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Journey To Excellence

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

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  1. Journey To Excellence Albert Lea Medical Center Mayo Health System

  2. Today’s presentation • ALMC today • The burning platform • Where we started • Lessons learned • The major stumbling blocks for us • Rewards • Next steps

  3. From 1905…

  4. To the present…

  5. 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

  6. 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

  7. 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

  8. What tools do we need… Baldrige Organizational Dashboard NationalQuality Forum (NQF) Six Sigma PDSA The Joint Commission Lean Health Minnesota Quality Council

  9. Mission Vision Mission Vision Alignment Baldrige Assessment

  10. 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

  11. 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

  12. 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

  13. 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

  14. Advancement Level 2006 Minnesota Quality Award

  15. 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 - 

  16. 2nd Application - 2008 • Re-established category leads • July 2008 submitted second application • September 2008 – second site visit

  17. Achievement Level 2008 Minnesota Quality Award

  18. 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

  19. 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

  20. 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’ ”

  21. 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

  22. Strategy Map

  23. Organizational goals Service Line goals Department goals Individual goals

  24. Work plan Example

  25. Dashboard

  26. 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

  27. 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

  28. 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

  29. 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

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