2010 AHCA/NCAL National Quality Award Program - Silver Award Overview - Session Two

1. 2010 AHCA/NCAL National Quality Award Program- Silver Award Overview -Session Two Lance Reynolds Kevin Warren Tim Case

2. Silver Award Criteria • 2.0 Organizational Profile • 2.1 Visionary Leadership and Social Responsibility and Community Health • 2.2 Focus on the Future • 2.3 Resident-Focused Excellence • 2.4 Management by Fact • 2.5 Organizational and Personal Learning • 2.6 Valuing Staff and Partners • 2.7 Systems Perspective, Agility, & Managing for Innovation • 2.8 Focus on Results and Creating Value

3. The first step towards getting somewhere is to decide that you are not going to stay where you are. J. Pierpont Morgan

4. 2.0 Organizational Profile • This was formerly referred to as Step I, and remains largely based on, the Bronze Award criteria. • Make sure you update any information you copy from a former Bronze Award application. • You are not bound by your previous Bronze Award application. • 2.0 establishes the foundation for the entire application.

5. The Writing Process Linkages: Organizational Profile (Key Factors) + Category Response = Results

6. Linkages Example #1 • Organizational Profile: • Vision: “Best Nursing Home in the State as measured by Resident, Family and Staff Satisfaction”. • Category 2.3 Response: No Resident, Family and Staff Satisfaction processes described. • Results: No results

7. Linkages (continued) Example #2 • Organizational Profile: • Vision: “Best Nursing Home in the Nation as measured by Resident, Family and Staff Satisfaction”. • Category 2.3 Response: Two years of conducting surveys • Results: Results are compared to local nursing homes only.

8. Organizational Profile Examiners use the Organizational Profile to determine what is important to you, the applicant, throughout their entire review process. It is a required part of their work. FOCUS

9. Silver Award Criteria • 2.0 Organizational Profile • 2.1 Visionary Leadership and Social Responsibility and Community Health • 2.2 Focus on the Future • 2.3 Resident-Focused Excellence • 2.4 Management by Fact • 2.5 Organizational and Personal Learning • 2.6 Valuing Staff and Partners • 2.7 Systems Perspective, Agility, & Managing for Innovation • 2.8 Focus on Results and Creating Value

10. 2.7 Systems Perspective, Agility, & Managing for Innovation • How does the organization effectively interconnect the individual components of its performance management system to view the organization as a whole and to ensure consistency of plans, processes, measures, and actions in order to maximize agility, encourage innovation, and achieve performance excellence?

11. 2.7 Systems Perspective, Agility, & Managing for Innovation How does your organization systematically: a. Ensure alignment of processes, measures, and action plans across departments and throughout various organizational levels to improve performance and customer satisfaction. • Describe key work processes. • Describe how the organization manages these processes to ensure that they are consistent with your strategic objectives and action plans described in 2.2. • Describe how action plans are integrated across departments and organizational levels to improve performance and customer satisfaction.

12. 2.7 Systems Perspective, Agility, & Managing for Innovation How does your organization systematically: b. Make meaningful change to improve your services, programs, processes, operations, care delivery model, and business model to create new value for your stakeholders. • Give examples of innovative changes made in the last year to improve resident care and quality of life, organization of work, and business results.

13. 2.7 Systems Perspective, Agility, & Managing for Innovation How does your organization systematically: c. Build agility—a capacity for rapid change and flexibility. • Describe how the workforce is cross-trained and empowered to be flexible. • Describe how work systems and processes are simplified to reduce response times to changes in customer needs and expectations. Give one or two examples.

14. Scoring Guidelines SECTION 2.1 – 2.7

17. Comparisons and Scoring • 50% to 65% (This is a strong organization) • Some current performance levels have been evaluated against relevant comparisons and/or benchmarks and show good relative performance • 70 to 85% (This is a National Award Winner) • Many to most trends and current performance levels have been evaluated against relevant comparisons and/or benchmarks and show areas of leadership and very good relative performance

18. Criteria Scoring Points and Weighted Percentages 18% 57.5% 39.5%

19. 2.8 Focus on Results and Creating Value • What are your organization’s key results that create value for your key stakeholders? • Explain how you use these key measures to drive performance improvement, or cross reference to relevant examples in other sections of the application.

20. 2.8 Focus on Results and Creating Value a. Health care outcomes: Give at least three (3) key clinical outcome results over appropriate time frames. At least one of the outcomes should clearly show improvement over time across at least three data points. Identify the strategies and specific changes used to improve this outcome. Assisted Living Facilities (ALFs) and Developmental Disability Residential Services providers (DD) may choose to substitute non-clinical process outcome results. If available, show your outcomes in comparison to competitors or to state or national averages, whichever seems most appropriate.

21. 2.8 Focus on Results and Creating Value: b. Government survey performance outcomes: • Provide government/state survey (deficiency) results over time (minimum of the last 3 surveys, but preferably 4 or 5 surveys). This requirement applies only to skilled nursing, ICF/MR, and others for which compliance with routine government compliance inspections is required. If available, show your outcomes in comparison to competitors or to state or national averages, whichever seems most appropriate.

22. 2.8 Focus on Results and Creating Value: c. Other outcomes: • In addition to the results reported above, provide a minimum of five (5) additional results drawn from the areas on the next slides. The results chosen and reported should cover the most important requirements for your organization’s success, highlighted in your organizational profile (section 2.0) and responses to the core values and concepts (sections 2.1 to 2.7). If possible, choose results to report for which you can provide comparative data from competitors and other long term care facilities. • Whenever possible, show your outcomes in comparison to competitors or other long term care organizations. You must at least show early stages of efforts to gather and use comparative data. You are encouraged to identify performance benchmarks or targets within your results reporting.

23. 2.8 Focus on Results and Creating Value Resident- and stakeholder-focused results: • Report your current levels and trends in key measures or indicators of resident, family and other stakeholder and partner satisfaction and dissatisfaction. Show how these results compare with the performance of your competitors and other nursing homes or long term care facilities.

24. 2.8 Focus on Results and Creating Value Financial and marketplace results: • Report current levels and trends in key measures or indicators of financial performance, including financial return, financial viability, or budgetary performance as appropriate. • Report current levels and trends in key measures or indicators of marketplace performance, including market share or position, market and market share growth, and new markets entered, as appropriate.

25. 2.8 Focus on Results and Creating Value: Workforce-focused results • Report staff turnover and/or retention rates (minimum of 3, but preferably 4-5 years). Show how these results compare with the performance of your competitors and other nursing homes or long term care facilities. • Report current levels and trends in key measures of employee satisfaction for the past four to five years. Show how these results compare with the performance of your competitors and other nursing homes or long term care facilities. • Report current levels and trends in key measures of workforce and leadership development. • Report current levels and trends in key measures of workforce health, safety and security, and workforce services and benefits, as appropriate. Include worker’s compensation claims and grievances over a four to five year period.

26. 2.8 Focus on Results and Creating Value: Process effectiveness results • Report current levels and trends in key measures of occupancy. • Report current levels and trends in key measures of work system performance such as supplier and partner performance, job simplification, changing supervisory ratios, med-pass, and cycle time reduction. • Report current levels and trends in key measures of preparedness for disasters or emergencies.

27. 2.8 Focus on Results and Creating Value: Leadership results • Report results for your key measures of accomplishment for your strategic and action plans outlined in 2.2. • Report results for key measures of ethical behavior. • Report results for key measures of promoting or supporting community health and services. And, Other results • As deemed appropriate for the applicant’s individual organization.

28. Guidelines for Responding to the Results Items • Focus on the most critical organizational performance results.

29. Guidelines for Responding to the Results Items • Focus on the most critical organizational performance results. • Note the meaning of four key requirements for effective reporting of results data: • Performance Levels • Trends • Comparisons • Integration: To show that all important results are included, segmented (e.g. by important resident or stakeholder, workforce, process and healthcare service groups), and as appropriate, related to key performance projections.

30. Guidelines for Responding to the Results Items • Focus on the most critical organizational performance results. • Note the meaning of four key requirements for effective reporting of results data. • Performance Levels • Trends • Comparisons • Integration • Include trend data covering actual periods for tracking trends.

31. Guidelines for Responding to the Results Items • Focus on the most critical organizational performance results. • Note the meaning of four key requirements for effective reporting of results data. • Performance Levels • Trends • Comparisons • Integration • Include trend data covering actual periods for tracking trends. • Use a compact format – graphs and tables.

32. Graphs and Tables

33. Graphs and Tables “Quality of Dining Experience” 12/1/2005 2/1/2006 4/1/2006 6/1/2006 8/1/2006 10/1/2006 12/1/2006 2/1/2007 4/1/2007 6/1/2007 8/1/2007 10/1/2007 12/1/2007 2/1/2008

34. Graphs and Tables

35. Graphs and Tables 14% 13% 12% 11% 10% 9% 8% 6% 5% 4% 3% 2% 1% 2008 J F M A M J J A S O N D

36. Graphs and Tables

37. Graphs and Tables 2004 2005 2006 2007 2008

38. Guidelines for Responding to the Results Items • Focus on the most critical organizational performance results. • Note the meaning of four key requirements for effective reporting of results data. • Performance Levels • Trends • Comparisons • Integration • Include trend data covering actual periods for tracking trends. • Use a compact format – graphs and tables • Integrate results into the body of the text and interpret where appropriate.

39. Guidelines for Responding to the Results Items • Focus on the most critical organizational performance results. • Note the meaning of four key requirements for effective reporting of results data. • Performance Levels • Trends • Comparisons • Integration • Include trend data covering actual periods for tracking trends. • Use a compact format – graphs and tables. • Integrate results into the body of the text and interpret where appropriate. • Interpret the graphed results.

40. Good Performance Levels • Performance levels permit evaluation relative to past performance, projections, goals and appropriate comparisons • Goals refer to a future condition or performance level that one intends to attain • Quantitative goals – “targets” • Targets might be projected on comparative or competitive data • Benchmarks refer to results that represent best performance inside or outside an organization’s industry

41. Relevant Comparisons and Benchmarks • Your organization is not unique • Review Baldrige Winners • Seek advice from AHCA Winners • Think outside the box

42. Scoring System • Levels – meaningful scale • Trends – appropriate time period • Comparisons – appropriate, similar, benchmarks • Integration – measures identified in your Organizational Profile and Process Items; harmonized to support goals

43. Scoring Guidelines Results

44. Results Results are 22% of the possible score so… Start Early!! • What results support our Key Strategic Objectives and Action Plans? • Do we clearly understand what each Item calls for? • Where do we get comparative data?

45. Silver Award Requirements to Recommend 1.Score a minimum of 358 total points. 2.Have no less than 88 (40%) points in sections 2.8. 3.Have no criterion in Band A and no more than two criteria in Band B.

46. Technical Requirements • Due electronically March 31, 2010 • 18-page limit • 1” Margins • 12-pt Times New Roman font • $500 application fee

47. Resources • AHCA/NCAL National Quality Award program requirements and application information (www.ahcancal.org). • Baldrige National Quality Award Program To order a free copy of the Baldrige Health Care Criteria for Performance Excellence:Tel: 301-975-2036Website: www.baldrige.nist.gov.

48. More Resources • Scoring guidelines at www.baldrige21.com • Scroll past Baldrige Excellence Tools list to More Baldrige Excellence Tools, Services and Resources • Scroll down to the line Scoring Guidelines 2010 Integrated Versions and click on Health Care

49. More Resources • Books available at www.ahcapublications.org: • Conducting Satisfaction-Based Customer Surveys: A Guidebook for Long Term Care Providers by Vivian Tellis-Nayak, Ph.D. • Continuous Quality Improvement: Using the Regulatory Framework by Barbara Baylis • Developing a Quality Management System: The Foundation for Performance Excellence in Long Term Care by Bernie Dana • Quality Management Integration in Long-Term Care: Guidelines for Excellence by Maryjane Bradley and Nancy Thompson

50. Final Review • Best done with “Walk the Wall” (remember the “war room”) • Ensure all sections are addressed • Remember: Examiners cannot assume, the document must stand on its own • Reconfirm page limits, page numbering and formatting instructions • E-mail some copies to ensure nothing lost in transmission. • And remember……