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SSM Health Care

SSM Health Care. Baldrige As a Business Model in SSM Health Care. Up Here, We Go By Results!. A story about a priest and a taxi driver who went to heaven …. Patients, Other Customers & Markets: Key Questions. Whom do you serve? What do they want from you? How do you know?. Sample Approach.

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SSM Health Care

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  1. SSM Health Care Baldrige As a Business Model in SSM Health Care

  2. Up Here, We Go By Results! A story about a priest and a taxi driver who went to heaven …

  3. Patients, Other Customers & Markets: Key Questions • Whom do you serve? • What do they want from you? • How do you know?

  4. Sample Approach

  5. Impact Analysis

  6. Listening and Learning Tools • Former & current patients & families • Satisfaction surveys • Primary-secondary market research • Comment cards • Selected patient follow-up calls • Internet web pages response system • Complaint Management System • Rounding

  7. Complaint Raised Address/Resolve & Follow-up No Issue Referred Resolved Complaint Entered into OFI Data Aggregated Report to QRC for System Level Aggregation Entity Leadership Review Systemic Issue Yes Initiate CQI Process No End Complaint Management

  8. Complaint Management • Categorizes complaints by issue • Creates follow-up forms • Tracks response time • Prints reports by department • Implements service recovery • Analyzed at all levels

  9. Patient Satisfaction Good Source: SSMHC Patient Satisfaction Survey Press Ganey Benchmark = 75th percentile

  10. Patients, Other Customers & Markets – Learnings • Clarity around definition of customer • Customer segmentation • Better use of listening and learning posts & data to drive decision-making • Standardized complaint management process

  11. Measurement & Analysis – Criteria Recap • Establish good measures of effectiveness for action plans (outcome measures) • Identify key drivers of results (in process measures) • Closely monitor performance results • Analyze performance data & look for correlations • Select & use benchmarks/comparative data

  12. System Network Performance Indicators Exceptional Results Entity Department Cascading Indicators

  13. Alignment of Indicators Through our exceptional health care services, we reveal the healing presence of God. Exceptional clinical outcomes Exceptional patient, employee & physician satisfaction Exceptional financial performance Operating margin % AMI, HF, PN, SIP Composite Scores Inpatient loyalty Overall physician satisfaction Overall employee satisfaction Service & quality indicators Inpatient loyalty indicators Employee satisfaction indicators Physician satisfaction indicators Reimburse-ment indicators Productivity/ expense indicators Liquidity indicators Profitability indicators Growth indicators Performance Management Process

  14. Monitoring Performance • Performance Indicator Reports • Hospital, skilled nursing, home care & physician practices • Quality Report • Daily Operations Reports

  15. Performance Indicator Report

  16. Measurement & Analysis– Learnings • Balanced set of measures • Measure what’s important • Monitor what you measure • Use of in-process measures • Do it real time – anticipate changes • Use comparative data • -If you want to be the best, then compare yourself to the best

  17. Staff Focus – Criteria Recap • Develop Work Systems – management & organization of work • Develop HR plan – Recruit/Retain • Motivate staff to contribute to full potential, to develop & learn, to be innovative and creative • Provide education, training & work design that supports goals & action plans

  18. Challenge: Nursing Shortage By 2010, it’s estimated there willbe a shortage of 1 million nurses.

  19. RN Recruitment Fast Track In Process Example • Indicator: Initial contact to Offer <48hrs • Goal: 48 hour fast track process • (IC to offer within 48 hours, 100% of time) • Improve conversion rate of applicants to hires • Pilot: SSMHC-STL staff nurses

  20. Why was process chosen? • Delays in current process (up to 6 weeks in contacting an applicant) • Several applicants frequently had accepted other offers • Focus group validation • Current nurses, nurses who left us, and applicants gave feedback re: timeliness

  21. Fast Track Nurse Hire Results • % Manager Interviews in 48 hours increased from 88% to 94.5% • % Offers in 48 hours increased to from 69% to 87%

  22. Work Life Balance

  23. Benefits to Fit Many Needs • Phased retirement • Defined Benefit plan plus Matched Savings plan – participants up 66% since 2001 • Tuition reimbursement and loan repayment - $4.5 million in 2003 • Long-term care insurance • Adoption benefits

  24. Systemwide Nursing Turnover Good HCAB = Health Care Advisory Board

  25. Systemwide Employee Turnover Source: SSM Employee Survey 25

  26. Good 2004 Employee Satisfaction Results

  27. Staff Focus - Learnings • Implement an employee satisfaction survey • Your staff is one of your greatest assets • Develop a reward and recognition system tied to what’s important to you as an organization • Engage in a succession planning/cross-training program as part of a broader staffing plan • Engage in regular forums to dialogue with employees to encourage staff input • Involve staff in design/redesign of work processes • Benchmark internally and externally for ideas • Incorporate HR into the planning process

  28. What processes drive the results that meet/exceed customer expectations?

  29. Process Management – Criteria Recap Business & Other Support Processes Health Care Delivery Processes • Admit • Assess • Treat • Discharge • How do you identify key process? • How do you identify process requirements? • How do you design processes? • How are business and support processes designed & managed to help you with your core health care processes?

  30. Sample Approach

  31. Process Focus • CQI Principles • Patients & other customers are our first priority • Quality is achieved through people • All work is part of a process • Decision-making by facts • Quality requires continuous improvement

  32. CQI Model – Process Design Approach Plan Do Check Act Plan Conceptual Design Standard- ization Identify Opportunity Future Plans Implement New Process Analysis Results • Team members? • Process to design? • Why process chosen? • How links to SFP? • Identify benchmarking opportunities • What other changes could improve process? • How can team improve to work more effectively in the future? • Initial results meet or exceed customer needs? • Results demonstrate new process' ability to meet or exceed customer needs? • Methods to be used to make new process permanent? • How can team's work be shared with others across the system? • Implement new process • How to change process if not meeting customer needs? • How design to avoid problems? • How can the impact of problems on customers be reduced? • Indicators designed into process to measure performance? • Customers' expected outcomes? • "Best way" to meet customer needs? • Research from other organizations?

  33. Continuum of Care Educate patients and family & ensure patient rights Health Care Delivery Model

  34. Business Processes • Supply chain management • Economies of Scale • Vendor relationships • Managing the supply chain management process • Performance measures

  35. Business Processes • Physician partnering

  36. Physician Partnering SSMHC Environment and Clinical Collaboratives • Mission • Commitment to CQI • Experience with the IHI Breakthrough Series

  37. The Concept By working together, we can improve system clinical performance resulting in exceptional patient care.

  38. Design Collaborative Prework Phase Send out invitation Learning session #1 Team formation and data collection Project work and completion Active phase Learning session #2, #3, #4 Data collection every 3 months Continuous Improvement Phase Conference calls every 2 months Clinical Collaboratives Start of Collaborative

  39. Clinical Collaboratives • Improving the Secondary Prevention of Ischemic Heart Disease (1/99) • Improving Prescribing Practices (5/99) • Using Patient Information to Improve Care (11/99) • Enhancing Patient Safety Through Safe Systems (3/00) • Improving the Treatment of Congestive Heart Failure (11/00) • Achieving Exceptional Safety in Health Care (1/02) • Improving the Care of Community Acquired Pneumonia Patients (11/03) • Improving Critical Care (1/04)

  40. Improving the Secondary Prevention of Acute Myocardial Infarction

  41. Improving the Care of Congestive Heart Failure Patients Better

  42. Achieving Exceptional Safety in Health Care New abbreviations added Good

  43. Achieving Exceptional Safety in Health Care Better

  44. Why Collaboratives ? • System priorities • Barrier disintegration • Spread • Networks of advocates and experts • Aggregation of data • Depth

  45. A Key Learning

  46. Process Management – Learnings • Importance of clearly identifying your key health care, business and support processes • Better involvement of suppliers in improving key processes • Clearly link key processes to customer expectations

  47. Questions

  48. Contact Information E-mail: Baldrige@ssmhc.com Eunice_Halverson@ssmhc.com Corporate Vice President, Quality Resource Center 314-994-7747 Andrew Kosseff, MD Andy_Kosseff_MD@ssmhc.com Medical Director, System Clinical Improvement 608-238-1337

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