS SCORECARDSSCORECARDS

Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,III, IVProcess

ImprovementPlans

90-Day Action Plans IndividualDevelopment

Plans PerformanceImprovement& Innovation

KnowledgeSharing

Saint Luke’s HospitalSaint Luke’s HospitalSLH Leadership forSLH Leadership for

Performance Excellence ModelPerformance Excellence Model

Page 10: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•Manage FinancialPerformance•Manage Customers•Manage Growth

and Development•Manage Clinical

and Administrative Quality•Manage People

• Leadership• Strategic Planning• Patient/Customer

Focus•Measurement and

KnowledgeManagement• Staff Focus•• Process ManagementProcess Management• Results Focus

Level 1 Processes Commitment to ExcellenceAssessment Model

Balanced Scorecard PerspectivesCustomer

SatisfactionFinanceGrowth &

Development PeopleClinical &

AdministrativeQuality

SSCCOORREECCAARRDD

BBAALLAANNCCEEDD

PPMMPP

PROCESSPROCESS SCORECARDSSCORECARDS

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,III, IVProcess

ImprovementPlans

90-Day Action Plans IndividualDevelopment

Plans PerformanceImprovement& Innovation

KnowledgeSharing

Strategic Focus Areas Strategic Planning

Saint Luke’s HospitalSaint Luke’s HospitalSLH Leadership forSLH Leadership for

Performance Excellence ModelPerformance Excellence Model

Page 11: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Physicians as Partners Physicians as Partners

Mary Ellen Doyle Mary Ellen Doyle (CNO) and Mark (CNO) and Mark

McPhee, MD (VP)McPhee, MD (VP)

Clinical and Clinical and Admin QualityAdmin QualityPeter Holt, MDPeter Holt, MD

Immediate Immediate Past Past PresidentPresident

Jama Johnson Jama Johnson (CFO)(CFO)FinancialFinancialFred Plapp, MDFred Plapp, MDSecretary/Secretary/

TreasurerTreasurer

Dawn Murphy Dawn Murphy (VP)(VP)PeoplePeopleMark Bernhardt, MDMark Bernhardt, MDVice Vice

PresidentPresident

George Hayes George Hayes (COO)(COO)

Growth and Growth and DevelopmentDevelopmentMichael Borkon, MDMichael Borkon, MDPresident President

ElectElect

Kevin Thorpe Kevin Thorpe (VP)(VP)

Customer Customer SatisfactionSatisfactionAnn Warner, MDAnn Warner, MDPresidentPresident

Saint Luke’s Hospital

Page 12: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Performance MeasurementPerformance MeasurementSaint Luke’s HospitalSaint Luke’s Hospital

•• Primary measurement toolPrimary measurement toolBalanced ScorecardBalanced Scorecard

•• 5 perspectives5 perspectives•• Key measures linked to Key measures linked to

strategystrategy•• Scoring criteria set by Scoring criteria set by

statistical methods and statistical methods and benchmarksbenchmarks

•• Tracks overall organization Tracks overall organization performanceperformance

•• Provides organizational Provides organizational alignmentalignment

Page 13: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Balanced Scorecard Trend ChartsBalanced Scorecard Trend Charts

125

150

175

200

225

250

275

300

325

350

1998

99Q

2

99Q

4

00Q

2

00Q

4

01Q

2

01Q

4

02Q

2

02Q

4

03Q

2

03Q

4

Aver

age

Days

Days Cash on HandDays Cash on Hand0%

5%

10%

15%

20%

25%

03Q

3

03Q

1

02Q

3

02Q

1

01Q

3

01Q

1

00Q

3

% N

ot M

eetin

g Ex

pect

atio

n

Longer than ExpectedLonger than ExpectedWait Time (IP; OP; ED)Wait Time (IP; OP; ED)

7.0%

7.5%

8.0%

8.5%

9.0%

9.5%

10.0%

00Q

3

01Q

1

01Q

3

02Q

1

02Q

3

03Q

1

03Q

3

% E

ligib

le M

arke

t Sha

re

Eligible Market ShareEligible Market Share

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

$100,000

1998

99Q

2

99Q

4

00Q

2

00Q

4

01Q

2

01Q

4

02Q

2

02Q

4

03Q

2

03Q

4

Net R

even

ue A

dded

/FTE

Human Capital Value AddedHuman Capital Value Added

0123456789

10

1998

99Q

2

99Q

4

00Q

2

00Q

4

01Q

2

01Q

4

02Q

2

02Q

4

03Q

2

03Q

4

Aver

age

Scor

e

Maryland Quality Indicator IndexMaryland Quality Indicator Index

Performance MeasurementSaint Luke’s HospitalSaint Luke’s Hospital

Page 14: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Performance MeasurementSaint Luke’s HospitalSaint Luke’s Hospital

Page 15: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

9090--Day Action PlansDay Action Plans

•• Making it “real” for leaders…Making it “real” for leaders…–– Operating MarginOperating Margin

–– Patient Safety IndexPatient Safety Index

–– Inpatient SatisfactionInpatient Satisfaction

–– Revenue GrowthRevenue Growth

–– RetentionRetention

Saint Luke’s HospitalSaint Luke’s Hospital

Page 16: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• One BSC measure from each One BSC measure from each perspective is selected (Strategic perspective is selected (Strategic Focus Area Focus Area –– SFA)SFA)

•• Managers develop department 90Managers develop department 90--day day action plans for each SFAaction plans for each SFA

•• Provides alignment of Hospital strategic Provides alignment of Hospital strategic plan at the department levelplan at the department level

•• Provides focus for managersProvides focus for managers•• Results reported monthly and trended Results reported monthly and trended

over timeover time

BSC Departmental Report FormBSC Departmental Report Form

Saint Luke’s HospitalSaint Luke’s Hospital

Page 17: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

BSC Departmental Report FormBSC Departmental Report FormPerformance AnalysisSaint Luke’s HospitalSaint Luke’s Hospital

Page 18: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Performance Management CyclePerformance Management Cycle

•• PlanningPlanning –– goal setting goal setting at start of the yearat start of the year

•• CoachingCoaching –– through through the yearthe year

•• ReviewReview –– at the end of at the end of the year, with merit the year, with merit increase awardedincrease awarded

Saint Luke’s HospitalSaint Luke’s Hospital

Page 19: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Shared BehaviorsShared Behaviors::“What is expected of me as an “What is expected of me as an employee of Saint Luke’s Health employee of Saint Luke’s Health System?”System?”

•• Job Specific AccountabilitiesJob Specific Accountabilities::“What am I accountable for because “What am I accountable for because of the job I hold?”of the job I hold?”

•• Personal CommitmentsPersonal Commitments::”What goals will I commit to for the ”What goals will I commit to for the coming year based on my own coming year based on my own individual talents?”individual talents?”

Performance ManagementPerformance ManagementProcess by Core ValueProcess by Core Value

Saint Luke’s HospitalSaint Luke’s Hospital

Page 20: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Assure financial stability by SLH departments and Assure financial stability by SLH departments and services collectively achieving operating margin goal.services collectively achieving operating margin goal.–– Department Director Personal Commitment:Department Director Personal Commitment:

Assure financial stability of East 3 by meeting budgeted Assure financial stability of East 3 by meeting budgeted gross revenue and maintaining supplies, salaries and other gross revenue and maintaining supplies, salaries and other expenses within 2003 budget. Measured with the monthly expenses within 2003 budget. Measured with the monthly flex budget report.flex budget report.

–– Registered Nurse I Personal CommitmentRegistered Nurse I Personal Commitment::Achieve 100% accuracy on charge entry and documentation Achieve 100% accuracy on charge entry and documentation measured by quarterly unit auditsmeasured by quarterly unit audits

Alignment of Strategy with the Alignment of Strategy with the Performance Management Process (PMP)Performance Management Process (PMP)

Saint Luke’s HospitalSaint Luke’s Hospital

Page 21: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• PI Model used to design, manage and PI Model used to design, manage and improveimprove

•• Key RequirementsKey Requirements are driven by customers are driven by customers and operational needsand operational needs

•• Key MeasuresKey Measures are driven by customers and are driven by customers and organizational requirementsorganizational requirements–– Includes both Includes both inin--processprocess and and outcomeoutcome measuresmeasures

Determination of Key Determination of Key Health Care Delivery ProcessesHealth Care Delivery Processes

Saint Luke’s HospitalSaint Luke’s Hospital

Page 22: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Wait TimesWait Times

•• Admission Audit ResultsAdmission Audit Results•• TimelinessTimeliness

•• AccuracyAccuracy

AdmittingAdmitting•• SchedulingScheduling

•• PrecertificationPrecertification

•• RegistrationRegistration

Key MeasuresKey MeasuresKey RequirementsKey RequirementsHealth Care ProcessesHealth Care Processes

Key Health Care ProcessesKey Health Care Processes

Saint Luke’s HospitalSaint Luke’s Hospital

Page 23: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Infection ratesInfection rates•• Medication errorsMedication errors•• Mislabeled/unlabeled specimensMislabeled/unlabeled specimens•• 77thth Scope of Work clinical Scope of Work clinical

outcomesoutcomes•• Unplanned returnsUnplanned returns•• Medical staff clinical indicatorsMedical staff clinical indicators•• Cost per dayCost per day•• Length of stayLength of stay•• Potentially avoidable daysPotentially avoidable days•• JCAHO Core MeasuresJCAHO Core Measures

•• TimelinessTimeliness•• AccuracyAccuracy•• ReliabilityReliability•• AccessAccess•• ResponsivenessResponsiveness•• EmpathyEmpathy•• CompetenceCompetence

Multidisciplinary CareMultidisciplinary Care•• Initial assessmentInitial assessment•• PlanningPlanning•• InterventionIntervention•• EvaluationEvaluation•• ModificationModification•• ResolutionResolution

Key MeasuresKey MeasuresKey RequirementsKey RequirementsHealth Care ProcessesHealth Care Processes

Key Health Care ProcessesKey Health Care Processes

Saint Luke’s HospitalSaint Luke’s Hospital

Page 24: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Turnaround timesTurnaround times•• StockoutStockout ratesrates•• Nutrition assessmentNutrition assessment•• Discrepancy ratesDiscrepancy rates•• QA measuresQA measures

•• TimelinessTimeliness•• AccuracyAccuracy•• CompetencyCompetency•• AppropriatenessAppropriateness

Care support servicesCare support services•• LaboratoryLaboratory•• RadiologyRadiology•• PharmacyPharmacy•• NutritionNutrition

Key MeasuresKey MeasuresKey RequirementsKey RequirementsHealth Care ProcessesHealth Care Processes

Key Health Care ProcessesKey Health Care Processes

Saint Luke’s HospitalSaint Luke’s Hospital

Page 25: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Business/Support ProcessesBusiness/Support Processes•• EducationEducation•• ResearchResearch•• Supplier ManagementSupplier Management•• Revenue Cycle ManagementRevenue Cycle Management•• Physician PartneringPhysician Partnering•• Human Resource ManagementHuman Resource Management•• Facilities ManagementFacilities Management•• Health Information ManagementHealth Information Management•• Hotel Services ManagementHotel Services Management

Saint Luke’s HospitalSaint Luke’s Hospital

Page 26: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Admitting physician ratioAdmitting physician ratio

•• Variable cost per caseVariable cost per case

•• IP tests/dischargeIP tests/discharge

•• Physician satisfactionPhysician satisfaction

•• PCP referralPCP referral

•• Physician participationPhysician participation

•• Improved productivityImproved productivity

•• Ease of accessEase of access

•• Physician partneringPhysician partnering

Key MeasuresKey MeasuresKey RequirementsKey RequirementsSupport ProcessesSupport Processes

Support Processes (example)Support Processes (example)

Saint Luke’s HospitalSaint Luke’s Hospital

Page 27: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Cash collections to targetCash collections to target•• Charge process auditCharge process audit•• Net days in Accounts Net days in Accounts

ReceivableReceivable•• Discharges not final billedDischarges not final billed•• Accounts per collectorAccounts per collector•• Calls received Calls received vsvs statements statements

sentsent•• Customer satisfactionCustomer satisfaction

•• CostCost•• QualityQuality•• TimelinessTimeliness•• EfficiencyEfficiency•• Patient friendly billing Patient friendly billing

teamteam

•• Revenue cycle Revenue cycle managementmanagement

Key MeasuresKey MeasuresKey RequirementsKey RequirementsSupport ProcessesSupport Processes

Support Processes (example)Support Processes (example)

Saint Luke’s HospitalSaint Luke’s Hospital

Page 28: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

ProcessProcess ScorecardsScorecards

Achieving Strategic Alignment Achieving Strategic Alignment Throughout the SLHSThroughout the SLHS

Saint Luke’s HospitalSaint Luke’s Hospital

Saint Luke’s HospitalSaint Luke’s Hospital

Saint Luke’s Health SystemSaint Luke’s Health System

Department UnitsDepartment Units

Individual EmployeesIndividual Employees

Page 29: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Recognition that all work is a process Recognition that all work is a process designed to meet customers’ needsdesigned to meet customers’ needs

•• Do we really understand how well our Do we really understand how well our processes are working?processes are working?

•• Serves to link daily operations, inServes to link daily operations, in--process process measures and BSC outcomes measuresmeasures and BSC outcomes measures

•• Used by process owners to monitor overall Used by process owners to monitor overall process performanceprocess performance

Why Process Level Scorecards?Why Process Level Scorecards?

Saint Luke’s HospitalSaint Luke’s Hospital

Page 30: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• MQA and Baldrige feedback:MQA and Baldrige feedback:–– SLH focus is on continuous improvementSLH focus is on continuous improvement–– Processes are not wellProcesses are not well--defined, defined,

documented and identified in many areasdocumented and identified in many areas–– Better definition of processes and better Better definition of processes and better

measurement of processes can yield even measurement of processes can yield even greater improvement opportunitiesgreater improvement opportunities

Saint Luke’s HospitalSaint Luke’s Hospital

Why Process Scorecards?Why Process Scorecards?

Page 31: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

RelationshipsRelationships

OrganizationalScorecard Process

ScorecardProvides Inputs

Enables Drill DownInto Processes

Saint Luke’s HospitalSaint Luke’s Hospital

Page 32: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

RelationshipsRelationships•• Organizational ScorecardOrganizational Scorecard

–– Is focused on key performance indicatorsIs focused on key performance indicators–– Enables determination of organizational healthEnables determination of organizational health–– Enables focus on improving in key areasEnables focus on improving in key areas

•• Process ScorecardProcess Scorecard–– Defines the activities within processes and handoffsDefines the activities within processes and handoffs–– InIn--process measures identify key control data pointsprocess measures identify key control data points–– Enables drillEnables drill--down to areas affecting performancedown to areas affecting performance–– Outcomes of processes feed the Organizational Outcomes of processes feed the Organizational

ScorecardScorecard–– Becomes the foundation for process improvement Becomes the foundation for process improvement

activitiesactivities

Saint Luke’s HospitalSaint Luke’s Hospital

Page 33: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Level 1 ProcessesLevel 1 Processes

•• Perform Financial ManagementPerform Financial Management•• Satisfy CustomersSatisfy Customers•• Enhance Growth and DevelopmentEnhance Growth and Development•• Provide Clinical and Administrative Provide Clinical and Administrative

ServicesServices•• Manage Human ResourcesManage Human Resources

Saint Luke’s HospitalSaint Luke’s Hospital

Page 34: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Level 2 Processes :Level 2 Processes :Manage Human ResourcesManage Human Resources

•• Hire staffHire staff

•• Orient new employeesOrient new employees

•• Train staffTrain staff

•• Develop staffDevelop staff

•• Motivate staffMotivate staff

Saint Luke’s HospitalSaint Luke’s Hospital

Page 35: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Level 3 Processes:Level 3 Processes:Motivate StaffMotivate Staff

•• Segment employeesSegment employees•• Determine employee satisfactionDetermine employee satisfaction•• Recognize employeesRecognize employees•• Provide and administer benefits and Provide and administer benefits and

compensationcompensation•• Provide a safe work environmentProvide a safe work environment

Saint Luke’s HospitalSaint Luke’s Hospital

Page 36: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Process Scorecard Process Scorecard –– ResultsResultsProcess: Employee Recognition Senior Leader Dawn Murphy

DEEP BLUEStretch Target

10Outstanding

LIGHT BLUEStretch

9,8Exceeds

Expectation

GREENGoal

7Meets

Expectation

YELLOWModerate

6,5,4Needs

Improvement

REDRisk3,2,1

ImmediateAction

Performance LevelSeptember, 2003

Measure MonthlyPerformance

Scoring Criteria (2003)

BSC Retention 89.8 > or = 86.9% 85.1 - 86.8% 83.3 - 85.0% 79.7 - 83.2% 76.0 - 79.6%Job: 61.6 > or = 67.3 61.7 - 67.2 56.5 - 61.6 51.7 - 56.6 < or = 51.6Supervisor: 59.8 > or = 70.6 59.9 - 70.5 49.2 - 59.8 38.4 - 49.1 < or = 38.3Commun: 53.9 > or = 55.3 54.6 - 55.2 53.3 - 53.9 58.5 - 53.2 < or = 53.1

Stay InterviewResults

Benefits: 60.7 > or = 72.5 60.8 - 66.6 54.9 - 60.7 49.0 - 54.8 < or = 48.9Angel: 4.4Teamwork: 4.3EOM: 4.7Nursing: 3.9

EmployeeRecognitionPrograms surveyresults

Tool Kit: 3.6

4.6- 5.0 4.1 - 4.5 3.6 - 4.0 3.1 - 3.5 < or = 3.0

Employeeparticipation inRecognitionprograms

299 > or = 310 302 - 309 296 - 301 275 -295 < or = 274

Employee sat :”Iam recognizedfor my work.”

68.2% Historical Data Not Available

Saint Luke’s HospitalSaint Luke’s Hospital

Page 37: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Saint Luke’s HospitalSaint Luke’s HospitalProcess Scorecard Process Scorecard –– ResultsResults

Page 38: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

So, Has the Baldrige So, Has the Baldrige Management Model Made a Management Model Made a

Difference?Difference?

Page 39: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Improved Financial PerformanceImproved Financial PerformanceOrganizational RewardsOrganizational RewardsBaldrige Business ModelBaldrige Business Model

100

150

200

250

300

350

400

1999 2000 2001 2002 2003

Day

s

SLH A Bond BETTERBETTER

Days Cash on HandDays Cash on Hand

Page 40: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Improved Customer SatisfactionImproved Customer SatisfactionOrganizational RewardsOrganizational RewardsBaldrige Business ModelBaldrige Business Model

75

80

85

90

95

100

1999 2000 2001 2002 2003

%

IP OP ED BETTER

Patient SatisfactionPatient Satisfaction

Page 41: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Sustained High Levels of Consumer PerceptionSustained High Levels of Consumer Perception

Organizational RewardsOrganizational RewardsBaldrige Business ModelBaldrige Business Model

NRC Perception Rankings vs. Top CompetitorsNRC Perception Rankings vs. Top Competitors

1122336655881616

20022002

1144335522661515

20022002

1122447755881616

20022002

Best NursesBest NursesBest DoctorsBest DoctorsOverall QualityOverall Quality

112233556613131515

113322886610101515

113355662212121515

113344772210101717

112233554413131212

112233665515151414

SLHSLHBBCCDDEEFFGG

200120012003200320012001200320032001200120032003HospitalHospital

Page 42: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Saint Luke’s HospitalSaint Luke’s HospitalProfitable Market ShareProfitable Market Share

8.0%

8.5%

9.0%

9.5%

10.0%

02Q1 02Q2 02Q3 02Q4 03Q1 03Q2 03Q3 03Q4

Per

cent

8.0%

8.5%

9.0%

9.5%

10.0%

02Q1 02Q2 02Q3 02Q4 03Q1 03Q2 03Q3 03Q4

Per

cent

BETTER

Page 43: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Improved Clinical OutcomesImproved Clinical OutcomesOrganizational RewardsOrganizational RewardsBaldrige Business ModelBaldrige Business Model

0

5

10

15

20

25

30

2000 2001 2002 2Q03

% o

f Pat

ient

s

SLHNational AverageNext Best

BETTERBETTER

Patients Receiving tPA Following Ischemic StrokePatients Receiving tPA Following Ischemic Stroke

Page 44: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• High Levels of Employee SatisfactionHigh Levels of Employee SatisfactionOrganizational RewardsOrganizational RewardsBaldrige Business ModelBaldrige Business Model

0

10

20

30

40

50

60

70

80

90

100

Diversity Mission Pride Accomplishment Overall Satisfaction

%

1999 2000 2001 2002 2003BETTERBETTER

Employee SatisfactionEmployee Satisfaction

Page 45: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

75

80

85

90

1998 1999 2000 2001 2002 2003

%

SLH Saratoga Institute

•• High Employee RetentionHigh Employee RetentionOrganizational RewardsOrganizational RewardsBaldrige Business ModelBaldrige Business Model

SLH RetentionSLH Retention

BETTERBETTER

Page 46: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Improved ProductivityImproved ProductivityOrganizational RewardsOrganizational RewardsBaldrige Business ModelBaldrige Business Model

Human Capital Value AddedHuman Capital Value Added

40

50

60

70

80

90

1998 1999 2000 2001 2002 2003

$K

SLHSaratoga Institute

BETTERBETTER

Page 47: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Saint Luke’s HospitalSustaining Performance Excellence

Saint Luke’s HospitalSaint Luke’s HospitalSustaining Performance ExcellenceSustaining Performance Excellence

•• Leadership drives and sustains the Leadership drives and sustains the processprocess

•• Leadership at all levels is importantLeadership at all levels is important•• More difficult to change the culture than More difficult to change the culture than

to learn the toolsto learn the tools•• Valuable team building experienceValuable team building experience•• Trust is extremely important Trust is extremely important

Lessons LearnedLessons Learned

Page 48: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• There are no “quick fixes”There are no “quick fixes”•• Must always focus on the customerMust always focus on the customer•• Should never be satisfied with the Should never be satisfied with the

present level of qualitypresent level of quality•• Decisions must be driven by data and Decisions must be driven by data and

compared to “best”compared to “best”•• Employees make it happen!Employees make it happen!

Lessons LearnedLessons Learned

Saint Luke’s HospitalSustaining Performance Excellence

Saint Luke’s HospitalSaint Luke’s HospitalSustaining Performance ExcellenceSustaining Performance Excellence

Page 49: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Study our feedback reportStudy our feedback report

•• Celebrate our strengthsCelebrate our strengths

•• Prioritize our OFIsPrioritize our OFIs

•• Use feedback to improveUse feedback to improve

•• Continue to share what we’ve learnedContinue to share what we’ve learned

•• Continue to learn from othersContinue to learn from others

Next StepsNext Steps

Baldrige Business ModelBaldrige Business Model

Page 50: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

•• Feedback, Feedback, Feedback!Feedback, Feedback, Feedback!

•• Criteria is the Best Way to Get Better, FasterCriteria is the Best Way to Get Better, Faster

•• Enhanced Our Internal PrideEnhanced Our Internal Pride

•• Positions Us Ahead of Our CompetitionPositions Us Ahead of Our Competition

•• Recognized as an Industry LeaderRecognized as an Industry Leader

•• Raises Healthcare Industry to Higher Levels Raises Healthcare Industry to Higher Levels of Performanceof Performance

The ValueThe ValueBaldrige Business ModelBaldrige Business Model

Page 51: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Our People Make the DifferenceOur People Make the Difference

They Are Our Competitive Advantage!They Are Our Competitive Advantage!

Saint Luke’s HospitalSaint Luke’s Hospital

Page 52: Integrating the Baldrige Business Model in Healthcare: · PDF fileIntegrating the Baldrige Business Model in Healthcare: ... Our Journey To Performance ExcellenceOur Journey To Performance

Thank You Thank You For Your AttentionFor Your Attention

Are There Any Questions?Are There Any Questions?