Leadership Development Institute IX February 15 and 16, 2007.

Leadership Development Institute IXLeadership Development Institute IXFebruary 15 and 16, 2007February 15 and 16, 2007

WinsWins Maury Regional Cardiac Surgery Agreement

Nashville Surgery Center

Home Health Named “Elite”

Susan Cooper Named Commissioner of Health

VICC Invited to Join Elite National Cancer Center Network

Congress Votes $131M for State Safety Net

VUMC Annual Report and Vanderbilt Medicine Win Top Awards

DNA Databank Ready to Launch

Meet me at the State of the Medical Center

Monday, March 5 at 4:00 PM

NEW LOCATION – STUDENT LIFE CENTER

PeoplePeople

PeoplePeople

People Satisfaction Survey - Meta-Analysis

• Surveys Included:– Community Survey – Fortune 100 Best – Physician Survey Places to Work– NDNQI Nursing Survey

• Key Themes:– Cooperation among work teams is a source of friction– Communication between different levels is problematic– Staffing and necessary tools are low rated by MD’s and RN’s– Residents and faculty report little influence over decisions– Adequacy of pay and sharing financial success remain low but

improved– Vanderbilt still ranks among the highest in Fortune 100 survey

for commitment of staff to mission and purpose

Projecting the Trend Forward

76%77%

64%

73%

65%

84%83%80%

81% 81%

50%

55%

60%

65%

70%

75%

80%

85%

90%

95%

100%

2002 2003 2004 2005 2006 2007 2008

Year of the Survey

Av

era

ge

Pe

rce

nt

Ag

ree

ing

(f

or

58

qu

es

tio

ns

)

Vanderbilt

Top 100

PeoplePeopleFortune 100 Best Places to WorkFortune 100 Best Places to WorkProjecting the Trend ForwardProjecting the Trend Forward

People People

Arnold Strauss, M.D.

Jennifer Pietenpol, Ph.D. Kevin Churchwell, M.D.

Jim Shmerling Ray DuBois Jr., M.D., Ph.D.

PeoplePeople David Posch Executive DirectorVMGChief Executive OfficerVanderbilt Clinic

• Strategic direction• Business development and growth

Marilyn Dubree, M.S.N., R.N.Chief Nursing OfficerVanderbilt Medical Center

• Oversees all nursing operations– VUH – PHV– VCH – TVC

• Strategic Direction• Practice Innovation• Nursing Ecology

Survey % ExcellentNational Percentile

Goal

Adult IP 63.5% 86.7 90th Percentile

VCH IP 72.6% 93.9 90th Percentile

Adult ED 57.7% 96.1 90th Percentile

VCH ED 64.6% 98.3 90th Percentile

OP Surgery 74.8% 86.0 90th Percentile

OP Technical 72.0% 98.1 90th Percentile

Clinic Visit 68.9% 81.5 90th Percentile

ServiceServiceQuality of CareQuality of CareJuly 2005 to December 2006July 2005 to December 2006

ServiceServiceLikelihood to Recommend Vanderbilt Likelihood to Recommend Vanderbilt July 2005 to December 2006July 2005 to December 2006

Survey % ExcellentNational Percentile Goal

Adult IP 67.2% 89.0 95th Percentile

VCH IP 77.8% 95.3 95th Percentile

Adult ED 60.5% 93.3 95th Percentile

VCH ED 69.4% 98.8 95th Percentile

OP Surgery 77.0% 95.3 95th Percentile

OP Technical 74.4% 98.1 95th Percentile

Clinic Visit 72.1% 65.6 80% Excellent

QualityQualityVUMC Mortality 2005-2007

2 1 3 2 4 2 0 3 2 1 0 0 0 3 2 4 1 2 1 3 0 0 1 2 1

5 7 4 36

8 5 5 6 106 9 2 4 1 6 3 4

8

5 82 3

0

25

33

25

3822

3226 25

3227

2730

33

19

3229

36

31

51

31 2831 30 40

41

37

33

38

42 3540

31

38

32 24

4842

35

45

30

41

3441

33

47

3748

50 41

10

13

11

12

1116

13

15

13

13

10

10 10

9

18

14

1020

14

15

10

11

17 11 15

37

0

10

20

30

40

50

60

70

80

90

100

110

120

Mor

talit

ies

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

O/E

Other Neurology Surgical Science Medicine Peds VUMC O/E Threshold Target Reach

Estimated Dec/Jan O/E

2.10%

2.20%

2.30%

2.40%

2.50%

2.60%

2.70%

2.80%

2.90%

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Month

Obs

erve

d M

orta

lity

Rat

e

Obs Death Rate Average Upper Limit Lower Limit

QualityQualityMonthly Mortality Rates2001-2006

*December 2006 = 2.23%

QualityQualityDecember Mortality Rates

December ofMonthly Mortality

Annual Mortality

2001 2.84% 2.87%

2002 2.78% 2.57%

2003 3.10% 2.53%

2004 2.62% 2.55%

2005 2.58% 2.33%

2006 2.23% 2.27%

QualityQualityPublicly Reported Measures JCAHO and CMS

QualityQualityPublicly Reported Measures JCAHO and CMS

GrowthGrowthVUSN Renovates Nursing AnnexVUSN Renovates Nursing Annex• $2.1 M renovation of classroom space• Construction began - 1/1/07• Anticipated completion – 7/31/07• Classes relocated to off-site location

(Carell Building) for Spring Semester

GrowthGrowthVUH Critical Care Tower Phase IIVUH Critical Care Tower Phase II• CON approved September 2006• $169.0 million project • Project mobilization underway:

– Construction crane in place – Medical Center Drive Restructuring

mid-March– Removal of old heliport complete

• New elevator construction underway in VUH

• Anticipated completion Fall 2009

GrowthGrowthMedical Research Building IVMedical Research Building IV

Langford Addition

Light Hall Addition Occupied 2005

MRV IV 385,000 GSF 221,900 NSF

13th Floor Framing (Top Research Floor)

GrowthGrowthVanderbilt Eye InstituteVanderbilt Eye Institute

• Construction underway• Occupancy January 2008• 48,778 GSF renovation of two floors • Program includes:

– The Tennessee Lion’s Pediatric Eye Clinic– Comprehensive eye care and low vision rehabilitation– A refractive laser suite and diagnostics area– An optical retail shop – Departmental, Faculty and Business offices– 40 subspecialty exam/treatment rooms – Treatment rooms for minor surgery and Argon and YAG laser surgery– New Pierce Ave. and South Garage entrances

View from Pierce and 23rd Ave.

GrowthGrowth

VUH East Garage ExpansionVUH East Garage Expansion • Project completes Fall 2007• Adds 800 parking Spaces• New Entry on 21st Ave.

New Garage Construction Looking South

21st A

VE.

GrowthGrowthVanderbilt Institute of Imaging ScienceVanderbilt Institute of Imaging Science• Occupied October 2006• 41,000 GSF• 6 Magnets

Vivarium Construction Above

GrowthGrowthCentralized Vivarium and Centralized Vivarium and Gross Anatomy Lab at VUIISGross Anatomy Lab at VUIIS• Five Floor Addition of 42,500 GSF• Gross Anatomy Lab 10th Floor• Three Vivarium floors• One Shelled floor

View from 21st Avenue

GrowthGrowthVanderbilt Ingram Cancer CenterVanderbilt Ingram Cancer Center

Clinic Entrance

Clinic Waiting & Reception

• Multi-phased project

• Construction starts March 2007

• Completion December 2008

GrowthGrowthHospital and ClinicHospital and ClinicKey Volume Measures ForecastKey Volume Measures Forecast

Volume

FY 2007

December

YTDFY 2007 Forecast

FY 2007 Target

% Forecast To Target

Discharges

LOS

CMI

Patient Days

Ambulatory Visits

ED Visits

Surgical Operations

25,333

5.1

1.81

130,223

531,370

45,911

19,988

50,622

5.1

1.82

259,612

1,094,900

94,500

40,350

49,170

5.4

1.82

263,101

1,085,143

94,540

40,924

+3.0%

-5.6%

0.0%

-1.3%

+0.9%

0.0%

-1.4%

FinancialFinancialVanderbilt University Hospitals and Clinics Vanderbilt University Hospitals and Clinics Financial Performance ResultsFinancial Performance ResultsFiscal Year 2006 - 2007 (in thousands) Fiscal Year 2006 - 2007 (in thousands)

FY 2007

December YTD

FY 2007

Forecast

FY 2007

Target

% Forecast

to Target

Net Revenue $584,018 $1,193,818 $1,183,863 +0.8%

Operating Expenses $569,512 $1,155,749 $1,141,559 +1.2%

Available for Capital

Improvements $14,506 $38,069 $42,304 -10.0%

FinancialFinancialVanderbilt Children’s Hospital & Clinic Vanderbilt Children’s Hospital & Clinic Key Volume Measures - Fiscal Year 2006 – 2007Key Volume Measures - Fiscal Year 2006 – 2007

FY 2007December

YTD

FY 2007

Forecast

FY 2007

Target

% Forecast

to Target

Volume

Discharges 6,636 13,100 12,500 +4.8%

LOS 5.8 5.8 6.0 -3.3%

Patient Days 38,387 75,844 75,096 +0.1%

Ambulatory Visits 75,968 155,000 147,078 +5.4%

ED Visits 20,256 42,000 41,000 +2.4%

Surgical Operations 6,318 12,920 13,092 -1.3%

FinancialFinancialVanderbilt Children’s Hospital & Clinic Vanderbilt Children’s Hospital & Clinic Financial Performance ResultsFinancial Performance ResultsFiscal Year 2006 - 2007 (in thousands) Fiscal Year 2006 - 2007 (in thousands)

FY 2007

December

YTD

FY 2007

Forecast

FY 2007

Target

% Forecast

to Target

Net Revenue $134,017 $270,833 $270,943 0.0%

Operating Expenses $124,841 $253,548 $256,771 -1.3%

Available for Capital

Improvements $9,176 $17,285 $ 14,172 +22.0%

FinancialFinancialVUH Performance ResultsVUH Performance ResultsFiscal Year 2006 – 2007 Fiscal Year 2006 – 2007 (in millions)(in millions)

FY 2007

December

YTD

FY 2007

Forecast

FY 2007

Target

% Forecast

to Target

Net Revenue $584.0 $1,193.8 $1,183.9 +0.8%

Expenses $569.5 $1,155.7 $1,141.6 +1.2%

Available for Capital

Improvements $14.5 $38.1 $42.3 -10.0%

Source: VUMC Department of Finance

FinancialFinancialUncompensated Care Amount and Rate Uncompensated Care Amount and Rate Year-to-Date December, 2006 Year-to-Date December, 2006 (in thousands)(in thousands)

FY 2007

Actual

FY 2007

Target

% Actual

To Target

FY 2006

Actual

% Year

to Year

Uncompensated Care Amount $119,860 $116,193 +3.2% $97,383 +23.1%

Uncompensated Care Rate 7.6% 7.5% +1.3% 7.1% +7.0%

Source: VUMC Department of Finance

FinancialFinancialUncompensated CareUncompensated CareAs of December 31, 2006As of December 31, 2006

• Self Pay Patients up 30% over Fiscal 2006 and 168% over fiscal 2005

• Uncompensated Care Rate up to 7.6% compared to 4.6% in Fiscal 2005

• $30 million in lost TennCare reimbursement compared to pre-disenrollment.

• Self Pay Patients are up in all major services since 2005 with the most significant increase in Trauma.

Solutions

– Increased payment rates for Adults and Children

– New Funding for Level I Trauma Centers

– Federal Approval of $131Million Disproportionate Share Pool for Tennessee that needs to grow to $400 million by 2010

FinancialFinancialTennCareTennCare

FinancialFinancialShape the Future CampaignShape the Future Campaignas of January 31, 2007as of January 31, 2007

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

2

University Wide Medical CenterDevelopment

Original Goal (FY 2008)

Raised toDate(01/31/07)

New Goal(FY 2010)

$1.25B $1.31B

$1.75B

$625M$571M

$888M

dol

lars

in b

illio

ns

FinancialFinancialPhilanthropyPhilanthropy

Priorities Goal Raised to Date % towards

goal

Facilities $301.3M $135.3M 45%

Endowed Support $190.9M $96.2M 50%

Scholarship Support $78.2M $25.1M 32%

Programs & Research $301.8M $262.4M 86%

Unrestricted $15.8M $34.1M 215%

Designation Pending $17.8M

TOTAL $888M $571M 64%

FinancialFinancialPhilanthropyPhilanthropy

VICC $50M Eye Institute $5M

VCH $40M CELA $2M

Dry Lab Building $21M Nursing Annex $2M

Kennedy Center $20M Anatomy Lab $2M

Critical Care Tower

$15M

Selected Facilities and Program Priorities thru 2010