Performance Excellence · Performance Excellence Linking Mission, Strategy and Improvement to Results Dean F. Kappel President/CEO Mid-America Transplant Services St. Louis, MO

Performance Excellence Linking Mission, Strategy and

Improvement to Results

Dean F. Kappel

President/CEO

Mid-America Transplant Services

St. Louis, MO

Key Questions

• Do you have a model to drive improvement in your results?

• Do you know how to sustain your improvements?

• Are your customers, partners and stakeholders satisfied and engaged?

• Are your processes systematic?

• Do you have the data to support your answers?

• How do you compare with others?

Baldrige Basics

Baldrige is a Systematic Process for Making Systemic Change

Baldrige Basics

• Systems Approach to Sustained Results

• Aligns Processes

• Achieve Strategic Transformation

• Assists Engagement of Employees, Customers and Partners

Alignment

Baldrige Basics

Goals and

Measures

Aim of the

Organization

Random Acts of Improvement

Adapted from

The Management Compass

by Michelle Bechtell

Alignment

Baldrige Basics

Goals and

Measures

Aim of the

Organization

Aligned Acts of Improvement

Adapted from

The Management Compass

by Michelle Bechtell

Who was Malcolm Baldrige?

• Secretary of Commerce 1981-1987

• Proponent of quality management as the key to this country’s prosperity and long term strength

• Congress established the award in 1987. Leaders recognized that the US must focus on quality to compete globally. The purpose was

– Recognize role model businesses

– Establish criteria for evaluating improvement efforts

– Disseminate and share best practices

Some Organizations That Have Won

• Motorola-1988

• Cadillac-1990

• Federal Express-1990

• Ritz Carlton-1992,1999

• SSM Healthcare-2002

• St. Lukes Hospital (KC)-2003

• Premier Group Purchasing-2006

• City of Coral Springs-2007

• Atlanticare Health System-2009

• Heartland Health System-2009

What Are the Benefits

• Baldrige hospitals are 6 times more likely to be a top 100 hospital by Thomson Reuters

• 3% of all hospitals are named a top 100

• 27% of Baldrige winning hospitals are named a top 100

MTS: Who We Are

• 4.5M Population; 110 staff

• Cover Parts of 3 States

• 4 Transplant Centers; 16 Programs

• 115 Acute Care Hospitals

• Organ, Tissue and Eye

• 2 In-house Operating Rooms

• 2 Bed ICU

• Cardiac Cath Lab, Echo

• CT Scanner; X-ray, Bronchoscopy

• Bedside Biopsy

The So What's

• What Kind of Results Can You Get?

• Some Examples

The Results of the MTS Quality Journey:

100% Increase in Lives Saved

100

200

300

400

500

600

700

2002 2003 2004 2005 2006 2007 2008 2010 2011 2012

2012

5th MBNQA

Application

2003

Show Me

Challenge

2006

MQA Winner 2005

1st MQA

Application 2008

1st MBNQA

Application

2011

2nd MBNQA

Site Visit

2010

MBNQA Site

Visit

2x MQA Winner

Organ Conversion

83% 81% 84% 87%

40%

60%

80%

100%

2009 2010 2011 2012 Proj

Conve

rsio

n R

ate

Conversion Rate OPTN Top Quartile

Sustaining High Organ Conversion Rates

Good

Organ Donors by Population

36.9 33.8 34.3

42.2

05

101520253035404550

2009 2010 2011 2012 Proj

Donors

/M P

op

Donors/M Pop OPTN Top Quartile

Top Quartile Performance

Good

Organ Donor Yield

3.01 3.23 3.54 3.67

0.000.501.001.502.002.503.003.504.004.505.00

2009 2010 2011 2012 Proj

Org

ans T

XP/D

onor

Organs TXP/Donor OPTN Top Quartile

Clinical Strategies Improve Results

Good

Voluntary RN Turnover

24%

14% 13% 8%

02004006008001,0001,2001,4001,6001,800

0%

5%

10%

15%

20%

25%

30%

2009 2010 2011 2012 Proj

Org

an R

efe

rral

s

Turn

ove

r

Turnover Organ Referrals

Minimal RN Turnover with Increasing Activity

Good

Overall Job Satisfaction

91% 93% 99% 99%

40%

60%

80%

100%

2006 2008 2010 2012 Proj

Sati

sfac

tion

Satisfaction External Vendor

Exceptional Job Engagement

Good

Organ Donor Cases In-House

83% 87% 88% 90%

0%

20%

40%

60%

80%

100%

2009 2010 2011 2012 Proj

% E

ligib

le C

ases

In-H

ouse

% Eligible Cases In-House AOPO

Industry Trailblazer

Good

Hospital Cycle Time

14:43

9:55

7:00

3:50 0:00

6:00

12:00

18:00

2009 2010 2011 2012 Proj

Tim

e p

er

Cas

e (

hh:m

m)

Time per Case (hh:mm) Internal Target

Industry Trailblazer

Good

Organ Donor Cost Comparison

26

19 15

21

11 9

7 8

0

5

10

15

20

25

30

2009 2010 2011 2012 Proj

$K

/Donor

Hospital MTS In-House

Dramatic Decrease with In-House Recoveries Good

Average OAC Comparison-All Organs

29.9 29.9 29.2 29.2

25.026.027.028.029.030.031.032.033.0

2009 2010 2011 2012 Proj

Avg

. OA

C (

$K

)

MTS OAC Lowest Cost OPO

OACs at or Below Benchmark Good

For More Information

• Baldrige Criteria for Performance Excellence: www.baldrige.nist.gov

• Assessment tools: Are we making progress as leaders? Are we making progress?

Organ Procurement Leadership -2015

• We need to constantly innovate and improve

• We need to set high expectations

• We need to engage our hospital partners in new, creative ways

• We need to hold our selves accountable for outcomes