Creating a Culture of Service Excellence Nursing: Job or Calling?

1. Creating a Culture of Service ExcellenceNursing: Job or Calling? David Handley Chief Executive Officer

2. To Whom It May Concern:             My name is ____.  I am a “Winter Texan” from Minnesota.             Two weeks ago I became very sick and was admitted to your Hospital.  Because I was 1800 miles away from my home and Doctors, I was very scared and   apprehensive.              The care I received at your Hospital was extraordinary.  Your staff was so caring, kind, and understanding in every phase of my treatment.  Three Staff Members stood out as going                  “Above and Beyond”, Brenda, a R.N., Alek, a Nurse’s Aide, and Dr. Habet.  I will recommend you to all of our friends here,                                                            Sincerely Yours

3. 214 Beds – Full Service Acute Care • Comprehensive Cardiac Care • Open Heart Surgery, Vascular • Comprehensive Surgical Care • Orthopedics, Neurosurgery, ENT, General, Urology, GI • Comprehensive Women’s and Pediatric Care • Neonatal, OB/GYN, Pediatric Subspecialties • Full scope of Medical Specialties • Neurology, Endocrinology, Rheumatology, Nephrology, Pulmonary • Level III Trauma Center • Over 30 Years in the Community • Original Location built in 1975 • 214 Bed Hospital built in 1998 • HCA Affiliated • Capital Investment • Shared Knowledge

4. Community Economic Impact • Current Staff of 750 Employees • Annual Payroll of $48 M • Annual Uncompensated Services of $58.6M • Annual Tax Base Property $1.1M Sales $180 K

5. Patient called Administration to relay the following: She and her husband are from out of town. Her husband had to come to Valley for lab work last week. Since the moment she walked in to the time she left she was very impressed with the care and service from each and every person they came in contact with. She noticed our Tree of Recognition in the hall and has since looked us up on the internet and seen other recognitions Valley has received. When in the valley again and they need medical services they will gladly come to Valley Regional. She hopes we continue in the same direction and wishes continued success.

6. Service Excellence • How do you Build a Culture of Service Excellence?

7. Living Mission Statement “Our Mission is to Treat Our Community as Family by Providing Quality Compassionate Care”

8. ENGAGED LEADERSHIP

9. Leadership Administration Commitment Directors and Managers Ongoing Training Focus on Excellence

10. Department Rounding • Structured Rounding to Assist with: • Equipment Needs • Departmental Issues • Repair Requests • Process Issues

11. Mr. Handley, My 13 year old daughter had knee surgery on July 12. As a mother I was very stressed out but as a nurse I was very confident that my daughter would get excellent care. The nurses and CNAs in day surgery were very friendly and understanding. The OR nurses and crew made me feel at ease. After surgery, Dr. Olson came out to tell to me that everything had gone well. The recovery room nurse kept me informed of my daughter's status about every 15 to 20 minutes. When my daughter made it back to day surgery, the staff kept my daughter comfortable. I want to thank all those who took care of my daughter and for making me proud to part of this team. I want to thank Liz Garza (lab), Delia (Day Surgery), Tony (Day Surgery), Maria (CNA), Anissa (OR), Sandro (OR), Dr. Roberts (OR), Dr. Olson, OR crew, recovery room nurse, and Joe (physical therapy). Thank you Mary O.

12. Professional Development • Tuition Assistance • CE Direct • Spanish & English Classes • School at Work Program • Emerging Leader Program • Clinical Ladder Program • Advanced Certifications

13. Nursing Focus • Improved Orientation • Performance Based Development System • Coaches • Nursing Council • Primary RN Staffing Model • Flexibility for Classwork • Hire for Compassion

14. VRMC Family • Cafeteria: Quick Charge, Grab & Go, Extended Hours, Cafeteria Discount, Lounge Area • Valley Federal Credit Union, Personal Finance Classes, Checking Accounts for Everyone • Savor The Sip • Subway • Raised Minimum Wage 20% above Federal Rate

15. Recreation & Health • Fitness Center • Wellness Program • Recreation Field • Basketball Court • Football, Softball, Volleyball Teams

16. To Whom it May Concern, My name is CS, my son is WS, he was admitted Sunday evening.  I have had several hard working nurses, but I have to say that Mrs. Rentas has been an excellent nurse, she is punctual in my little boy’s medicine time, every time I asked a question she would help me to the best of her knowledge.  There is no other way I could express my gratitude but to write this letter!  Sincerely, CS PS Thank you for your excellent staff!

17. During Hurricane Dolly the Hope Fund helped over 25 Employees affected by the devastationAt HCA, we take care of our own. Even in tough economic times, we support our HCA family members through the Hope Fund. To date, we've helped over 8,700 HCA families in need

18. Celebrations • Service Awards • CharroFest • National Certification Recognition • Frist Award Celebration • Diversity Day • Hospital Picnic • Holiday Gala • Monthly CEO Birthday Luncheons • Hospital and Nurses Week Celebrations

19. Focus on Service

20. Compassion • How is Compassion Measured? Patient Satisfaction Scores

21. Service Expectations • AIDET • Patient Encounter Closure • No Passing Zone • Compliment other employees/ departments • Cleanliness • Quietness

22. AIDET • Acknowledge • Make eye contact. • Acknowledge the patient by name. • Put patients at ease and make them feel comfortable • Introduce • Introduce yourself, your skill set, and experience. • Duration • Communicate how long preparation, tests/results, and waiting times will be. • Explanation • Help patients and family members understand what you will be doing and why. • Clarify expectations and future plans. • Thank You • Let patients know that you have enjoyed working with them. • Thank the family for using us and entrusting us with the care of their loved one.

23. The family of Maria G. Torres would like to heart fully thank you for having such great staff. Dr. Juan Rodriguez, Dr. Ponce, Dr. Sy, RN’s Maria, Victoria, Cesar (Jay), Manny, Amy, Mook, Laura, Juan, Isabel, Deborah and Roberto. They all treated my mother with a lot of care and compassion. Please thank them all for being so wonderful at what they do. My mother would like to specially thank Jay (Cesar) for being so sensitive and caring and to Manny, who was always able to find her veins with no problem. Thank you,

24. No Passing Zone Acknowledge every patient, visitor, employee and physician with a warm smile and greeting. • Communicates Courtesy and Respect

25. Compliment Another Employee or Department Each Day “BOO” • Brag • On • Others When you position co-workers and other employees in a positive light: • Makes the patient feel more comfortable • Demonstrates our commitment to their safety • Demonstrates our teamwork

26. All Hands On Deck • Cleanliness is everyone's responsibility. • All staff & volunteers are watchful of hallways and all floors. -Pick up dropped items from the floor -Clean spills immediately • All hallways and public areas are maintained free of clutter, including beds, carts, stretchers, computers, and any equipment that is not in immediate use. • Valley Regional Shuffle

27. Quietness Creates a healing environment Reduces anxiety Increases overall perception of professionalism Yacker Tracker Sound Meter

28. Dress Code • Increases the level of professionalism • Patients are reassured by professional appearance • Professional appearance communicates competence and authority

29. Next Steps • Bedside Reporting at Shift Change • Hourly Rounding

30. Compassion is a vital part of the healing process.

32. Compliment Letters “I am sending you this letter to let you know that I am very happy with the care I was given by your staff for a colonoscopy.  The morning of the procedure all the nurses who took care of me were attentive and courteous and made me feel very comfortable. (I had been feeling kind of nervous).  I was so grateful to them for the way they treated me because I never had a colonoscopy and they made me relax and feel like I was in the best of hands. If you should ever need a previous patient to recommend your hospital, either by giving a speech or writing a letter, please feel free to ask me and I will be more than glad to do this for you.”

33. Community Service • Contributor to: • American Heart Association • American Cancer Society • United Way of Cameron County • March of Dimes • University of Texas – Brownsville • Boys and Girls Club • Camille Lightner Playhouse • Moody Clinic

34. New Technology Airstrip OB Bedside Computers ECHO Machine Xerox Machines Classroom Projectors Impella HD in Endoscopy eMAR Pharmacy Robot • PACS • ICU Monitors • Hospital Wide Internet • Dictation System • Wireless EKG for EMS • PK Mobility • eSignature • Digital Mammography • 64 Slice CT

35. What are the results????

36. Community Service • VRMC Raised Over $85,000 in 2011 for the United Way!!!

37. Recipient of the 2005,2006, 2008, 2010 Distinguished Hospital Award for Clinical Excellence HealthGrades Recognizing Overall Clinical Excellence: recipients represent the top 5% of hospitals in the nation.

38. Employee Overall Engagement

39. Pathway to Excellence • Formerly Texas Nurse Friendly • VRMC Designated in 2008

40. Patient Satisfaction March 2005 VRMC Ranked 163 out of 176

41. Inpatient Satisfaction Scores HCA Ranking • 12th in Q4, 2010 Q4, 2010

42. Compliment Letters “To the Valley Regional Medical Center Staff, from Doctors, nurses and anyone I have left out. You all have been wonderful and very knowledgeable and very considerate of my mother-in-law. You all from the time we checked in to the time we left the hospital have treated us like we were family of yours. We thank you from the bottom of our hearts and will recommend and praise this hospital to everyone we know. Thank you again and please let all the staff at this Medical Center know how much they are in our hearts.”

43. Summary • Engaged Leadership to Support Staff • Living Mission Statement • Create an Environment of Service, Compassion, and Mutual Respect • Hire for Kindness

44. Questions? David.Handley@HCAHealthcare.com