May 19, 2005 13th International HPH Conference Dublin Session II-4 1 13th International Conference on Health Promoting Hospitals -Session II-4- Dublin,

May 19, 2005 13th International HPH Conference DublinSession II-4

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13th International Conference on Health Promoting Hospitals

-Session II-4-Dublin, May 19, 2005

The Hospital as HPH-Strategy-Focused Organisation

Mag. theol. Elimar Brandt, BerlinProf. Dr.paed. Dr.sc.phil. Werner Schmidt, BerlinCA Dr.med. Rainer Hübner, Bernau

IMMANUEL DIAKONIE GROUPGERMAN HPH NETWORK (DNGfK)


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1. What should be implemented?

Strategic guidelines for healthpromotion in hospitals

„HPH-Strategy“

1.1 18 Core HPH Strategies

1.3 Standards for Health Promotion in Hospitals

1.2 Health Promotion Principles

(Pelikan u.a. 2005)

(Gröne u.a.2005)

(Rootmann u.a.2001)


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18 HPH Core Strategies(Pelikan u.a.)


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Six Core HPH Strategiesfor Hospital Patients

Quality development Strategic positioning

Patients as persons

PAT-1: Assuring/improving

health promoting living in the hospital for patients

PAT-4: Offering specific services for health promoting illness management for patients

Patients in their patient role

PAT-2: Assuring/improving

health promoting co-production of patients in treatment and care

PAT-5: Offering specific services for health promoting lifestyle development for patients

Hospital / community setting

PAT-3:Assuring/improving

a health promoting hospital setting for patients

PAT-6: Initiating of/participating in the development of health promoting community

settings for patients

(Pelikan u.a. 2005)


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Six Core HPH Strategies for Hospital Staff

Quality development Strategic positioning

Staff as persons STA-1: Assuring/improving

health promoting living in the hospital for staff

STA-4: Offering specific services for health promoting illness management for staff

Staff in their professional roles

STA-2: Assuring/improving

health promoting co-production of staff in work processes

STA-5: Offering specific services for health promoting lifestyle development for staff


STA-3: Assuring/improving

a health promoting hospital setting for staff

STA-6: Initiating of/participating in the development of health promoting community

settings for staff

(Pelikan u.a. 2005)


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Six Core HPH Strategies for the Hospital Community

HP Quality development

HP Strategic positioning

Citizens as persons

COM-1: Assuring/improving

health promoting access to the hospital for citizens

COM-4: Offering specific health promoting illness management for citizens

Citizens as patients


health promoting co-production with services in the region

COM-5: Offering specific health promoting lifestyle development for citizens



a health promoting hospital setting for citizens

COM-6:Initiating of /participating in the development of health promoting community settings for citizens

(Pelikan u.a. 2005)


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1.2 Health Promotion Principles

1. Empowering

2. Participatory

3. Holistic (physical + psychological + social)

4. Intersectoral

5. Equitable

6. Sustainable

7. Multistrategy

(Rootman et.al. 2001)


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1.3 Standards for Health Promotion in Hospitals

Standard 1: Management Policy

Standard 2: Patient Assessment

Standard 3: Patient Information and Intervention

Standard 4: Promoting a Healthy Workplace

Standard 5: Continuity and Cooperation


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2. How can be implemented?

Three basical options for strategy implementation

2.1 Integration of HP-Core Strategies in a TQM system (f.e. EFQM)

2.2 HP-Standard implementation in connection with a self-assessment tool

2.3 HPH-Policy implementation with EFQM & Balanced Scorecard (BSC)

(Brandt u.a. 2000, Pelikan u.a. 2003)

(Gröne u.a. WHO 2004)

(Brandt / Schmidt 2004)


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2.3 Implementation with BSC in connection with EFQM - Model

EFQMExcellence Model

BalancedScorecard

(BSC)

HealthPromoting

Organi-sationel

Structure&

Cultureof the

hospital

HPHPolicy


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BSC - Development for theImmanuel Diakonie Group

2.3.1 Determination of the strategic destination (Vision)2.3.2 Definition of strategic orientations2.3.3 Development and introduction of values2.3.4 Determination of strategic key themes2.3.5 Commitment to strategic objectives and

development of a strategy map incl. formulation of „Story of the strategy“

2.3.6 Balanced Scorecard with measurements, targets, and strategic initiatives


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2.3.1 Strategic destination (Vision) of the IMMANUEL DIAKONIE GROUP

„…The WHO HPH concept is inserted in connection with comprehensive quality

management in the organizational structure and culture of the hospital and the values of the Hospital Holding are observed in staffs

daily work in the hospital.” (2002)


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2.3.3 Values of the IMMANUEL DIAKONIE GROUP

• Development, discussion and validation of 18 values

• 12 of 18 values are directly related to the strategy standards and principles of health promotion in hospitals

• value 18 obliges explicit to integration of the WHO HPH Policy in the structure and culture of the organization (2003)


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2.3.4 Strategic Key Themes of the IMMANUEL DIAKONIE GROUP

• Health Promoting Corporate Culture

• Process Optimization and Quality Management

• Highest possible health gain through comprehensive patient orientation

• Partnership and Health Centers


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2.3.5 Commitment to 20 strategic objectives and development of a

strategy map


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BSC Characteristic

Concentration on 20 strategic objectives with max. per objective:

1-2 Measurements and1-2 Strategic initiatives

put in order 4 business perspectives» Finance» Customer» Processes» Innovation

With cause and effect relationships between strategic objectives.


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BSC structure(Example)

Diagram of the cause and effectrelationships between strategic objectives

Strategic Theme:Health Gain through Pat. Orient.

StrategicObjectives

Measurement Target StrategicInitiative

Patientneeds

consider&

documented

% Patientrecords

with doc. spec.pat.needs

F1 F2 F3

10% 30% 70% Task forcesPatient needs

Increase staffHP-Competence

Pat. needs considerand doc.

HP-Hospitalsetting

Pat. co-producerin treatment proc.

Increase health Gain

Increase patient

satisfaction

Increase customerloyalty

Make positiveoperating results


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HPH Policy and the Strategic Key Themes of theIMMANUEL DIAKONIE GROUP

•1. Health Promoting Corporate Culture(Standard 1 and 4)(Core Strategies for Staff)

• 2.Process Optimization and Quality Management (Standard 1 and 4)(Core Strategies for Staff)

• 3. Highest possible health gain through comprehensive patient orientation

(Standard 2 and 3)(Core Strategies for Patients)

• 4 Partnership and Health Centers(Standard 5)(Core Strategies for Community)

Strengthen staffs health

competence (I6)

Lead staff to success (I4)

Configurate and place a Immanuel Diakonie

Group related corporate

identity (P3)

Increase staff satisfaction (K2)

Arrange professional public relations (F4)

Health promotingcorporate culture

Promote communicantculture (I1)

Establish regularlyself-assements (I5)

Create transparent structures of

responsibility and information (P2)

Introduce a comprehensive

human resource development

(P7)

Make positive operating results (F2)

Process optimization and

quality management

Perceive patients, occupants and

relatives holistic (I2)

Identify and reduce

depreciative

processes (P6) Consider and

document the needs of patients

and occupants (P5)

Increase patient-, occupant- and relatives

satisfaction (K1)

Plan for case costs (F1)

Involve patient as co-producer of his health (P1)

Highest possible health gain through comprehensive

patient orientation

Distinguish performancespectrum (I3)

Promotin health in the region (K3)

Open additional business segments and financial

resources (F3)

Partnership andhealth centers

F

C

P

I

Strategy Map (Immanuel Diakonie Group Berlin)

Organize care

networks andcooperations

(P4)


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2.3.6 Balanced Scorecard IMMANUEL DIAKONIE GROUP

Strategic Objectives

Fin

ance

Cu

sto

mer

Pro

cess

esIn

no

vat

ion

F1 Plan for case costF2 Make positive operatingF3 Open additional business segments and financial resourcesF4 Arrange professional public relations

K1 Increase patient/occupant/relatives satisfactionK2 Increase staff satisfactionK3 Promoting health in region

P1 Involve patient as co-producer of his healthP2 Create transparent reponsibilty- & information structuresP3 Configurate & place a IDG related corporate identityP4 Organize care networks and cooperationsP5 Consider & document patient- & occupants needsP6 Identify & reduce depreciative processesP7 Introduce a comprehensive human resource development

I1 Promote communication cultureI2 Perceive patients, occupants & relativs holisticI3 Distinguish perfomance spectrumI4 Lead staff to successI5 Establish regularly self-assessmentsI6 Strengthen staffs health competence


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BSC Immanuel Diakonie Group(Perspective: Finance)

CS SHP PRI

StrategicInitiativeMeasurementStrategic Objectives

Fin

ance

F1 Plan for case cost

F2 Make positive operating

F3 Open additional business segments and financial resources

F4 Arrange professional public relations

% informed departments

% in turnover

% proceeds

Realization ratePR-Conception

Task forceInformation

Transfer

Quarterlyreports

Analysisadd.

business

PR-plan foraction

HPH Policy

CS:Core HPH StrategiesSHP: Standards HP

PRI: HP Principles

P4P5C4C5

5 7

1


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CS SHP PRI


Cu

sto

mer

C1 Increase patient/occupant/relatives satisfaction

C2 Increase staff satisfaction

C3 Promoting health in region

HPH Policy

Satisfaction index

Satisfaction index

Rate of RealisationRegionalHealth plan

Patientsurvey

Staffsurvey

ProjectRegional

Health

BSC Immanuel Diakonie Group(Perspective: Customer) CS:Core HPH Strategies

SHP: Standards HPPRI: HP Principles

P1P3

S1S2S3

C1C2C3C4C5S6P6

2

5

4

1

1

12


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CS SHP PRI


Pro

cess

es

P1 Involve patient as co-producer of his health

P2 Create transparent reponsibilty- & informationstructurs

P3 Configurate & place a HPH/ID Group related corporate identity

P4 Organize care networks and cooperation's

P5 Consider & document patient- & occupants needs

P6 Identify & reduce depreciative processes

P7 Introduce a comprehensive human resource development

% includedPatients (doc.)

Patientsurvey

Realizationinstallment

Task forceResponsib.

& Inf.Structure

•Realization Action plan•Awareness Pat. & Staff

Number & valuationof cooperation's

Task forceoptimize coop.

•Task forceValues

(implementation)•Pat./Staff servey

•Realization Pat.needs dok.•Pat. satisfaction (needs index)

Quality workingGroup

Patient needs

% change of processes

Improvementmanagement

Realizationinstallment

Personalmanagement

HPH Policy

BSC Immanuel Diakonie Group(Perspective: Processes) CS:Core HPH Strategies


P2P4

S2S3

S3P3

S6/P6 C1/C2 C6

P1P4

S2(1+3)

S2

3

4

1to5

5

2

4

4

2

12

1to7

47

12

2

12


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CS SHP PRI


I1 Promote communication culture

I2 Perceive patients, occupants & relatives holistic

I3 Distinguish performance spectrum

I4 Lead staff to success

I5 Establish regularly self-assessment

I6 Strengthen staffs health competence

Inn

ova

tio

n

HPH Policy

% departmentswith monthly activities

TrainingFeedback

culture

Score pro employeefor HCT participation

HolisticCompetence

Training (HCT)

Realization ofPDDC-Targets

Performancedistinguish

developmentconcept (PDDC)

•Number of EOC(Employee/year)•% aim agreements

•Manager-train.•Employee-

orientedConversation

(EOC)

•EFQM Self assessment(Score / RADAR)

•% EFQM-Train. Employee

EFQM Trainingof Self

Assessment-team

Number of supplies /year

HospitalsHealthyLifestyleSupplies

BSC Immanuel Diakonie Group(Perspective: Innovation) CS:Core HPH Strategies


S1S2S3

P1toP5

C1C2C3

S2(S1)(S3)

S2

S4S5

4

23

15

4

1

4

1to5

3

247

12

1+246+7

123


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Strategic Management Process with the Balanced Scorecard

Phase I:Development/

revise the Balanced Scorecard

Phase II:Communication

and Specification

Phase III:Translate into

operational control

Phase IV:Learning and

adaptation

( nach Horváth 2000))


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Implementation of the BSC

What does that mean?• 1. BSC: an integral part of the Management-

and Control systems• 2. BSC: an integral part of the Planning system • 3. Lead staff with BSC • 4. BSC: Integration in the Report system• 5. BSC and EFQM- Model coordinate use


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April 11, 2005: Start meeting for BSC Implementation

of the Immanuel Diakonie Group (in 3 hospitals) with 100 Participants

• Statement CEO• Nomination of „Responsible employees“ for

every Strategic Objective and for every Strategic Initiative

• Final Training• Next steps


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Consistency:

• The HPH Strategy/Policy is an integral part of the BSC of the Immanuel Diakonie Group

• The BSC of the Immanuel Diakonie Group is now the official Management instrument in the institutions of this Holding

• We are sure:


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The Strategic destination (Vision)of the Immanuel Diakonie Group

becoming reality:

„The WHO HPH concept is inserted in connection with comprehensive quality management in the organizational structure and culture of the hospital and the values of the Hospital Holding are observed in staffs daily work in the hospital.”


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[email protected]

[email protected]

Documents

May 19, 2005 13th International HPH Conference Dublin Session II-4 1 13th International Conference on Health Promoting Hospitals -Session II-4- Dublin,