May 13, 2013 3:00 – 4:30 PM ET

1. Partnership for PatientsHospital Engagement NetworkAll Hospital EventGenerating Engagement Among Physicians and Leadership at all Levels May 13, 2013 3:00 – 4:30 PM ET

2. Welcome and Overview:The nature of leadership at all levels. Paul McGann, MD & Dennis Wagner, Co-Directors, Partnership for Patients Jack Jordan, Deputy Director, Partnership for Patients Fred Butler, Jr., Communications Lead, Partnership for Patients

3. Partnership for Patients Objectives • 40% reduction in hospital-acquired conditions: • Adverse Drug Events • Catheter-Associated Urinary Tract Infections • Central Line Associated Blood Stream Infections • Injuries from Falls and Immobility • Obstetrical Adverse Events • Pressure Ulcers • Surgical Site Infections • Venous Thromboembolism • Ventilator-Associated Pneumonia • 20% reduction in hospital readmissions compared to 2010. Participants aim to reach these goals nationwide within 3 years.

4. Our Infrastructure: 26 Hospital Engagement Networks (HENs) • LifePoint Hospitals, Inc. • Michigan Health and Hospital Association • Minnesota Hospital Association • National Public Health and Hospital Institute • Nevada Hospital Association • New Jersey Hospital Association • North Carolina Hospital Association • Ohio Children’s Hospital Solutions for Patient Safety • Ohio Hospital Association • Premier • Tennessee Hospital Association • Texas Center for Quality and Patient Safety • UHC • VHA • Washington State Hospital Association • American Hospital Association / Health Research & Educational Trust • 31 State Hospital Associations • Ascension Health • Carolinas - HealthCare System • Dallas-Fort Worth Hospital Council Foundation • Dignity Health • Georgia Hospital Association Research and Education Foundation • Healthcare Association of NYS • Hospital & Healthcare System of Pennsylvania • Intermountain Healthcare • Iowa Healthcare Collaborative • Joint Commission Resources, Inc.

5. National Support SystemHospitals Engaged, Reporting, Improving, & Generating Benchmark Results on PfP in April 2013 **As of March 2013, the method for classifying hospitals as improving and meeting benchmark status was changed and clarified, making data for the “Showing Benchmark Status” for March onwards non-comparable to those shown in earlier months.

6. Framing: Campaign Update • New, encouraging results • Insights from 1 on 1 meetings • Affinity Groups: • Harm Across the Board • Readmissions • Medication Safety • Maternal Health • Patient and Family Engagement • Rural • Procedural Harm • Product Safety and Resource Management

7. Framing: 30/6/60 Benchmark • Our next milestone: To demonstrate 30% improvement in 6 or more priority areas by 60% or more of each HEN's hospitals by July 2013.

8. Framing: Preventing Harm Across the Board • Template • Resources • Affinity Group • HRET role/fellows • Training available: • Next session on May 14, 2013 from 3:00-4:00pm ET. Register here!

9. What more can we do to engage leadership, physicians and patients to achieve Partnership for Patient Campaign Goals? Carol Wagner, Senior Vice President Patient Safety , Washington State Hospital Association Martin Hatlie, National Content Developer

10. Objectives • Learn from leaders how they engage physicians to prevent harm across the board. • Hear insights from high performing hospitals integrating leadership, physician and patient engagement strategies to improve outcomes. • Learn from patients how they engage or expect to be engaged. • Share HEN success stories using resources and relationships to engage physicians and leaders • Foster sharing of insights and experiences that help us achieve Campaign Goals.

11. Questions to Run On • What more can we do to engage healthcare leaders and physicians in achieving the outcomes patients expect? • What more can we do to engage leadership, physicians and patients to achieve Partnership for Patient Campaign Goals?

12. How to Participate on This Call In order to ask a question or provide a comment: • Via the “Ask a Question” Box • Please type your question or comment in the “Ask a Question” box located directly under the slides on this platform.

13. Creating a culture of engagementUsing safety as a common denominator David Whitehead President and Chief Executive Officer Backus Health System Norwich, CT

14. The culture conundrum … 14

15. … Or, “How I became an HRO evangelist” 15

16. At last — a common framework “Success is only possible when everyone knows what’s expected and what’s important.” 16

17. At last — a common framework “Success is only possible when everyoneknows what’s expected and what’s important.” • Board • Medical Staff • Management • Staff • Volunteers • Patients • Families • Community 17

18. At last — a common framework “Success is only possible when everyone knows what’s expected and what’s important.” • Zero preventable harm • How? • A mirror … • And a picture frame Imagine your loved one here … 18

19. At last — a common framework “Success is only possible when everyone knows what’s expected and what’simportant “What gets measured gets done.” Dashboard shared with Board, staff, physicians … tied to P4P rewards 19

20. Measurement as a test of leadership • “How many preventable deaths has our hospital had in the past year?” • “How many times in the past month have we ‘gotten lucky’ regarding harm?” • How do we know? 20

21. Rear-views and windshields • Backus HEN dashboard • 12 months without pressure ulcer • 11 months without an adverse drug event • 9 months without a surgical site infection • 8 months without a fall resulting in injury • 8 months without a central line associated blood stream infection 21

22. Rear-views and windshields • 3 preventable deaths in first six months of current fiscal year. 22

23. Serious Safety Event Rate 23

24. Safety Event Rate 24

25. Ingredients … 25

26. … and a recipe … Communication • Training (yes, all physicians, too) • Quarterly all-staff updates Measurement • Training (yes, all physicians, too) • Quarterly all-staff updates Accountability 200% (Me and you) “A JUST CULTURE” 26

27. … yield new levels of engagement. Physician champions Physician Director of Performance Improvement trains volunteers on HRO Not just clinicians Manager of Regulatory Compliance teaching an HRO session for clinical and non-clinical staff Patient involvement Patient-Family Advisory Group participation in clinical redesign decision-making. 27

28. Engagement can be contagious 28

29. Physician Engagement in Quality and Safety at Vidant Health David Herman, MD Chief Executive Officer Walter Pofahl, MD Board Chair Kim Blanton, MIS/LS Patient Advisor Joan Wynn, PhD Chief Quality Officer

30. Vidant Health Map

31. Leadership Commitment “Vidant Health will provide 100% optimal care, best patient experience, and zero events of preventable harm by October 1, 2013.” Board of Trustees April 20, 2010

32. Progress 62% reduction in HAI since 2008 98% optimal care on core measures for all 10 hospitals combined (up 20 percentage points since 2007) Financial Impact in FY 12 = $1,811,650 System-wide hcahps patient experience at 91st percentile

33. Getting Started Ref: Engaging Physicians in a Shared Quality Agenda IHI, 2007

34. Turning Data to action

35. Capacity Building

36. The Great Rate Debate - Or how we eliminated the denominator in support of continuous improvement • Rates work well at the start of the campaign • As improvement develops raw numbers work best • Each case is a person • Real data can be analyzed • New learning and new science is developed • Better engagement from the raw numbers

37. A Patient Story of Physician engagement

38. Physician Engagement in Quality and Safety at Vidant Health David Herman, MD Chief Executive Officer Walter Pofahl, MD Board Chair Kim Blanton, MIS/LS Patient Advisor Joan Wynn, PhD Chief Quality Officer

39. What more can we do to engage healthcare leaders and physicians in achieving the outcomes patients expect? Patty J. Skolnik, Executive Director, Citizens for Patient Safety LilleeGelinas, MSN, RN, FAAN, VP & Chief Nursing Officer, VHA Inc. Sherri Loeb, RN, Patient Navigator Debbie Nadzam, PhD, BB, FAAN, Joint Commission Resources, Inc.

40. Development and Deployment of Leadership and Physician Activation Bundles Susan Whitehurst, MSN, RN Master Black Belt Senior Consultant and Project Manager J.C.R. HEN

41. Objectives • Discuss the impact of leadership and physician engagement • Review the J.C.R. HEN tool design process • Describe the leadership and physician activation tools • Identify pearls, offers, and requests

42. Leadership and Physician Engagement To achieve optimum effectiveness leaders should articulate a clear vision and direction. Engaged leaders demonstrate the ability to communicate this vision to the various learning styles of the people who are expected to contribute towards reaching this vision. People desire to know how the world will be different for those who follow. They need to be sold on a vision that excites them. Engaged leaders take every opportunity to paint a better tomorrow, not just for some but for all. http://stevenalston.com/articles/h-engaged-leadership/

43. The tool design process • Leadership Team Charter • Review of the Literature • Voice of the Customer • Drilling down to root cause/s of engagement • Target tool selection and design for the desired impact • Keeping the patient and family in the center • Creating a standardized format • Keeping it simple!

44. Model Design

45. Net Forward Energy

46. Pearls: All of us are leaders… • Leadership is the ability to influence positive change in others which is very different than managing tasks • Leaders who are “Self Aware” know and understand what other people “see” when they are interacting in an ever-changing world • Activating change through the use of leadership and physician tools can only be accomplished through human behavioral awareness and building relationships together

47. Offers and Requests • Site Visit Pilot Testing in June and July • Dissemination of change packages to J.C.R. HEN Hospitals • Sharing of the Change Package on the Community of Practice Website • Our request – Steal shamelessly, engage patients in this work as you redesign your tools, and share your findings with us so that we can learn from one another.

48. Washington State Hospital Association Jennifer Hanscom Executive Director/CEO Washington State Medical Association Carol Wagner, RN Senior Vice President Patient Safety Washington State Hospital Association WSHA NCD Call Engagement-May 13, 2013

49. Roadmap for Partnership for Patients

50. What Partnership with Medical Association Can Do for You • Align strategies and strengthen communications with physicians • Help advance work through specialty societies • Engage physician champions as key to success • Advance the latest literature for improvement strategies • To get to 40% we have to go beyond the basics • Create momentum for Partnership for Patients in the physician community