Thomas Jefferson University Hospitals

Industry: Healthcare & Education Website: www.jeffersonhospital.org

CUSTOMER OVERVIEWEstablished in 1825, Thomas Jefferson University Hospitals (TJUH) are an integral part of the Jefferson Health System providing services at five locations with 957 licensed acute care beds across the Philadelphia region. TJUH has been ranked by U.S. News & World Report among the nation’s top medical centers in eight specialties and has achieved MAGNET designation for superior nursing care.

CUSTOMER PROFILE

Philadelphia, PA

“We were looking for a partner who had the software and experience to go

beyond automating what we had in Excel and PowerPoint and could help us connect

metrics with accountability and action.” - Ronald P. Burd Executive Vice President for Strategy and Organizational Development

In 2006, as a way to position the hospitals to successfully address a rapidly changing healthcare industry, new economic factors and impending health reforms, TJUH held an internal review of its overall strategy and performance programs. This review resulted in the creation of a new culture-driven performance model that was designed to focus the organization on core strategic value areas, tie operations, budgets, and people to the strategy, and help the system navigate a journey toward performance excellence.

The organization chose to implement a Balanced Scorecard performance management framework as a way to support the new model and to help integrate various aspects of the model into the organization. As a first step, a small team of senior leaders created a top-level Scorecard using the organization’s five strategic value areas (Quality and Safety, Service, People, Finance and Operations, and Growth) as the Scorecard perspectives and then defined key high-level strategic objectives and metrics within each perspective. This initial Scorecard was presented to 50 vice presidents and senior directors who suggested more than 90 projects that they felt would address various under-performing metrics on the Scorecard.

Plymouth Meeting, PA | San Francisco, CA | info@activestrategy.com w w w . a c t i v e s t r a t e g y . c o m

BACKGROUND

While these high-level projects were now more clearly defined and better aligned than ever before, it was obvious from the sheer volume of proposed work that some different approaches would be required to close the gaps and achieve organizational goals.

TAKING THE NEXT STEPThough the team that had developed the first Scorecard at TJUH recognized that performance management tools alone would not guarantee favorable results for the long term, there was a strongly held belief that these tools and processes, when placed in the context of an overall performance model, deployed effectively, and supported by strong leadership at all levels, would drive significant benefit. So they set out to find external resources that could support their efforts. Late in 2008, the TJUH team learned of ActiveStrategy, an organization that provides performance excellence consulting and performance management software called ActiveStrategy Enterprise® (ASE). TJUH found that ActiveStrategy offered the solution they were seeking to align efforts supporting their strategic values, develop a common view of key metrics and initiatives, and drive accountability across the organization.

CUSTOMER PROFILE

Plymouth Meeting, PA | San Francisco, CA | info@activestrategy.com w w w . a c t i v e s t r a t e g y . c o m

ActiveStrategy began working closely with the hospitals’ executive leadership and designated Strategic Value Champions to build and automate Performance Dashboards and Scorecards. In parallel, hospital performance improvement teams were trained in Six Sigma, Lean, Work-Out, and CAP performance excellence methodologies.

The initial top-level Scorecard that had been developed by the small core team has now been expanded into an increasingly solid network of linked, cascaded Scorecards that are automated in ASE. This framework has been developed with feedback from 85 senior leaders, performance improvement leaders, and change agents, as well as substantial contributions from nearly 300 different staff members. All TJUH employees are encouraged to view the system Scorecards in real time, using links to ASE posted on the hospitals’ intranet. This wider participation in the process is an important part of ingraining the culture-driven performance model.

A project scoping process has also been implemented to develop projects that support positive results in measures that are most critical to achieving the hospitals’ goals. The TJUH staff leverage the project management capabilities within ASE to help standardize the improvement processes, monitor progress, and communicate results. For example, several projects were put in place to improve the system’s “Length of Stay” measure. These were tracked in ASE so that any impact on the outcome measure could be monitored. Over the course of two fiscal years, this key operational indicator improved by 8% and the hospitals continue to set more aggressive targets in this and other strategically-aligned areas. In fact, the hospitals recently added a benchmark comparator to some of the key measures it tracks in ASE, allowing TJUH to see how performance matches up to best-in-industry results.

ASE Stoplight Charts, Program Groups, and Measure Detail pages are being used in conjunction with existing resources to produce visually compelling, accurate reports on their five key service line areas. A “Results and Outcomes” report is also in the works to serve as a repository for tracking key operating indicators related directly to the pursuit of TJUH’s goal of achieving excellence in organizational performance. Another dashboard they created in ASE helps leaders monitor overall readiness for accreditation in specific programs, helping the hospitals address any issues much more proactively than before.

Example of a Stoplight Chart in ASE

*Data for illustration only*

RESULTS In addition to the progress noted in the hospitals’ Length of Stay measure, dozens of other key measures from MRSA infection rates to HCAHPS metrics have shown significant improvement. The hospitals have also seen over $7 million in reduced expenses as a result of the overall model and performance improvement efforts. Organizational alignment has also improved dramatically. In 2009, for the first time ever, TJUH was able to tie goals for over 250 leaders and managers specifically to the organizational Scorecard goals.

In 2010, TJUH was recognized for its level of proficiency by the Keystone Alliance for Performance Excellence (KAPE), which is Pennsylvania’s state-level performance excellence organization. The feedback report from KAPE cited the hospitals’ use of ASE software as one of the organization’s most significant strengths. The report praised the fact that “data for Balanced Scorecard metrics are collected from various sources utilizing an integrated software suite that is also used to report Balanced Scorecard metrics to all management levels.” This was the first time TJUH had applied for the award and to be recognized at this level was a significant step on its continuing journey toward excellence.