Key Steps in Creating & Sustaining Excellence 1. Create a context for excellence 2. Enroll others (starting with leaders) in the vision for excellence 3. Create alignment, ownership and transparency to drive improvement focus 4. Establish a systematic Leadership System clarify expectations of leaders 5. Foster a process honoring culture 6. Build Loyal Relationships the foundation to accomplishment H.E.N_081312 41
Created A Shift In View Regarding Stakeholders From Stakeholder Satisfaction To Stakeholder Partnership & Loyalty H.E.N_081312 42
Identifying Our Core Competency of Building Loyal Relationships with Patients & Families Physicians Associates Volunteers H.E.N_081312 43
Relationships Are the Foundation for Accomplishment Triangle Narrow base of Relationship = Little Space for Accomplishment Accomplishment RESULTS ACTIONS OPPORTUNITIES POSSIBILTIES RELATIONSHIPS The Breadth of Relationship H.E.N_081312 44
Relationships Are the Foundation for Accomplishment Accomplishment Triangle Broad base of Relationship = Huge Space for Accomplishment RESULTS ACTIONS OPPORTUNITIES POSSIBILITIES RELATIONSHIPS The Breadth of Relationship H.E.N_081312 4
Building Loyal Relationships (percentile May 2012) Outpatient Convenient Care 96 th 92 nd 98 th Physicians Ambulatory Surgery Patients 95th 98th Emergency Department Associates 91 st H.E.N_081312 46
A Recent Letter from a Physician Patient Dear Mr. Fox, Recently I had some cardiac challenges and was cast into a whirlwind of cardiologic testing and OP procedures. I must praise your hospital and facility further and ask that you praise your staff for exceptional expertise, care, commitment and interpersonal warmth. They are truly outstanding. I wish I had chosen Good Sam to be my practicing hospital when I opened my practice 19 years ago. H.E.N_081312 47
Other Key Lessons Learned in Creating and Sustaining Excellence Focus on culture not just tactics Culture outperforms strategy every time and culture with strategy is unbeatable. Stretch goals drive innovation Physician relationships and engagement are priority: Physician champions transform clinical practice Clinical Integration Program enables high physician alignment Creating a highly professional nursing staff achieves collaboration between physicians and nurses and improves experience and outcome of care H.E.N_081312 48
Key Lessons Learned in Creating and Advancing Performance Excellence Across All Pillars Participation in National QI and Patient Safety Initiatives and benchmarking against the best accelerates adoption of EMB and world-class results Formalize the informal become less persondependent The path to sustained excellence requires humility H.E.N_081312 49
The Path to Sustainable Excellence Requires Humility How Much You Really Know About World-Class Business Management 10 9 8 7 6 5 4 3 2 1 Baldrige Recipients Path of Travel for an Organization X Start Genitect, LLC John Vinyard (770) 642-5433 1 2 3 4 5 6 7 8 9 10 How Good You Feel You Are H.E.N_081312 50
Sustained Excellence Good Samaritan Organizational Results H.E.N_081312 51
. Health Care Outcomes H.E.N_081312 52
0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 GSAM Complication Index Index 75th Percentile 90th Percentile Great 0.00 January-10 February-10 March-10 April-10 May-10 June-10 July-10 August-10 September-10 October-10 November-10 December-10 January-11 February-11 March-11 April-11 May-11 June-11 July-11 August-11 September-11 October-11 November-11 December-11 January-12 February-12 March-12 April-12 Rolling 12 Months H.E.N_081312 53
GSAM Mortality Index Index 75th Percentile 90th Percentile 1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 January-10 February-10 March-10 April-10 May-10 June-10 July-10 August-10 September-10 October-10 November-10 December-10 January-11 February-11 March-11 April-11 May-11 June-11 July-11 August-11 September-11 October-11 November-11 December-11 January-12 February-12 March-12 Rolling 12 Months H.E.N_081312 54 Great
Percent 100% 80% 60% 40% 20% Core Measure Bundles 99% 100% 100% 98% 100% 99% 100% 96% 100% 98% 100% 100% 94% 100% 93% 97% 94% 92% 95% 87% 91% 90% 94% 85% 83% 82% 84% 66% Great 0% AMI HF PN SCIP 2006 94% 83% 66% 84% 2007 98% 87% 82% 85% 2008 99% 98% 91% 90% 2009 100% 99% 92% 95% 2010 100% 100% 94% 93% 2011 100% 100% 96% 94% Jan-Feb 2012 100% 100% 100% 97% Source: Midas Top Decile H.E.N_081312 55
DVT Cases 200 180 160 140 120 100 80 60 40 20 0 Hospital Acquired DVTs 180 172 130 55 46 Breakthrough Improvement 2007 2008 2009 2010 2011 2012 20 Great Source: Internal Metric - TSI H.E.N_081312 56
Rate per 1,000 Device Days 2.0 1.5 1.0 0.5 0.0 Ventilator Associated Pneumonia (VAP) Rate No Infections Healthcare Sector and Benchmark Leadership 0.3 0.3 No Infections 2006 2007 2008 2009 2010 2011 2012 Great Source: NHSN & CDC NHSN Mean H.E.N_081312 57
ACUTE CARE 30 DAY READMISSIONS RATE (Rolling 6-month time period) 12.0 11.9 11.5 UCL 11.6 % 30-DAY ACUTE CARE READMISSIONS 11.0 10.5 10.0 CL LCL 9.5 APR-MAY 11 MAY-OCT 11 11.2 2012 TARGET < 10.1 JUN-NOV 11 JUL-DEC 11 10.9 ROLLING 6 MONTHS 10.7 AUG 11- JAN 12 SEP 11- FEB 12 10.7 9.9 OCT 11- MAR 12 58
4.05 AVERAGE LENGTH OF STAY ACTUAL AVERAGE LENGTH OF STAY 4.00 4.00 3.95 3.90 3.85 3.80 3.75 UCL 3.96 CL LCL 3.91 3.90 3.86 3.85 3.76 3.75 3.76 3.70 JAN 11 - JUNE 11 FEB 11 - JULY 11 MAR 11 - AUG 11 APR 11 - SEPT 11 MAY 11 - OCT 11 JUN 11 - NOV 11 JUL 11 - DEC 11 ROLLING 6 MONTH TIME PERIOD AUG 11- JAN 12 SEPT 11 - FEB 12 59
Length of Stay (LOS) vs. CMI 2006-June 2012 4.50 1.50 LOS (days) 4.45 4.40 4.35 4.30 4.25 4.20 4.15 4.10 1.324 1.332 1.405 1.438 1.427 1.438 High Acuity / Lower LOS 4.44 4.44 4.42 4.45 4.26 4.22 4.30 2006 2007 2008 2009 2010 2011 2012 1.44 1.45 1.40 1.35 1.30 1.25 1.20 CMI LOS CMI (Case Mix Index) H.E.N_081312 60
Creating a Culture of Patient Safety Rate of Improvement 100 80 60 40 20 100 th Percentile for Patient Safety 0 Source: Thomson Reuters 2004-2008 H.E.N_081312 61 0 20 40 60 80 100 Performance
. Associate Engagement. Patient Satisfaction. Physician Engagement Measuring Our Core Competency: Building Loyal Relationships H.E.N_081312 62
Building Loyal Relationships with Associates 100 Overall Associate Satisfaction 87 86 96 93 97 Great 80 73 Percentile 60 40 20 0 Sustained Top Decile Performance 2006 2007 2008 2009 2010 2011 Source: Morehead Top Decile H.E.N_081312 63
Transforming the Patient Experience: 2003-2012 Patient Satisfaction Results - Percentile (Press Ganey) 100 80 60 40 20 9189 92 80 7879 63 38 35 29 1816 18 92 92 96 96 98 95 95 9496 97 7782 83 72 6260 54 38 0 Outpatient Inpatient Emergency Amb Surg Conv Care 2003 18 18 54 38 2004 16 29 72 62 2005 38 35 77 60 2008 80 63 82 83 95 2009 91 78 92 96 94 2011 89 79 92 98 96 Jun-12 92 96 95 97 H.E.N_081312 64
Building Loyal Relationships with Physicians 100 Physician Survey Results 97 97 96 93 87 Good Percentile Rankings 80 60 40 20 69 Sustained Top Decile Performance 0 2006 2007 2008 2009 2010 2011 Source: HealthStream Top Decile H.E.N_081312 65
. Growth. Funding Our Future H.E.N_081312 66
Building Loyal Relationships Surgery Volume Up 31% 2006-2011 10,000 9,904 9,500 9,000 8,500 8,546 9,061 9,136 8,000 7,500 7,569 7,728 7,000 2006 2007 2008 2009 2010 2011 H.E.N_081312 67
Results of Sustained Performance Excellence GSAM Market Share for Overlapping Markets (Overall IP) Percent 25% 20% 15% 10% 17.0% Increase 25.6% Decrease 7.4% Decrease 6.9% Decrease 8.4% Decrease 5% 0% GSAM Hosp A Hosp B Hosp C Hosp D 2006 20.0% 12.5% 18.8% 10.1% 10.7% 2007 20.5% 11.7% 19.2% 9.6% 10.8% 2008 21.4% 10.8% 16.8% 9.5% 10.8% 2009 23.1% 9.4% 17.8% 9.2% 10.1% Q3 2010 23.4% 9.3% 17.4% 9.4% 9.8% Source: CompData H.E.N_081312 68
Percent 9% 7% 5% Operating Profit Margin vs. Benchmark "AA" Rated Hospitals Healthcare Sector and Benchmark Leadership 5.98% 6.04% 7.39% 6.73% 8.25% 9.30% Great 3% 1% 1.09% 2006 2007 2008 2009 2010 2011 2012 Budget S&P AA/AA+ Ratings Moody AA Ratings H.E.N_081312 69
Additional External Validation of Performance Excellence 2010 Lincoln Gold & Baldrige Quality Awards Recipient Top 50 Hospital for Cardiovascular Care by Thomson Reuters (2011) 100 Top Hospital for Overall Excellence by Thomson Reuters (2009, 2011, 2012) Midas+ Platinum Quality Award (2008, 2009, 2010, 2011, 2012) Environmental Leadership Circle Award from Practice Green Health (2012) Delta Group ranks GSAM #1 in Illinois and #4 in the USA for Overall Hospital Care 2010 H.E.N_081312 70
FINAL OBSERVATION Creating and Sustaining Performance Excellence Depends Upon A Conscious Choice & Discipline H.E.N_081312 71
THE CHOICE TO SUSTAIN GREATNESS Greatness is not a function of circumstance. Greatness, it turns out, is largely a matter of conscious choice, and discipline. We are not imprisoned by our circumstances. We are not imprisoned by the luck we get or the inherent unfairness of life. We are not imprisoned by crushing setbacks, self-inflicted mistakes or our past success. We are free to choose, free to become great by choice. -- Jim Collins (from Great By Choice) H.E.N_081312 72
Even with the strategic success of G2G, we never forget the real purpose of our work. JACK H.E.N_081312 73
B lessed. May your holiday be decorated with the most precious of gifts & your New Year rich with love. Happy Holidays from Joe, Nicole & Jack Stevens H.E.N_081312 74
Thank You David S. Fox, President Advocate Good Samaritan Hospital Downers Grove, Illinois david.fox@advocatehealth.com H.E.N_081312 75