Transcript Document 7252935

Why Baldrige as a
Quality Platform?
Presented to:
The Quality Colloquium
On the Campus of Harvard University
August 25, 2004
Robert J. Harriman, PhD
V.P., Quality Improvement
and Patient Safety
Baptist Hospital, Inc.
[email protected]
L. Craig Miller, M.D., FCCP
Sr. V.P., Medical Affairs
Baptist Health Care
Pensacola, Florida
[email protected]
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Seven Categories of the
Health Care Criteria
1. Leadership
2. Strategic Planning
3. Focus on Patients, Other Customers,
and Markets
4. Measurement, Analysis, and
Knowledge Management
5. Staff Focus
6. Process Management
7. Organizational Performance Results
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Journey to Performance Excellence
Began in 1995

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
No Secrets
Commitment to Performance
Excellence
Benchmark Best Practices
Customer Satisfaction Teams
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Journey to Performance Excellence

Real Time Accountability

Non-Negotiable Results

Leadership Development

Never Stop Learning
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BAPTIST HEALTH CARE
Culture of Quality
PILLARS OF
EXCELLENCE
VALUES
PEOPLE SERVICE
FINANCIAL
SUPERIOR
SERVICE
VISION
QUALITY
MISSION
To provide superior
service based on
Christian values to
improve the quality
of life for the people
and communities
served
GROWTH
BALDRIGE
CRITERIA
FOR EXCELLENCE
STEWARDSHIP
INTEGRITY
INNOVATION
TEAMWORK
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1. Leadership
 Senior
Leadership Direction
 Empowerment, Innovation and Agility
 Key Performance Measures;
Improving Leadership System &
Effectiveness
 Support of Key Communities and
Community Health
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Pillars of Operational
Excellence
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Achieving Extraordinary Levels of
Service and Operational Excellence
Mission
Vision
Values
Key Components
Actions that
Support Service
and Operational
Excellence
Employee +
Satisfaction
Patient
Leadership
+
Satisfaction
Development
Standards of
Performance
Service Excellence
Teams
Leadership Core
Competencies
Behavioral Based
Interviewing
Weekly Patient
Satisfaction Tracking
Leadership
Development Training
Peer Interviewing
Scripting
Cascade Learning
Communication
Boards
Patient Communication
Boards
Daily Line Up
Employee Forums
Nurse Leader
Rounding
Administrative
Rounding
Best Practice Sharing
Nurse Discharge Calls
Bright Ideas
Service Recovery
Reward & Recognition
Hardwiring
Success
Systems of Accountability
90 Day Plan
360 Degree Feedback Pillars of Excellence
Leader Report Cards CARE & BAR reports Performance Evaluation
Satisfaction Feedback System
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2. Strategic Planning

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Strategic Planning Process
Process Considerations
Action Plan
Development/Deployment
Short and Longer Term Action Plans
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Methods Used in Alignment
of Strategic Planning
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3. Focus on Patients, Other
Customers and Markets
Patient/Customer and Health Care Market
Knowledge
 Patient/Other Customer/Market Segments
 Listening/Learning and Using
Patient/Customer Requirements
 Patient and Other Customer Relationships
and Satisfaction

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Listening & Learning
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Listening and Learning Activities
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Customer Snapshot
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4. Measurement, Analysis and
Knowledge Management

Data Gathering/Alignment to
Support Operations and Decision
Making

Information and Knowledge
Management
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BHI’S SYSTEMATIC APPROACH
DATA
Solucient Action
Solucient Explore
Benchmarking Visits
Bright Ideas
CaduCIS
Direct Feedback – Staff and Partners
EIS (Executive Information System)
Employee Exit Interview
Employee Forum Evaluation Form
Employee Surveys
Florida Cancer Data System
HealthSource (24 hour call program)
HIS (Hospital Information System)
MIDAS (Medical Information Data
Access System)
Physician Action Line
Press, Ganey and Associates
Sperduto
Teams
TrendStar
VHA Southeast
ACTION
(Review/Refine)
INFORMATION
KNOWLEDGE
(Alignment)
(Deployment)
Leader Performance Evaluation (y)
90-Day Action Plan (q)
StopLight Report (q)
BAR (Financial/H.R. Indicators) (m)
CARE Report (Clinical Indicators) (m)
Nursing Report Card (m)
Responsibility Report (m)
Productivity Report (bi-w)
3600 Feedback Survey (bi-y)
Patient Satisfaction Reports (w)
HPAR (q)
Physician Satisfaction Reports (y)
Financial Statements (m)
Board Reports (m)
Financial Focus Packets (m)
Traditions (Employee Orientation)
Physician Orientation
Serv-U (90 days following Traditions)
Daily Line-Up (aka Baptist Daily)
Daily Rounds
Communication Boards
Employee Forums
Inside Baptist (Intranet)
Standard of the Month
Firestarter Meetings
Department Head Meetings
Baptist University –
Colleges of Performance Excellence
College of Clinical Excellence
College of Leadership Development
Physician Leadership Development
Medical Staff Meetings/Retreat
Board of Directors Meetings/Retreat
Informal, Intentional Deployment
DASHBOARD
This systematic approach reflects how, through fact-based management and extensive organizational learning and sharing, we align and
integrate our performance with our organizational needs. This provides a strong foundation for use in refining and continually
improving our performance.
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5. Staff Focus
Organization and Management of Work
 Effective Communication and Skill Sharing
 Staff Performance Management System
 Recruiting, Hiring Retaining Staff
 Staff Education, Training and
Development
 Staff Well-Being and Satisfaction

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6. Process Management

Key Health Care Services and
Processes

Process Performance Improvement

Key Support and Business Practices
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Service Design Process
Step 1
Step 2
Step 3
Step 4
Step 5
Step 6
Conception
Feasibility
Approval
Plan for
Implementation
Implementation
Evaluation
Idea
Financial
Senior
Create
Execute
Evaluate
Generation /
Screening
Concept
Development
Productivity
Cycle
Tune
Volume
Regulatory
Capital
Sourcing
Leaders
and, if necessary,
Board
a Team
Develop
Strategies and
Goals
Develop Action
Steps
Develop
Monitoring and
Evaluation Targets
Develop Exit or
Decline Strategy
Plan
and Monitor
Actual
Performance
to Goals
Develop
Corrective
Action Plans
if necessary
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EBCI Process
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7. Organizational Performance
Results
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Health Care Results
Patient/Other Customer-Focused Results
Financial and Market Results
Staff and Work System Results
Organizational Effectiveness Results
Governance and Social Responsibility
Results
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High Employee Morale
90
80
70
60
50
40
30
20
10
0
1996
1997
Actual
1999
Industry Average
2001
2003
Best in Class
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Low Employee Turnover
17.0%
16.0%
15.0%
14.0%
13.0%
12.0%
11.0%
10.0%
2000
2001
2002
2003
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BH %-tile
D
M
D
M
D
Employee Morale
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Se
p
0
ec
50
ar
20
Ju
n
60
Se
p
40
ec
70
ar
60
Ju
n
80
Se
p
80
ec
90
ar
100
M
Patient Percentile
Patient Satisfaction Correlated
to Employee Morale
BH Employee Morale
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Baptist Hospital, Inc., Results
Clinical Quality Pillar
% of ADC
Pressure Ulcers
FY 98 FY 99 FY 00 FY 01 FY 02 FY 03
Actual
Target
Hospital Average
Best in Class
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Infection Prevention Results SINU
Ventilator –Related Pneumonia
12
10
8
6
SINU
4
2
0
2000
2001
2002
2003
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IHI Critical Care Collaborative
Cost Results
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15
SINU Cost
Hospital Cost
10
5
0
April
May
June
July
August
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Physician Satisfaction Survey
Active Physicians (n=139)
Top 2 Ratings
2001
2003
Satisfaction with Primary Hospital
80%*
90%
Quality of Emergency Department
67%
93%
Quality of Medical Records
78%
79%
Quality of Laboratory Services
82%
92%
Quality of Radiology Services
80%
96%
Quality of Nursing Staff
75%
93%
Overall
Quality of Pharmacy
82%
96%
*Ratings of “4” or “5” (Completely Satisfied or Very Satisfied)
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Outcome Profile at Baptist Hospital
Standardize
Variation % Diff
from Predicted
1999
2003
3%
2
1
0
-1
-2
-3
Mortality
Morbidity
Complications
Yr. 1999-2000: 12,253 IP Case
Case Mix Index: 1.62
Yr. 2002-2003: 13,124 IP Case
Case Mix Index: 1.72
Significant at 90% confidence level
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Baptist Hospital, Inc., Results
Financial Performance Pillar
Days
Net Days in Accounts
Receivable
1999
2000
BHI
2001
2002
2003
Moody's Medians
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Baptist Hospital, Inc.
Results Growth Pillar
Net Patient Revenue
1999
2000
BHI
2001
2002
2003
Moody's Medians
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Summary
 Make
Patient-Defined Quality and
Value the Strategy
 Convey
the Vision
 Measure
Performance at the WholeSystem Level
 Assure
Cooperation across the
Continuum
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Conclusion
“In times of change the learner
will inherit the earth while the
learned find themselves
wonderfully equipped to live in a
world that no longer exists.”
Eric Hoffer (1902-83)
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