Engaging a Changing Workforce through Evidence- Based Practice and HR Analytics. September 29, 2014 Joseph Cabral Chief Human Resources Officer

Transcription

1 Engaging a Changing Workforce through Evidence- Based Practice and HR Analytics September 29, 2014 Joseph Cabral Chief Human Resources Officer

2 North Shore-LIJ Health System 2013 Operating Statistics: More than 9,440 physicians* More than 10,000 nurses* More than 3,200 volunteers 16 Hospitals/more than $7 billion operating margin Opened a new Medical School in 2011 Nation s third largest, non-profit, secular health system Service area of 7 million people Recipient of the National Quality Forum s 2010 National Quality Healthcare Award More than 48,000 employees the largest employer on Long Island the 3 rd largest private employer in New York City More than 6,000 hospital and long-term care beds* 4 million patient contacts 25,600 births 283,700 hospital discharges 640,000 emergency visits 133,400 ambulatory surgeries 91,400 ambulance transports * Does not include affiliate organizations

3 0.7M (Alaska) North Shore LIJ has a service area of 7 million people in Manhattan, Queens, Staten Island and Long Island 1.0M 0.7M (Montana) (N. Dakota) 0.6M (Vermont) 0.6M (Wyoming) 0.8M (S. Dakota) 1M (Rhode Island) 0.9M (Delaware) 0.6M (Washington DC)

4 Fortune 500 Potential Ranking (2012) $8.5B - $6.1B Ranking 303 Revenue $ $ $ $ $ $6.71 $ $ $ $ $ $6.11

5 An Integrated System Not just a collection of distinct, individual entities Administratively and clinically integrated Community Health Centers Labs Physician Offices Tertiary Hospitals Nursing & Rehabilitation Community Hospitals Tertiary Hospitals Community Hospitals Nursing & Rehabilitation Patients & Families Specialty Hospitals Physician Offices Home Care & Hospice Specialty Hospitals Specialty Centers Community Health Centers Assisted Living Ambulance Services Community Health Home Care & Hospice Assisted Living

6 BUSINESS ENVIRONMENT

7 HEALTHCARE DELIVERY S PERFECT STORM 7

8 External Pressures Health Care Reform Crisis 8

9 The Business Environment Consumerism & Transparency National & Regional Physician Shortages Increasing Government Oversight Increasing Costs Fragmented Care Health Reform Uncertainty Aging Population Growing Diversity Declining Reimbursement Increasing Life Expectancy Questionable Quality & Satisfaction Medical Technology Advancements Increased Need for Skilled Workforce 9

10 Higher Costs Higher Quality

11 The Aging Population Significant trends in New York State

12 Growing Diversity

13 The Educated Consumer Patients are prepared with media and internet information Informed questions about diagnosis and treatment options Drug advertising Consumer cost concerns Options

14 Age of Transparency

15 Change in the Business Model Shift To Ambulatory Shifts lower acuity case load from inpatient to outpatient setting Advancements in minimally invasive techniques and procedures Diagnostic efficiencies Patient satisfaction Boutique services Health Clinics located inside pharmacies

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17 Dissatisfied Patients

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19 NYC Area Hospital Closures Since 2000 In 10 years, 20 hospitals (4,562 beds) have closed, putting added pressure on remaining hospitals in the N.Y. metropolitan area to raise performance standards. 19

20 Healthcare Reform and Value Based Care

21 U.S. Healthcare System

22 Let s Start at the Beginning The only thing we know about the future is that it will be different. The best way to predict the future is to create it. - Peter Drucker

23 Our Workforce, the Driver of Change

24 24

25 October 28, 2008 Time Inc. Plans 600 Layoffs Time Inc., the world s largest magazine publisher, plans to cut 6% of its work force more than 600 positions. January 26, 2009 Layoffs Spread to More Sectors of the Economy Furloughs, wage reductions, hiring freezes and shorter hours did not do enough. A year into this recession, companies across the board are resorting to mass job cuts. July 21, 2011 Companies are Laying Off Companies are laying off employees at a level not seen in nearly a year, hobbling the job market and heightening fears about the pace of economic recovery. February 8, 2009 Economy Shed 598,000 Jobs in January In a bleak report on Friday, the Labor Department said that almost 600,000 jobs disappeared in January and that a total of 3.6 million jobs had been lost since the beginning of the recession in December 2007.

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27 Focusing on Talent Management 27

28 Why Talent Management? Roughly 62% of our revenue is spent on Human Capital Critical for business continuity High correlation between customer satisfaction and employee satisfaction 20% of our workforce are over the age of 55 and nearing retirement 32% of our leaders are over the age of 55

29 The U.S. Healthcare Workforce TABLE 1A.3 Prospects for Growth in the U.S. Health Care Workforce, Note: Columns may not add to total due to omission of occupations with small employment. Source: U.S., Department of Labor. Bureau of Labor Statistics. (2010). National employment matrix, Retrieved September 16, 2010, from

30 Physician Workforce Growing shortage - Specialists in high demand - Primary Care Greatest demand Lowest compensation Projected Shortfalls of Physicians Relative to Demand Source: Advisory Board; Recruiter Benchmarking Survey; 2009 Report based on 2007 data

31 Nursing Workforce Recession delays retirement giving false sense of security - Mean age of Nurses in NY State = % of NY state nurses are >40 years old - Applicants turned away from RN schools due to lack of faculty Source: HANYS; June 2010 Nursing Workforce Survey

32 Allied Health Workforce Growing demand particularly for Nurse Practitioners and Physician Assistants Difficulty recruiting Demand will continue to rise due to Health Care reform and physician shortage - Will play vital role in improving access to primary care

33 Health System Mid Level Provider- Growth Year Nurse Practioner Headcount Physician Assistant Headcount *Includes all business units in the system

34 Driving Performance through Your Workforce

35 Alignment Employee Survey Performance Appraisal Baldrige

36 36

37 Linking Metrics to Performance Establish the organization s line of sight and direction Create clear measures Communicate the metrics Organizational Scorecard Month/Year Date Dashboard

38 Linking Metrics to Individual Performance Dashboard QUALITY Scorecard Month/Year Financial Performance Patient Experience Date 38

39 Linking Metrics to Performance Excellence Patient Experience Integrity Caring Innovation Teamw ork Do not forget to focus on the values! If you throw your heart over the fence, the rest will follow. -Anonymous

40 Organizational Alignment Smith, Anne, RN NSUH

41 Incentive Compensation NSLIJ Health System - Annual Incentive Plan Calculation YOUR NAME AND TITLE HERE Base Salary $200 Target Bonus 20.0% $40 Target Total Cash Compensation $240 Actual Bonus as of 13.5% $27 September 17, 2007 Actual Total Cash Compensation as of $227 Above (Below) Target ($13) Circuit breaker is assumed to be "achieved". SYSTEM Goal (100% Weight) Weight Thr. Tgt. Max. Result Payout Patient Experience Likelihood to Recommend (Inpatient) 25% % Weight * Result * Target Bonus $0.0 Quality CMS Overall Indicators 25% 85% 85% 95% 70% 0% Weight * Result * Target Bonus $0.0 Quality/Financial Perf. Excess Days 25% 8,244 10,305 12,367 11, % Weight * Result * Target Bonus $12.1 Financial Performance Controllable Margin 25% 0.3% 0.4% 0.7% 1.1% 150% Weight * Result * Target Bonus $15.0 System Results $27.1 OK Link between performance and bonus payout: Performance Payout Threshold 50% Target 100% Maximum 150%

42 Talent Management Cycle(Hardwiring) NOVEMBER Performance Reviews for Dept Heads/Mgrs (IDP s) Open Enrollment High Potentials selected DECEMBER Performance Reviews for Sr. Execs (IDP S) Salary Increases (across the board) JANUARY Sr. Leadership retreat Mail W2 s to employees NYSNA Negotiations FEBRUARY High Potentials Kickoff Cascading of Goals- CEO/COO EHS Annual Health Review OCTOBER Finalize 2009 HR Budget Open Enrollment meetings Performance Reviews for all employees (IDP s) Flu shot distribution MARCH Leadership Immersion Program 360º process for high potentials SEPTEMBER EEO Reports to the Department of Labor APRIL Application for President s Award Annual Educational Mandatorys Employee engagement survey AUGUST Succession Planning key positions identified High Potentials identified and assessed JULY JUNE MAY Resident On-boarding Review of metrics for Service Progress measured for financial and operational efficiency Quality measures tracked Annual Mandatory Compliance Training President Award Winner(s) Announced Employee self-service-setting up kiosks at each site (Summer) Applications for Summer Interns 403(b) auto enrollment Handbook for staff Health & Welfare benefit review

43 Employee LifeCycle eapplications eonboarding eorientation eperformance Management esuccession Planning

44 Evidence-Based Practice Team STEPPS (Strategies & Tools to enhance Performance and Patient Safety) - An innovative infrastructure - A systematic approach to improve quality safety efficiency through optimizing team performance What is Team STEPPS Empowerment through education - Overall improvement in care - Decrease in mortality - Lower incidence of patient harm - Reduced infection rate Cost avoidance was over $21 million

45 Meaningful Metrics Meaningful metrics refer to those data that actually are used to drive change or influence management decisions.

46 Recruitment Metrics Turnover Rates Vacancy Rates Openings Promotions Transfers Terminations days Terminations 360 days Total Terminations Cost Per Hire Total Hires Employee Referrals Resumes Received Interviews Conducted Advertisements Job Fairs Open Houses Diversity Sourcing Effectiveness Time to Fill Agency Fees Candidates in Pipeline Demographics Recruiter Effectiveness Declined Job Offers

47 Talent Management: Keeping it Simple Effective Talent Management Engaged Employees Satisfied Customer/ Patient Strategy Execution Business Results

48 However beautiful the strategy, you should occasionally check the results. -Winston Churchill

49 Outcomes

50 Executive Summary Sample

51 Overall Entity Mean: Inpatient 2002 q4 Employee Engagement & Service Excellence Facilities with higher aggregate organizational commitment scores have higher patient satisfaction scores Going forward, orienting your facilities and the System in general toward these elements will be an important step in building an ongoing case for the value of investing in people 84 Patient: Service Employee* Excellence Overall Entity Organizational Mean Score: Commitment Inpatient Q4 Score 2002 Hospital A 87.5% 82.6% Hospital B 79.0% 82.5% Hospital C 77.7% 79.0% Hospital D 75.2% 77.4% Hospital E 74.9% 82.5% Hospital F 69.6% N/A Hospital G 67.6% 81.3% Hospital H 66.2% 78.7% Hospital I 60.1% 71.6% Hospital J 57.1% 72.0% r = Organizational Commitment *Excludes hospitals/facilities that did not have patient and operational performance metrics. Green shading represents top three facilities for each metric, red shading represents bottom three.

52 Employee Survey Results 59% Healthcare Benchmark Agree / Disagree: I am a valued employee here

53 Employee Survey Results I understand how my work contributes to the goals of my hospital/facility 88% Healthcare Benchmark

54 54

55 Performance Metrics Scorecard Performance Sample Data Only M etrics Executive Summary Health System For the Period Ending 7/31/2008 Priority Indicators Current Data Targets Trends 1 Patient Experience (Press Ganey) Rolling Average Annual Annual Annual 3 Month (Apr 08 - Jun 08) Threshold Goal Stretch Goal Trend Likelihood to Recommend (Inpatient Score) Likelihood to Recommend (Inpatient Percentile) Quality Apr 08 Annual Annual Annual 3 Month (Preliminary) Threshold Goal Stretch Goal Trend CM S Blended (AM I, PNE, HF, SCIP) 97.4% 85.0% 90.0% 95.0% Blended = applying a weight of 75% to the CMS overall (AMI, PNE, HF) and 25% to SCIP. 3 Financial Performance 3 Mo. Variance YTD YTD YTD YTD (YTD Actual Actual Threshold Goal Stretch Goal to YTD Goal) Operating M argin (in thousands) $ 29,939 $ 16,825 $ 18,694 $ 22,433 4 Productivity 3 Mo. Variance YTD YTD YTD YTD (YTD Actual Actual Threshold Goal Stretch Goal to YTD Goal) Reduction in Excess Days 16,170 7,237 9,649 12,061 favorable/(unfavorable) Current data does not meet/exceed goal Current data meets or exceeds goal Current data does not exceed goal

56 Excess Days LOS Reduction There has been a decrease of 96,213 days, which has resulted in a increase of 275 beds of capacity March 2011 Occ % 89.5% 89.2% 89.4% 87.3% 90.2% (Excl. Newborn, exempt units and pediatrics)

57 Service Excellence Inpatient Satisfaction 1.4% Improvement ER Satisfaction 6.6% Improvement * * Through February 2011

58 Service Glen Cove Hospital percentile rank

59 Core Measure Composite Score North Shore - Long Island Jewish Health System Core Measure Composite Score Q Q AMI HF PNE SCIP 11.6 % 9.3 % 3.2 % 8.2 % Improvement Improvement Improvement Improvement Source: Premier 80.0 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q

60 Quality Outcomes ICU Central Line Associated Bacteremia Index ICU Ventilator Associated Pneumonia Index Surgical Site Infection (Class I & II) Rate MRSA (Methicillin-Resistant Staphylococcus) Index 70% Reduction 50% Reduction 24% Reduction 23% Reduction Source: NSLIJHS Quality Management

61 (in billions) North Shore-LIJ Health System Revenue $8 $6 Source: Finance $4 $2 $

62 Employee Engagement Pays Off -Companies with high levels of employee engagement show turnover rates that are 40% lower than companies with low levels of engagement. Estimated cost of replacing employees is between 50% and 150% of salary. -Hay Group Research Disengaged employees can undermine the success of an organization - they are not strongly committed to achieving a company s goals and objectives, and may not be motivated to act in accordance with its mission/values. -Enterprise Engagement Alliance

63 National Quality Healthcare Award - Today the National Quality Forum (NQF) announced North Shore Long Island Jewish (LIJ) Health System as the recipient of the 2010 NQF National Quality Healthcare Award for its ongoing commitment to providing highquality, transparent, patient-centered healthcare. - North Shore-LIJ is a clear leader in striving to make high-quality care commonplace for every patient and a central part of its culture. We are at the precipice of change in healthcare in America, which will have implications for every healthcare facility in every community. ~Janet Corrigan, President & CEO, NQF - For us to succeed as a healthcare organization and strengthen public trust, we recognized long ago that quality must be a top priority for every employee, regardless of whether they re cleaning patients rooms or performing surgery in the operating room. ~Mr. Dowling, President & CEO, North Shore-LIJ

64 Our Workforce is Our Competitive Advantage!

65 ` Every Life Deserves World Class Care