Service Excellence University of Missouri Health Care September 1, 2005

1. From Good to Great Service Excellence University of Missouri Health Care September 1, 2005

2. The charge for University of Missouri Health Care is to move from a good organization to a great one. We HAVE a sense of urgency to do this.

3. Our employees, our physicians and our patients ARE our health system’s top priority.

4. UMHC Culture This commitment requires people to change.

5. ‘Hardwiring Excellence’ by Quint Studer • Model for organizational excellence • Guide for best practices, not a mold

6. Becoming a World-Class Organization Requires: • Committing to excellence • Measuring the important things • Building a culture around excellence • Creating and developing leaders • Focusing on employee satisfaction • Building individual accountability • Aligning behaviors with goals and values • Communicating at all levels • Recognizing and rewarding success

7. Our Commitment to Excellence The journey to excellence begins with a firm and measurable commitment from EVERYONE.We no longer want to be good. Our goal is to be Grrrreat!

8. Our Commitment to Excellence There is no ‘THEY’

9. University of Missouri Health Care Our Mission As part of a land-grant university, University of Missouri Health Care’s core mission is to provide education, research and service to the residents of Missouri with an emphasis on the needs of rural Missouri. Our Vision To offer programs of unsurpassed excellence that will be integrated into a highly efficient, fiscally sound, professionally outstanding, service oriented health system that is unified in a common purpose to be one of the premier comprehensive academic health systems in the nation.

10. Our Values Quality.We believe in quality – quality in the patient care we deliver and the people we hire. Efficiency.Our goal is to provide the highest quality care at the lowest possible price. Caring Attitude.We care about the people who come here, whether they are patients or visitors. We treat them with courtesy and respect. Participation. We encourage and depend on our staff to help us guide this organization. Their guidance is accomplished by participating in elected and appointed committees and task forces.

11. Community w Growth w Finance w Quality w People w Service We identified six Columns of Excellence to provide the foundation for setting goals and direction for service and organizational excellence at University of Missouri Health Care

12. Service Quality People Growth System Approach to Columns Financial Patient Satisfaction Key Clinical Indicator Review Medication Errors Reduction of Patient Falls Turnover Turnover – First 90 Days Employee Satisfaction & Retention Employee Evaluation Completion Wins Operating Margin (MTD/YTD) Cash Collection New Patient Volume Growth Surgical Growth No Shows Examples

13. Service Quality People Growth Facility Approach to Columns Financial Key Clinical Indictors – results for the org Reward & Recognize leaders Reward & Recognize staff Turnover Staff forums Upcoming hospital celebrations Operating Margin Cash Collections AR days Market Share Specific Service line growth No Shows Community Events Patient Satisfaction Reward & Recognize leaders of areas scoring well Standard of the Month Celebration Patient letters Examples

14. Service Quality People Growth Department Approach to Columns Financial Dept Patient Satisfaction Patient comments What we have improved Where we need to focus Ideas from staff Dept Quality Indicators R&R improved areas Key action steps for staff to take next 30 days New tools & equipment Introduce new employees New Tools & Equipment Dept Turnover Upcoming training activities Reward & Recognition Dept Productivity Dept supply costs Key actions for staff to take next 30 days Hospital/Dept financial performance YTD Dept admissions Community Events Hospital growth YTD Examples

15. Building a Culture Around Excellence • Core Team Formed • January 2005 • Service Teams Formed • April 2005 • Approximately 100 employees involved to date • Quarterly Leadership Retreats

16. Standards Team Team Members: Ben Atwell Shanna Baldridge Karen Broz Dr Robert Bynum Dave Geiger Marty Hausman Michel Hayes Craig Hosey Pam Mulholland Karen Scott Kay Steward

17. What We Do Purpose : To create the foundation of our culture of Service Excellence Goals: We asked ourselves : What kind of behaviors do we need to become a culture of excellence for patients, staff, and physicians? The answer: The Standards of Performance

18. The Commitment Current Staff • All signing is cascaded down through executive Leadership, then their direct reports, etc… • All staff are to have signed by September 30, 2005 New staff • HR – on line Standards prior to application access • Departmental signing as well and departmental orientation (added to orientation checklist)

19. Our Projects Education: A traveling carnival : UH, CRH, EFCC, QD • Positive Learning Environment • Fun and Interactive • Different Booths to Represent each Standard • Prizes, candy, etc. for winners Standard of the Month

20. Team Members: Patient Satisfaction Team Laura Phillips Bonnie Potter Linda Robb Dan Smith Susan Straatmann Patty Wells Darian Younger Barb Barrett Deb Calder Jan Degraffenreid Paula Flandermeyer Shawn McGrew Ellen McKenzie Nakia Moore Katherine Payne

21. What We Do Purpose • Ensure highest level of service is consistently provided • Develop new ideas to continually improve the service and to share best practices among departments to help others learn Goals • Look for ways to “wow” patients and families • Solicit input on ways to improve care • Develop & implement “key words at key times” • Implement communication boards in patient rooms • Implement nurse leader rounding • Implement discharge phone calls

22. Our Projects • Cascade Learning Packets • Interest, Concern, Apologize, Respond, and Educate • Quick Wins for specific areas

23. Team Members: Physician Satisfaction Team Pete Ackerman, MD Marty McCormick Karen Calhoun, MD David Mountjoy Steve Calloway, RPh Sue Scott, RN Kevin Dellsperger, MD Tom Selva, MD Jessica Hardy Beth Van Hove Nancy Jones, RN Jennifer Wallace, RN Melissa Lyons, M3 Andrew Wheeler, M3 Dennis McGowan Mary Williamson, RN

24. What We Do Purpose: Responsible for “wowing” physicians and improving the level of service to them and their patients Goals: • Implement action steps with outcomes that will be seen by medical staff as a “win” • Modify key processes within the institutions that will allow for ease in patient care delivery

25. Our Projects Quick Wins: • House Phone Conversions • Replacing Tone Pagers with Text Capabilities • On Call Schedules – On Line, One Reference Point • Hospital Marketing for Physician Providers • Facility Improvements – Hit Squad concept • Nurse Call Line

26. Priority Focus: “Patient Care Made Easier” Hypothesis: Addressing Patient Care Made Easier will improve physician, staff and patient satisfaction levels Action Steps: • Identified discharge planning process as area for re-design • PSTF team joins forces with nursing administration to reach key goals for discharge planning revisions • Blitz Session to address key goals scheduled for September 30, 2005

27. Employer of Choice Team Team Members: Anissa Leaseburg Mindy Cherrington Lezlie Dahlke Linda Davis Gayla Maier Ramonna McKinzie Theresa Nation Brenda Quinlan Carey Smith Randy Wade Angela Waller David Wiss

28. What We Do Purpose Implement programs and opportunities to help employees feel they are doing meaningful, purposeful and worthwhile work Goals To make UMHC the “destination employer”, not a stepping stone

29. Our Projects Our projects will focus on system wide policies, procedures and programs that can be implemented to make UMHC an Employer of Choice. Future recommendations: • Encouraging opportunities for employees to be involved in decision making about issues that affect them, such as hiring decisions and work space and facility decisions • Ensuring that UMHC has a market competitive compensation program that encourages and rewards superior performance and shares gains with rank and file employees • Enhancing an already strong benefits program • Sustaining a culture that holds everyone in the organization, at all levels, accountable for their performance

30. Measurement Team Team Members: Kim Bass Amy Camp Karen Cox Rachel Haverstick Christine Heath Bruce Horwitz Will Kiehl Manuel Navarro Michele Schutte David Sohl Barb White

31. What We Do Purpose: • To correctly measure, interpret, and communicate progress toward the organization’s objectives Goals: • To develop and distribute performance data in a clear and useful format to all departments and administration • Work with leadership to promote understanding and utilization of data • Assist other teams by providing information for planning, decision-making and reward/recognition

32. Our Projects Current and future projects/actions: • Design patient satisfaction reports for each unit, department and facility • Create a presentation to provide an overview and explain the data to departments • Review/evaluate current survey tools • Develop methodology for distribution and review of survey comments

33. Sample Reports

34. More Sample Reports Five Best - Employee Satisfaction UHC Employees Mean CRH Employees Mean Guest House Human Resources 79.5 88.4 CPG Brookfield 84.7 Ortho Rehab 75.4 Endoscopy Data Processing, TSS/ITS 71.7 76.4 PM&R Clinic 76.1 Pharmacy 66.6 OMER 73.9 Admitting 66.1

35. Service Recovery Team Team Members: Anita Beall Susan Lee Kim Brucks Velma Moore Lorna Carver Carol Nierling Karen Harris Dan Smith Candace Hawkes Tracie Wideman Mickie Kummer Amanda Wood

36. What We Do • To provide staff with information to enhance their customer service skills • To provide staff with the tools necessary to “recover” when a customer’s expectations have not been met

37. Our Projects • Develop a brochure for staff that provides key words/scripting to promote good customer service skills • Develop an educational video with case scenarios depicting excellent customer service delivery • Provide each department with a “tool kit” that will provide immediate access to resources for service recovery • Develop a log for each department to document service recovery occurrences and to determine trends for process improvement

38. Our Projects • The educational brochure attached will give staff information to enhance their customer service skills and includes the “I CARE” document • This brochure will also list specific measures to take when service recovery is needed • It will also be used during new staff orientation to promote appropriate customer service skills with new staff and will reinforce our Standards of Performance

39. Communications Team Team Members: Cindy Alverson Freese Clay Anderson, M.D. Jennifer Coffman Rosemary Frank Janice Gartman Paula Heaviland Mary Jenkins Julie McKay Scott Stever Susan Straatmann Tina Taylor Carol Wilhite

40. What We Do Purpose: To encourage and facilitate open, truthful and timely communication using a wide variety of communication sources Goals: • To ensure all University of Missouri Health Care employees have easy and convenient access to both system-wide and department-specific information • To help other Service Excellence teams communicate their initiatives, projects and progress with the entire University of Missouri Health Care staff and, when appropriate, the community at large

41. Team Principles Six principles should guide all communication Be truthful Be transparent Be kind Be an active listener Be respectful Be timely

42. Our Projects Communication Boards: Step one:Place one public communication board in each of the seven major facilities, including: • University Hospital • University Physicians Medical Building • Columbia Regional Hospital • Ellis Fischel Cancer Center • Quarterdeck • School of Medicine • Missouri Rehabilitation Center Step two:Place one department-specific communication board in every department within University of Missouri Health Care

43. Our Projects Public Communication Boards will contain: System-wide and facility-specific Communication that falls under one of the six columns of Service Excellence Department Communication Boards will contain: Department-specific information that falls under one of the six columns of Service Excellence

44. Future Projects Training for Managers: Cascade learning on how to hold staff meetings Communication Support: Help other teams construct communication plans for disseminating information about their programs, plans, progress and people

45. Reward & Recognition Team Team Members: Kevin Anderson Barb Brucks Karen Calhoun, MD Carol Clark Justin Delap Deborah Harvey Louise Harvey Ron Hausheer Sarah Knoerr Cheryl Kyle Jane Nelson Kym Pieper Catherine Price Wayne Richards Deneal Sullivan Ceresa Ward

46. Our Purpose Goal: Impact staff, physician and patient satisfaction by: • Reinforcing desired behaviors by rewarding & recognizing employees • Building a culture of ownership and responsibility with regards to reward and recognition Actions: • Work with leaders to identify recognition opportunities • Evaluate and improve existing programs • Implement new programs for areas where there are gaps • Assist with other celebrations as needed “Compensation is a right; Recognition is a gift.” - Rosaveth Moss Kanter -

47. Proposed Basic Structure

48. Department Based Proposal • Budgeting for department based recognition • Spontaneous recognition for “crunch time” effort • Other department based activities

49. Support Requested Making This Work • Consistently give verbal Thank You’s and write Thank You Notes • Nominate staff, peers, and leaders for Heroes/Legends • Tell great stories at meetings and events • Harvest the celebrations – collect stories from your direct reports and expect them to collect from their staff “Never underestimate the difference you can make!” - Quint Studer -

50. Leadership Development Team Team Members: Kevin Anderson Kim Bass Lynne Hedrick Susan Heimsoth Linda Lightfoot Juni Muhota LuAnn Tandy Ceresa Ward and… Your Participation is Requested