Rome Wasn t Built in a Day: Building Organizational Foundation Through Culture, Structure, and Accountability

Transcription

1 Rome Wasn t Built in a Day: Building Organizational Foundation Through Culture, Structure, and Accountability Presented By: Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC Chief Nursing Officer, Hospital Corporation of America The Medical Center of Aurora Aurora, Colorado Roman Coliseum

2 The Medical Center of Aurora About Us 346 Licensed Beds 4 Campuses 1,700 Employees 92,000+ ED Visits 80 Behavioral Health Beds Magnet Designated Level II Trauma Center Our Mission Above all else we are committed to the care and improvement of human life 2

3 Building Organizational Foundation Through Culture, Structure, and Accountability Presentation Outline Changing Culture Leadership Development Employee Engagement & Retention Patient Perception Evidence of Success Q & A Athens Acropolis Parthenon

4 Building Organizational Foundation Through Culture, Structure, and Accountability Learning Objectives Verbalize two strategies to create an environment in which improving the patient perception is an organization-wide responsibility Describe numerous tactics to reduce turnover and improve employee engagement Explain the role structure and accountability play in improving culture and outcomes

5 Changing Culture Ancient Roman Coliseum at dawn

6 I Am Why

7 Changing a Culture It s Everyone s Job When a patient and his or her family consider a hospital stay, they think of the person who provided that wow moment. Often, that person is a doctor or a nurse. But it could also be: The friendly intake professional who answered questions about confusing insurance information The dietary worker who brought in a satisfying meal every evening The environmental services tech who made the patient s room sparkle and did so with a smile The pharmacist who came by as the patient was leaving just to make sure all medication instructions made sense The discharge coordinator who called a couple days later to make sure followup doctor appointments were all set Milton Johnson, Chairman & CEO Hospital Corporation of America

8 Leadership Changes A Healthy Level of Patience Marcus Aurelius Leader Turnover Julius Caesar YTD Constantine the Great Nursing Non-Nursing Caesar Augustus 8

9 Changing a Culture Culture eats strategy for breakfast. ~Dr. Peter F. Drucker

10 Leadership Development The Gate of Life at the Colosseum in Rome

11 Leadership Development Institutes Facility Based for Front Line Leaders Planning Team Interdisciplinary Attendees Full Day Presentations Activities Linkage Grids

12 Leadership Development Division-wide Leadership Development Institutes Clinical Nurse Coordinator Training Program Division Orientation Facility Orientation Structured Orientation Competency Inventory Navigator Culture of Excellence Off Stage Executive Coaching 12

13 Leadership Tactic Validation Accountability Bi-annual 9 box of all leaders Cascaded goals 90 day plans Outcome based evaluations Outcome based incentive plans Minimum attendance requirements at development sessions Accountability Matrix Education Department coaching & validation Monthly Meeting Model Goal Setting Monthly Annually 90 Day Plan Monthly Departmental Monthly Operating Reviews Monthly 13

14 Employee Engagement & Retention Santi Luca e Martina Church and Clivo Argentario Road

15 Employee Selection Where to Start?

16 Employee Selection Resume Review Behavioral Based Interview Tool Peer Panel Interview Job Shadowing Final Sign Off by HR & Senior Leader

17 Onboarding Personalized welcome note from CNO for RNs Personalized welcome letter from the unit Orientation presentation by Senior Leaders Leaders eat lunch with new hire during orientation Personal welcome Schedule review HR round at day 15 Benefit review HR round at day 60 Q&A Leader round at day 30 & 90 Studer Tool Survey Educator/Preceptor weekly check-in Nights and weekends included!

18 And Beyond First year turnover is a Sentinel Event HR Stay Interviews Transparency Walk-A-Mile Program Nightshift Breakfast Senior Leader Breakfast Cup of Joe with the CNO Quarterly Lunch with CNO/ACNO Quarterly Employee Forums Julius Caesar, Roman Emperor, did not rule for long, but gave Rome fresh hope for the future Bi-annual Exceptional-Solid-Low Conversations Annual Development/Career Plan Review

19 Employee Engagement & Retention Accountability Monthly data push to Leadership Team Detail by department Includes employee name and reason for leaving Monthly review during Leadership Meetings HR review of all peer panel interview packets HR review of all 30 & 90 day rounding forms Tactic Stoplight Report Employee Rounding Log Thank You Note Log Employee Engagement Action Plan Senior Leader Rounding Validation Monthly Monthly Monthly Monthly Weekly 19

20 Patient Perception Pantheon, Rome

21 Patient Perception Meetings Purpose To provide an opportunity for nursing, ancillary, and essential leaders to work together to improve the patient experience To hold all leaders accountable to the same standard regarding the patient experience To create transparency surrounding rounding and results

22 Patient Perception Meetings Attendees CNO/ACNO, Chair Senior Leaders Inpatient Nursing Directors & Managers Ancillary & Essential Directors & Managers ED Leaders OR Leaders

23 Patient Perception Meetings Agenda Connect to Purpose Report Out 90 Day Plan Current Goal Current Performance to Goal Action Items Weekly Summary How many patients touched? What did you learn? What coaching/follow-up is needed? Who did you recognize? What key messages were shared with staff? What do you need from peers to be successful? What ideas do your peers have to help you be successful? I attribute my success to this - I never gave or took any excuse. ~ Florence Nightingale

24 Patient Perception Meetings Keys to Success All leaders are challenged to have action plans targeted at specific areas where there is opportunity for improvement Discrepancies between assumptions and data are discussed True trust and collaboration among leaders Be the CEO of your unit

25 Patient Perception Meetings Evidence of Success Encounters with employees not demonstrating our values are openly discussed, including loop closure Specific discussions about which support personnel are successful on which units Leaders conducting patient rounds on units other than their own Staff being publicly recognized across departments Dome of the Pantheon Temple Accountability Breeds Response-Ability. ~Steven Covey

26 Patient Experience Accountability Weekly Patient Perception Meetings with 90 Day Plan Weekly CEO/CNO/ACNO Nurse Leader Rounding Validation & Coaching Weekly CEO/CNO/ACNO Review of Rounding Logs Annual Competency Station at Skills Labs Tactic AIDET Nurse Leader Rounding Patient Call Manager Patient Communication Boards Bedside Shift Report Hourly Rounding Staff Communication Boards Validation Quarterly Weekly Weekly Daily Daily Daily Monthly 26

27 One Leaders Perspective David Leslie, MBA, BSN, RN, NEA-BC Associate Chief Nursing Officer The Medical Center of Aurora One Leader s Perspective

28 Evidence of Success Arch of Septimius Severus

29 Evidence of Success: People Employee Engagement: Overall Engagement 82% 80% 78% 76% 74% 72% 70%

30 Evidence of Success: People Turnover 30.5% First Year Turnover 23% 20.4% 19.4% 16.9% 17.6% 14.1% 11.2% 9.2% % Overall Turnover All RN 15.9% 15.2% 15.2% 14.7% 12.7% 12.3% 13.2% 54% All RN

31 Evidence of Success: Service HCAHPS Overall Rating of Care Nurse Leader Rounding 1Q14 2Q14 3Q14 4Q14 1Q15 2Q15 3Q15 4Q15 1Q16 2Q Q15 2Q15 3Q15 4Q15 1Q16 2Q16

32 Evidence of Success: Quality Hospital Acquired Conditions CAUTI Goal = Zero CLABSI YTD YTD 5 MRSA 3 CDIFF YTD YTD

33 Evidence of Success: Finance Contract Labor DOLLARS 10M 8.9M 7.2M FTEs

34 Thank You! Insert Your Photo Here Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC Chief Nursing Officer The Medical Center of Aurora Questions? What would you attempt to do if you knew you could not fail ~Anonymous

35 Resources Patient Perception Agenda Quality Meeting Agenda 35

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