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2. Aligning Lifelong Learning and Continuous Improvement with the Business Directionat SSM Health Care Dawn Runge, Ph.D. Corporate Vice President – Organizational Effectiveness Russ Scalpone, Ph.D. Corporate Director – Organizational Effectiveness October 2012

3. SSM Health Care Mission Through our exceptional health care services, we reveal the healing presence of God.

4. Mission Defined: Characteristics of Exceptional Health Care Services Exceptional Patient Care Clinical: Clinical Composite Indicators Patient Satisfaction: Likelihood to Recommend Safety: Patient Serious Event Rate Exceptional Commitment Employee Engagement Physician Overall Satisfaction Exceptional Financial Performance/ Growth Financial: Operating Margin Growth: Net Patient Revenue

5. SSM Health Care System Based in St. Louis, Mo., with facilities located in four Midwest states including Missouri, Illinois, Wisconsin, Oklahoma Provides services in inpatient, outpatient, outpatient surgery and emergency department hospital settings, two nursing homes, and home care Traces its roots back to 1872, when Mother Mary Odilia Berger and four sisters migrated to the United States from Germany The congregation, now known as the Franciscan Sisters of Mary, sponsors SSM Health Care 25,600 employees, 7,300 employed and affiliated physicians, 6,750 nurses and nearly 2,400 volunteers all working together to provide exceptional health care services

6. More About SSM Health Care First health-care recipient of the Malcolm Baldrige Award First large health system to go tobacco-free inside and out SSM is implementing an electronic health record in all its hospitals Top 6 percent of hospitals to implement electronic health records Core Competencies: We know how to improve We use values to guide decision-making We take advantage of being a system

7. Mission & Strategic Direction WHY WHAT HOW How are we going to improve? Leadership Concept

8. SSM Health Care Corporate Organizational Effectiveness Corporate Vice President – Organizational Effectiveness Administrative Education Assistant Reports to Senior Vice President – Human Resources Corporate Manager – OE Corporate Director – CQI Corporate Director – OE/CQI • Curriculum Development and Instruction • Manage SMEs & Faculty • Physician Leadership Development • CME Process for System • Member of Physician Leadership Council • Manage Leadership Pathways & OD Roundtable Team • Curriculum Development and Instruction • Education Strategy • Evaluation and Assessment • Design CQI Effectiveness Measures • System CQI Projects • MBNQA Category Five • Co-Manage CQI Workgroup • Knowledge Sharing • Curriculum Development and Instruction • Manage SMEs & Faculty • Support CQI Effectiveness Measures • Manage Corporate Office CQI Projects • MBNQA Category Six • Co-Manage and Support CQI Workgroup • CQI Website • Quality Companion • Database • CQI Knowledge Sharing Corp. Systems Specialist – OE Corp. Education Consultant – OE Corp. Education Specialist – OE Create Courses in LMS Create & Maintain Catalog System Admin – Performance Development Track Training Metrics Live Meeting Administrator Member of LMS Team Member of Performance Development Teams • Curriculum Development and Instruction • Manage SMEs & Faculty • Administer School at Work • Manage Emerging Leaders • Member of Performance Development Teams and Educator’s Roundtable • Curriculum Development Create Online Courses • Integrate Online Courses with LMS Function • Maintain all Online Programs • Member of LMS Team • Web 2.0 Teamwork • Quality Companion Database

9. Purpose of the Learning Function Help SSMHC achieve its mission of exceptional health care services by developing leadership and serving as a resource for leaders throughout the System. “At SSM Health Care, we have a saying that was coined by our former President/CEO Sister Mary Jean Ryan: ‘No matter what your title, no matter what your job…you are an SSM Health Care leader.’ For us, leadership is the process of achieving the goals of the organization in a way that reflects our history, heritage, mission and values. Education and training is an integral part of SSM’s culture, and we continue to invest our resources into developing and retaining our employees because we want to further their intellectual, spiritual and emotional well-being at work and home.” Bill Thompson, President/CEO March 2012

10. Baldrige Performance Excellence Model Organizational Profile: Environment, Relationships, and Challenges 2: Strategic Planning 5: Workforce Focus 1: Leadership 7: Results 3: Customer Focus 6: Process Management 4: Measurement, Analysis, and Knowledge Management

11. Workforce Management

12. Leadership Development Performance Development Process Succession Planning Programs Process Improvement Methodology Other Areas of Organizational Effectiveness (OE)

13. Leadership Development Performance Development Process Succession Planning Programs Process Improvement Methodology Other Areas of Organizational Effectiveness (OE)

14. Core Curriculum at SSM University • Built on our Leadership Competency Model and past accomplishments • Designed for leaders who drive 85% of organizational change • Uses internal resources in design and as faculty • Links courses to our Mission, Values, the “Exceptionals,” Competency Model, and MBNQA • Updated continuously via a range of needs analysis inputs

15. SSM Health Care Leadership Competency Model • Organizational Development & Curriculum Plan • 101 Leader Series • 201 Leader Series • Leader Development Programs • Physician Leadership • Other Needs Diagnosis Process SSM University Policy Board Professional Organizations Universities • Fontbonne University • ACHE • Health Care Advisory Board • Press Ganey • Healthstream • ASQ Organization Capabilities To Implement SSM Strategies Special Needs Surveys & Executive Fact-Finding SSM Educator & OD Roundtables; CQI Workgroup SSM Satisfaction Results & Drivers LMS Performance Development Results SSM Functional Groups • Nursing • Physicians • Human Resources • IHT • CQI • Other

16. SSM Training Effectiveness Level 1: Reactions Level 2: Learning Level 3: Behavior Level 4: Results • Feedback surveys for all courses • Overall Satisfaction • Relevancy/applicability to job • Accomplishment of learning objectives • Semi-annual survey of titled leaders • CQI needs assessments • Special needs assessments • Testing (certain courses) • Performance demonstration (some courses) • Learning applications (most courses) • Performance demonstrations (some courses) • Documenting, tracking and sharing of learning applications • All CQI courses • All leader development programs • Conduct surveys to assess behavioral change associated with learning objectives • Document and track learning goals within the Performance Development Process • Assess changes in organizational performance metrics (e.g. financial, operational, patient, and employee measures, etc.) • Special studies on Employee and Physician metrics • Document improvements in organizational metrics linked to training application • All CQI course applications • All leader development programs

17. Mission & Values Based Leadership • Champion for Clinical Quality, Patient Safety, Physician Professionalism, and Support of Code of Conduct • Leads and Manages Change and Ability to Influence Others • Committed to Achieving Results • Models AEPC Service Standards • Demonstrates Integrity & Courage • Develops Self through Personal Growth/Learning • Maintains Optimistic (Can Do) Attitude • Demonstrates Knowledge of SSM History, Traditions and Catholic Social Teachings • Demonstrates Flexibility with Industry Changes • Holds Self and Others Accountable Engaging an Exceptional Workforce Exceptional Financial Stewardship Exceptional Process Improvement ExceptionalPlanning • Understands Health Care Finance Principles Appropriate to Role • Comprehends & Utilizes Budgets & Financial Reports • Assumes Risk & Responsibility for Financial Decisions • Holds Self & Others Accountable for Financial Results • Gives and Receives Feedback • Communicates Effectively • Coaches & Mentors Others • Promotes Teamwork & Achieves Results through Others • Addresses & Resolves Conflict • Develops Others & Builds Trust • Holds Self & Others Accountable for Physician and Employee Satisfaction • Comprehends & Utilizes CQI Plus • Makes Decisions Based on Data • Achieves Results through Process Analysis & Modification • Holds Self & Others Accountable For Exceptional Clinical Outcomes, Safety and Patient Satisfaction • Participates with Clinical and Admin Leadership in Setting Direction & Goals • Demonstrates Critical Thinking Skills • Sets Priorities & Allocates Resources • Develops / Organizes / Implements Strategic Plans • Holds Self & Others Accountable for Achieving Strategic Initiatives

18. Growth of Leadership Development at SSM Goal is to develop leaders at ALL levels, regardless of title Tuition reimbursement is available for ALL employees after 6 months of employment

19. Leadership Development SSM University Goal is 1,600 courses in 2012 with 95% satisfaction rate with current series (3rd gen) with ILT, on-line and mobile learning options Continuing 2012 School at Work program in all regions – Collaboration with STLCC for courses beyond graduation (pilot in STL) Informal learning programs very successful with increase in hours “Inside Leadership Council” = 4 hrs “Read to Lead” = 36 hrs “Leaders for Lunch” = 24 hrs “Lifelong Learning” policy increase to 80 hrs in 2013 with more opportunities for hours Physician Leadership Development Program has four levels: New Physician Orientation – Pilot Underway at St. Clare New Physician Leader – Curriculum done July 2012 Ongoing Physician Development – September 2012 Advanced Physician Development – Planning in Progress

20. School at Work (SAW) – Nine-month program for entry level employees to attend courses during work hours to develop leadership & technical skills – Upon graduation, they move to degree-seeking status STLCC & SSM – Created program (pilot) to prepare SAW graduates for college entrance exams through enrollment Emerging Leaders – 10-month leadership development program tailored to the needs of staff and front line leaders to grow into future managers – 95% satisfaction rate with 90% promotion rate upon completion Leadership Pathways – Rigorous, two year development program designed for the top 25 directors to become future executives – 98% satisfaction rate with 92% promotion rate upon completion Executive Integration – Created for new executives to ensure a consistent understanding of our history, mission, values and philosophy of SSM Health Care; and are clear on executive expectations, key operational processes and performance metrics Areas of Organizational Effectiveness (OE)

21. Leadership Development Performance Development Process Succession Planning Programs Process Improvement Methodology Other Areas of Organizational Effectiveness (OE)

22. What is the Performance Development Process? 360 DEGREE FEEDBACK • GOAL SETTING • Departmental to Support Mission • Individual to Develop Leader ANNUAL PERFORMANCE REVIEW

23. Translating Mission into Strategy and Action

24. Alignment of Performance Development Process with Strategic/Operational Plans Mission Statement Network Goals Strategic/ Operational Plans Entity Goals Department Plans, Posters & Graphs Department Goals Performance Development Process (Goals, 360 And Evaluations) Passports

25. Connecting Our Work What “we” will do as a department to improve performance What “I” will do to support the department’s improvement goals

26. Areas of Organizational Effectiveness (OE) Leadership Development Performance Development Process Succession Planning Programs Process Improvement Methodology Other

27. Succession Planning Programs • Emerging Leaders • In third year, with approximately 150 participants each cycle • Approximately two additional training programs per year for alumni • Leadership Pathways • In fourth year, with approximately 25 participants at one time • Alumni enter the ACEs Program • Advancement of Careers & Education (ACEs) • Began March 2011 – Will continue to grow due to incoming LP graduates • Program changes include two courses per year • Success is dependent upon the individual • Executive Integration • Program for new executives to better understand expectations of their role, SSM history, governance, key operational & strategic processes, etc.

28. Purpose of Emerging Leaders & Leadership Pathways • Improve overall quality of high potential leaders • Provide overview of talent in the organization • Repository of information regarding employee ability and performance coupled with career interests • Provide recruiting information when key positions are open • Identifies key developmental areas • Provides opportunity for long term development of high potential individuals: • Training • Coaching • Developmental assignments • Networking and visibility

29. Leadership Development Performance Development Process Succession Planning Programs Process Improvement Methodology Other Areas of Organizational Effectiveness (OE)

30. Continuous Process Improvement (CQIplus) SSM utilizes the CQIplus model for designing, innovating and improving work processes to meet key customer/patient requirements and achieve better performance, reduce variability, and improve outcomes. This model is based on SSM’s five quality principles: Patients and other customers are our first priority Quality is achieved through people All work is part of a process Decisions should be based on facts Quality requires continuous improvement Areas of Organizational Effectiveness (OE)

31. We Use CQIplus to Improve The Science of Becoming Exceptional

32. Applied CQIplus Education Additional CQI Related Training – All Staff • Creativity & Innovation • Leading and Managing Change • Key Process Metrics • Measuring Health Care Quality Through Statistical Process Control

33. Workforce-Level Integration Improvement Goals included in Passport Participates in CQI Teams Training in CQIplus Tools & Methods

34. Entity/Region Level Integration All AC members Champion CQI Projects PTL Projects in Every Department CQI Projects Support Strategic & Operational Plans CQI Metrics Monitored by AC CQI Director Input into Strategic & Operational Plans Entity Teams Participate in Regional & System Level Sharing Events

35. System-Level Integration • Educational Curricula: • Staff • OTL • PTL/ATL Train-The Trainer, Curriculum Administration, & Evaluation • Organizational Learning/Performance Improvement Interventions • Entity-Level • Unit/dept.-level Training Policy CQI Project Tracking & Metrics CQI Mentoring & Coaching • Community Building & Knowledge Transfer • CQI Directors • CQI Practitioners/PTLs

36. Science in a Toolbox • Team Facilitation Tools • Lean Tools • Six-Sigma Tools • Change Management Tools CQIplus is a set of tools, techniques and training to improve processes. Depending on the problem or opportunity identified, teams use the appropriate mix of tools to achieve the project objectives. This “Mix” is the Methodology.

37. Why Focus on Variation? Our patients and other customers don’t feel the average they feel the variation ! S P R Average E A D

38. How Do We Know We Are Effective?

39. Performance Management: Linkage of PIR to Other Performance Reports

40. Performance Management: How Our Data Links With Our Planning Process

41. Data Knowledge Wisdom Information More Than Just Data… Analysis Communication Application • Why do we collect the information we do? • What do we do with it? • How do we use it to set goals? • How do we share it? • How do we ensure that it is accurate and timely?

42. Leadership Development Performance Development Process Succession Planning Programs Process Improvement Methodology Other Areas of Organizational Effectiveness (OE)

43. Other ICD-10 training under way Created ‘LMS Road Show’ to educate new and current users on system functionality Installation of Badge Card Readers for easy course registration & influenza vaccination processing Working with IHT on single sign-on for all physicians into LMS Training effectiveness measures noted as strength on MQA & MBNQA Feedback Reports Continue to refine the way in which we measure & deliver training so as to assess the business effects of the training

44. Questions?