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Journey To Excellence. Albert Lea Medical Center Mayo Health System. Today’s presentation. ALMC today The burning platform Where we started Lessons learned The major stumbling blocks for us Rewards Next steps. From 1905…. To the present…. Major Operating Divisions. Albert Lea Clinic
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Journey To Excellence Albert Lea Medical Center Mayo Health System
Today’s presentation • ALMC today • The burning platform • Where we started • Lessons learned • The major stumbling blocks for us • Rewards • Next steps
Major Operating Divisions • Albert Lea Clinic • Naeve Hospital • Behavioral Health/Fountain Centers • Partnerships • Mayo Clinic Oncology • Diversified Wound Care • Mercy Health System • Over 1,200 employees, including 56 providers • 19 nurse practitioners/physician assistants
Allergy Anesthesiology Cardiology Ear, Nose & Throat Dermatology Emergency Medicine Endocrinology Family Practice Internal Medicine Neurology Obstetrics/Gynecology Occupational Medicine Oncology Ophthalmology Optometry Orthopedics Pathology Pediatrics Plastics Pulmonology Rehabilitative Medicine Pain Clinic Podiatry Psychiatry Radiology Rheumatology Surgery Urology Wound Care Medical Specialties
The burning platform… • Major changes in the way we worked were inevitable • Revenues were decreasing • Resources were becoming limited • Quality was becoming even more important • Consumers had higher expectations
What tools do we need… Baldrige Organizational Dashboard NationalQuality Forum (NQF) Six Sigma PDSA The Joint Commission Lean Health Minnesota Quality Council
Mission Vision Mission Vision Alignment Baldrige Assessment
Where do we start? • With a framework (model)… “You always start with a model. ...Because with a model you can ask questions. From questions we gain insight. With insight you gain knowledge. And with knowledge you can improve the model.” -W. Edwards Deming
Where we started… • Attended some conferences • Mayo Health System • Quest for Excellence Conference • MN Quality Conferences spotlighting Baldrige winners • MN Quality Evaluator training - 2005 • Black-Belt Leadership Program - 2005 • Covertly, more than overtly • Human Resources/Staff Development (HR/SD) • Read applications of Baldrige Winners • Identified some ideas to try • Created an HR/SD Dashboard of results • Engaged Leadership Council in discussion
The Who The What & How Baldrige Framework: A Systems Perspective Organizational Profile Environment, Relationships, and Challenges 5 Workforce Focus 2 Strategic Planning 1 Leadership 7 Results 3 Customer Focus 6 Process Management 4 Measurement, Analysis, and Knowledge Management
2006 – First Application • Established category teams • Lead by Senior Leaders • Mix of frontline managers • Required education for all staff • 10 – 15 minutes about “what we are doing and why” • August 2006 – first application submitted • December 2006 – first site visit • Application & Opportunities for Improvements (OFI’s) on the intranet for all staff
Advancement Level 2006 Minnesota Quality Award
What we learned in 2006 • We had a clearly stated mission/vision/values, but we didn’t communicate the connection between mission & frontline work – the red arrows!!! • We had a strategic plan but it didn’t address what we considered challenges, nor did the work of the frontline align to the strategic plan – those red arrows again!!! • We had an approach to determine customer satisfaction, but we didn’t really understand their wants and needs -
2nd Application - 2008 • Re-established category leads • July 2008 submitted second application • September 2008 – second site visit
Achievement Level 2008 Minnesota Quality Award
Mission Vision What we learned in 2008… • We’re improving, but not there yet!!! • Key Strengths: • Visionary leadership • Patient-focused excellence • Management by fact (just not many facts yet) • Key OFI’s • Many initiatives – not fully deployed • Many areas not using a fact based system to refine approaches • Planning process does not address challenges
Stumbling Blocks • Universal understanding of the criteria • Build internal resources • Leadership buy-in • CEO/CAO are key • But so are the frontline leaders • Making changes visible • Commitment to the time and energy
Rewards (from Leadership) • More focused planning that links the organization and the departments • Helps us get our arms around the work • Focuses the energy • An organized framework • A strategy to evaluate outcomes and effectiveness of our work • We think about “the process” • We think about “how we know ‘good’ vs ‘needs improvement’ ”
Some examples: • Focused strategic planning with linkages to results and to MHS initiatives • Metrics aligned to critical success factors • Quality • Service • Financial • Community Benefit • Practice Diversification
Organizational goals Service Line goals Department goals Individual goals
Baldrige Criteria for Performance Excellence ALMC Plan ALMCDashboard FMEA'S SBAR AIDET Baldrige Criteria for Performance Excellence • Safety Outcomes • Events with Harm • Serious Reportable Events (SRE’s) • SRE Process • Service Outcomes • Press Ganey Results • Customer • Quality Concerns (CQC’S) Baldrige Criteria for Performance Excellence Every patient Every Day Frontline Solutions PDSA LEAN • Clinical Outcomes • Core Measures • Ambulatory Quality Measures • Public Websites Quality Model
Challenges: • Results are not immediate • Criteria is always changing • Writing/Updating the application is time consuming • Making it about the feedback and not about the award • How to keep the drumbeat going
Next Steps • Continue the relentless drumbeat • Is there a process? • Is there a way to measure whether it’s good or not? • How do you know it’s good enough? • Senior Leader Champion • 6 Leaders are auditing MCQ training in September • Continue to create the link of the work to the mission, vision, and values • Submit a third application by December 2009
What never changes… • The needs of the patient alwayscome first • Service is key to providing excellent care • Patients and families do not care how much you know unless they know how much you care • Caring, well-trained staff “Never believe that a few caring people can’t change the world. For, indeed, that’s all who ever have.”Margaret Mead