Transcript Document

EMBEDDING CHANGE
IN THE PROCESS OF CARE
2008 Quality Symposium
November 6, 2008
Steven J. Corwin, MD
Executive Vice President & Chief Operating Officer
Wilhelmina Manzano, RN, MA
Senior Vice President & Chief Nursing Officer
NewYork-Presbyterian Hospital:
An Extraordinary Decade
 Delivery of Great Patient Care
 Strategically Significant Volume Growth
 Improved Patient Throughput
 National Reputation on the Rise
 Financially Sound
 Unparalleled Capital Investment & Philanthropy
1
Key Drivers of Success
 Clear Articulation of Vision and Values
 Effective Organizational Structures and Processes
 Consistent Communication to Align Organization
 Measurement Systems to Improve Performance
 Ability to Drive and Sustain Commitment
2
Our Vision
To be Among the Top
Academic Medical Centers in
Clinical and Service Excellence,
Patient Safety,
Research, and Education
3
The Patient is at the Core of All We Do
“ In addition to our excellent
reputation for quality of care,
we want to be second to none
in the service we provide to
our patients.”
Herbert Pardes, MD
President and CEO
4
Key Elements of The Patient Experience
QUALITY
SAFETY
SERVICE
5
Commitment to NYP Values
 Respect
Every Person Counts
 Teamwork
Working Together
 Excellence
Exceptional Quality and Service
 Empathy
Listen, Understand and Respond
 Innovation
Creative Ideas, Cutting Edge Solutions
 Responsibility
Honoring our Past, Ensuring our Future
6
Our Strategic Initiatives Support The Patient
..and provide
a common direction
and shared focus
7
Investment in Patient Centered Care
Data Driven
Accountability:
Plans, Targets,
Public Reporting
Staff Training
and
Engagement
Awards
and Recognition
Engaged Board and
Appointed Leadership
A
Comprehensive
Strategy
Implementation of
Proven
Best Practices
Constant
Communication
Clear Standards
and Expectations
8
Nursing: Central to the Strategy
 Single Nursing Board Led by Chief Nursing Officer
 Center for Professional Nursing Practice
 Align Nursing Goals with NYP Strategic Initiatives
 Enhance NYP Nursing Presence
 Ensure Robust Nursing Workforce
9
Nursing Recruitment & Retention Strategies
 Leadership Development
 Affiliation with Over 25 Schools of Nursing
 Major Investments in Nursing at Bedside
 Nursing Residency Programs
 Rewards and Recognition
10
Declining Nursing Vacancy Rates
RNs 2006 - 4,119
RNs 2007 - 4,342
20
RNs YTD 2008 4,523
15
10
5
0
2006
2007
Sept 2008 YTD
NYP/WC
5.12
4.82
2.92
NYP/CU
7.72
4.56
3.57
MSCHONY
8.38
8.66
6.81
NYP/WD
13.95
12.77
8.06
NYP/AP
4.91
7.2
4.00
6.67%
5.67%
3.94%
NYP
11
11
Decrease in Nursing Turnover
20
15
10
5
0
2006
2007
Sept 2008 YTD
NYP/WC
12.5
12.01
9.23
NYP/CU
8.55
8.87
8.61
MSCHONY
10.43
8.22
10.09
NYP/WD
18.1
18.72
6.33
NYP/AP
7.55
8.86
7.66
10.63%
10.41%.
NYP
9.05%
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12
Engage and Empower Care Team
 Feel Valued & Take Pride In Their Work
 Connect With Their Patients
 Support From Supervisors
 Know Their Voice Is Heard
Creates A Better Patient Experience
13
Raising the Bar in Quality & Safety
Re-Energized Structure & Processes
Worked Closely with Clinicians
Launched Key Initiatives
Solidified Quality / Operations Partnership
Began to Foster Ownership by All
14
Invigorated Quality Processes
Quality
Council
 Set NYP Quality Strategy
 Prioritize Initiatives
Quality
Operations
Committee
 Facilitate Front-Line Implementation
Risk
Mitigation
Committee
 Identify High-Risk Activities
 Monitor Performance
 Analyze Data & Monitor Performance
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Engaging Physicians
 Single, Integrated and Collaborative NYP Medical Board
 Links Physicians With:
– Caregivers
– Administration
– Trustees
 Creation of a Patient Safety Culture:
– Medication Reconciliation
– Patient Verification
– Critical Results Reporting
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Strong Physician Partnerships
 Engaging Residents: Housestaff Quality Council
 Strategic and Operational Alignment with Schools and FPO
 Invigorating Service Line Physician Leadership
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The Communication Imperative
 Integrated and Streamlined Messages
– Clear
– Accurate
– Relevant
– Two-Way
 Multidisciplinary Executive Committee
 Office of Internal Communications
 Enhanced Communication to Caregivers
18
Measurement Systems and Managing with Data
 Quarterly/Annual Targets
 Monthly Dashboards
 Automated & Expanded
Internal Data Distribution
 Unit & Campus Level
 Timely Reporting
19
Improved Employee Satisfaction
NewYork-Presbyterian Hospital
Overall Job Satisfaction
90
2002 - 2008
80
76
72
72
77
76
72
71
67
67
67
67
2002
2003
2004
2005
2006
2007
2008
NYP
72
72
71
76
76
72
77
Norm
65
67
67
67
67
N/A
67
70
65
67
60
50
20
Improved Patient Satisfaction
83.5
NewYork Presbyterian Hospital
Patient Satisfaction Monthly and YTD Mean Scores
March 06 to September 08
83.0
82.5
82.0
81.5
81.0
80.5
80.0
79.5
M
ar
-0
6
A
pr
-0
6
M
ay
-0
6
Ju
n06
Ju
l-0
6
A
ug
-0
6
Se
p06
O
ct
-0
6
N
ov
-0
6
D
ec
-0
6
Ja
n07
Fe
b07
M
ar
-0
7
A
pr
-0
7
M
ay
-0
7
Ju
Ju n-0
l/A 7
ug
-0
7
Se
p07
O
ct
-0
7
N
ov
-0
7
D
ec
-0
7
Ja
n08
Fe
b08
M
ar
-0
8
A
pr
-0
8
M
ay
-0
8
Ju
n08
Ju
l-0
8
A
ug
-0
8
Se
p08
79.0
Monthly Mean Scores
YTD Mean Scores
21
Significant Impact on Hand Hygiene
NewYork-Presbyterian Hospital
Hand Hygiene Compliance Trends By Campus
2007-08
100%
95%
90%
Rate
85%
80%
75%
70%
65%
60%
55%
50%
Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep
NYP/AP
NYP/C
NYP/WC
NYP/MSCH
NYP Overall
Target
22
Reduced Hospital Acquired Pressure Ulcer Rate
NewYork-Presbyterian Hospital
Pressure Ulcer Rate
2006-Dept. YTD 2008
20%
18.88%
15%
12.65%
10%
9.34%
All Adult ICU Rates
5%
0%
2006
2007
YTD 2008
23
Ongoing Challenges as We
Continue to Build, Improve,
and Sustain Commitment
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Patient Safety Fridays
 All 5 Campuses Every Friday
 Led by Quality & Patient Safety with Operations
 Embrace National Patient Safety Goals
 Clinical and Environmental Rounds
 No Distractions amd Everyone Participates
25
It’s Always About the Next Patient!
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