12/9/2013

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IHI National Forum “Defining Moments”

Achieving Excellence and Reliability

Baldrige Performance Excellence Program

December 2012

Faculty

• Craig Deao: R&D Leader, The Studer Group

• Joel Ettinger: President, Category One Inc.

• Josh Ettinger EVP Category One Inc. and President, Magellan Institute

• Susan Hawkins: SVP Performance Excellence, Henry Ford Health System

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Experience Objectives

• Introduce a Framework for organizational excellence

• Assess, compare, performance against Baldrige role models

• Redefine excellence

• Describe how the Framework creates inspired cultures and immediately improving performance

What Will NOT Happen

• You will not understand all of it—it’s too big

• We will not address all elements of the Framework equally—it’s too big

• Know everything you need to do when return to your worksite and colleagues—it’s too big

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Criteria for Performance Excellence

Business Health Care Education

A disciplined approach to addressing key patient/customer, stakeholder, and operational requirements integrating cycles of refinement

and innovation

How Do You/We Know That…

• Effective leadership system is in place that assures sustainability, excellence, agility, relentless patient focus – even in economically difficult times

• Pervasive innovation is a key differentiator

• Strategic planning process produces appropriate stretch targets fully deployed

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How Do You/We Know That…

• Market data are valid/segmented to design/deliver products/services that people want/need

• The people we serve can easily access services

• Accurate satisfaction, loyalty, referral, & engagement determination systems exist

• Information systems are based on user needs and produce “actionable” information

How Do You/We Know That…

• Everyone has the knowledge they need to have to “ make” healthcare great

• Culture is optimal, work systems carefully designed, necessary skills secured, all workforce is proud, recognized, loyal, engaged

• New services are designed systematically with patient/customer, evidence-based input

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How Do You/We Know That…

• We provide, always, the finest error free medicine humanly possible

• We out-compete the competition in all important ways – care experience and research funding

• Our clinicians are magnificent members of the an amazing workforce that makes the health care

• All major processes are continually improved, waste eliminated everywhere

How Do You/We Know That…

• All key results based on Critical Success Factors are measured, trended, compared to competition and best-in-industry

• The approaches to work and improvement, and innovation are systematic, deployed and aligned on an enterprise-wide basis

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These Things Happen,

No Longer

The Baldrige Performance Excellence Program

What are the Criteria?

“The leading edge of validated management

practice”

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What are the Criteria?

• Expectations or requirements

• Structured approach to improvement

• Framework for a systems view of performance management

• Based upon a set of core values

• A common language

Criteria Purposes

• Alignment of key components

• Go beyond conformance-to-standard to a focus on excellence

• Facilitate communication and sharing among all types of organizations

• Working tool for understanding and managing performance improvement

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Criteria Key Characteristics

• Focus on results

• Are non-prescriptive and adaptable

• Support a systems perspective

• Support goal-based diagnosis

THE FRAMEWORK

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Four Harmonized Components Simplified

• Organizational Profile – Who are we? What is important to us?

• Core Values – What do we believe in?

• Criteria – How do we do it

• Performance Differentiators – How well are we doing it? (results)

BALDRIGE: The Pursuit of Excellence

FEELING, THINKING, BEING, THEN DOING

Visionary Leadership

Patient-focused Excellence

Organizational and Personal Learning

Valuing Workforce Members and Partners

Agility

Focus on the Future

Managing for Innovation

Management by Fact

Social Responsibility and Community Health

Focus on Results and Creating Value

Systems Perspective

ORG PROFILE & 7 CATEGORIES OF CRITERIA CORE VALUES/CONCEPTS

PERFORMANCE DIFFERENTIATORS (ADLI)

How are our APPROACHES SYSTEMATIC?

How are our approaches fully DEPLOYED?

How does LEARNING and IMPROVEMENT

happen?

How is our work ALIGNED and INTEGRATED?

HOW DO YOU KNOW EMPOWERMENT

SO WHAT WHAT ARE YOU THINKING

EVERY, EVERY, EVERY

HOW DOES INNOVATION

DISTINGUISH US

CORE COMPETENCIES

SEGMENTATION ENGAGEMENT

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The Comprehensive Excellence Continuum

Right to Operate

Org Excellence

MI

TQM

TPS & Six Sigma

JCAHO

ISO9000 HFAP

CMS/State Surveys

Other Govt.

Surveys

Leadership/Customer Driven

Compliance/QA/QC Driven

Magnet

Maintain Innovation

DNV

Improvement RighttoOperate

OrgExcellence

MI

TQM

TPS&SixSigma

JCAHO

ISO9000HFAP

CMS/StateSurveys

OtherGovt.Surveys

Magnet

Maintain Innova on

DNV

Improvement

Accelerators

Pillar Framework 6-month EBL assessments LEM Stoplight Report Support Service Survey PCM SG Portal RED Strategy Planning Process Virtual Tokens of Recognition Service Guarantee

Leader Evaluation Process Goal Cascade Monthly Meeting Model 90-day Plans Linkage grids LDI CDI

Peer Interviewing

30/90 day meetings

AIDET

Managing Up

highmiddlelow Performer

Conversations

Rounding on Employees

Leader Rounding for Outcomes

Hourly Rounding

Pre- and Post-Visit Calls

SG’s Best Practices

Standardization Accelerators Must

Haves®

Performance

Gap

Objective

Evaluation

System

Leader

Development

Aligned Goals Aligned Behavior Aligned Process

Specific and interdependent practices that have value to all businesses to create better places to

work & higher quality services for customers.

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World Class Quality

“ The most comprehensive list of actions to achieve world-class quality is contained in the Malcolm Baldrige Criteria. ”

Joseph Juran

Quality Progress

August, 1994

Respondents Who Used the Criteria Quality Progress

Percent Answering

0 10 20 30 40 50 60 70 80

To communicate with the public sector

To apply for an award

To communicate with other companies

To communicate with business partners

To set up quality processes companywide

For informal self-assessment companywide

For written self-assessment companywide

To set up quality processes departmentwide

For written self-assessment departmentwide

To improve existing processes companywide

For informal self-assessment departmentwide

Part of a course or seminar curriculum

To communicate with others inside a company

To improve existing processes departmentwide

Source of information on business excellence

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The Framework Effectively Enables

• Sustainability

• Innovation

• An engaged workforce

• Significantly greater integrated physician relationship

• Proactively address the more knowledgeable customer

The Baldrige Effect

• Reduce cost, waste, errors – Less work, Better Work, More Accomplished

• Silos replaced by system integration and collaboration

• To better manage the future – health care reform, ACOs, declining reimbursement

• Improved performance in all key results

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The Baldrige Effect

• It creates the culture and context to EXECUTE and FULLY DEPLOY Best Practices…

and, preferably…

• Better Than Best Practices—Intelligent Risk and Innovation

2012 Award Recipients

• Lockheed Martin Missiles and Fire Control, Grand Prairie TX

• Mesa Products, Tulsa OK

• North Mississippi Health Services

• City of Irving

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Manufacturing Award Recipients

• 3M Dental Division (1997)

• Armstrong Building Products Operations (1995)

• Boeing Airlift & Tanker Programs (1998)

• Cargill Corn Mill (2008)

• Clarke American Checks, Inc. (2001)

• Corning Telecommunications Products Division (1995)

• Eastman Chemical (1993)

• Honeywell Federal Manufacturing Technologies (2008)

• IBM Rochester (1990)

• Lockheed Martin Missiles and Fire Control (2012)

• Medrad (2003, 2010)

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Manufacturing Award Recipients • Milliken & Company (1989)

• Motorola CGISS (2002)

• Motorola, Inc. (1988)

• Nestle Purina Petcare (2010)

• Solar Turbines Inc. (1998)

• Solectron Corporation (1991 and 1997)

• Sunny Fresh Foods (1999, 2005)

• STMicroelectronics -- Region Americas (1999)

• Texas Instruments Defense Systems & Electronics (1992)

• Westinghouse Commercial Nuclear Fuel Division (1988)

• Xerox Business Products & Systems (1989)

Service Award Recipients

• BI (1999)

• Boeing Aerospace Support (2003)

• Caterpillar Financial Services U.S. (2003)

• DynMcDermott Petroleum Operations (2005)

• Federal Express Corporation (1990)

• GTE Directories Corporation (1994)

• Merrill Lynch Credit Corporation (1997)

• Operations Management

International, Inc. (2000)

• Premier, Inc. (2006)

• The Ritz-Carlton Hotel Company, L.L.C. (1992 and 1999)

• Xerox Business Services (1997)

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Small Business Award Recipients • Branch-Smith Printing Division

(2002)

• Freese and Nichols (2010)

• Granite Rock Company (1992)

• Los Alamos National Bank (2000)

• Mesa Products, Inc. (2006, 2012)

• Midway USA (2009)

• Pal’s Sudden Service (2001)

• K&N Management (2010)

• Park Place Lexus (2005)

• PRO-TEC Coating (2007)

• Stoner, Inc. (2003)

• The Studer Group (2010)

• Texas Nameplate (1998, 2004)

• Trident Precision Manufacturing, Inc. (1996)

Education Award Recipients

• Chugach School District (2001)

• Community Consolidated School District 15 (2003)

• Iredell-Statesville Schools (2008)

• Jenks Public Schools (2005)

• Monfort College of Business (2004)

• Montgomery City Schools (2010)

• Pearl River School District (2001)

• Richland College (2005)

• University of Wisconsin-Stout (2001)

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Non-Profit Award Recipients

• City of Coral Gables (2007) • City of Irving (2012) • Concordia Publishing House (2011) • US Army Armament Research, Development and

Engineering Center (2007)

• VA Cooperative Studies Program Clinical Research Pharmacy Coordinating Center (2009)

Health Care Award Recipients

• Advocate Good Samaritan Hospital (2010)

• AtlantiCare (2008)

• Baptist Hospital, Inc. (2003)

• Bronson Methodist Hospital (2005)

• Heartland Health (2008)

• Henry Ford Health System (2011)

• Mercy Health System (2007)

• Poudre Valley Health System (2008)

• North Mississippi Medical Center (2006)

• North Mississippi Health Services (2012)

• Robert Wood Johnson (2004)

• St Luke’s Hospital (2003)

• Sharp HealthCare (2007)

• SSM Health Care (2002) Schneck Medical Center (2011)

• Southcentral Foundation(2011)

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When are you too busy to pursue

excellence?

BALDRIGE: The Pursuit of Excellence

FEELING, THINKING, BEING, THEN DOING

Visionary Leadership

Patient-focused Excellence

Organizational and Personal Learning

Valuing Workforce Members and Partners

Agility

Focus on the Future

Managing for Innovation

Management by Fact

Social Responsibility and Community Health

Focus on Results and Creating Value

Systems Perspective

ORG PROFILE & 7 CATEGORIES OF CRITERIA CORE VALUES/CONCEPTS

PERFORMANCE DIFFERENTIATORS (ADLI)

How are our APPROACHES SYSTEMATIC?

How are our approaches fully DEPLOYED?

How does LEARNING and IMPROVEMENT

happen?

How is our work ALIGNED and INTEGRATED?

HOW DO YOU KNOW EMPOWERMENT

SO WHAT WHAT ARE YOU THINKING

EVERY, EVERY, EVERY

HOW DOES INNOVATION

DISTINGUISH US

CORE COMPETENCIES

SEGMENTATION ENGAGEMENT

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ORGANIZATIONAL PROFILE

Organizational Profile

• Who are we?

• What’s important to us?

• What do our customers want? What does our workforce need?

• What are we really good at?

• What are our challenges and advantages?

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PERFORMANCE DIFFERENTIATORS

Characteristics of Great Companies

• Know the right things to do

• Do the right things

• Do the right things well

• Do the right things well…ALL THE TIME.

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Performance Differentiators Approach/Deployment

1. Approach--Systematic

• Approaches are repeatable

• Use data/information to enable evaluation, learning and improvement

2. Deployment--Full

• Extent to which systematic approaches are used by all appropriate work units

3. Learning/Improvement—Ongoing Cycles

• Evidence of fact-based systematic evaluation and improvement

• Organizational learning important to the achievement of critical success factors

4. Integration and Alignment

• Integration of plans, processes, information, resources, actions, results, analysis and learning throughout the organization

Approach and Deployment

• Approach

– A method or process

– Steps

– Ownership

– Repeatability (systematic)

• Deployment

– The approach is disseminated to all places and people

– The approach includes and/or considers all segments

– What is your systematic approach to deployment?

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Learning, Alignment, and Integration

• Learning / Refinement – Is the process effective?

– How do you know?

– What measures do you review?

– When are they reviewed?

– What is your systematic approach to learning, improvement, and innovation for this process?

• Alignment / Integration – Do our systems and

processes support and/or reinforce what matters?

– Do our systems and processes appropriately and effectively work together

Performance Differentiators

• Results:

– Current good or excellent results

– Results trended > three years show improving trends

– Trended results compared to industry performance are at least good

– Trended results are best-in-industry, world-class

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Scoring Band Information

Band Band

Number Descriptors

0-250 1

Early stages of developing and implementing approaches to Category

requirements. Important gaps exist in most categories.

251-350 2

Beginning of a systematic approach to the primary purposes of the Items,

but major gaps exist in approach and deployment in some Categories.

Early stages of obtaining results stemming from approaches.

351-450 3

A systematic approach to the primary purposes of most Items, but

deployment in some key Areas to Address is still too early to demonstrate

results. Early improvement trends in some areas of importance to key

requirements.

451-550 4

Effective approaches to many Areas to Address, but deployment in some

Areas is still at early stages. Further deployment, measures and results

are needed to demonstrate integration, continuity and maturity.

Scoring Band Information

Band Band

Number Descriptors

551-650 5

A sound, systematic approach responsive to many of the Areas to Address with

a fact-based improvement process in place in key areas. No major gaps in

deployment, and a commitment to organizational analysis and learning.

Improvement trends and/or good performance reported for most areas of

importance.

651-750 6

Refined approaches, including key measures, good deployment and good results

in most Areas. Some outstanding activities and results clearly demonstrated.

Good evidence of continuity and maturity in many Areas. Basis for further

deployment and integration is in place, with a focus on industry analysis,

learning and sharing of best practices. May be “industry” leaders or

benchmark leaders in some Areas

751-875 7

Refined approaches, excellent deployment, and good to excellent

improvement and levels demonstrated in most Areas. Good to excellent

integration, with analysis. Learning, and sharing of best practices as key

management strategies. “Industry” leadership and some benchmark leadership

876-1000 8

Outstanding approaches, full deployment, excellent and sustained results.

Excellent integration and maturity, with analysis, learning and sharing of best

practices pervasive. National and world leadership.

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Results Category One, Inc.

Year 5 QV Scores

Rank Business Unit Score

1 Pacific 701 2 Guidance & Navigation Op 660 3 Sensing & Control—NA 652 4 Solid State Electronics Center 646

5 Space Systems 644 6 Industrial Automation & NA 612 7 Defense Avionics Systems 602 8 Business & Computer Sys 598 9 Motion & Sensor Products Ops 590 10 Europe—Space & Aviation Control 576

11 Transport Systems 550 12 Satellite Systems Ops 528 13 Europe—Ind Auto & Control 522 14 Europe 517 15 Europe—Sensing & Control 515 16 Europe—BC Solutions & Services 488

17 Europe—BC Products 482 18 Technology Center 448 19 Southeast Asia 481 20 BC Products—NA 406 21 BC Solutions & Services—NA 365 22 Latin America 344 23 China Area 371

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1.0 Leadership

1.1 Leadership System 70%

1.2 Company Responsibility & Citizenship 60%

2.0 Strategic Planning

2.1 Strategy Development Process 70%

2.2 Company Strategy 60%

3.0 Customer & Market Focus

3.1 Customer & Market Knowledge 65%

3.2 Customer Satisfaction & Relationship

Enhancement 70%

4.0 Information and Analysis

4.1 Selection & use of Information & Data 70%

4.2 Selection & Use of Comparative

Information & Data 55%

4.3 Analysis & Review of Company

Performance 50%

Industrial Automation and ( ) US

477 464

565 574612

0

100

200

300

400

500

600

700

Yr. 1 Yr. 2 Yr. 3 Yr. 4 Yr. 5

5.0 Human Resource Focus

5.1 Work Systems 70%

5.2 Employee Education, Training &

Development 60%

5.3 Employee Well-Being & Satisfaction 65%

6.0 Process Management

6.1 Management of Product & Service

Processes 65%

6.2 Management of Support Processes 55%

6.3 Management of Supplier &

Partnering Processes 70%

7.0 Business Results

7.1 Customer Satisfaction Results 58%

7.2 Financial & Market Results 60%

7.3 Human Resource Results 55%

7.4 Supplier & Partner Results 65%

7.5 Company-Specific Results 52%

Total Points: 612

1.0 Leadership

1.1 Leadership System 48%

1.2 Company Responsibility & Citizenship 45%

2.0 Strategic Planning

2.1 Strategy Development Process 50%

2.2 Company Strategy 38%

3.0 Customer & Market Focus

3.1 Customer & Market Knowledge 40%

3.2 Customer Satisfaction & Relationship

Enhancement 37%

4.0 Information & Analysis

4.1 Selection & use of Information & Data 44%

4.2 Selection & Use of Comparative

Information & Data 35%

4.3 Analysis & Review of Company

Performance 45%

5.0 Human Resource Focus

5.1 Work Systems 50%

5.2 Employee Education, Training &

Development 50%

5.3 Employee Well-Being & Satisfaction 55%

6.0 Process Management

6.1 Management of Product & Service

Processes 49%

6.2 Management of Support Processes 50%

6.3 Management of Supplier &

Partnering Processes 40%

7.0 Business Results

7.1 Customer Satisfaction Results 44%

7.2 Financial & Market Results 46%

7.3 Human Resource Results 45%

7.4 Supplier & Partner Results 40%

7.5 Company-Specific Results 45%

Total Points: 448

( ) Technology Center

128

247

322

401 448

0

100

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300

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500

Yr. 1 Yr. 2 Yr. 3 Yr. 4 Yr. 5

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463502 529

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Year 4 to Year 5 Progress

0 100 200 300 400 500 600 700 800 900 1000

1

2

3

4

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6

7

8

9

10

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13

14

15

16 1st Year Applicant

17

18

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21

22

23

550 - 690

Scoring Range of Baldrige

site-Visited Companies

When it comes to Culture and Excellence

“Do or do not.

There is no try.” Yoda

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0

5

10

15

20

25

30

35

Year 1 Year 2 Year 3 Year 4 Year 5

% o

f P

ati

en

ts

SLH

National Average

Next Best

Saint Luke’s Hospital Percent of Patients Diagnosed

with Ischemic Stroke Receiving tPA

BETTER

Sustained Performance

Greater Efficiencies

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Sustained Clinical Performance

Improving Productivity

0

5

10

15

20

25

30

35

2000 2001 2002 2003 2004

% o

f P

ati

en

ts

SLH

National Average

Next Best

Percent of Patients Diagnosed with Ischemic Stroke Receiving tPA

Saint Luke’s Hospital

BETTER

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•

• •

•53

•2 0 0 3 2 0 0 4 2 0 0 5 2 0 0 6 2 0 0 7 2 0 0 8 2 0 0 9 1Q 2011

•Transforming the Patient Experience: 2003 - 2011

•Patient Satisfaction Results - Percentile (Press Ganey)

•93 •91 •91

•88

•18

•29

•35

•77

•61 •63

•78

•54

•72

•77

•83 •80

•38

•18 •16

•100 •98 99 97

•80

•60

•40

•20

•0

•92

•89 •88

•82

•96 94

•95

•79

•60

•76

•83

•62

•38

•Outpatient Inpatient Emergency Amb Surg Conv Care

•52

•Results of Stakeholder Loyalty

•KAPE 110211

•Source: CompData

•Per

cen

t

•25%

•20%

•15%

•10%

•5%

•0%

• 20.5% 20.0%

•G S A M H o s p A H o s p B H o s p C H o s p D

•21.4%

•23.1% 23.4%

•GSAM Market Share For Overlapping Markets •(Overall IP)

•17.0% Increase

•25.6% Decrease

•7.4% Decrease

•2006 2007 2008 2009 Q3 2010

•6.9%

Decrease

•8.4%

Decrease

•57

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Inpatient Satisfaction

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Q1

95

Q3

95

Q1

96

Q3

96

Q1

97

Q3

97

Q1

98

Q3

98

Q1

99

Q3

99

Q1

00

Q3

00

Q1

01

Q3

01

Q1

02

Q3

02

Q1

03

Q3

03

Q1

04

Q3

04

Q1

05

Q3

05

Baptist Percentile Gulf Breeze Percentile

Outpatient Satisfaction

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Q1

96

Q3

96

Q1

97

Q3

97

Q1

98

Q3

98

Q1

99

Q3

99

Q1

00

Q3

00

Q1

01

Q3

01

Q1

02

Q3

02

Q1

03

Q3

03

Q1

04

Q3

04

Q1

05

Q3

05

Baptist Percentile BMP Percentile

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Ambulatory Satisfaction

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Q1

97

Q3

97

Q1

98

Q3

98

Q1

99

Q3

99

Q1

00

Q3

00

Q1

01

Q3

01

Q1

02

Q3

02

Q1

03

Q3

03

Q1

04

Q3

04

Q1

05

Q3

05

Baptist Percentile BMP Percentile Gulf Breeze Percentile

Emergency Department Satisfaction

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Q1

96

Q3

96

Q1

97

Q3

97

Q1

98

Q3

98

Q1

99

Q3

99

Q1

00

Q3

00

Q1

01

Q3

01

Q1

02

Q3

02

Q1

03

Q3

03

Q1

04

Q3

04

Q1

05

Q3

05

Baptist Percentile Gulf Breeze Percentile

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Home Health Satisfaction

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Q4

97

Q1

98

Q2

98

Q3

98

Q4

98

Q1

99

Q2

99

Q3

99

Q4

99

Q1

00

Q2

00

Q3

00

Q4

00

Q1

01

Q2

01

Q3

01

Q4

01

Q1

02

Q2

02

Q3

02

0 Q1

03

Q2

03

Q3

03

Q4

03

Q1

04

Q2

04

Q3

04

Q4

04

Q1

05

Q2

05

Q3

05

Baptist Percentile

Patient Satisfaction Starts With Employee Satisfaction

0

20

40

60

80

100

Q1

96

Q3

96

Q1

97

Q3

97

Q1

98

Q3

98

Q1

99

Q3

99

Q1

00

Q3

00

Q1

01

Q3

01

Q1

02

Q3

02

Q1

03

Q3

03

BH Patient %-tile BH Employee Morale

12/9/2013

42

Customer-Focused Outcomes - HCAHPS

Customer-Focused Outcomes

Top Box Scores for Patient Satisfaction

8 years of consistent improvement

12/9/2013

43

Rate of Change: SG Partners Improve Where Others

Decline

Source for National Benchmark: NACHR - JWT Source for Best Practice: ANCC

0%

5%

10%

15%

20%

1998 1999 2000 2001 2002 2003 2004 2005 2006

YTD

BMH National Benchmark Best Practices National Benchmark

Good

5.4%

12.9%

14.6%

Bronson Memorial Hospital: RN Turnover

12/9/2013

44

Workforce-Focused Outcomes

Staff Voluntary Turnover

Workforce-Focused Outcomes

Physician Engagement Scorecard

12/9/2013

45

•

•55

•Physician Engagement and Relationship •Physician Engagement Survey Results

•Go

od

•Perc

entile

•Source: HealthStream •Top Decile

•56

NMMC Results

Measure Percentile

Employees 93rd

Physicians 99th

Patients 90th

Key Process Measures – Customer Satisfaction Press Ganey 501+ beds

12/9/2013

46

0

10

20

30

40

50

60

70

2000 2001 2002 2003 2004

# D

ay

s

SLH

COTH Top Quartile

A-Bond

BETTER

*SLH data represents best 5% of comparative group

*

Saint Luke’s Hospital

Net Days in Accounts Receivable

NMMC Results

0.6 0.7

4.45.2 5.1

9.5

7.4

11.1

0

2

4

6

8

10

12

1999 2000 2001 2002 2003 2004 2005 2006

$ M

illio

ns

Cumulative financial gains from outcomes management of focused DRG losers

Care-Based Cost Management: Making the Business Case for Quality

12/9/2013

47

0

1

2

3

4

5

6

7

8

9

10

IP OPPatient Type

Min

ute

s

Year 1 Year 2Year 3 Year 4

BETTER

Saint Luke’s Hospital

Admitting Wait Time

50% increase in PVHS discharges from 2000 to 2008

18% increase in Competitor discharges from 2000 to 2008

39% population growth in Competitor’s home county from 2000 to 2008

11% population growth in Larimer County from 2000 to 2008

Financial & Market Outcomes

Patient Discharges: 50% increase since 1st Baldrige application

12/9/2013

48

Remaining Competitive

Hospital Charges

NMMC Results

Measure Percentile

FTE’s 14th

Total Labor Expense 9th

Charges per Discharge 8th

Operating Margin 90th

Total Margin 95th

Key Process Measures – Efficiency/Finance Solucient 501+ bed, Case Mix Adjusted

12/9/2013

49

2005 Medicare per Capita Spending by Hospital Referral Region

Dartmouth Atlas data

When are you too busy to pursue

excellence?

12/9/2013

50

Category One Inc. Redefining Excellence

Joel H. Ettinger

Josh H. Ettinger 412-968-1015

joel.ettinger@category-1.com