Repeatable Performance Excellence Drives Profitability For the ...

Repeatable Performance Excellence

Drives Profitability

For the 2015 Baldrige Recipient

Glenn Crotty, Jr., MD Executive Vice-President and COO Charleston Area Medical Center John Vinyard Managing Partner Genitect

CAMC SERVICE AREA West Virginia’s Population: 1.8 million Primary and Secondary Service Area: 557,328

Cabell

Mingo

Lincoln Wayne

Wirt

Jackson

Kanawha

Roane

Ritchie Wood

Boone

Raleigh

Wyoming

McDowell

Logan

Mercer

Clay

Gilmer

Upshur

Lewis

Calhoun

Braxton

Webster

Pocahontas Nicholas

Tyler

Doddridge Harrison Taylor

Barbour

Monroe

Greenbrier

Summers

Fayette

Ohio

Monongalia

Wetzel

Marshall

Brooke

Hancock

Marion

Preston

Pendleton

Mineral

Grant

Hardy

Tucker

Randolph

Jefferson

Berkeley

Morgan

Hampshire

Mason

Pleasants

Putnam

Primary Service Area

Secondary Service Area

• 48 Ambulatory Sites • Provider Based

• Imaging, Urgent Care, Laboratory

• 40,000 Inpatient Visits

• 690,000 Outpatient Visits

• 115,000 Emergency Department Visits

• 4 Acute Care Hospitals • 908 Total Beds

MISSION AND VISION

Mission: Striving to provide the best health care to every

patient, every day.

Vision: Charleston Area Medical Center, the best health

care provider and teaching hospital in West Virginia, is

recognized as the:

• Best place to receive patient-centered care.

• Best place to work.

• Best place to practice medicine.

• Best place to learn.

• Best place to refer patients.

VALUES

Quality

Service with compassion

Respect

Integrity

Stewardship

Safety

PERFORMANCE IMPROVEMENT

JOURNEY

2000

Six Sigma

2005

Baldrige

Journey

Begins

2007

Lean

2008

Transforming

Care Together

2012

Focus On

Baldrige

Processes &

Systems

2015

Malcolm

Baldrige

National

Quality Award

2011

Started

Using

Critical

Systems

Importance of Organizational Learning

and Agility . . .

. . . a Baldrige Core Value

“If the rate of change on the outside exceeds the rate of change on the inside, the end is

near.” Jack Welch, Former Chairman and CEO

General Electric Corp.

Why Improve?

According the latest research,

Baldrige hospitals were recording faster five-year performance improvement than peers

and were 83% more likely to be among Truven Health 100 Top Hospitals®.

Truven Health

7

• Covers six sectors: • Manufacturing

• Service

• Small business

• Health Care

• Education

• Not-for-Profit

• Since 1988 • 1,639 Baldrige applications

• Over 10,000 applications to state quality awards

• 109 award recipients (including several twice) • 18 in Health Care

Why Baldrige?

• 368 applications since healthcare became

eligible under its own sector (1999)

• The most of any sector, even though Health Care was not

eligible for the first 11 years!

• 18 Recipients

• Last Year --- 2015 --- Health Care was:

• 62% of the Applications

• 50% of the Site Visits

• 25% of the Winners (CAMC Health System)

Baldrige Healthcare History

Baldrige Aligns The Focus

Adapted from Applied Strategic Planning, Goodstein, Nolan, and Pfeiffer, 1993

Near Term

Direction

Future

Vision

(Year 1) (Year 2-3) (Year 3-4)

A Typical Organization

Work Group

Individual

1000 Unaligned

Projects Malcolm Baldrige

Principles

Planned Journey

The Final Outcome

Baldrige Aligns the

Organization and Creates

Accountability

- John Vinyard

- Marlene Yanovsky

Health Care Criteria for Performance Excellence Overview and Structure

The leadership triad

(Leadership, Strategy, and

Customers) emphasizes

the importance of a

leadership focus on

strategy and customers.

The Organizational Profile sets the

context for your organization. It serves as

the background for all you do. The results triad

(Workforce, Operations,

and Results) includes

your workforce-focused

processes, your key

operational processes,

and the performance

results they yield.

All actions lead to

Results – a composite

of health care and

process, customer-

focused, workforce-

focused, leadership

and governance, and

financial and market

results.

The basis of the Health Care Criteria is a set of Core Values and

Concepts that are embedded in high-performing organizations.

The system foundation

(Measurement, Analysis,

and Knowledge

Management) is critical to

effective management and

to a fact-based, knowledge-

driven, agile system for

improving performance and

competitiveness.

Clarity of Alignment & Relationships

Strategic

Challenges

Work

Process

Design

Key Work

Processes

Short-Term

Actions

Long-Term

Actions Strategic

Objectives

Critical

Success

Factors

Strategic

Advantages

Strategic

Opportunities

Measures

(BSC)

Key Work

Systems

What We Called The “Mother of All Charts”

Today’s Focus

Baldrige:

Example: Senior Leadership ‘Hows’

Example: Senior Leadership ‘Hows’

We Use An Approach of Critical Systems

SO … For Leadership …

Option 1: 20+ Small systematic approaches to

accomplish what we need in leaders

(and try to tie these together)

OR……

Option 2: One approach to Leadership

which addresses most of the

20 small systematic approaches

(the hows) for all leaders

19

The Critical Systems: (Baldrige Users Guide)

1. Leadership

Leadership System

Communication System

Governance System

Organizational Sustainability System

Legal Compliance & Ethical System

Support To Key Communities System

2. Strategic Planning

Strategy Development System

Manage Innovation System

Strategy Deployment System

3. Customer Focus

Customer Communication & Response System

Customer and Market Knowledge System (Voice of the Customer)

Customer Satisfaction Determination System

Customer Relationship System (includes customer segmentation)

Complaint Management System

4. Measurement,

Analysis, and

Knowledge Management

Performance Measurement Selection System

Comparative Data Selection & Use System

Performance, Data Analysis & Use System

Data Availability System

Organizational Knowledge System

Data, Information & Knowledge Quality System

5. Workforce Focus

Workforce Capability & Capacity System

Hiring & Career Progression System

Workforce Work Environment System

Workforce Benefit System

Workforce Enrichment & Engagement System

Workforce Performance Management System

Workforce & Leadership Development System

Workforce Engagement Assessment System

6. Operations Focus

System & Work Process Design System

Process Management System

Process (Performance) Improvement System

Supply Chain Management System © 2016

CAMC in

2011

CAMC in

2013

CAMC in

2016

VIDEO

ENTERPRISE MODEL

LEADERSHIP SYSTEM

Set Direction

Align and Cascade

Implement Action Plans

Achieve the Plan

DEPLOYMENT PROCESS

Pillars Strategic Objectives

BIG DOTS (4 Year)

System Goals

BIG DOTS (1 Year)

Entity Action Plans

Entity Scorecard (1 Year)

Department Action Plans

Department Scorecard (1 Year)

Individual Performance Planner (All Employees)

Individual Scorecard (Managers)

SYSTEM LEVEL

Strategic

SYSTEM LEVEL

Operational

ENTITY LEVEL

Operational

DEPARTMENT LEVEL

Operational

INDIVIDUAL LEVEL

Operational

TOP 5 BOARD

A3 PROBLEM SOLVING

TOP 5 BOARD SAFETY CROSS

• Effectiveness: An important tool to know if the safety bundle is being followed on each shift.

• Only green if all parts of the bundle are completed; serves as an internal audit tool for key processes of care. A magical tool

• Addresses accountability as the issue is discussed with the involved individual(s) that day.

Video nicu nurse

IMPLEMENTATION OF STRATEGY AND ACTION PLANS RESULTS

PERFORMANCE IMPROVEMENT

BREADTH AND DEPTH

FOUNDATION FOR LEAN

5S Workplace Organization

Standardization

Visual Management

Problem Solving

Human Centered Work

5S Workplace

Organization Standardization

Visual

Management

Problem Solving

Just in

Time

Built in

Quality

Continuous Improvement

Highest Quality

Healthcare

Human Centered Work

FOUNDATION FOR LEAN

5S Principles

1. Sort (Removal)

2. Set In Order (Orderliness)

3. Shine (Cleanliness)

4. Standardize (Adherence)

5. Sustain (Self-Discipline)

5S is the key to Workplace Organization

FOUNDATION FOR LEAN

RN DIRECT PATIENT CARE TIME

Improving the health and economics of our

community.

CORE COMPETENCY

Improving the

health and

economics of

our community.

CORE COMPETENCY

Uncompensated Care Percentage of WV Total

Cumulative Savings = $177,019,702

FY 2015 Annualized Savings = $21,216,254

SUSTAINABILITY Cost Reductions

2011 2012 2013 2014 2015 0.0

0.2

0.4

0.6

0.8

1.0

OB

SE

RV

ED

TO

EX

PE

CT

ED

RA

TIO

CAMCHS

G

OO

D

RESULTS

Inpatient Mortality Inpatient Overall Quality - Local Competitors

COMPARION

1,923 lives

saved from

2011 to 2015

2011 2012 2013 2014 2015 1

2

3

4

5

SC

OR

E

CAMCHS Top 10%

G

OO

D

Employee Satisfaction Overall

OUR LEARNING… • Identify key organizational issues and systems that need improvement.

•Create line of sight from strategic plan to everyday work.

•Focus on the few (Top 5)

•Use culture to drive change.

• Innovate for the future.

ROLE MODEL PRACTICES

• Leadership System

• Strategic Planning Process

• Core Competency

• Performance Improvement Culture

[email protected] 304-388-5000