Transcript No Slide Title
Newton-Wellesley Hospital Rising From the Ashes!
Pat Jordan Chief Operating Officer Bentley College June 18, 2009
State of the Union – FY01
•$1M per month loss for 54 months •Total clinical revenue $122M •No capital, no training •Limited patient satisfaction surveying •(39 th percentile - Inpatient) •Employee turnover 20+% •Low morale
State of the Union – FY01
15,000 10,000 5,000 0 -5,000 -10,000 -15,000 -20,000 -25,000 FY 1993 FY 1994 FY 1995 FY 1996 FY 1997 FY 1998 FY 1999 FY 2000 NWH Operating Income
FY01 – 02 Increase Volume
•Financial State-of-Emergency •Capital investment •Grow with Partners affiliation •Consumer image campaign •Maintain focus on quality
Partners Collaborations
Clinical Collaborations Mass General Hospital for Children Breast Center/Breast & Ovarian Cancer Risk Assessment Program Spine Center Joint Center Cardiology (EP and ECHO) Vascular Surgery Thoracic Surgery Obstetrics Maternal Fetal Medicine Gyn Oncology Radiation Oncology Endocrinology General Surgery PET/CT MIGS Assisted Reproductive Medicine Psychiatry Teaching Collaborations: Residency program in Surgery Residency program in Pediatrics Residency program in Medicine Residency program in Anesthesia Residency program in Psychiatry (MGH/McLean) 50+ MGH staff physicians on campus 50+ NWH medical staff training with MGH
NWH Growth
New Emergency Department 4 new Operating Rooms Joint Center Bariatric Center Cancer Center/Radiation Oncology Primary Care Cardiology/Vascular Services UCC New Beds ASC
MetroWest Mt. Auburn NWH St. E’s 10 mi BI N Caritas Norwood
The Market
BIDMC BWH NEMC MGH
FY03 Create Loyalty
•Benchmark with Marriott, RMV, Greenwich •Healthcare Advisory Board •Baptist •Management Team to Pensacola •Connect with Quint •Adopt pillar model/balanced scorecard
FY09 Operating Goals & Objectives
CareFirst Service
Top 5% in Patient Satisfaction.
People Quality/ Safety Finance Growth
Voluntary annual turnover rate of 8% or less.
Employee Survey in Q2 FY09.
Plan for Physician Satisfaction Survey FY10 Achieve a patient fall rate below the NDNQI 25 th percentile Implement EMAP for 75% of licensed inpatient beds by Q1 FY10 Achieve 90 % hand hygiene compliance before and after patient contact Achieve Influenza Vaccine Rates, Q2 FY09 80%- eligible employees 80%- eligible inpatients Ambulatory E-Prescribing of 80% by end of Q4 FY09 Maintain transfers due to lack of beds to 9 or less per month Achieve margin of $12.7M for NWH and Affiliates Meet or exceed performance based Achieve budgeted FY09 volume representing 4% growth in inpatient discharges, and 9% growth in outpatient activity.
contract targets: Recruit 10 PCP’s Achieve 100% of withhold Improve patient Achieve $1.625M savings from operations improvement activities through-put to reduce LOS by 4 hrs without a statistically significant increase in re-admission rates Prepare for COMPASS system implementation in Q1FY10 Build Cancer Center and 24 bed I/P unit to increase bed capacity
CareFirst Service
Inpatient Satisfaction
* Compared to MA Peer Group
87.1
100 90 80 30 20 10 0 70 60 50 40 Press Ganey Quarterly Results Quarter To Date Press Ganey Results 85.8
100 90 80 70 60 50 40 30 20 10 0
CareFirst Service
ED Patient Satisfaction
* Compared to MA Peer Group 87.3
86.3
Press Ganey Quarterly Results Quarter To Date Press Ganey Results
100 90 80 70 30 20 10 0 60 50 40
CareFirst Service
Outpatient Satisfaction
* Compared to AHA Region 1
93.1
92.1
Press Ganey Quarterly Results Quarter To Date Press Ganey Results
100 90 80 20 10 0 70 60 50 40 30
CareFirst Service
Ambulatory Surgery Patient Satisfaction
* Compared to AHA Region 1 93.2
93.9
Press Ganey Quarterly Results Quarter To Date Press Ganey Results
50 40 30 20 10 0 100 90 80 70 60
CareFirst Service
Urgent Care Center Patient Satisfaction
* Compared to All Facility DB 87.1
87.9
Press Ganey Quarterly Results Quarter To Date Press Ganey Results
Service Tactics
Greeter Program Tools & Equipment Scripting in Key Areas Support Cards Service Recovery Discharge Phone Calls Service Operations Committee Service Academy
Support Cards
Support Card
Gina Kline, and Kristy Boyd
Unit Date:
Tanger 4 West 11-Oct-02
Please rate each department on a scale of 1(very poor), 2 (poor), 3 (fair), 4 (good), 5 (very good), or N/A (not applicable) Standard:
Accessibility Timeliness Accuracy Attitude Operations
Can we reach a live person or use an electronic system s tool for reach out?
Response tim e and delivery when prom ised Did we receive the right product or was a variation com m unicated?
Was it a nice experience? Did you receive service with a sm ile?
Day to day operations are run effectively and efficiently?
SHIFT
Day Eve Noc Day Eve Noc Day Eve Noc Day Eve Noc Day Eve
FOOD SERVICES
Kevin O'Connor #57794
SUPPLIES
Charlie Miceli #56584
ENVIRONMENTAL SERVICES
Rudy Viscomi #51460
TRANSPORT
Rudy Viscomi #51460 5 4 5 4 4 4 4 4 N/A 4 3 4 5 4 4 3 3 4 4 4 N/A 4 3 4 5 5 5 3 5 5 5 4 N/A N/A N/A 4 4 5 5 4 4 5 5 4 N/A N/A 5 4 5 5 4 4 5 5 4 4
EQUIPMENT
Rudy Viscomi #51460
BIO-MED ENGINEERING
Charlie Miceli #56584
LINEN
Rudy Viscomi #51460
PHARMACY
Steve Clark #51308
ENGINEERING/MAINTENANCE
Bill Sullivan #57645 4 5 5 5 5 4 N/A N/A 5 5 5 4 N/A N/A N/A 4 5 5 4 5 4 N/A N/A 5 5 5 4 N/A N/A N/A 4 5 5 5 5 4 N/A 5 5 5 4 N/A N/A N/A N/A 4 5 5 5 5 4 N/A 5 5 5 4 N/A N/A N/A N/A 4 5 5 5 5 4 N/A 5 5 5
Comments:
Any score of 1 or 2 should always contain a comment for follow up.
Service Recovery
SOC
Purpose:
Timely review of patient positive/negative comments by all leaders will lead to investigation, service recovery and ultimately service improvement and an increase in patient satisfaction scores
Scope:
All leaders of clinical and support departments Chaired by President of the Hospital
SOC
SOC NAME PHONE POSITIVE COMMENTS SURVEY COMMENT UNIT
(401)780-XXXX (781)237-1648 (508)872-XXXX (508)533-XXXX 280520709 289316175 289317702 289317317 I found *Dr. Keith Isaacson to be very honest and very compassionate. He explained everything - very thoroughly. I am pleased that I chose him and MIGS.
Everything was like "clockwork." *DR. CURTIS AND HIS TEAM were EXCEPTIONAL - efficient, caring and professional.
Everyone I came in contact with was very professional, kind, courteous and knowledgeable ESPECIALLY Reno and Lyn in the radiology dept. MIGS/ART Adult Gi Reno stayed by my side the entire time and was there when I woke up. She was such a comfort to me at a very trying time. She made a BIG difference in my visit. Your entire nursing and volunteer staff is outstanding. Carol in the main Lab was most helpful to me when my scheduling went off track. She made it happen.
I can't say enough about how wonderful Dr. Robinson & his staff are! Dr. Robinson is caring & concerned & I felt confident that he was looking on for both me & my baby.
CT SCAN MFM
SOC
SOC NAME PHON E SURVEY NEGATIVE COMMENTS
(617)308 -XXXX (617)969 -XXXX
COMMENTS
292171147 170510511 The food was not of good quality. It was not very tasty and temperatures were not great. Everything was warm.
Please note, upon entering hospital registration area (8:30 p.m.) I was totally alone found no one for 10 minutes. Person then told me wrong directions & wrong floor to go to: Went back to registration area & had to wait 10 more minutes until someone else finally came & directed me to sleep unit. This should never, ever happen.
150401752 256928543 Bed & furniture were very uncomfortable. Room noise level was constantly high. Impossible to get rest or sound sleep.
The doctors whom stood in for my main doctor, need to rethink there bedside manors. I glad to say that they aren't my doctors & they happen to be women doctors.
(508)234 -XXXX (978)451 -XXXX (978)725 -3855 259349241 230422821 264089872 One nurses' assistant was HORRIBLE - rude, mean-spirited, insensitive - after mentioning it to the regular nurse, she dismissed it as "just being her way." Very unpleasant.
Would've been nice if someone explained how the bed worked & showed me where all the lights were. In the morning I discovered the subtle over-the bed lights that I would've liked to have used the previous night.
Metal staples were used even though I told the doctor of METAL ALLERGY. Got a BAD INFECTION!!
UNIT
Usen 6 NEURO/ ASL Usen 4 Usen 6 Usen 6 5 West 3 West
ASSIGNED TO
Kevin O’Connor Mary Murray Judy Thorpe/ Bill Sullivan Fred Millham/ Priscilla Velardo Priscilla Velardo Mary Ellen Olson Fred Millham
People
Annualized Employee Turnover Rate
12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Oct-08 Nov-08 Dec-08 Jan-09 Feb-09 Annulized Turnover Rate FY09 Mar-09 Apr-09 May-09 FY09 Turnover Goal Jun-09 Jul-09 Aug-09 Sep-09
People Tactics
Thank You Cards 45 & 90 Day Interviews 180 Day President’s Lunch Reward & Recognize Fitness Center Cambridge College EFAP Enhance Employee Orientation Physician & Employee Satisfaction Survey
People Tactics-Employee Survey
- Surveyed in October 2005 (Sperduto) 1205 employees participated in the survey (56% response rate) 73% of employees surveyed showed positive morale – 93d percentile New England - Key areas of strength: NWH image, goals/mission, meaningful work, pride in working at NWH, would recommend NWH as place to get care, value in Partners affiliation
People Tactics-Physician Satisfaction
- Surveyed in June 2006 (Press Ganey) - “Overall facility” scored in the 99 grouping & 99 th th percentile of All Facility in the Community Hospital grouping - “Quality of patient care” scored in the 99 th both grouping percentile for - “Quality of the nursing staff” scored in the 99th percentile in both benchmark groups - “Likelihood of recommending to family & friends” scored in the 99 th percentile
Management Relative Performance Rankings
NAME
5 6 7 1 2 3 4 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38
TITLE
Dept. 1 Dept. 2 Dept. 3 Dept. 4 Dept. 5 Dept. 6 Dept. 7 Dept. 8 Dept. 9 Dept. 10 Dept. 11 Dept. 12 Dept. 13 Dept. 14 Dept. 15 Dept. 16 Dept. 17 Dept. 18 Dept. 19 Dept. 20 Dept. 21 Dept. 22 Dept. 23 Dept. 24 Dept. 25 Dept. 26 Dept. 27 Dept. 28 Dept. 29 Dept. 30 Dept. 31 Dept. 32 Dept. 33 Dept. 34 Dept. 35 Dept. 36 Dept. 37 Dept. 38
DOH
02/11/85 02/25/02 07/16/01 02/10/03 11/25/85 06/28/76 02/11/03 08/01/99 12/03/01 05/13/02 04/22/02 04/24/00 10/21/02 02/16/98 09/09/96 07/05/01 03/26/01 9/20/2004 9/9/2002 03/25/96 07/18/88 10/16/95 11/17/97 06/03/91 05/27/86 04/05/93 01/03/01
Mean Feb-03
2.4
3.0
2.6
2.5
2.0
2.8
2.9
2.5
1.9
2.5
2.5
2.1
2.5
2.1
2.8
2.3
2.1
2.7
2.1
2.6
2.1
2.3
1.6
2.1
07/09/01 08/27/01 1.5
2.0
Mean Nov-03
2.8
2.9
2.3
2.3
1.8
2.7
2.5
2.7
2.3
1.2
2.0
2.6
1.8
2.3
1.5
2.8
1.7
1.8
1.3
2.5
1.7
1.3
1.0
1.3
1.3
RIF RIF 1.4
Mean Jan-05
2.8
2.7
2.7
2.6
2.6
2.6
2.6
2.5
2.5
2.5
2.4
2.3
2.3
2.3
2.3
2.3
2.3
2.3
2.0
1.9
1.9
1.8
1.8
1.7
1.6
1.1
08/31/98 06/13/01 07/26/99 05/29/01 12/09/72 1.9
2.8
2.7
2.0
1.7
PIP 2.4
2.3
RIF RIF
High, Medium, and Low
Attitude Appearance Commitment to Customer Needs Customer Waiting Privacy Safety Awareness Sense of Ownership
Low
(Rarely meets standards) Points out problems in a negative way Positions leadership poorly Thinks they will outlast you
Medium
(Sometimes meets standards) Loyal most of the time Influenced by low and high performers Could just need more experience
High
(Consistently meets standards) You relax when you know they are scheduled Good influence on others Strong sense of ownership
Leader Evaluation
CAREfirst Standards Compassion Attitude Responsibility Excellent & Quality Accomplishment of Goals & Objectives Service People Quality, Regulatory, and Safety Finance Growth Leadership & Management Competencies Practices & promotes ethical behavior Problem solving/Decision-making Leadership Communications & Interpersonal Skills Accountability Vision & Strategic Planning
Leader Evaluation
Leader Report Card
Leadership Institutes
• •
26 LI’s conducted
• •
Invitees include 180 leaders (supervisors and above, including Chief s and Chairs) Quarterly for two day’s and off site Creating a Culture of Service Excellence Roger Dow, Sr. V.P. Marriott Corporation Dan Grabouskas, MA Registrar of MV Largely in house trainers with key note speakers
October 2002 January 2003
The Goal of Champions Jeff Taylor, Founder, Monster.Com
Robin Brown, G.M. Four Seasons Hotel (
May 2003
Balancing Dollars and Sense Barry & Eliot Tatelman, Jordan’s Furniture Kate Walsh, COO, Novartis
External Leader Development
•
Studer Group
•
Pensacola Baptist Hospital
•
Greenwich Hospital
•
Multidisciplinary teams with executive management
•
Typically 3 days away
•
Goal is to train in Service Excellence and re-recruit good employees
•
Since 2003 we have sent nearly 1,400 trainees to training in places like Pensacola, San Diego, LA, Dallas, Las Vegas, Orlando, etc..
NWH Time-Line
Service
Discharge Phone Calls in Surgery
Infrastructure
Care First, EMT RPR
People
CF Awards, NEO, Cambridge College Masters Program, EFAP
Pre
Purposeful Rounding, Expand PG to Outpatient Arena, Support Cards, Service Recovery Program, Discharge Phone Calls in Inpatient, Greeter Program Service Hotline G&O, LI Leader Report Card, Communication Boards Thank You Cards 45 & 90 Day Interviews, Presidential Lunch Care Teams, OE EE Sat. Survey, Team Awards Peer Bright Idea's, Tool Interviewing Time, Six Sigma 1 Standards of Excellence Leader Eval SOC, Enhanced Leader Rounding, MHQP Satisfaction Survey in Primary Care, Roll-out Discharge Phone Calls to Additional Service for Patient Care Areas, Patients, Enhancements to Service Recovery ST RPR, Empl. Eval, & HML MD Sat Survey, Six Sigma 2, EE Sat Survey, Shipley Fitness Center Outlook Mtg Request Concierge Visitors, EE Bonus Program MD Sat. Survey, CF Service Academy, Lean
FY03 FY04 FY05 FY06 FY07
What Have we Learned?
•Leadership from the top •Focus •Perseverance not brain surgery •Accountability •Start with people •Reward and recognition •Low performers
Financial Results
$15.0
$10.0
$5.0
$0.0
($5.0) ($10.0) ($15.0)
FY99 FY00 FY01 FY02 FY03 FY04 FY04 FY06 Finance - Operating Income (000’s omitted) FY07 FY08 FY09
Outcomes
• Double digit growth-410M in revenue • Gross revenues tripled since FY01 • Market share growth of 6 points • Top 100 Hospital 5 of past 7 years • Consumers Digest Top 50 hospitals for Patient Safety 2005 • BBJ Best Places to Work 2007, 2008
Outcomes
• Patient satisfaction 80th – 95th percentile • Employee Turnover 8% • Employee Satisfaction 93rd percentile • Physician Satisfaction 99th percentile • Highest RN Satisfaction 2,000+ • Partners Quality Close (ex: not a single central line infection for past 18 months) • Unannounced Joint Commission survey eg. Clean, handwashing
Image Impact
100% 100% 2002 2003 2007 2002 2003 2007 80%
76.6% 72.3%
60%
61.3% 55.9% 47.5% 60.0%
40% 20% 0%
TOTAL Core Primary
Unaided Awareness of NWH by Area: 2002 2007 80%
73.5%
60%
49.9% 48.2%
40%
42.5% 52.1% 36.5% 42.4% 35.7% 36.3%
20%
18.8% 22.8% 11.5% 23.0% 22.8% 12.0% 24.3% 31.3% 21.7% 15.8% 22.9% 15.7% 10.8% 30.4% 12.2% 11.0% 15.0% 8.9% 19.5% 12.1% 10.1%
0%
TOTAL Core Primary Re mainde r
Proportion Identifying NWH as Having Best Overall Reputation: 2002-2007
Northe rn We s te rn Northe rn Southe rn
NWH is separated from MGH by a one 10 th of a percent in having the best overall reputation and is number 2 in our service area.
How We Did It
• Goals and Accountability (leader and support cards, session L) • Leadership Development • LI, Service Academy • S.O.C.
• Reward/Recognition • Bonuses, Celebrations, Team Awards • Transparency • Must Haves
What Did We Learn?
• Leadership from the top • Focus • Perseverance not brain surgery • Accountability • Start with people • Reward and recognition • Low performers
Current Focus • Hardwire Service and People • Process Improvement • Action OI • Growth “Get more efficient (current AOI is 18 work”
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