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Saving Lives through Performance Excellence

Saving Lives through Performance Excellence. Rulon F. Stacey, PhD, FACHE President/CEO, Poudre Valley Health System. Private, integrated health system locally owned, not-for-profit Full spectrum of healthcare services

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Saving Lives through Performance Excellence

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  1. Saving Lives through Performance Excellence Rulon F. Stacey,PhD, FACHE President/CEO, Poudre Valley Health System

  2. Private, integrated health system locally owned, not-for-profit Full spectrum of healthcare services 2 tertiary hospitals, outpatient campus, numerous satellite clinics Regional medical hub for cardiac & trauma services, orthopedics, oncology, neonatal intensive care & bariatric surgery Poudre Valley Health System

  3. Service area: Northern Colorado, Wyoming & Nebraska 5,300 employees, 600 physicians & 1,000 volunteers $1.4 billion in annual revenue Poudre Valley Health System

  4. Community hospital serving Fort Collins, Colorado 1,500 employees, 300 independent physicians & 575 volunteers 24% annual employee turnover 5 CEOs in 4 years $250 million in annual revenue Changing healthcare market Demand for physician integration Where Our Journey Started - 1997

  5. Performance Excellence Journey • Leadership: Find an improvement model • The Work Horse Philosophy

  6. To provide world-class health care Our Vision Wendy Oncology patient

  7. Striving for results in the 90th percentile or top 10% of available national comparative databases Definition of World-Class Craig Trauma patient

  8. Communicate Direction Set Direction Our Beliefs

  9. New Employee Orientation Forums for Employees & Volunteers Quarterly updates on performance & action plans that support each Strategic Objective Name Badges Meeting Templates Learn & Lead Program Vision/Mission/Values Team Leadership Meetings Medical Executive Committees Communicate Direction

  10. Plan & Align

  11. Core Competencies

  12. Identify strategic opportunities How can we provide a lifetime of care? Align economic incentives & build relationships Outpatient services, home health, sub-acute care, third-party administrator, strategic vendor relationships Win-win for PVHS, other healthcare providers, patients & community Improve clinical quality Partnering: An Innovative Strategy

  13. Rural dilemma Insufficient volumes to ensure quality Choice: Revenue or optimal outcomes? New alternative PVHS + Regional West Medical Center = Medical Center of the Rockies Improved outcomes & revenues for all The Ultimate PartnershipPVHS & Regional West Medical Center

  14. Poudre Valley Medical Group (PVMG) 27 Clinics, 180 clinicians, 600 support staff Physician Changing Model 2008: nearly 100% independent practice 2011: 25% in PVMG, 75% independent University of Colorado Hospital Share overall management structure Pool revenue and expenses Partnering: Next Generation

  15. Execute the Plan & Drive Performance

  16. Execute the Plan & Drive PerformanceBalanced Scorecard Process

  17. Develop People

  18. Performance Review Process Reward & Recognition, including Peer-to-Peer Coupons Optional Performance Plan Learn & Lead, Building Blocks of Leadership Learn & Grow Grand Rounds, Tuesday Afternoon Conferences Mentoring Program Tuition Reimbursement Professional Associations, Conferences Develop People

  19. Performance Review Process Best Practice: Integration of Values, Behavior Standards, Core Competencies, Key Customer Requirements & Personal Goal Cards Develop People

  20. Execute the Plan & Drive PerformancePersonal Goal Cards

  21. Learn, Share & Innovate

  22. Performance Excellence Teams Baldrige-driven improvements PDCA Model for Process Improvement LEAN Transformation Process Design Best practices: Stakeholder involvement & Voice of the Customer Learn, Share & Innovate

  23. 20 interdisciplinary teams with staff, physicians, partners, vendors & community members Community focus groups Wayfinding, spirituality, furniture, menus, naming National site visits with physicians, staff & vendors Mock-ups for OR, trauma suite, patient room & elevator Day-in-a-Life Scenarios An Example: Medical Center of the Rockies

  24. Results Gabriel, NICU “Graduate”

  25. Healthcare Outcomes Risk-Adjusted Mortality Rate

  26. Customer-Focused Outcomes Top Box Scores for Patient Satisfaction 9 years of consistent improvement

  27. Customer-Focused Outcomes HCAHPS* *Hospital Consumer Assessment of Healthcare Providers & Systems

  28. Financial & Market Outcomes Patient Discharges 59% increase in PVHS discharges from 2000 to 2010 19% population growth in Larimer County from 2000 to 2010 15% increase in Competitor discharges from 2000 to 2010 40% population growth in Competitor’s home county from 2000 to 2010

  29. Workforce-Focused Outcomes Staff Voluntary Turnover

  30. Workforce-Focused Outcomes • Staff: 93rd percentile for employee satisfaction (MSA) • Volunteers: 99% satisfaction on internal survey • Physicians: 96th percentile for physician loyalty (Gallup) • Top 100 Best Places to Work, 2008, 2009, 2010 • Modern Healthcare

  31. Workforce-Focused Outcomes Physician Engagement Scorecard

  32. Remaining CompetitiveHospital Charges

  33. Community Benefit • Charity Care • Family Medicine Center • Community Case Management • Patient Navigators • Poudre Valley Nurse Line • Mental Health & Substance Abuse Partnership • Lifestyle Challenge • Healthy Kids Club • Well City Initiative • Poudre Valley Prenatal • Aspen Club • Safe Kids Coalition • Teen Motor Vehicle Safety Coalition

  34. Increased hospital discharges almost 50% with only 11% population growth Doubled the workforce Added 2nd hospital, outpatient campus & numerous offsite clinics Expanded service area from Fort Collins community to 50,000 square miles in Colorado, Wyoming, Nebraska Challenging Times…

  35. Challenging Times Continue U.S. Healthcare Patient Protection & Affordable Care Act Future Trends Integration: Coordinate care, patient is the customer Value: Deliver quality outcomes and high levels of service at a reasonable cost Transparency: Learn, grow and respond

  36. Top 10% for Inpatient Mortality, Patient Satisfaction, Employee Satisfaction & Physician Engagement (PVHS) 2008, 2009, 2010 Top 100 Best Places to Work, Modern Healthcare (PVHS) 2008, 2009, 2010 Magnet designation PVH since 2000, MCR 2010 NDNQI Outstanding Nursing Quality Award for last 3 years World-Class Results

  37. To provide world-class health care Our Vision Molly 4th generation treated at PVH

  38. Additional Information: PVHS Center for Performance Excellence Priscilla Nuwash: pjn@pvhs.org Sonja Wulff: sbw2@pvhs.org www.pvhs.org

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