THE RECOVERY INNAT THE ORTHOPEDIC & SPORTS INSTITUTE OF THE FOX VALLEY

A Miron Construction Case Study

Vision: To create an extraordinary extended-stay experience that is radically unique, relevant to our patients’ needs, and memorable.

PICTURE THIS

It’s midnight. You’re lying in a hospital bed amidst bright lights, beeping machines, and blinking monitors. Your hospital gown does little for your modesty, and less in keeping you warm. !ere is an endless parade of doctors, nurses and specialists coming in and out of your room, often times talking to each other as if you aren’t even there. In the hallway, carts with medical supplies roll by and you can hear people at the nurses’ station discussing plans for the upcoming weekend. Just as you begin to drift o" to sleep, you are awoken by someone looking for yet another blood sample. Multiple painful pokes later, they’re gone. Too bad the searing pain where your hips used to be isn’t.

TIME TO MAKE A CHANGEEach time a patient enters a healthcare facility and interacts with the people, processes, and systems in place, they have some kind of experience. !e question is: Is it an experience that is forgettable or memorable, meaningful or meaningless . . . or just plain horrible?

On a recent McKinsey survey1, patients were asked to allocate 100 points among the factors that influence their decision-making process when it comes to choosing a hospital. Survey results showed that, on average, 20 percent of the respondents’ choice is based on a hospital’s clinical reputation. Remarkably, 41 percent is based on the hospital’s nonclinical reputation– in other words, the hospital’s image as it relates to the patient experience. A doctor’s recommendation and the hospital’s location account for the remainder of respondents’ decision-making criteria.1 McKinsey Quarterly Q4, 2009.

America's First Recovery Inn for Orthopedics

New healthcare research underscores just how important nonclinical elements have become. A survey of more than 2,000 US patients with commercial insurance or Medicare revealed that most of them are willing to switch healthcare providers for better service and more desirable amenities. In fact, many patients are already asking their physicians to refer them to specific facilities specializing in personalized care.

Healthcare facilities generate most of their profits from commercially-insured patients. Before selecting a healthcare facility, these patients are more likely than not to weigh the nonclinical aspects of their upcoming visit. Therefore, as competition for commercial patients

intensifies, healthcare facilities must move beyond simply fixing problems. !ey need to redesign their organizations, facilities, and methods to attract and retain not only new patients but also top talent keenly focused on ensuring an extraordinary patient experience at every touch point.

!he research was clear. So was the need for change.

LEARNING FROM LEADERSSome ver y successful companies—Southwest Airlines, Apple, and Panera Bread, for example—focus their e"orts on ‘attaching’ their customers as a natural order of business. How do the best-of-the-best command their market share (in some cases, five to seven times that

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PROJECT DESCRIPTION

The Recovery Inn is an addition to

the Orthopedic and Sports Institute

Ambulatory Surgery Center. Its purpose

is to provide extended stay healing

space and care for individuals who have

undergone full joint replacement surgery.

The Recovery Inn was established to

allow patients with orthopedic issues to

be treated compassionately, efficiently,

cost-effectively, and with reduced

healing time, all at one location.

“It was clear to us from the beginning that the Recover! I"n would be… must be #$fferen%. Satisfying our patients is not good enough. Emotionally attaching our patients to the

O!"#$%&'() & S%$!"* I+*"(","& will create and sustain the &#ea' (a)ient *+(erienc,. ”

CURT KUBIAK E-&),"(.& D(!&)"$! $/ OSI

of their competitors)? What experience created their uncontested space? Was it pricing, advertising, marketing, facilities, innovation, or service?

To find these answers, we took a good look at the service world f rom their perspective . . . meaning, from the outside in. Through our research, we learned that each best-of-the-best organization uses experience-based design tools to intentionally create positive emotional outcomes for their customers. !at’s the good news. !e not-so-good news is, few healthcare organizations systematically seek to understand what patients value in the nonclinical aspects of their visits. To set ourselves apart in the world of orthopedics, we asked our patients, and ourselves, what the ideal service experience looks like—each step, each process, each system, each person involved. By working in this nontraditional way, we identified the people, processes, and systems required to achieve the service goals for each impression area.

NEXT STEPSMembers of the Orthopedic & Sports Institute team set out with a very specific vision in mind: To create an extraordinary extended-stay experience that is radically unique, relevant to our patients’ needs and memorable.

How did we achieve it? !e first step to exploring our ideal patient experience by asking di#cult questions and taking the time to listen to the answers. !e answers to these questions, along with in-depth research, provided our team with the knowledge and foresight to move forward on our exciting journey toward reaching the next level of orthopedic care.

With the assistance of the design and construction team, Performa, Inc. and Miron Construction Co., Inc., OSI sta" members and physicians were brought together as co-creators of the ideal patient

experience. Who better to walk through the experience than those who live it each and every day?

!rough a collaborative process known as Innovation Teams, employees f rom various areas came together to answer the following di#cult questions:

What will help our patients heal faster? !

What will ensure a positive and !memorable experience for their family members?How is OSI unique, both within and !outside of the healthcare industry?Are we relevant and do our services !meet the current needs of our patients?Would our patients defend our !organization and our services? What kind of f irst impression do we !make? What are we best at? !

What can we bring to market f irst? !

What sets us apart from similar !organizations? Is there a compelling reason for our !patients to return?

CHALLENGE

Design and build the Recovery Inn

of the future: A place where patient

comfort and care are the top priorities.

SOLUTION

Designed and built a healthcare facility

unlike any other. One that not only

resembles an upscale hotel with all of the

associated amenities, but also promotes

faster recovery times, a better patient

experience, and delivers recovery care at

a significant cost savings compared to

traditional hospitals and skilled nursing

facilities.

A Miron Construction Case Study

WHAT WE DISCOVEREDSo, what did we determine patients were seeking in an extended-stay experience? !ey were searching for a sense of control over all aspects of their environment, from food to medication to privacy. !ey were looking for place that felt like home, where their family members were integrated into the entire process. !ey desired a space that conveyed a luxury hotel room feel, a space that exemplified comfort, warmth and respect. Ultimately, what they wanted was personalized service in all aspects of the design.

IMPRESSION AREASWe knew that incremental change would not deliver our service promise. And so, we started over. With a clean slate, we built the Recovery Inn from the inside out and the outside in. We mapped every process, every connection point, to better understand what worked and what didn’t.

We identified the desired outcomes for every impression area in the Recovery Inn. !is nontraditional approach helped our innovation teams clearly understand the vision for each phase of the ideal patient experience. We set out to build a space where we could develop emotional, meaningful, and memorable relationships with our patients at every impression area within the Recovery Inn.

IMPRESSION AREA 1:The Experience BeginsBalancing the priorities of physicians and their patients is critical for the Recovery Inn and OSI’s overall goal to create and sustain the ideal patient experience. At the heart of the process is “Joint Venture,” OSI’s pre-surgery education process. Seven to 14 days prior to surgery, Care Coordination begins with the patient’s guided, personalized experience and OSI’s warm, f riendly Welcome Book. When surgery dates are selected, “Joint Venture” is scheduled. Patients and their families

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join OSI’s Care Coordination team to begin the pre-surgery education process. During Joint Venture, personalized patient information is gathered. Patients are asked what they like to eat, drink, read, watch, and listen to. !is information is added to a central database to ensure that Recovery Inn caregivers provide service with a personal touch.

IMPRESSION AREA 2: Expecting the Best (from ourselves)With ‘time poverty’ a"ecting us all, the last thing we want to do is wait a minute longer than necessary—or worse, duplicate our e"orts. Our recent patient process-flow study produced an amazing result. With the addition of the Recovery Inn’s comprehensive educational and guided-care process, time spent by the patient in registration, diagnostics, and lab was reduced by 30 percent! Streamlining the

care process is critical to ensuring that patient and family first impressions are solidly in the “WOW” category. Along our journey, we learned that family members want to be involved in all discussions relating to the care of their loved ones. To this end, OSI physicians and sta" keep families well-informed in person and face-to-face. Families, too, want to feel welcome, cared for and safe. We also learned how important it is for the physician/family consult area to be a comfortable, private space. Safety, pain control, privacy, confidence, comfort, respect, individualized attention, and convenience help ensure patients and families remain informed and happy.

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“ The Recovery Inn will allow our medical team to care for more patients in Northeast Wisconsin and beyond, all of whom will benefit from a cost-effective, top-quality, upscale-service environment.”DAVID EGGERT, MD Board-Certified Orthopedic Surgeon, Orthopedic & Sports Institute

IMPRESSION AREA 3: iDesign Patient SuiteWhen patients feel in charge of their healing experience, they also feel less stressed, less anxious and more positive regarding what happens to them in the healthcare setting. To this end, OSI’s Joint Venture pre-education program not only helps patients thoroughly understand what to expect at every stage of their scheduled procedure, it encourages them to be active participants in the design of their Recovery Inn experience. Simply asking patients, before they arrive, the types of snacks and beverages they like, what kind of music they prefer, which movies they’ve been waiting to see, and what books and magazines they like to read is unusual enough. For patients to enter their Recovery Inn healing suite on day one and find their favorite snacks and beverages, their preferred reading material, and an iPod pre-loaded with their favorite music and movies is absolutely, positively extraordinary.

IMPRESSION AREA 4: A Fond Farewell!is is how it usually goes. It’s your last day as a patient. After hours of staring at the ceiling, you’re beyond ready to leave. All you want is to be in the comfort of your own home. You can’t wait to see your bed, your couch, a TV that’s not suspended from the ceiling. At last, it’s time to go home. At 3 p.m. people in scrubs gather around your bed to issue instructions and tell you things to remember as you recover. There are fond farewells and detailed instructions about your pain medication, your anticoagulant, your home healthcare, the equipment that will help you get around, the follow-up appointments with your surgeon . . . everything you need to hear. But not right then.

This is how it should go. For starters, patient discharge should not start on the last day of a patient’s stay. And yet, this practice is traditional and decades old. At the Recovery Inn, a new, e"ective and comprehensive discharge process was created, one that begins on Day 0, and ends with the patient receiving their discharge information in their preferred format.

ADDITIONAL UNIQUE FEATURES OF THE FACILITY

Personalized family parking and !luggage transfer through bell assistanceConcierge services !

Personal Care Team !

Café with fresh, made-to-order meals !and personal chefs on staffNo hallways; open, clear-view !environment Family gathering center designed like !upscale hotel lobby with f ireplace, flat-screen TV, comfy furniture, medical library and nursing station for easy family accessPatient pain control - constantly tracked !and monitored. Anesthesia services are on call throughout each patient’s stay. Personalized, long-acting blocks and pain pumps help ensure patient comfortInnovative, comfy OrthoPants: No more !open-back hospital gowns!Personalized physical therapy and !healing walkway for post-surgery rehabilitation Advocate to help patient and family !navigate the insurance process, assisting in sorting out f inancial issues that can detract from an exceptional healing experiencePrescription pick-up before departure; !no need for a trip to the pharmacySeamless connection between imaging, !exam, surgery, physical therapy and recovery

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The Recovery Inn:

At The Orthopedic & Sports Institute of the Fox Valley

FEATURES OF THE TWELVE PRIVATE HEALING SUITES

Floor-to-ceiling windows with

pleasant landscaped views

A spacious, private bathroom

right next to the patient’s bed

Large roll-in shower with

convenient pull-down seat

Roomy closet with access from

within the room and bathroom

Nightstands and lamps; comfortable

liftchairs and guest settees

In-room refrigerator for beverages,

snacks, and ice packs

Soothing cove lighting and

healing suite nightlights

42” flat-screen TV, DVD player

and wireless Internet access

Aesthetically pleasing message

boards to keep patients

and families well-informed

Enhanced infection-

reduction elements

IN CONCLUSION

It was not the intent of The Recovery Inn team to simply compete but, rather, to change the rules of the game. And the Recovery Inn is doing just that.As much as it is important to understand each patient’s particular needs and concerns, unique though they are, they all have two things in common. One, they prefer not to have to deal with their injury. And two, now that they need to deal with it, they prefer a pain-free experience. With these shared preferences well in mind, we help improve our patients’ outlook by providing extraordinary, personalized service and exceptional pain management.

Simply put, we facilitate each patient ’s entire treatment plan . . . from pre-operative testing, to surgery, to pain management, to post-operative therapy. It’s all here, under one roof. Our ultimate goal is to ensure that our patients return to the lifestyles they enjoyed before their injury as safely and quickly as possible. No infections. No readmissions. !ey leave our facility with nothing but healing on the horizon.

A Miron Construction Case Study

RESULTS

Average rate of infection at

Wisconsin hospitals: 5-6%

Average rate of infection at

OSI Recovery Inn: 0%

Average readmission rate at

Wisconsin hospitals: 12%

Average readmission rate at

OSI Recovery Inn: 0%

Services at OSI Recovery Inn

cost, on average, one third less

than services at a comparable

hospital.

Patient healing time has been

reduced by 8 hours.

Miron is committed to building more than just buildings. We believe wholeheartedly in partnering with our clients to develop solutions that deliver business results. For many, that means increasing their bottom line, or enhancing their ability to recruit and retain the best and brightest. For others, it’s giving them a competitive edge. Our Experience-Based Design services offer our clients the ability to distinguish themselves in an increasingly competitive marketplace. That is why we are committed to collaborating with owners and

design partners to create unique, differentiating experiences that exceed client expectations. We know it is no longer enough to simply satisfy. At the end of the day, it’s all about helping our clients be successful. Experience-Based Design is just one way we’re helping clients deliver on their promises.

Simply stated, our commitment reaches beyond construction; our passion brings dreams to life!

CONTACT: Steve Tyink

920.969.7047

steve.tyink@miron-construction.com

miron-construction.com