performance excellence engage for the new age rulon f. stacey, phd, fache president, university of...
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Performance ExcellenceEngage for the New Age
Rulon F. Stacey, PhD, FACHEPresident, University of Colorado Health
© Copyright PVHS 2012 All Rights Reserved
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Poudre Valley Health System• Private, locally owned, not-for-profit, integrated
health system• Full spectrum of healthcare services
– 2 tertiary hospitals (420 beds), outpatient campus, growing number of physician practices & outpatient facilities
– Joint ventures: Surgery centers, home care, sub-acute care, third-party administrator
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Poudre Valley Health System
• Service area: Northern Colorado, Wyoming & Nebraska• 5,300 employees, 600 physicians & 1,000 volunteers• $1.4 billion in annual revenue
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Where Our Journey StartedPoudre Valley Health System, 1997
• Community hospital serving Fort Collins, Colorado
• 1,500 employees, 300 independent physicians & 575 volunteers
• 24% annual employee turnover• 5 CEOs in 4 years• $250 million in annual revenue• Changing healthcare market• Demand for physician integration
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• Leadership: Find an improvement model• The Work Horse Philosophy
Performance Excellence Journey
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• Systems approach• Feedback
– Measures progress– Notes major strengths– Guides improvements
Why Baldrige?
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Our Vision
To provide
world-class health care
WendyOncology
patient
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Definition of World-Class
Striving for results in the 90th percentile
or top 10% of available national
comparative databases
CraigTrauma patient
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Core Competencies
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Customer-Focused OutcomesTop Box Scores for Patient Satisfaction
10 years of consistent improvement
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Workforce-Focused OutcomesStaff Voluntary Turnover
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Workforce-Focused OutcomesEmployee Engagement
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Workforce-Focused OutcomesPhysician Engagement Scorecard
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Healthcare OutcomesRisk-Adjusted Mortality Rate
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What’s Next?• How do you sustain world-class performance?
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Wave of Change in U.S. Healthcare• Patient Protection & Affordable Care Act• Future Trends
– Integration: Coordinate care, patient is the customer– Value: Deliver quality outcomes and high levels of
service at a reasonable cost – Transparency: Learn, grow and respond
• Challenge for healthcare providers– New reimbursement model– Higher accountability for quality
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Engage for the New Age
• New physician model• New partners• Lean thinking
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New Physician Model
• Colorado Health Medical Group
27 clinics, 180+ clinicians, 600 support staff
• Growing integration
2008: Nearly 100% independent practice
2012: 25% in CHMG, 75% independent
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New Partners
• The perfect partner: University of Colorado Hospital • Magnet• #1 Academic Medical Center, U.S. News and World Report• Academic medicine and research• Continuous care for patients all over Colorado
• New partners across the region• Memorial Health System, Colorado Springs, Colorado• Ivinson Memorial, Laramie, Wyoming
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From Independent to Inter-Dependent
• A collection of providers taking
shared responsibility for patients
over a period of time• Remove cost without
compromising quality• Integrate between facilities,
between providers• Improve what you’re already
supposed to be doing well
Doctors
Acute Care Hospitals
PharmaciesRehabilitation
Providers
Other Providers
Why Partner?
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• Emergency Department length of stay down 72 minutes• Clinic registration times down 50%• Time for surgery pre-admit appointments down 50%• Design for new cancer center based on patient preferences• OR turn-around times in national top 1%
Lean Thinking
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• Performance Excellence is not about:– Being average– Being perfect
• Performance Excellence is:– Asking the right questions– Continuing to improve– Having the right people around the table– Sharing and learning from others
Lessons Learned
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Lessons Learned
• Work with state quality program• Must have commitment from senior leaders and Board• Don’t give up• Stop cramming for the test: Live it!• Consider it productive time• Make it how you do your business• It can’t be about the award
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Health Care Moving Forward
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Two Curves
The challenge of a 2 curve problem is to prosper in the
1st while you prepare for the 2nd
Cur
ve 1
Curve
2
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Dramatic Changes to the Competitive Landscape
The blurring of lines between not-for-profit and for-profit health care creates new and more pragmatic competitors
The blurring of lines between health care’s traditional participants – insurers, hospitals, and physicians – resulting in new market entrants
Joint Venture to Form New System
Joint Venture to Acquire Catholic Hospitals acquires
acquires
Copyrighted by Kaufman, Hall & Associates, Inc. 2012
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Throughout All of These Challenges and Changes,Performance Excellence Still Saves Lives!
Molly 4th generation treated at PVH