Welcome to Scripps
Name Table Tents On both sides of your card please print using big letters and bold colors Your first name, first initial of last name Your position and specialty (if applicable) Your work site
Orientation Facilitators From Scripps Center for Learning & Innovation (CFLI) Juergen Deutzer, RN, MSN Learning Leader Becky Lundgren, MN, RN-BC, CHTP Professional Development Specialist Rebecca Everett, MS Professional Development Specialist Linda L. Medal, MA Professional Development Specialist
Share with Your Group in 30 seconds or less In your role specifically, how do you positively impact patient-centered care?
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Today s Agenda We Stand for Excellence Scripps We have a greater mission. Patient-Centered Care We put our patients first. Our Journey to Excellence We are thought leaders. We actively participate in change. Review and Preview p. 2
Stretch Break
Scripps Health We have a greater mission
Scripps Legacy History is filled with those who dare to follow their dreams and in so doing change the world. Ellen Browning Scripps Mother Mary Michael Cummings
Mother Mary Michael Cummings & Sisters of Mercy Founded St. Joseph s Dispensary in 1890
Chris Van Gorder - President & CEO
Our Mission Scripps strives to provide superior health services in a caring environment and to make a positive, measurable difference in the health of the individuals we serve. We devote our resources to delivering quality, safe, cost effective, socially responsible health care services. We advance clinical research, community health education, education of physicians and health care professionals and sponsor graduate medical education. We collaborate with others to deliver the continuum of care that improves the health of our community. p. 5
Mission superior health services in a caring environment Cardiac Care Scripps Prebys Cardiovascular Institute The most advanced heart care facility on the West Coast
Mission superior health services in a caring environment Trauma Care
Mission superior health services in a caring environment Integrative Medicine
Mission advance clinical research moving discoveries from the laboratory benches to patient bedsides in the safest, most efficient way possible.
Mission advance education of physicians and health care professionals Research generates knowledge. Education communicates knowledge. The result is superior patient care.
Mission We collaborate with others to improve the health of our community In 2014, Scripps contributed $373 million in community benefit programs and services. Uncompensated Care Mercy Outreach Surgical Team (MOST) Community-Based Health Improvement
Scripps Values Quality: We provide the highest quality of service. Respect: We demonstrate complete respect for the rights of every individual. Efficiency: We care for our patients every day in a responsible and efficient manner. p. 5
Scripps Today Four Hospitals on Five Hospital Campuses Over 30 Outpatient & Specialty Centers SHAS (Scripps Health Administrative Services) SSRS (Scripps System Resource Services) Home Health Hospice
Organizational Structure Overview
Hospital Locations Four (4) hospitals on five (5) campuses
Scripps Clinics Carmel Valley Clinic Encinitas Clinic Mission Valley Clinic Rancho Bernardo Clinic Rancho San Diego Clinic Santee Clinic Scripps Clinic Specialties Scripps Clinic La Jolla OB/GYN Scripps Clinic Del Mar Sorrento Mesa Torrey Pines Clinic
Scripps Coastal Medical Centers Encinitas Vista - Cedar Carlsbad Escondido Oceanside - Mission Hillcrest Obstetrics & Gynecology Oceanside Rehab Vista Del Mar Sycamore Eastlake
By the Numbers Two of San Diego s five adult trauma centers 30+ outpatient centers 14,000+ Scripps employees 2000+ volunteers 200+ medical residents and fellows 2.1 million outpatient visits annually 69,000 inpatient discharges annually 2,700+ contracted and affiliate physicians
System-Wide Employee Distribution FY15 EMPLOYEE HEADCOUNT % Scripps Medical Foundation (SMF) - Clinics 2,743 20% Scripps Mercy - San Diego 2,440 17% Scripps Health Administrative Services (SHAS) (includes SSRS) 2,413 17% SMH La Jolla 2,258 16% Scripps Green Hospital 1,451 10% SMH Encinitas 1,370 10% Scripps Mercy - Chula Vista 1,063 8% Home Based Services 272 2% TOTAL 14,010
Break Time
Getting healthy at Scripps is a team effort a partnership between physicians, patients, family, friends, clinicians, and thousands of others you may rarely meet, but who work each day to create and maintain a world of healing through One Scripps. The truth is, none of us can do what we are doing alone. -Chris Van Gorder
Where do you fit in?
Scripps Vision Scripps Health will continue to be the leading health care delivery system in the greater San Diego community, as evidenced by the highest clinical quality, patient safety, and patient, physician and employee satisfaction. This will be achieved through unending focus on patientcentered and compassionate care, cost-effective operations, research, advanced technology and innovation. p. 5
Strategic Goals Transform to a high value, patient-centric, coordinated wellness, prevention and acute model of care. Recruit, retain, and develop our talent to succeed in the new customer-centric delivery model. Succeed financially under new payment models. Grow enrollment and services to meet the needs of the community.
Vision Building San Diego s Future Patient-centered and compassionate care Advanced Technology Research Advanced Technology
Vision Building San Diego s Future Scripps Radiation Therapy Center Scripps Proton Therapy Center
Philanthropy fulfills our vision Philanthropy fulfills our vision Scripps Prebys Cardiovascular Institute Scripps Genomic Medicine Scripps Encinitas and Scripps Mercy San Diego expansions
Total Contribution Margin Healthcare Reform: Payment Impact - Hospitals Reimbursement rates are declining $340m $ Current Breakeven ($98m) DSH HMO/PPO Medicare Medicaid Indigent/ No Pay Payer Type Amounts are FY10 hospital income/(loss) in millions Other
Annual Health Expenditure Per Capita, US and Selected Countries Source: The World Bank.org Annual health expenditure per capita
Life Expectancy Life Expectancy at Birth 2000-2011 - The Organisation for Economic Co-operation and Development (OECD StatExtracts)
Evolution of Health Care
Organizational Structure Redesign
Mary Ellen Doyle RN, BSN, M.B.A Corporate Vice President Nursing Operations
Group Message Create a short commercial, tweet, or elevator speech that addresses the following Scripps History Mission, Values, and Vision Why choose Scripps? Why work for Scripps?
Lunch Time Please be back in your seats ready to begin again in one hour
Patient-Centered Care We put our patients first
High Quality Health Care Safe Effective Patient Centered Timely Efficient Equitable Compassionate
Who Are Our Patients? Caucasian Hispanic Asian African American Many others
What Do They Value and Expect? Affordable, patient-centered, accessible care Value = Quality Cost
Patients Rights Involve family and individuals in decisions regarding care, treatment, and services. Respect individual cultural and spiritual values. Meet each patient s identified needs to include visitors of their choice. Support and advocate for our patients rights. p. 7
Patients Rights Pain Management Any care team member is responsible for routine pain screening and prompt reporting to the RN if screening reveals the presence of pain. Scripps Pain Management policy End-of-Life Care How will we respect patients rights and demonstrate compassion for the patient and family?
Scripps Service Standards First Impression Make Amends Clean & Safe Environment Communicate Effectively p. 7
First Impression Welcoming, friendly attitude and greeting What does it convey to the patient and family? Setting expectations upon admission What can you do? p. 7
Communicate Effectively It s more than just what you say Words Tone Body Language p. 8-11
Clean, Safe and Private Environment If You See it or Hear it, You Own it! No matter where you are: Everyone picks up trash and cleans up spills Every patient is your patient Always ensure the room is clean and neat Reduce clutter in the room as it is a safety hazard Respect patients privacy by: Closing the curtains or door Lowering your voice for private conversation Staying in Situational Awareness
Make Amends The Four Steps to Service Recovery 1. Listen 2. Apologize 3. Solve 4. Thank you p. 11
Patient Satisfaction
Patient Satisfaction Surveys HCAHPS Inpatients Home Health Press Ganey Hospice Ambulatory Surgery Clinics Imaging Emergency Department Urgent Care p. 12-17
Inpatient Survey Question Example During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted? Never Sometimes Usually Always What number would you use to rate this hospital stay? (Based on a rating of 1 10) How does the Scripps get credit? p. 12-17
Cultural and Linguistically Appropriate Services
Scripps Language Services (24/7) It is essential to use qualified, competent, and professionally trained medical interpreters to ensure our patients safety, increase patient satisfaction, increase compliance with the law, and decrease the risk of medical error, liability and malpractice. Interpretive Services (oral word) Over-the-Phone Interpretation (Cyracom blue phones or Language Line) Friendly Voices Interpreters (medically qualified) Video Remote Interpreting for American Sign Language (ASL) Translation Services (written word) Signs and Braille for visually impaired p. 8
Stretch Break
The Patient Experience Activity 1. How can you create a positive first impression? 2. How can you communicate effectively? 3. How can you maintain a clean, safe, private environment? 4. How can you make amends if needed? p. 7-11
Patient Experience ACTIVITY Scenario 1 Scripps Patient Perspective: You are approaching the front desk in a health care environment that is new to you. The two people behind the desk are speaking in a different language and laughing. You feel like they are laughing at you. Scripps Employee Perspective: You are at the front desk. Your friend just finished telling you about her funny weekend, in Spanish. You both laugh about it. At the same time, a patient arrives at the desk, looking a bit upset.
Patient Experience ACTIVITY Scenario 2 Scripps Patient Perspective: You are meeting your morning caregiver for the first time and they start the conversation with I am here to do your assessment. They seem preoccupied with their phone that keeps going off and interrupting your conversation. They finally take the call. You feel very annoyed, and unimportant. Scripps Employee Perspective: You walk into a patient s room and begin your initial assessment. A few minutes into the assessment, your work phone keeps ringing. After a message has been left you look down to answer your phone the next time it rings. The call was regarding another patient that needs you urgently.
Patient Experience ACTIVITY Scenario 3 Scripps Patient Perspective: You were scheduled for a CT scan at 9:00 am and now it is noon. Your wife is very upset since no one is telling you why the wait is so long and you feel no sense of control. Your test has already been delayed three times. A staff member comes in the room with a tray for the other patient in the room with you, but you really want them to get you some answers. You feel this wait is very unreasonable. Scripps Employee Perspective: You walk into a patient room to deliver a lunch tray to the patient in the far bed. Mrs. Johnson, wife of the patient in the first bed, verbalizes to you that she is very upset that her husband has been waiting so long. You are not the person taking care of this patient
Patient Experience ACTIVITY Scenario 4 Scripps Patient Perspective: You suddenly had to call 911 and be taken to the ER. After a 5 hour wait in the ED to get a bed, you are just getting settled. There was no time to get any of your belongings when the first responders took you and you are really concerned about who is going to take care of your dog. A staff member comes in to collect your co-pay. You cannot believe someone has come into the room asking you for money! Scripps Employee Perspective: You are going into a patient s room to get the copay taken care of. You know little about the patient as you did not have the time to look over their records. You say to the patient
Break Time
Our Journey to Excellence We are thought leaders We actively participate in change
Learning Objectives: Using the Excellence All Around You visual map, we will discuss: Scripps strategies for success. Value by Design principles. how you can help Scripps succeed in this challenging healthcare environment.
Charting the Course A learning conversation around the visual map.
Visual Map Instructions: 1. Clear the table to make room for this exercise. Make sure you have: a map a flipbook entitled Scripps Excellence All Around You. 2. Select 1 person to be the facilitator, who will use the instructions in the flipbook to guide the discussion 3. Select 1 person to be the note taker, to record a few key points in the discussion. The form for the note taker is in the flipbook. 4. You will have 20 minutes for this activity. Facilitators are roaming the room, ready to assist you if needed. 5. Questions? 6. Unfold the visual map at your table and begin.
DEBRIEF the Visual Map Activity 1. Describe the flow from the bottom to the top of the mountain. 2. What is patient-centered care? Tell me some of the example of what you will do in your role to provide patient-center care? 3. Find the Winds of Change. What do you think about these changes? What questions came up in your group?
DEBRIEF (continued) 4. Find The Complacency Plateau. What does it represent? 5. Name 3 things shown on the map that prevents us from being efficient. 6. Find the Cost Cycle Billboard. If you were running Scripps, what would you do to keep the business successful? 7. What are the names of the 2 pillars holding up the bridge?
What is Scripps Value by Design? Changing from a firefighting approach to a proactive approach
Strategies for Success Include: Value by Design- develop and engage our people to reduce cost, eliminate waste and create value. Innovate to manage the health of the people we serve. Transform delivery of clinical care. Move to new payment models.
All employees are expected to actively participate and share expertise. be creative thought leaders. solve problems and take ownership of solutions. have courage to expose challenges. trust and be flexible to try new ways of doing things.
Stretch Break
Profit: Why Waste Matters Profit = Revenue - Expenses = - = - = - = - = - = -
Profit: Why Waste Matters What can cause expenses to increase? Profit = Revenue - Expenses $20 = $100 - $80 = - = - = - = - = -
Profit: Why Waste Matters What will happen to profit if expenses go up and revenue stays the same? Profit = Revenue - Expenses $20 = $100 - $80 $0 = $100 - $100 = - = - = - = -
Profit: Why Waste Matters What is happening today with reimbursements? Profit = Revenue - Expenses $20 = $100 - $80 $0 = $100 - $100 = - = - = - = -
Profit: Why Waste Matters Profit = Revenue - Expenses $20 = $100 - $80 What is your profit? $0 = $100 - $100 -$40 = $80 - $120 = - = - = -
Profit: Why Waste Matters Profit = Revenue - Expenses $20 = $100 - $80 $0 = $100 - $100 -$40 = $80 - $120 $20 = $100 - $80 = - = -
Profit: Why Waste Matters Profit = Revenue - Expenses What happens to profit if we can eliminate waste from our $20 = $100 - $80 $0 = $100 - $100 -$40 = $80 - $120 $20 = $100 - $80 processes? $20 = $80 - $60 = -
Profit: Why Waste Matters Profit = Revenue - Expenses What if we get really good at eliminating waste from our processes? $20 = $100 - $80 $0 = $100 - $100 -$40 = $80 - $120 $20 = $100 - $80 $20 = $80 - $60 $40 = $80 - $40
8 Types of Waste DOWNTIME Value Added TYPES OF WASTE: Defects Overproduction Waiting Not using full potential Transport Non-Value Added Inventory Motion Excess Processing
Group Message Create a short commercial, tweet, or elevator speech that addresses the following Scripps History Mission, Values, and Vision Why choose Scripps? Why work for Scripps?
We Stand for Excellence Scripps We have a greater mission. Patient-Centered Care We put our patients first. Our Journey to Excellence We are thought leaders. We actively participate in change. p. 2
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