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Miami Children’s Health SystemStrategic Planning and DevelopmentProprietary and Confidential
Miami Children’s Health SystemSystem-Wide Strategic PlanStrategic Plan Framework and Three Year Goals
February 2016
Proprietary and Confidential
Page
Strategic Planning Objectives 3
Goal Setting Framework 5
Executive Summary 9
Deep Dive of 2016 Goals 15
Three Year Goal Plan 60
Table of Contents
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Strategic Planning Objectives
01 02 03
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04 05
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The objectives of the planning effort are the following:
› Develop a focused 3-year strategic plan and roadmap for MCHS
› The plan will systematically evaluate and monitor all ongoing health system efforts and serve as the organizational blueprint, appropriately allocating resources to each of the four OpCos based on MCHS’s long-term objectives
› The plan will be supported by and inform the long-range financial forecast and the priorities of the OpCos
› Align implementation of strategies and goals with leadership goals and annual budget (operating calendar)
Planning Objectives
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Goal Setting Framework
01 02 03
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04 05
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Goal Setting Framework
› Organizational priorities, imperatives and goals were developed through the strategic planning process and incorporate the pillars of people, service, growth, margin, quality and innovation
› The purpose of the strategic plan is to align all goals and projects across the system with the organizational priorities
Proprietary and Confidential Miami Children’s Health System | 7
Organizational Priorities
› Priorities address industry wide trends in response to the changing reimbursement landscape and serve as guiding framework for plan development
› Priorities unified around providing holistic care to patients and families
› Achievement of priorities will enhance MCHS’s brand nationally and internationally as the premier, independent children’s health system
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MCHS Organizational Priorities Corresponding Organizational Imperatives
Improve quality outcomes (quality, innovation) #1: Develop centers of excellence around key service lines for common, and rare and complex diseases#2: Develop foundational services to support hallmark service lines #8: Increase focus on research and develop outreach/education programs
Excel in customer service and experience by delivering compassionate care, affordability and access (people, service, innovation)
#5. Enhance ambulatory services#6. Exponentially grow and develop global health to drive tertiary and quaternary volumes #7. Focused marketing around outreach, education and communication internally (staff and physicians) and externally (patients) to improve delivery of patient care and patient engagement
Manage provision of care along care continuum (people, service, quality, innovation)
#3. Enable complete management of patient across care settings via interdisciplinary collaboration #4. Create infrastructure to operationalize and scale CIN
Enhance breadth and depth of care (quality, service, growth, innovation)
#1. Develop centers of excellence around key service lines for common, and rare and complex diseases#2. Develop foundational services to support hallmark service lines #8: Increase focus on research and develop outreach/education programs
Advance the engagement and empowerment of our people (people, service)
#11. Develop culture of empowerment and engagement to achieve strong recruits and employee retention and high performing leaders
Develop appropriate payor models and alternative revenue streams to manage risk and optimize margin (margin)
#9. Adopt vision driven philanthropy#10. Develop value based payor models and identify, quantify and budget alternative revenue streams
Develop interoperable data analytics & IT capabilities to produce real time, actionable information (quality, innovation)
#12. Utilize data analytics to improve clinical outcomes and achieve customized approach to clinical care
Organizational Priorities and Corresponding Imperatives
Executive Summary
01 02 03
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Executive SummaryStrategic goals by year and alignment with organizational priorities
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Organizational Priority 2016 Goals 2017 Goals 2018 Goals
Improve quality outcomes / enhance breadth and depth of care
• Brain wellness/Neuro home programs*• Movement disorders COE*• Adult congenital heart disease program*• Maternal/fetal program*• Cardiac specialty outpatient clinics*• Hip Program*• Ortho Hub in Broward*• Spine COE*• Limb Lengthening & Deformity Program* • Phase I/II clinical trial program*• Defined outpatient center for oncology
and hematology*• Development of Oncology service line
P&L*• Diabetes COE*• Gastroenterology COE*• Acquisition of 3 geographic practices and
one new CIN partner*• Plastics / Beckwith Wiedemann /
Peripheral Nerve COE*• Chronic care prototype*• Explore academic and research affiliations
to complement or enhance research capabilities/services, provide support/internships to a breadth of services
• Personalized medicine*
• Stroke and cerebrovascular clinic*
• Neuro oncology services*• Solid organ transplant
services (heart failure/heart transplant, kidney and liver)*
• Non operative ortho clinics*• Expand fracture care
services offsite*• Dedicated outpatient
oncology clinic*• Strategic alignment with
radiation oncology provider*
• Human milk depot• High risk labor and delivery
unit*
• Achieve CoC accreditation with commendation (Oncology)*
• Vaccine therapy program (Oncology)*
• Achieve national designationsfor services lines / COEs
*Identified by SLT as a brand enhancing strategic goal
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Executive SummaryStrategic goals by year and alignment with organizational priorities
Miami Children’s Health System | 11
Organizational Priority 2016 Goals 2017 Goals 2018 Goals
Excel in customer service and experience by delivering compassionate care, affordability and access
• Expand Telehealth capabilities• Expand outpatient services/locations in
conjunction with physician distribution planning
• Develop global health affiliations and increase international patient admissions*
• Develop customer relationship management tools to facilitate and streamline access, engagement, education, communication and experience
• Smart Hospital capabilities
• Develop one stop shop MOB• Scale concierge services• Develop on site guest
accommodations• Creation of a system wide
education plan and yearly calendar of events
Manage provision of care along care continuum
• Development of case management and patient care teams*
• Operationalize and scale CIN
Advance the engagement and empowerment of our people
• Improve staff development• Emphasize active recruiting and best fit for
position practices; enhance onboarding• Drive empowerment among staff
increasing • Improve staff engagement
*Identified by SLT as a brand enhancing strategic goal
Proprietary and Confidential
Executive SummaryStrategic goals by year and alignment with organizational priorities
Miami Children’s Health System | 12
Organizational Priority 2016 Goals 2017 Goals 2018 Goals
Develop appropriate payormodels to manage risk and optimize margin
• Promote growth and development of internal fundraising infrastructure
• Align donor campaigns to foster clinical, research and education enhancements around centers of excellence and special projects to achieve tiered growth in annual campaign targets over time
• Elevate level of engagement of all board members: foundation, hospital and system to actively support the philanthropic initiatives
• Achieve revenue neutral transition to MSDRG
• Develop office of sponsored programs to increase revenue from external sources, including grants and awards
• Identify and systematically plan for investments in projects that will yield alternative sources of revenue
• Transition any remaining commercial charges to MSDRG
• Progressively increase the unrestricted cash flow by 2-3% per year until 50% is achieved
Develop interoperable data analytics & IT capabilities to produce real time, actionable information
• Enterprise Resource Planning • Business Intelligence
*Identified by SLT as a brand enhancing strategic goal
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Tying it All TogetherWhat will we accomplish through all of this?
Miami Children’s Health System | 13
• Provision of organ transplant
• Development of COEs for common and rare and complex diseases
• Creation of High Risk Labor and Delivery Unit
• Precision and personalized medical management
Enhance breadth and depth of subspecialty
services
•Alignment with maternal/fetal partners to feed clinical services
•Development of CIN to expand network of PCPs and subspecialists
•Provision of care to medically complex patients through PCMH
•Creation of supportive care team infrastructure to own and manage patients along care continuum
•Provision of collocated, interdisciplinary services in a one stop shop medical office building model to enhance coordination of care
Develop innovative care delivery model to achieve patient engagement and
satisfaction
•Distribution of resources to appropriate sites of services at optimal locations within the region through acquisition of practices or recruitment of subspecialists (PSA Expansion)
•Global Health
Expand our geographic footprint
Local, regional and international brand
recognition and market dominance in
our primary and outer service areas
The following three-pronged approach represents brand enhancing initiatives which encompass all of the organizational priorities to effectuate our vision for what we want to achieve as an organization
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Summary of FTE Needs
FTEs Brain Cardiac Oncology OrthoPSA (2016-
2018) Other programmatic initiatives Total
RevenueGenerating
(Y/N)
Admin support1 0.5 (Survivorship) 16 1 research admin
18.5N
Care coordinator/patient navigator
1 clinical care coordinator
1.0 Clinical RN
coordinator all programs
4.5 (global health); 1.5 pre admit case managers (2016), 3 service line specific case managers (2016), 2 IP case managers (2017), 2 pre and
post discharge case managers (2017), 1 fellowship coordinator 6.5 Y
Clinical research coordinator
1 shared 2 for GI IBD research, data coordinator
3 N
Genetic counselor 1 (research) 1 N
Nurses1 research nurse
2 RN's to support outpatient at NCH & NOC/PSL (shared)
0.5 oncology nurse, 1 research nurse
26.5 Y
Nutritionist 0.5 (shared) 1 OP clinics (shared) 1 2.5 Y
Fellows 1 neurosurgery fellow 1 N
Pharmacy1 research pharmacy
FTE (phase I trials)1 FTE research pharmacy (support clinical trial
growth) 2 N
Physicians
1 neuroscientist(1.27) .79 cardiologist and .48
interventional cardiologist
Ass. Medical Director of Clinical Research
Oncology
18.8 (excluding neuro and
cardiac recruits)
22 Y
Physician assistant
1.59 for outpatient/specialty clinics
2 ARNPs
12 (excluding neuro and
cardiac recruits) 15.5 N
Practice Manager
.79 shared in Palm Beach & Port St Lucie & Aventura (multi
specialty shared support) 0.79 N
Psychology 0.25 psychologist 0.25 Y
Social Worker 0.5 (shared) 1.28 1.7 N
Other
0.13 neuropsychologist
3.43 EKG technicians sonographers Outpatient
locations at NCH, Aventura, NOC and Port St Lucie
1 Certified Teacher
1.0 orthocast tech, 2
licensed athletic trainers
1FTE coordinator for research and fellows, 1 marketing content specialist, 1 marketing data
analyst, 6 TM&E FTEs (recruiter, sourcer and support), 1 grant coordinator, 1 grant writer, 1
regulatory FTE 14.5
6.4 11.1 9.3 4 48.8 20.5 100
Source: PSA approved FTEs, goal leaders’ FTE listing per goal slides Miami Children’s Health System | 14
Deep dive into 2016 organizational imperatives and goals; one slide per goal depicting the following:• Alignment between imperatives and corresponding organizational priority(ies)
• SLT champion(s) for the organizational imperatives
• Goal lead(s)
• If the goal is strategic or operational in nature or requires capital
• Specific metrics or measures of success to achieve in 2016
• Implementation steps/milestones by quarter assigned to responsible team member(s) to track progress
2016 Goals
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01 02 03 04 05
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 16
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Tim Birkenstock)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Brain)
Goal (Sara Widing, Dr. Jayakar)
In pursuit of statewide market dominance by 2018, develop the infrastructure and implement Brain Wellness programs including Rare Chromosomal Clinic, Pediatric Brain Index, Retail Offerings, Cognitive, Motor & Behavioral Medicine Integration for patients and families served by the Brain Institute by 2018.
2016 Measurable Outcome 150 Polysomnograms; 50 EEGs/ERPs; 30 fMRI; 105 neuropsych screens; 25 TMS tests
Foundational,Service
Providers, Infrastructure
Implementation Milestones & Action Items
2016 Timeline
Responsible Team Member(s) Capital Cost(s)
Salaries &
Benefits
Operating Expense/
OtherPrincipal Supporting
Foundational Recruit key positions to build foundation & program platform:A. Recruit ARNP for program development for both Brain Wellness and
Neuro Home*B. Recruit clinical coordinator for Brain Wellness and Neuro Home
Q1 TME Barba & Soto, Widing, Heckathorn, LegalMarlenne, Evelyn, Nancy, Widing, Cheryl Gimenez, Darren Dase
$190K
Service Providers
.25 FTE contract onboarding from FIU. Includes pending hospital privileges and credentialing.
Q1 TME Widing, Azaret, Jayakar, PSA $29k
Recruit & onboard Neuroscientist Q1 TME Widing, Jayakar $146K
Recruit and onboard social worker for Brain Wellness, Neuro Home & OP Q1 TME Barba, Bell-Taylor $78k
Recruit and onboard nutritionist for Brain Wellness & OP needs Q1 TME Barba, Corrigan $70K
Recruit and onboard patient navigator for Brain Wellness and Brain Institute Q1 TME Widing, Barba $86K
Recruit and hire post doc neuropsychologist. Q3 TME Neuropsychologist Hire $41K
Infrastructure Brain Wellness Program Development & Implementation - Cognitive, Behavioral and Motor
Q2/Q3 ARNP New Hire Above
Cognitive Lead TBD, Behavioral Lead, Azaret, Motor Lead TBD
$25k
Capital Purchase & Implementation Radio Frequency Ablation (RFA) Device Q2/Q3 Purchasing Widing, Jayakar, Clinical Engineering, Legal, Finance
$24k
Develop & Implement 2 Brain Wellness Program Offerings including medical and retail models– including neurorehab such as Autism.
Q2/Q3 Widing Schleifer, Terrell, Jessica Thomas, ARNP/RN Hire, Finance, IT
$25k
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 17
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Tim Birkenstock)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Brain)
Goal (Sara Widing, Dr. Jayakar)
Develop and implement Neuro Home program to provide 24 hours, 7 days per week availability of Brain Institute experts to all Brain Institute families who elect to participate by 2018; provider portal and network to achieve statewide market dominance and beyond by 2018.
2016 Measurable Outcome Maintain market dominance in Dade & Palm Beach County; solidify market growth in Lee & Collier counties; Grow dominance in Broward with 15 incremental neurosurgical cases.
Foundational,Service
Providers, Infrastructure
Implementation Milestones & Action Items
2016 Timeline
Responsible Team Member(s) Capital Cost(s)
Salaries &
Benefits
Operating Expense/
OtherPrincipal Supporting
Foundational Recruit key positions to build foundation & program platform:A. Recruit ARNP for program development for both Brain Wellness and
Neuro Home*B. Recruit clinical coordinator for Brain Wellness and Neuro Home
Q1 TME Barba & Soto
Widing, Heckathorn, Legal
$165K
Service Providers
Recruit and onboard social worker for Brain Wellness, Neuro Home & OP Q1 TME Barba, Bell-Taylor $78k
Infrastructure Develop & Implement statewide Marketing & Communication Plan Q1/Q2 Marketing Widing, Jayakar, Ragheb $35k
On call model for ARNP to cover 24/7 family portal Q1/Q2Soto
New ARNP/RN Hire, Karacaoglu,TME, Call Infrastructure
$225k
Develop provider network • Secure 2 new relationships • Go live (will include online/data sharing, linking protocols and pathways.)
Q2 & Q3Q4
Widing, Jayakar, Ragheb
IT, Marketing, Legal, PSA$30k
Develop family portal – Start with Epilepsy Population in 2016• Program development (Development includes online portals, online
family chat rooms, processes, procedures, etc.)• Go live (pending hiring of ARNP & Coordinator in Q2)
Q2
Q3
IT, ARNP/RN Hire
Dean, Rodriguez, Marketing Support; Perhaps Legal
$30k
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 18
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Tim Birkenstock)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Brain)
Goal (Sara Widing, Trevor Resnick, John Ragheb)
Develop and implement a Movement Disorders Center of Excellence to leverage market differentiators and treatment offerings for Movement Disorder patients in the State of Florida and Nationally/Internationally by 2018.
2016 Measurable Outcome 1-3 incremental cases in 2016 (Selective Dorsal Rhizotomy or Deep Brain Stimulation)
Foundational,Service
Providers, Infrastructure
Implementation Milestones & Action Items
2016 Timeline
Responsible Team Member(s) Capital Cost(s)
Salaries &
Benefits
Operating Expense/
OtherPrincipal Supporting
Foundational Define Rehab/Therapy Network Opportunities to help drive referrals -include protocol development and alignment for spasticity patient screening and standards of care
Q1/Q2 Terrell Sara Widing, Cheryl GimenezJennifer Perez
Finalize outcome measures for both medical and surgical patients in Movement Disorders. Work with IT to build distinct fields in PEDS; implement; begin measuring.
Q1 Monduy, Niazi
Smit, IT
Infrastructure Create, finalize and implement marketing and communications plan specific to movement disorders
Q1/Q2 Marketing Monduy, Niazi, Rehab $30k
Ongoing business development and roll out rehab/therapy network opportunities. Identify and implement at least 2 new partners/opportunities.
Q2 Rehab TBD,Widing
Widing, Monduy, Niazi, Legal,Marketing
Continue discussions with SLT regarding IP Rehab Component - this is a limitation for program growth
Q1-Q4 Widing, Ragheb
Ragheb, Resnick
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 19
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Tim Birkenstock, Dr. Granado, Dr. Feld, Jackie Gonzalez)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Cardiac)
Goal (Erika Vila)
Formalize partnership with CCF for provision of ACHD services at NCH and OP clinics by end of 2016.
2016 Measurable Outcome Achieve 67 cath/EP cases; 61 Cardiac MRIs; 302 echos; and 647 office visits (adult defined as > 17)
Foundational, Service Providers,
Infrastructure
Implementation Milestones Timeline Responsible Team Member(s) Capital Cost(s)
Salaries & Benefits
Operating Expense(s)
Principal Supporting
Foundational 1. Credential 4 NCH employed cardiologists to perform ACHD at CCF
Q1 Medical Staff Office
Dr. RhodesErika Vila
Foundational 2. Establish network of adult subspecialists to support IP ACHD care (privileges at NCH)
Q4 Erika Vila Dr. Granado
Service Providers 3. Recruit, Identify, and On-board Program Director for Adult Congenital Program
Q1 – Q3 Dr. Rhodes Dr. Feld Erika Vila
$366,000
Infrastructure 4. Education and training of current nursing staff to manage these capabilities
Q3 – Q4 Erika Vila Jamie Wiggins, Erika Vila
PotentialOT/Educational Costs
Foundational 5. Identify, secure, and operationalize bed space for adult patients in tower (or potential backfill location)
Q1 – Q2 Erika Vila John Rhodes, Erika Vila,FacilitiesNursing
Infrastructure 6. Document policies and procedures, including standards, quality outcomes and measures, track, report, and monitor clinical outcomes through recruitment and on-boarding of Database Quality Coordinator.
Q1 – Q4 John Rhodes, Erika Vila, Anthony Rossi, Robert Hannan
Erika Vila $100,000
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 20
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Tim Birkenstock, Dr. Feld)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Cardiac)
Goal (Erika Vila)
Develop a comprehensive Fetal Program through increased access to fetal-diagnostic providers in the tri-county market and enhanced referral relationship with Maternal/Fetal Medicine by end of year 2016
2016 Measurable Outcome2015a – 39 Neonatal Pump Cases | 2016 Goal: 50 Neonatal Pump Cases
2015a – 115 Fetal Echos | 2016 Goal: 200 Fetal Echos
Responsible Team Member(s)
Capital Cost(s)
Salaries & Benefits
Operating Expense(s)
Foundational, Service Providers, Infrastructure Implementation Milestones Timeline Principal Supporting
Service Providers 1. Recruit an ambulatory cardiologist to join Dr. Drossner in performing fetal services in Stuart, Port St. Lucie, Boynton/Del Ray (Palm Beach Market)
Q2 Dr.Rhodes
Dr. Feld, TMEErika VilaDr. Drossner
1 Echo Machine($200k)
$332,500 Office Space
Service Providers 2. Transition and on-board Nao Sasaki from Quality/Education Administrator role to Attending Physician with focus on cardiac MRI (50%) and Fetal Echo (50%)
Q1 Dr. Feld Erika VilaDr. Rhodes
Cardiac MRI capability at DMC ($100k)
2 Echo Machines ($300k)
$332,500
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 21
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Tim Birkenstock)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Cardiac)
Goal (Erika Vila)
Development of outpatient clinics to achieve clinical differentiation in the following programs: Roadmap, NeuroCardiac, Electrophysiology, Single Ventricle Survivorship, ACHD & Transition
2016 Measurable Outcome Operationalize and deploy 5 subspecialty clinics in the community by end of 2016.
Foundational, Service Providers, & Infrastructure
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Salaries &Benefits
Operating Expense(s)
Principal Supporting
Infrastructure 1. Deploy physicians and sub-specialty clinic (i.e., NeuroCardiac) in Aventura rehab component
2. Deploy Port St Lucie/Stuart sub-specialty clinic (Fetal/ACHD/EP capability)
3. Deploy Boynton/Del Ray sub-specialty clinic through strategic affiliation/potential acquisition of community cardiologist
4. Deploy Weston sub-specialty clinic in collaboration with other service lines
Q1 2016
Q1 – Q2 2016
Q2 – Q3 2016
Q3 – Q4 2016
Erika VilaDr. RhodesDr. FeldDr. DrossnerNancy HumbertTim BirkenstockACC Team Member
(Aventura Pro Forma)
(Previous Slide)
(Previous Slide)
Echo, and Supporting Equip
$200k (duplicate)
(Previous Slide)
$365,750
$352,450
(Aventura Pro Forma)
(Previous Slide)
Leased Office Space
Leased Office Space
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 22
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Armando Llechu)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Ortho)
Goal (Janel Grover)
Development of Hip Program in 2016
2016 Measurable Outcome 35 surgical Hip cases =$175K CM
Foundational,Service
Providers, Infrastructure
Implementation Milestones & Action Items
2016 Timeline
Responsible Team Member(s) Capital Cost(s)
Salaries &
Benefits
Operating Expense/
OtherPrincipal Supporting
Foundational Develop & execute marketing and outreach campaign to increase physician referrals to Hip program & differentiate ourselves from competing programs.
Q1 J. Grover Carmen Pages, Olga Laurenti $30K
Foundational Complete physician distribution strategy for Hip program. Q1 J.Grover Elizabeth Algarra
Infrastructure Partner with OR management to ensure appropriate block allocation for all physicians.
Q1 J.Grover Zoila Araica
Foundational Obtain & evaluate Market share analysis for Broward & Miami-Dade Ortho services, as well as zip code analysis for patients seeing Dr. Horowitz.
Q2 J.Grover Business Intelligence team
Foundational Evaluate impact of marketing and outreach efforts; Assess the need for additional campaigns.
Q4 J.Grover Carmen Pages, Olga Laurenti
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 23
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Armando Llechu)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Ortho)
Goal (Janel Grover)
Develop Ortho Hub in Broward by 2017
2016 Measurable Outcome 1,500 new office visits/yr in Miramar; 1,100 new office visits/yr in Aventura
Foundational,Service
Providers, Infrastructure
Implementation Milestones & Action Items
2016 Timeline
Responsible Team Member(s) Capital Cost(s)
Salaries & Benefits
Operating Expense/
OtherPrincipal Supporting
Foundational Develop and execute aggressive marketing and outreach campaign in Broward Co and Aventura.
Q1 Marketing / Outreach
J.Grover, Carmen Pages, Olga Laurenti
$40K
Foundational Complete/monitor physician distribution strategy for comprehensive Ortho services in Broward market.
Q1 J.Grover Elizabeth Algarra
Foundational Obtain & evaluate Market share analysis for Broward, as well as zip code analysis for patients being seen at Miramar and Aventura.
Q2 J.Grover Business Intelligence team
Foundational Fully operationalize Aventura with Ortho presence 3 days/week Q3 J.Grover Elizabeth Algarra
Infrastructure Complete Miramar clinic shelled space (2,134 SQ FT) to increase Ortho presence in Miramar/Broward by adding additional exam rooms/availability for Ortho clinics.
Q4 Construction J.Grover, Marlenne Burt, Katherine Aranda
$527K
Service Providers
1.0 clinical RN coordinator FTE for case management and care coordination of non spine patients to support general program growth; 1 Ortho cast tech for fracture care in in Aventura, Miramar, West Kendall and main; 2.0 licensed athletic trainers as physician extenders to support sports program at Pinecrest
Q2-Q4 TME J. Grover $203,840($62,400, 49,920, $91,520 for 2)
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 24
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Armando Llechu)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Ortho)
Goal (Janel Grover)
Expand Spine Center footprint in Broward/N.Miami Dade in 2016
2016 Measurable Outcome 10 incremental surgical spine cases = $750K CM
Foundational,Service
Providers, Infrastructure
Implementation Milestones & Action Items
2016 Timeline
Responsible Team Member(s) Capital Cost(s)
Salaries &
Benefits
Operating Expense/Ot
herPrincipal Supporting
Foundational Develop and execute aggressive marketing and outreach campaign inBroward, and Aventura (if applicable) around Spine program.
Q1 Marketing / Outreach
J.Grover, Carmen Pages, Olga Laurenti
$40K (duplicate)
Foundational Obtain & evaluate Spine-specific Market share analysis for Broward, as well as zip code analysis for Spine patients being seen at Miramar and Aventura.
Q2 J.Grover Business Intelligence team
Foundational Fully operationalize Aventura with Spine presence 1 day/week. Q3 Ambulatory Manager
J. Grover Elizabeth Algarra
Infrastructure Secure distribution of EOS Xray machine to Miramar (major market/Joe D. differentiator). To be placed in conjunction w/ completion of shelled space.
Q3 J.Grover Sheryl Selinsky $775K incl room prep
Infrastructure Complete Miramar clinic shelled space (2,134 SQ FT) to increase Ortho presence in Miramar/Broward by adding additional exam rooms/availability for Ortho clinics.
Q4 Construction J.Grover, Marlenne Burt, Katherine Aranda
$527K(duplicate)
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 25
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Armando Llechu)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Ortho)
Goal (Janel Grover)
Develop Limb Lengthening & Deformity Program in 2016
2016 Measurable Outcome 35 surgical Limb cases =$150K CM
Foundational,Service
Providers, Infrastructure
Implementation Milestones & Action Items
2016 Timeline
Responsible Team Member(s) Capital Cost(s)
Salaries &
Benefits
Operating Expense/
OtherPrincipal Supporting
Foundational Develop & execute marketing & outreach campaign to increase physician referrals to Limb program & differentiate ourselves from competing programs.
Q1 J.Grover Carmen Pages, Olga Laurenti $30K
Foundational Complete physician distribution strategy for Limb program. Q1 J.Grover Elizabeth Algarra
Infrastructure Partner with OR management to ensure appropriate block allocation for all physicians.
Q1 J.Grover Zoila Araica
Foundational Obtain & evaluate Market share analysis for Broward & Miami-Dade Ortho services, as well as zip code analysis for patients seeing Dr. Schoenleber.
Q2 J.Grover Business Intelligence team
Foundational Evaluate impact of marketing and outreach efforts; Assess the need for additional campaigns.
Q4 J.Grover Carmen Pages, Olga Laurenti
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 26
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Jose Perdomo, Jackie Gonzalez, Dr. Granado)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Oncology)
Goal (Dr. McCafferty + Oncologist)
Phase I /II Clinical Trial Program
2016 Measurable OutcomeDevelop business plan and programmatic initiatives for phase I clinical program, identify and recruit clinical lead
Foundational,Service
Providers, Infrastructure
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Salary & Wages
Operating Expense(s)
Principal Supporting
Foundational 1. Designate phase I working group (pharmacy, nursing, lab & pathology, social work and oncology leadership)
Q1 Dr. McCafferty John Girard
Foundational 2. Identify a clinical lead from oncology to pursue phase I and phase IItrials
Q1 John Girard Dr. McCafferty, Dr. Granado
$500k
Service Provider 3. Need clinical research coordinator Q2 TME John Girard $50k
Foundational 4. Identify physical space requirements for defined program in the inpatient space for clinical practice + administrative/ancillary support space + dedicated research pharmacy?
Q2 Construction Working group TBD
Infrastructure 5. Define the short & long term programmatic research goals with a proforma and 5 year business plan
Q2-Q3 John Girard Clinical Lead, Dr. McCafferty, consultants
TBD $50k
6. Identify pharmaceutical partners to guide/advise development of program
Q3 John Girard Working group TBD
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 27
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Jackie Gonzalez)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Oncology)
Goal (John Girard)
Defined OP Center for cancer and blood disorders including key clinical programs (survivorship, genetics, education, palliative care and late effects clinics) Execute on strategy for oncology program either through alignment with physician partner or academic institution; Find common outpatient clinic space out of the confine of the private office (Sickle Cell Clinic, Coagulopathy Clinic, Late Effects, etc…)
2016 Measurable OutcomeDevelop a long term treatment plan (survivorship plan) for every patient completing a course of treatment
Foundational,Service Providers,
Infrastructure
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Salariesand Wages
Operating Expense(s)
Principal Supporting
Foundational 1. Recruit key staff members to staff key outpatient clinics. (Physician Leader Palliative Care), 2 ARNPs, 2 social workers, 1 certified teacher, 2 RNs)
Q1 TM&E/PSA John Girard, Janet Bell-Taylor, Kara Marante, Peggy Townsend
n/a ~$600k
Infrastructure 2. Identify and purchase navigation software for survivorship (including late effects and other post acute therapeutic treatments clinics) to track patients internally and enable patients to keep track of records, appoints, etc.
Q1 John Girard John Girard, Peggy Townsend, IT, Dr. Orces
$10k $0 $10k (2017)
Foundational 3. Identify space/location of outpatient center of excellence for cancer and blood disorders. Relocate infusion area from 3N to collocation with outpatient clinic space. Provide physician offices proximal to cancer center/clinic.
Q1-Q2 Space PlanningConstruction
Service Line leaders,consultants, etc.
TBD n/a
Foundational 4. Identify/Define/purchase standardized treatment protocols [clinical pathways] by histology and age at diagnosis ( + define long term treatment plan for patients)
Q3 Peggy Townsend
Physicians, Nurses, IT, Dr. Granado,Jackie Gonzalez
n/a
Service Providers 5. Identify training and certification modules for Hem/Onc Nurses to meet and exceed accreditation and industry (USNWR) standards.
Q1 Regina Fritz Peggy Townsend n/a $5,000
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 28
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Jackie Gonzalez, Michael Durr)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Oncology)
Goal (John Girard)
Understanding the book of business: Oncology service line P&L EXPANSION OF CAPABILITY BY NEW Partnerships and alliances
2016 Measurable OutcomeFinancial reporting of full service line (IP/OP and ancillaries), capability to break out by tumor site or department
Foundational, Service Providers, Infrastructure
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Salaries & Wages Operating Expense(s)
Principal Supporting
Foundational Extrapolate data set to include patient encounters by oncology diagnosis code for all departments (lab, radiology, op infusion, IP, etc)
Q1 Finance BI, John Girard n/a n/a $0
Foundational Implementation of Insight to Oncology, I2O, CHAMPS’ data analytics software that merges clinical and billing data to measure out-migration, disease trends, heat maps, etc. and associated costs/savings.
Q1 Girard Rev Cycle, BI, IT (interface)
n/a Included in current contract
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 29
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Dr. Feld, Dr. Granado)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Common Diseases)
Goal (Peter Heckathorn, Paul Westhoff)
Endocrinology / Diabetes COE Realign with Secondary strategy
2016 Measurable Outcome 276 new cases per doc * $360K CM per new doc *4-$1.4M value of new FTEs (276 is benchmark)
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Finalize sub-market areas to target Peter Heckathorn
2. Contract broker to identify and lease space Nichole L Construction
3. Recruit and hire (physicians and support staff) TME $480,000 (2 physiciansand 6 support)
4. Commence practices (somewhat standardized; includes IT, revenue cycle, training and education, process and procedures, among other elements)
Aaron Williams
5. Marketing Marketing $100k
6. Planning for group session space (unique ENDO COE element)
Construction
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 30
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Dr. Feld, Nancy Humbert, Michael Davis)
Develop Key Service Expansion through acquisition and CIN strategy
Goal (Peter Heckathorn, Paul Westhoff et al.)
Acquisition of 3 “geographical practices” and one new CIN partner
2016 Measurable Outcome
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in Capital Budget
(Y/N)
Operating Expense(s)
Principal Supporting
1. Identify practices to target 3/31/16 L. Feld /Peter Heckathorn
2. Reassess NCH and MOB/satellite locations Nichole L Construction, Service Line leaders for PSA & practice manager, ACC team can support as needed
3. Contract (physicians and support staff) Legal $3.4M (16 physicians and 26 support staff)
4. Commence practices (somewhat standardized; includes IT, revenue cycle, training and education, process and procedures, among other elements)
Aaron Williams
5. Marketing Marketing $100k
6. Planning for space allocation Construction
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 31
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Dr. Feld, Dr. Granado)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Common Diseases)
Goal (Peter Heckathorn, Paul Westhoff)
Gastroenterology COE CONSIDER REGIONAL EXPANSION BY ACQUISITIONS and RECRUITMENTS; ALIGNMENT WITH BOCA, BROWARD AND PALM BEACH PEDS GIs AND LINK TO ASCs IN THE AREAS
2016 Measurable Outcome $1,478 CM per case * 80 cases/doc/year =$118K contribution/year
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in Capital Budget
(Y/N)
Operating Expense(s)
Principal Supporting
1. Finalize sub-market areas to target Peter Heckathorn
2. Contract broker to identify and lease space Nichole L Construction
3. Recruit and hire (physicians and support staff TME $180K (1 totalphysician FTE
and 1 total support FTE)
4. Commence practices (somewhat standardized; includes IT, revenue cycle, training and education, process and procedures, among other elements)
Aaron Williams
5. Marketing Marketing $100K
6. Planning for on-campus exam rooms, staff offices, conference room, etc(unique IBD COE element)
Construction Osnyl Cruz
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 32
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Dr. Granado, Tim Birkenstock, Jackie Gonzalez, Nancy Humbert)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Common Diseases)
Goal (Dr. Granado)
Chronic Care Protoype
2016 Measurable Outcome Achieve horizontal organization of services for medically fragile patients
Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Implementation Milestones Timeline Principal Supporting
1. Build comprehensive program roadmap for completely integrated care system for the management of medically fragile (chronic patients)
Q1 Dr. Rosa Olivares
Jamie Wiggins, Dr. Biehler, Michael Durr, Evelyn Terrell, Susan Churchill, Ivette Roldan, Dr. Reyes, Janet Bell-Taylor, Jamie Tarshis
2. Operationalize preventative maintenance component – organization of medical home Q2-Q4 Dr. Rosa Olivares
3. Operationalize IP component – interdisciplinary coordination of care and patient navigation through discharge
Q2-Q4Philicity
Tinnie-Wilson
4. Operationalize outpatient component – specialty clinics and prescribed pediatric extended care (PPEC), home health, school support and rehab, post acute care partners
Q2-Q4Janet Bell
Taylor
5. Standardize inpatient care of medically fragile patientsQ2-Q4
Dr. Biehler
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 33
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Dr. Feld, Dr. Granado)
Develop Centers of Excellence around Key Service Lines for Common, and Rare and Complex Diseases (Rare and Complex Diseases)
Goal (Dr. Granado, Peter Heckathorn, Paul Westhoff)
Plastics / Beckwith Wiedemann / Peripheral Nerve COE COUPLE WITH OTHER SURGICAL (ENT)
2016 Measurable Outcome $146K contribution margin (12maxillofacial cases in 2016); + $263 CM per hand surgery case
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in Capital Budget
(Y/N)
Operating Expense(s)
Principal Supporting
1. Finalize sub-market areas to target ?? Peter Heckathorn
2. Contract broker to identify and lease space Nichole L Construction
3. Recruit and hire (physicians and support staff) TME $450K (1 physician and
support)
4. Commence practices (somewhat standardized; includes IT, revenue cycle, training and education, process and procedures, among other elements)
Aaron Williams
5. Marketing Marketing $100k
6. Find space for, acquire, and train appropriate people on a hand scanner and additional 3D printer (unique Plastics COE element)
Jeff Friedman Nestor Ventura
$450K C-Arm + $71K 3D printer
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 34
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Jose Perdomo)
Increase focus on research and develop outreach/education programs
Goal (Dr. McCafferty, Dr. Gereige)
Explore academic and research affiliations to complement or enhance research capabilities/services, provide support/internships to a breadth of services
2016 Measurable Outcome Execute one new research or academic affiliation
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Work with medical education and research stakeholders to identify opportunities for new affiliations
Q1-Q4 Dr. Gereige Dr. McCafferty, GME Committee & Scientific Advisory Committee
2. Identify partner/thought leader at new affiliate organization
Q2 Dr. Gereige Dr. McCafferty, GME Committee & Scientific Advisory Committee
$5,000 travel expenses
3. Develop and execute an agreement with one new affiliate organization
Q4 Dr. Gereige Dr. McCafferty, GME Committee & Scientific Advisory Committee
TBD [Ex. $50,000 (basedon 5 trainees completing 2 semesters of graduate work at FIU @ $10,000 each) 2017 earliest
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 35
Improve Quality
Outcomes
Enhance Breadth and
Depth of Care
= Capital project= Operational Goal= Strategic Goal
Organizational PrioritiesImprove Quality Outcomes
Enhance Breadth and Depth of Care
Organizational Imperative (Jose Perdomo)
Increase focus on research and develop outreach/education programs
Goal (Dr. McCafferty)
Build a research infrastructure to support research in personalized medicine and health outcomes by recruiting experts in genomics and population health
2016 Measurable OutcomeOnboard experts in epidemiology, biostatistics, and research data management to provide research support services for the Patient Centered Outcomes Research Institute (PCORI) Clinical Data Network and facilitate the personalized medicine projects, including CYP2D6.
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in Capital
Budget (Y/N)
Operating Expense(s)
Principal Supporting
1. Complete onboarding for epidemiologist, biostatistician and data manager
Q1 Dr. McCafferty New hires approved in FY2015
2. Implement infrastructure to support PCORI reporting Q1 Dr. McCafferty TBD Epidemiologist, TBD Data Manager, TBD DataCoordinator
$1M personalizedmedicine IT
$56,000 for data coordinator (25%comp from grant); 75% dedicated to registry growth per US News methodology
3. Get CYP2D6 protocol open for enrollment Q3 Dr. McCafferty Study team $225,000 (total costs of executing the protocol )
4. Complete PCORI reporting Q2-Q4 TBD Data Manager TBD Data Coordinator
5. Facilitate ID next areas of opportunity for outcomes research, including expertise and staffing
Q2-Q4 Dr. McCafferty TBD Epidemiologist, TBD internal subject matter experts, Dr. Granado
$25 ,000 consulting
6. Include outcomes with actionable genetic results in patient medical record (operationalize outcomes in system)
Q4 Dr. Orces Dr. McCafferty, Pharmacy IT build might be required - TBD
7. ID next areas of need and opportunity for personalized medicine including expertise and infrastructure for biobanking
Q2 Dr. McCafferty Pharmacy, Lab, PSA
8. Develop project plan around next opportunity for personalized medicine including staffing and expertise requirements
Q4 Dr. McCafferty TBD PM Med Dir, SME for next opportunity, Pharmacy, Lab, Dr. Orces, Strategy
$25,000 consulting
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 36= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Excel in customer service and experience by delivering compassionate care, affordability and access
Organizational Imperative (Nancy Humbert)
Enhance Ambulatory Services
Goal (Evelyn Terrell)
Expand telehealth capabilities within ambulatory network & among JMC affiliation
2016 Measurable Outcome
(1) 2 international contracts signed and operationalized (2) 4 School Health deployments operationalized (3) 1 Home Health program operationalized (4) 1 Telehealth mobile unit (5) Telehealth Service Line international consult volume growth by 5% over PY (6) Telehealth Service Line domestic pediatric consult volume growth by 5% over PY(7) Telehealth Service Line affiliation Jupiter Medical Center encounter/ consult volume by 50% PY
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
International: 1. 2 international contracts signed 2. Project/program planning, activation, and deployment
Q1, Q2Q3, Q4
Evelyn TerrellLucienne Wallner, Dr. Maggioni, Anita Wilson, Edwit Tironi, William Manzie
Domestic- School Health1. 1 School Board contract signed 2. Project/program planning, activation, and 4 deployments (locations)
Q1, Q2Q3, Q4
Evelyn TerrellCindy Harrah, Susan Churchill, Jill Tahmooressi, Anita Wilson, Edwit Tironi, William Manzie. Others TBD
Domestic- Home Health1. 1 Home Health contract signed 2. Project/program planning, activation, and deployment
Q1, Q2Q3, Q4
Evelyn TerrellMark Llorente, Jamie Wiggins, Anita Wilson, Edwit Tironi, William Manzie. Others TBD
Domestic- Telehealth Mobile Unit 1. Project/program planning, activation, and deployment
Q1, Q2Q3, Q4 Evelyn Terrell
Dr. Roldan, Anita Wilson, Edwit Tironi, William Manzie, Others TBD
Tele-Intervention ExpansionSustain and grow tele-intervention services in Monroe County. Expand tele-intervention services to Miami-Dade County by end of Q2 2016, gaining Early Steps State Office approval and contracting with three (3) new community partners.
Q2 Marc Welsh Keylsa Lee
Telehealth Expansion Among Affiliations – Jupiter Medical Center Evelyn Terrell Carla Salvatore-Bimmler, Jill Tahmooressi, Karen Sinclair, Linda Foley, Genevieve Sierra
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 37= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Excel in customer service and experience by delivering compassionate care, affordability and access
Organizational Imperative (Nancy Humbert, Armando Llechu)
Enhance Ambulatory Services
Goal (Marlenne Burt)
Target high concentration population areas to expand the organizational footprint through the delivery of OP services and programs in alignment with physician distribution
2016 Measurable OutcomeOperationalize Pinecrest UCC, Pinecrest Sports Destination Center, UCC Main Campus, requires Capital Budget approval: Expand Dental Services in Doral, Telehealth Dental Mobile Service, Orthopedic Services in Broward at the Miramar OC Planning process for Aventura UCC;
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in Capital Budget
(Y/N)
Operating Expense(s)
Principal Supporting
Pinecrest UCC 1. Project planning 2. Project activation3. Project Implementation” 4. Project “go-live”
Q1, Q2Q3, Q4
Josie Diaz & Marlenne Burt
Entire activation team: Construction, Marketing, Lourdes Nieves, Monica Ruiz-Valls
$5,053,256 (combined UCC/Sports)
Sports Destination Center1. Project planning 2. Project activation3. Project Implementation” 4. Project “go-live”
Q1, Q2Q3, Q4
Josie Diaz & Marlenne Burt
Entire activation team: Construction, Nursing Manager and Director, marketing, Operations and clinical leaders
See above
Planning for the Aventura UCC, Homestead, Southern Broward (Coral Springs – within 35 mile radius from MC)1. Identify location 2. Project planning3. Project activation and implementation
Q1, Q2Q3, Q4
Josie Diaz & Marlenne Burt (Untilnew Regional Dir on board)
Ambulatory network leadership TBD
Ortho Services in Broward – Miramar Shell Space Expansion (CapitalRequest)1. Project planning 2. Project activation3. Project Implementation” 4. Project “go-live”
Q1, Q2Q3, Q4
Janel Grover Marlenne Burt (or may be Regional Director TBD) (other team members TBD)
Proforma in progress –approx. $527,000 – build out costs ONLY
Dental Telehealth Mobile Unit Services Commencement 1. Project planning 2. Project activation3. Project Implementation” 4. Project “go-live”
Q1, Q2Q3, Q4
Dr. Rosie Roldan Evelyn Terrell Grant – Proforma
available from Merry Pargas
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 38= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Excel in customer service and experience by delivering compassionate care, affordability and access
Organizational Imperative (Nancy Humbert, Dr. Granado, Michael Durr)
Exponentially grow and develop global health to drive tertiary and quaternary volumes
Goal (Lucienne Wallner)
Secure additional international Global Health affiliations
2016 Measurable Outcome Achieve 10 additional Global Health affiliations by year end
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline
Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Identify target countries to establish affiliations
Q1 LucienneWallner
Dr. Maggioni
2. Contact identified countries to deploy medical/business team
Q1 LucienneWallner
Dr. Maggioni
3. Assess needs in targeted country to customize affiliation program
Q1 LucienneWallner
Dr. Maggioni
4. Develop competitive material/prices for targeted affiliation programs
Q2 Lucienne Wallner,
Rebecca France, Carolina Cervera, Georgette Alfau
5. Develop international templates and legal documentation necessary for agreements
Q2 Legal Dr. Maggioni, Lucienne Wallner, Michael Sisti
6. Market GH services to targeted audience Q3 Marketing Lucienne Wallner, Teresita Lopez, Dr. Maggioni
7. Execute affiliation agreements with targeted countries
Q3 LucienneWallner
Dr. Maggioni
8. Assess outcome by monitoring increase in patient volume growth referred by affiliation agreements
Q4 LucienneWallner
Dr. Maggioni, Teresita Lopez
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 39= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Excel in customer service and experience by delivering compassionate care, affordability and access
Organizational Imperative (Nancy Humbert, Dr. Granado, Tim Birkenstock, Ed Martinez, Michael Durr)
Exponentially grow and develop global health to drive tertiary and quaternary volumes
Goal (Lucienne Wallner, Teresita Lopez)
Increase total number of international patient admissions
2016 Measurable Outcome Achieve 5%+ annual growth in international patient admissions
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in Capital
Budget (Y/N)
Operating Expense(s)
Principal Supporting
1. Establish Automated Daily Admissions Monitoring Report:• Use BI Reports as source for daily admissions• Perform audits of reports to ensure that 100% of global patients are being captured
Q1 Teresita Lopez
Maylee Sanchez, Juan Lopez
2. Establish Global Health Registration Process:• Hire and train new registrar designated for GH Patients in order to more accurately register
patients and capture 100% of global admissions with corresponding international addresses and international referring physician information
• Improve access and turn-around-time for patients at admission
Q1 Teresita Lopez
Julia Rodriguez, Lourdes Castro
3. Intake:• Create automated process for registering new GH patient requests received via the Nicklaus
Children's Global Health website link in order to reduce TAT and the potential for the patient/admission to a competing hospital
Q1 Teresita Lopez
Georgette Alfau
4. Access:• Meet with individual sub-specialty practices in order establish turn-around times for appts. & POC
for possible admissions. • Provide 2 educational lunch and learns to physician practices and GH Stakeholders in order to
emphasize "same day" culture for global patients
Q1-Q2 Lucienne Wallner
Teresita Lopez, GH Practice Lead
$250K
5. Finance:• Establish competitive pricing for targeted diagnosis based on demand established from previous
admissions volumes
Q3 Michael Sisti Lucienne Wallner
6. Admissions resulting from signed Affiliation Agreements• Work closely with GH affiliations goal team to secure additional admissions from newly signed
affiliation agreements
Q4 Lucienne Wallner
Dr. Maggioni, Teresita Lopez
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 40= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Excel in customer service and experience by delivering compassionate care, affordability and access
Organizational Imperative (Michael Kushner, Ed Martinez)
Focused marketing around outreach, education and communication internally (staff and physicians) and externally (patients) to improve delivery of patient care and patient engagement
Goal (Marcia Diaz de Villegas, Melissa Moreira, Maylee Sanchez, Janet Bell, Ana Rodriguez, Loubna Noureddin, David Bratt)
Develop data-driven, user-friendly, consumer-centric tools (such as customer relationship management) and information to facilitate and streamline access, engagement, education, communication and experience
2016 Measurable Outcome 15% yoy growth in new patient volume
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Hire a marketing data analyst (to be shared with the Strategy team) to provide insight and reporting across all digital marketing initiatives
Q1 Marcia Diaz De Villegas
RecruitmentRobert Prieto
1 FTE ($80K)
2. Launch MCHS way, Customer Service, and New Values integration training into one and deploy campaign Q1 Loubna Noureddin
Ana RodriguezJanet B.T.,Oscar Mesa, Scott Gallimore,Suly Prieto
3. Consolidate all Community Education resources and initiatives under Learning & Development Services Q1 Loubna Noureddin
Wendy Johnson
4. Retain content specialist to develop branded content, including web content update, and patient education and engagement content. Physician enterprise marketing position and freelance writer will support this.
Q1 Rachel Perry Carmen Pages 1 FTE ($80K)
5. Support increased signage production Q1 Juan Rabionette
Supplies ($75K)
6. Create new way finding support system (using medical maps). Q2 Patricia Kane Marcia Diaz de Villegas, Ana Rodriguez, Juan Rabionet
7. Establish/pilot a family faculty initiative Q3 Ana Rodriguez Janet Bell-Taylor
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 41= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Excel in customer service and experience by delivering compassionate care, affordability and access
Organizational Imperative (Michael Kushner, Ed Martinez)
Focused marketing around outreach, education and communication internally (staff and physicians) and externally (patients) to improve delivery of patient care and patient engagement
Goal (Marcia Diaz de Villegas, Melissa Moreira, Maylee Sanchez, Janet Bell, Ana Rodriguez, Loubna Noureddin, David Bratt)
Develop data-driven, user-friendly, consumer-centric tools (such as customer relationship management) and information to facilitate and streamline access, engagement, education, communication and experience
2016 Measurable Outcome 15% yoy growth in new patient volume
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
8. Establish a consolidated call center operation for all front end patient activities (Phase I physician referral, scheduling, pre-registration, operator) (Phase II PFS)
Q1 Ana Rodriguez Marcia Diaz de Villegas, Melissa Moreira
$200K Y
9. Lead the operational move and collaborate with IT to ensure system functionality (if approved) Q1- Q2 Angel Sepulveda
IT, plant ops, Construction
10. Develop book of knowledge and scripts for the call center Q1 – Q2 Rachel Perry
11. Complete implementation of CRM (Customer Relationship Management) system across Marketing, Patient Access, Customer Services, TM&E, Finance, Research Institute, Physician Outreach and MCHF
Q2 Marcia Diaz De Villegas
Robert Prieto,David BrattAna Rodriguez, Maylee Sanchez
$650K IT
12. Lead Customer Service component of the CRM, including process flow and Call tree and solutions Q2 Idolidia Paula PMO. Servicearea leaders and staff
13. Deploy CRM Database to childlife specialist to gather increased analytics on patient preferences. Increasing patie3nt sat, align programming/orders/delivery of services to better meet the individualized needs of the patient
Q1 Q2 Kara Marante Marketing, IT
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 42= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Excel in customer service and experience by delivering compassionate care, affordability and access
Organizational Imperative (Ed Martinez, Dr. Kini, Dr. Granado, Jackie Gonzalez)
Focused marketing around outreach, education and communication internally (staff and physicians) and externally (patients) to improve delivery of patient care and patient engagement
Goal (David Bratt, Anita Wilson, Ed Tironi)
Develop Smart Hospital capabilities (integrated vital sign monitors, infusion pumps, RFID recognition of team members) including alerting clinicians and care teams of changes in patient condition
2016 Measurable Outcome15% yoy growth in new patient volume; Completion of Large pump Integration and Successful deployment of Small Pump Integration
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s)
Implementation Milestones Timeline Principal Supporting
1. Infusion pumps integration by unit. The order of the units to be implemented during 2016 will be determined in January 2016. 100% go live in quarter 4
Q1-Q4 Ed Tironi Anita Wilson, Irvin Alfonso
2. Build RFID infrastructure Q1-Q2 David Bratt Aleida Gavallas $700K IT
3. Define RFID workflow for assets and patients Q3 David Bratt Aleida Gavallas
4. Go live Q4 David Bratt Aleida Gavallas
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 43= Capital project= Operational Goal= Strategic Goal
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Operating Expense(s)
Principal Supporting
1. Case management training through ACMA program, inter rater reliability training for both clinical guidelines (InterQual and MCG) Q1 Philicity Tinnie-Wilson Rebecca France
2. Provide statistics for 3-year historical trending of ALOS to develop baseline Q1 IT
3. Establish target for actual v. expected LOS to expand coverage for case managers to include weekends and holidays Q1 Philicity Tinnie-Wilson Rebecca France,
4. 50% completion of case management dashboard Q1 IT
5. Comparison of medicaid v. commercial payorsto reduce denials for medical necessity Q1 Philicity Tinnie-Wilson Rebecca France
6. 100% admission reviews completed (for all patients) for clinical medical necessity Q1-Q4 Philicity Tinnie-Wilson Rebecca France
7. 100% completion of case management dashboard Q2 IT
8. Rollout case management dashboard and report performance Q2 IT Rebecca France, Philicity Tinnie-Wilson
9. Optimize post discharge call program throughout system to curb readmissions, increase patient satisfaction and control LOS Q2 Philicity Tinnie-Wilson Rebecca France, unit leads
10. Establish case management policies and procedures Q2 Philicity Tinnie-Wilson
11. Optimize preventable readmissions including 30, 60 and 90 days and avoidable days which contribute to discharge delays and higher LOS Q3 Michael Gagnon Philicity Tinnie-Wilson, Josh Sumarll
12. Establish pre admission case management for planned procedures Q3 Philicity Tinnie-Wilson
13. Recruit 1.5 FTE for pre admit case management specific to surgical services Q3 TME Rebecca France, Philicity Tinnie-Wilson, Ana Ruiz
$150K
14. Provision of iPhones for case management team Q3 TME Rebecca France, Philicity Tinnie-Wilson
$2K
15. Identify space for case management team Q3 Construction Rebecca France, Philicity Tinnie-Wilson
16. Include achievement of top box percentile patient satisfaction in annual evaluations Q4 Ana Rodriguez Rebecca France, Philicity Tinnie-Wilson
17. IT integration with Cerner for care management module to fully support case management program Q4 IT
Manage provision of care along care
continuum
Organizational Priorities Manage provision of care along care continuum Organizational Imperative (Tim Birkenstock, Michael Davis, Ed Martinez)
Achieve complete management of patient across care settings via interdisciplinary collaboration
Goal (Philicity Tinnie-Wilson)
Development of case management team to optimize transition of care (pre, concurrent and post discharge) to improve patient satisfaction and outcomes
2016 Measurable Outcome
1-2% / year reduction in ALOS based on evaluating causes for preventable readmissions, ED case management, discharge control, one day stays, extended day admissions and observations stays, hospital acquired conditions and increased focus on pediatric medicine to manage chronic conditions
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 44= Capital project= Operational Goal= Strategic Goal
Implementation Milestones Timeline Responsible Team Member(s) Operating Expense(s)
Principal Supporting
1. Complete transition of care plan across system with case managers and service line care teams (case management to look at scheduled procedures up to one month in advance, complete pre assessment call 2 weeks prior to admission, one week prior to admission follow up call and documentation of assessment, confirm authorizations, confirm patient status [IP, OP]), assignment of responsibility to service line care teams
Q1 PhilicityTinnie-Wilson
Rebecca France and service line leaders, Marlenne Burt
2. Design pre assessment and post discharge follow up tool Q2 IT
3. Recruit 3 service line specific case managers (pre admission, concurrent and post discharge follow up) Q3 TME Philicity Tinnie-Wilson, Rebecca France and service line leaders
$300K
4. Combo case management and service line training for teams Q3 PhilicityTinnie-Wilson
Rebecca France and service line leaders
5. 100% Tracking of readmissions for all service lines Q4 PhilicityTinnie-Wilson
Rebecca France and service line leaders
6. Include achievement of top box percentile score for patient satisfaction in annual evaluation Q4 PhilicityTinnie-Wilson
Rebecca France and service line leaders
Manage provision of care along care
continuum
Organizational Priorities Manage provision of care along care continuum
Organizational Imperative (Tim Birkenstock, Michael Davis, Ed Martinez, Dr. Granado)
Achieve complete management of patient across care settings via interdisciplinary collaboration
Goal (Philicity Tinnie-Wilson)
Dedicated patient care team and support resources for key service lines to include patient care coordinator/nurse navigator, social worker, financial counselor, patient advocate, behavioral and mental health, etc..
2016 Measurable Outcome 1-2% / year reduction in ALOS, top decile score for patient satisfaction
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 45= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Manage provision of care along care continuum
Organizational Imperative (Michael Davis, April Andrews)
Create infrastructure to operationalize and scale CIN
Goal (Michael Sisti)
Integrate community primary care, subspecialty physicians and other health organizations into CIN population health model; develop standard physician rounding and needs based physician distribution
2016 Measurable OutcomeSecure base of aligned PCPs and employed specialists, begin moving them through phases 1 and 2 (of 5 phases) of the practice transformation plan, and begin executing on its contacting strategy that aligns incentives with improved outcomes
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in Capital Budget
(Y/N)
Operating Expense(s)
Principal Supporting
PCP CIN Enrollment1. Enroll 54 CIN Participation Agreements of Existing Aligned PCP's2. Enroll 100% of employed specialists in CIN3. Enroll 25% of Hospital-Based NON-employed specialists in CIN
Q1,Q2,Q3Q1
Q1,Q3
Kara Marante
PSA, Legal
Contracting/Managed Care1. Commence deployment 3 year contracting strategy for CIN (initiate conversations with 5 big insurers and 3 Medicaid plans2. Run analytics on three plans for partnership, decide optimal contract model, negotiate competitive Medicaid PCP capitation
agreement for aligned physicians3. Enter negotiations for 3 plans (2 commercial and one Medicaid)4. Execute 2 contracts, evaluate remaining plans, create reports with results to distribute to CIN members, achieve goal of 50K lives
under management
Q1
Q2
Q3Q4
Michael Sisti
Education1. Hold 1 town halls and 10 lunch & learns at physician practices Q1-Q4
Michael Sisti
Practice Transformation1. 108 PCPs Complete Phase 12. 100% of Employed Specialists Complete Phase 1; 50% of NON-Employed Specialists Complete Phase 13. 162 PCPs Complete Practice Transformation Phases (Phase 1: 54; Phase 2: 108) 4. 100% of Employed Specialists Complete Phase 2; 25% of NON-Employed Specialists Complete Phase 1; 25% of NON-Employed
Specialists Complete Phase 2
Q2Q2Q4Q4
PSA
Kara Marante, Physician Liaisons, Dr. Rosa Olivares, Carlos Allyon
Manage provision of care along care
continuum
Miami Children’s Health System | 45
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 46= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Manage provision of care along care continuum
Organizational Imperative (Dr. Granado, Michael Davis)
Create infrastructure to operationalize and scale CIN
Goal (Dr. Biehler, Quality Administrator Dr. Orces)
Establish the use of evidence-based IP/OP best practices in collaboration with community physicians
2016 Measurable OutcomeAll employed/aligned physicians trained on best practices, achieving the following:• 45% of practices reporting results•45% adherence to best practice thresholds
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Finalize best practices, based on the following criteria:• High cost, high frequency• High cost, low frequency• Low cost, high frequency• Low cost, low frequency
Q1 Dr. Biehler Quality Administrator, Dr. Granado
2. Develop best practices checklist to enable office adherence Q1 Dr. Biehler Quality Administrator, Dr. Granado, Michael Gagnon, Dr. Orces
3. Establish and capture baseline measures for participating practices Q2 Quality Administrator
Physician Liaison Team
4. Train participating CIN practices on best practice adherence and reporting (phase 1 of practice transformation)
Q2 Dr. Biehler Dr. Granado, Physician Liaison Team
5. Deploy via Cerner and health fusion EMRs and/or Cerner HealthE Registries platform. Develop manual entry report for non EMR practices and non Health Fusion or Cerner EMR users
Q3 Dr. Orces Dr. Granado, Ed Martinez
6. All employed/aligned physicians trained on best practices, achieving the following: • 50% of practices reporting results• 60% adherence to best practice thresholds
Q4 Dr. Biehler Dr. Granado, Quality Administrator, Dr. Orces, Adam Stoller, EdMartinez
Manage provision of care along care
continuum
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 47= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Manage provision of care along care continuum
Organizational Imperative (Ed Martinez)
Create infrastructure to operationalize and scale CIN
Goal (Anita Wilson)
ESTABLISH data and technology infrastructure to equip physicians to provide continuous care - ensure access to patient info and transferability across care settings
2016 Measurable Outcome Complete clinically integrated decision model to examine practices as a whole
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Establish bi directional flow of data to patient
Maylee Sanchez $1M IT
2. Establish bi directional flow of data to physician
Maylee Sanchez
3. Develop data repository Maylee Sanchez
Manage provision of care along care
continuum
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 48
= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Advance the engagement and empowerment of our people
Organizational Imperative (Michael Kushner)
Develop culture of empowerment and engagement to achieve strong recruits, employee retention and high performing leaders
Goal (Magaly Barroso)
Improve staff development and groom appointed successors by increasing their authority, responsibilities and mentorship
2016 Measurable Outcome Reduce leader transition to 15% for those that undergo the cross functional process
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in Capital Budget
(Y/N)
Operating Expense(s)
Principal Supporting
1a. Create a 6 months onboarding program for new leaders (hired and promoted). 1b. Ensure that prior to recruiting that there is agreement on competencies and skills that are required1c. Agree on compensation range/arrangements for critical positions before recruitment process begins
Q1-Q4 Margaret Gibson, IT.Janet Lara Vital, MagalyBarrosoand Karla Alvarado
Increased supplies $25K)
2. Target areas to create a ladder approach and develop depth of succession within areas of critical talent needs and hard to find talent. Create layers for areas that currently do not have.
Q1-Q4 Magy Barroso
3. Create a targeted program for performance to sit in on QPCs, annual appraisals and crucial conversations for identified leaders that need assistance with providing feedback and improving employee relations
Q1-Q4 Ilene Fedyniack IT 1 FTE (additional TM) $90K
4. Create fellowship style programs for some of the key hard to fill identified leader roles
Q3-Q4 Magy Barroso $75k
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Miami Children’s Health System | 48
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 49
Organizational Priorities Advance the engagement and empowerment of our people
Organizational Imperative (Michael Kushner, Dr. Feld, Dr. Granado)
Develop culture of empowerment and engagement to achieve strong recruits, employee retention and high performing leaders
Goal (Magaly Barroso)
Emphasize active recruiting and determine best fit defined for each position; enhance on boarding.
2016 Measurable Outcome Fill high level key strategic positions within labor market time or less.
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s
Principal Supporting
1. Support PSA: Realign JB to solely Physician. Shepard candidates thru PSA recruitment process. 2016 hiring 58 docs and 20 extenders. Meeting monthly with Dr. Feld ensuring quality and timely execution. Lead process improvement initiatives.
Q1 LonayBostic
Magy & PSA leadership
2 FTE (Recruitment coordinator $50K and sourcer $70K)
2. Support hiring Expansion: Support effective quality hire thru launching a mystery shopper type programs where a 3rd party will interview potential hires and new hires on their applicant experience.
Q1 CarlaBiltres
Margaret, Magy, UCC leaders
4 FTE (1 Recruiter $75K, 2 Sourcer $120K and 2 support $90K)
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 50
Organizational Priorities Advance the engagement and empowerment of our people
Organizational Imperative (Michael Kushner, Dr. Feld, Dr. Granado)
Develop culture of empowerment and engagement to achieve strong recruits, employee retention and high performing leaders
Goal (Magaly Barroso)
Emphasize active recruiting and determine best fit defined for each position; enhance on boarding.
2016 Measurable Outcome Fill high level key strategic positions within labor market time or less.
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s
Principal Supporting
3. Pilot video recorded interviewing to share recorded initial interviews with leader prior to initial interviews and pilot texting component for positions for applicants. And realign Taleo applicants with different applications in different categories. Further enhance true panel interview format.
Q2 Magy It, Francis $45K Y
4. Develop and deploy mobile versions of recognition apps to be used by families, staff and leaders thru nominations and tokens, create more visible venues
Q2 Magy IT Francis
5. Look for and implement Taleo overlay with scheduling capabilities to automate for more efficient process the interview scheduling process and realign the scheduling process using VP admin to schedule vp/Docs interviews (TM&E does not have access to calendars process takes 2 – 3 days finding availabilities
Q2 Magy IT, Marcia (call center), Janet (HRIS)
$35K y
6. Development of strategy of affiliation for enhancing the academic programing of the Nicklaus child life team creating a internship program for best recruit of hard to find specialist.
Q1 Kara Marante
Volunteer Services
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 51= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Advance the engagement and empowerment of our people
Organizational Imperative (Michael Kushner)
Develop culture of empowerment and engagement to achieve strong recruits, employee retention and high performing leaders
Goal (Loubna Noureddin)
Drive empowerment among staff increasing service levels.
2016 Measurable Outcome 80% of departments using the program effectively. 3% HCAP-specific Qs rating improvement overall.
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in Capital Budget
(Y/N)
Operating Expense(s)
Principal Supporting
1. To support employee empowerment, work with task force, leaders and champions to develop and implement a service recovery program.
Q1 LoubnaNoureddin
Suly Prieto, Michael Gagnon, Ming Far, Jamie Wiggins, Elena Ortega, Hortensia Cesar, Janet B., Taylor, Christine Serrano
$50,000
2. Pilot program in 3 areas – Radiology, ED, OR Q2 LoubnaNoureddin
Jamie Wiggins, Scott Gallimore, Elena Ortega, Janet Bell Taylor, Christine Serano
$10,000
3. Increase effectiveness of staff onboarding process by including a buddy for 100% of employees. Revisit program elements to simplify bonus review process and improve overall assessment review process.
Q2 LoubnaNoureddin
Scott Gallimore $27,000
4. Integrate Service recovery program into all patient-related departments Q3 Loubna Noureddin
Same as item 1
5. Evaluate program and monitor progress. Identify effectiveness measures and monitor employee feedback regarding recurring issues.
Q4 LoubnaNoureddin
Same as item 2
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 52
Organizational Priorities Advance the engagement and empowerment of our people
Organizational Imperative (Michael Kushner)
Develop culture of empowerment and engagement to achieve strong recruits, employee retention and high performing leaders
Goal (Janet Bell Taylor)
Engage employees by incentivizing quality ideas, expanding benefits and appreciation initiatives and increasing focus on employee wellness
2016 Measurable Outcome Reduce number of unfavorable responses regarding compensation in employee engagement survey
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Establish a pool of salary dollars for recruitment & retention of key employees and leaders
Q1 Janet Lara Vital
TM’s, IT support, Legal
2. Review organization bonus structure and Leader hierarchy and recommend changes based on market demands and growth of the organization.
Q2 Michael Kushner
Janet Lara Vital, legal, IT
3. Create a performance management structure for all employed physicians Q2-3 Lonay Bostic IT, Dr. Feld & PSA leadership team
4. Complete comprehensive benefit study to comply with Affordable Care Act reform and implement recommendations
Q2 - 3 Jacqueline Vacquer
Legal, IT
5. Execute on the new Employee Wellness Pilot to include the TOP test and employees’ children. Prepare for commercialization phase of TOP.
Q2 - 4 Janet Lara Vital
Michael Davis, Michael Kushner, Emp communications,
6. Expand convenient care clinic to corporate office building (including tenants). Use telehealth to expand employee health services to ambulatory sites.
Q4 Lucy Castellanos
Janet, IT, Evelyn for Telemedicine, Construction, Marketing, Legal
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 53= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Develop appropriate payor models and alternative revenue streams to manage risk and optimize margin
Organizational Imperative (Lucy Morillo)
Adopt vision driven philanthropy
Goal (Meschelle Huether, Nancy Castleman-Dion, Flavia Llizo)
Promote growth and development of internal fundraising infrastructure (development officers, physician leaders, volunteers and senior leaders)
2016 Measurable Outcome Increase annual targets to an average of $1.15M for Directors of Major Gifts
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Develop appropriate payor models and
alternative revenue streams to manage risk and optimize
margin
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Increase access to technology (i.e. iPads) Q1 Richard Perez IT Department $15,000
2. Increase Foundation involvement with affinity membership organizations (i.e. ballet, opera, yacht clubs etc.)
Q1-Q2 Lucy Morillo Flavia Llizo, Rebecca Interian $15,000
3. Targeted, industry-specific development training Q1-Q4 Flavia Llizo Education and Development $56,000
4. High level prospect management efforts focused on leadership gifts
Q1-Q4 Meschelle Huether Nancy Castleman-Dion, Michael Mowatt, Joe Deary, Pietro Bonacossa, Jacky Donate, Betty Galan, Kate Meenan, Harold Robaina, Alex Salcedo, Melissa Wetzel, Patricia Alonso, Sofia Durkee
n/a
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 54= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Develop appropriate payor models and alternative revenue streams to manage risk and optimize margin
Organizational Imperative (Lucy Morillo)
Adopt vision driven philanthropy
Goal (Meschelle Huether, Nancy Castleman-Dion, Flavia Llizo)
Align donor campaigns to foster clinical, research and education enhancements around centers of excellence and special projects to achieve tiered growth in annual campaign targets over time
2016 Measurable Outcome Raise a minimum of $25M
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Develop appropriate payor models and
alternative revenue streams to manage risk and optimize
margin
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Finalize components of campaign priorities (i.e. final naming & programmatic opportunities, bricks & mortar, etc.)
Q1 Hospital SLT & OLT Nancy Castleman-Dion n/a
2. Hire new planned giving coordinator Q1 TM&E Richard Perez, Joe Deary $64,000
3. Hire 5 senior development officers (local and regional) and appropriate support staff
Q3 TM&E Richard Perez, Flavia Llizo $400,000
4. Expand fundraising efforts. to outside markets (i.e. Northeast, Collier , Palm Beach etc.)
Q4 Flavia Llizo, Meschelle Huether
Morgana Nieves, Lisbet Fernandez-Vina, Maria Moldes, Julie Katz, Adolfo Lopez, Cristina Guerrero, Monica Diaz , Yesenia Rodriguez
$150,000
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 55= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Develop appropriate payor models and alternative revenue streams to manage risk and optimize margin
Organizational Imperative (Lucy Morillo)
Adopt vision driven philanthropy
Goal (Dr. Narendra Kini, Lucy Morillo)
Elevate level of engagement of all board members: foundation, hospital and system to actively support the philanthropic initiatives
2016 Measurable Outcome All system-wide boards to meet philanthropic support minimums for membership
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Develop appropriate payor models and
alternative revenue streams to manage risk and optimize
margin
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s
Principal Supporting
1. Standardize philanthropic support for individual board members of System entities at minimum of $50k annually
Q1 Dr. Narendra Kini, Lucy Morillo
Legal Department n/a
2. Ensure System board individual philanthropic support exceeds 7-figures
Q1 Dr. Narendra Kini, Lucy Morillo
Legal Department n/a
3. Increase volunteer leadership with addition of five new volunteer leaders that have the capacity to make 7-figure gifts
Q1-Q4 Lucy Morillo Dr. Narendra Kini n/a
4. Develop tiered approach for board membership from Foundation to Hospital; Hospital to System based on philanthropic support (modeled after top leading hospital systems)
Q2-Q3 Dr. Narendra Kini Lucy Morillo, Tim Birkenstock and Legal Department
n/a
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 56= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Develop appropriate payor models and alternative revenue streams to manage risk and optimize margin
Organizational Imperative (Tim Birkenstock, Michael Davis, Michael Durr, April Andrews)
Develop value based payor models and identify, quantify and budget alternative revenue streams
Goal (Michael Sisti)
Achieve revenue neutral transition to MSDRG
2016 Measurable OutcomeConversion of 3 additional major commercial payors to MSDRG (following 2 in 2015) with opportunity for additional margin through incentivized case management for NCH's total book of business
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs Included in CapitalBudget (Y/N)
Operating Expense(s
Principal Supporting
1. Analyze financial impact of proposals, and develop counter proposals to optimize margin
Q1-Q4 Carolina Cervera Michael Sisti
2. Develop amendment language Q1-Q4 Andre Susla Michael Sisti
3. Monitor actual collected to expected (through the revenue realization report - MedAssests)
Q1-Q4 Carolina Cervera Michael Sisti
4. Ensure contractual flexibility to allow for new value-based provisions where applicable
Q1-Q4 Michael Sisti Andre Susla
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Develop appropriate payor models and
alternative revenue streams to manage risk and optimize
margin
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 57= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Develop appropriate payor models and alternative revenue streams to manage risk and optimize margin
Organizational Imperative (Jose Perdomo)
Develop value based payor models and identify, quantify and budget alternative revenue streams
Goal (Dr. McCafferty)
Develop office of sponsored programs to increase revenue from external sources, including grants and awards
2016 Measurable OutcomeEstablish Office of Sponsored Programs with an initial focus on developing processes and policies, tracking existing sponsored activities, and supporting proposal development and submission from central office.
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in CapitalBudget (Y/N)
Operating Expense(s)
Principal Supporting
1. Review sponsored programs policies and processes and identify gaps, including current sponsored activities and proposal development and submission
Q1 Dr. McCafferty Dr. McCafferty, Post Award, Finance, Foundation
$45,000 ops (contract grant writer ,supplies, educationand certifications
2. Revise or develop policies and process per the gap analyses Q1 TBD Manager Dr. McCafferty, Post Award, Finance, Foundation
$10,000 consulting fees
3. Engage external experts and internal stakeholders in review of gap analyses to determine information infrastructure (supporting platform) to create central repository
Q2 Dr. McCafferty TBD Manager, Post Award, IT, Cindy Harrah, Evelyn Terrell, Marc Welsh, Dr. Gereige
$25,000 consulting fees
4. Develop education and communication plans for new policies and processes, including current award management and proposal development and submission
Q2 TBD Manager Dr. McCafferty, Post Award
5. Execute education and communication plans, including current awardmanagement and proposal development and submission
Q3 TBD Manager Dr. McCafferty, Post Award
6. Design processes for proposal tracking and submission and identify IT solutions for 2017 implementation
Q4 TBD Manager Dr. McCafferty, TBD Pre-award, IT FTE (FY2016 $30,374 + CFB) Grant Coordinator 6/1 hire)
7. Work with units which are managing sponsored programs to determine pain points
Q4 TBD Manager Dr. McCafferty, Post award, TBD Pre Award
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Develop appropriate payor models and
alternative revenue streams to manage risk and optimize
margin
Proprietary and Confidential
2016 Goal SettingCascade goal setting with leadership responsibilities
Miami Children’s Health System | 58= Capital project= Operational Goal= Strategic Goal
Organizational Priorities Develop appropriate payor models and alternative revenue streams to manage risk and optimize margin
Organizational Imperative (Michael Davis, April Andrews, Jose Perdomo, Tim Birkenstock, Ed Martinez)
Develop value based payor models and identify, quantify and budget alternative revenue streams
Goal (Michael Davis)
Identify and systematically plan for investments in projects that will yield alternative sources of revenue
2016 Measurable Outcome Develop MCHS's venture portfolio to have a strong positive outlook and healthy distribution of conservative to risky investments, spanning straightforward healthcare, products, pharmaceuticals, biomed, and services industries.
Excel in customer service and experience
by delivering compassionate care,
affordability and access
Implementation Milestones Timeline Responsible Team Member(s) Capital Costs
Included in Capital
Budget (Y/N)
Operating Expense(s
Principal Supporting
1. Create a prospectus of existing investments, and metrics for success on future investments (risk, % likelihood of ROI, etc.)
Q1 Liam Kelly
2. Establish governing processes, due diligence, and standard contracting terms Q1-Q2 Elizabeth Lopez Legal
3. Set direction for investments (% reinvestment & % return to the hospital/system) Q2 Michael Davis
4. Invoy: Accounts Management (monitor, maintain and support or exit) - Relationship with Jumpstart- Organizational structure (people and infrastructure)
Q1 Jose Perdomo
5. Emergency Medical Drone Response: Accounts Management (monitor, maintain, support or exit)- Pilot
Q1 Peter Carr
6. Next Galaxy: Accounts Management (monitor, maintain and support or exit)- Technical functionality (set-up) & pilot CPR training
Q1 Peter Carr
7. TMMC: Accounts Management (monitor, maintain and support or exit)- Go-live with new facility (key metric OB unit % referral)- MCHS employed neonatology to support TMMC- Actual to budget (at the level of both the Hospital Board and holding company)- Other Ventures with Nueterra
Q1 Michael Davis
Narendra Kini, Andre Susla, Tim Birkenstock, Ed Martinez
8. Internal Startup Operations: KidzStuff Ongoing Debbie Da Silva
9. Internal Startup Operations: KidzStuff- E2E Project Management
Q1 Debbie Da Silva
10. Internal Startup Operations: App Development to promote patient/family engagement and/or facilitate clinician ease-of-use (Mobile Apps, Discharge Apps, CareNotify, CareNarrative, CareDocuments)
Ongoing Peter Carr
11. Internal Startup Operations: TOPs Program with Interactive Health Ongoing Peter Carr
Manage provision of care along care
continuum
Advance the engagement and empowerment of
our people
Develop appropriate payor models and
alternative revenue streams to manage risk and optimize
margin
Appendix
Miami Children’s Health System | 59
Three Year Goal Plan
Miami Children’s Health System | 60
01 02 03 04 05
Proprietary and Confidential Miami Children’s Health System | 61
Improve quality outcomes; Enhance breadth and depth of careDevelop centers of excellence around key service lines for common, and rare and complex diseases (Brain)
Develop the infrastructure and implement Brain Wellness programs including Rare Chromosomal Clinic, Pediatric Brain Index, Retail Offerings, Cognitive, Motor & Behavioral Medicine Integration for patients and families served by the Brain Institute by 2018.
Neuro Home
Spasticity/movement disorders
Stroke & cerebrovascular
Neuro Oncology
Description of Goal Interdependencies 2016 2017 2018 Costs(exclude FTE salaries)
Business Impact
FTEs
24/7 virtual, at home care, results in less ED visits and admission
Neurophysiology testing, behavioral & cognitive therapies
5.25 FTEsOptimize neuro-development potential during first decade guided by personalized biomarkers
Personalized wellness clinic, diagnostics (MRgFUS, wireless EEG, neuromodulation (TMS)
$1M/year equipment lease
5 FTEs
Develop COE for congenital/vascular malformation, support OR backfill
Construction of angiosuite
205 cases by 2018 with $500K+ incremental operating income
2.3 FTEs
Provision of deep brain stimulation for patient, streamline clinical protocols
Neurology CP volumes to drive surgical cases
Provision of subspecialty services to patients
Collaboration among providers
Gait lab $155K
1-3 incremental cases/yr; 2 cases = $122k in net revenue ($61K net revenue per case)
No additional equipment
Year 1:150 Polysomnograms; 50 EEGs/ERPs; 30 fMRI; 105 neuropsychscreens; 25 TMS tests. 10 n/s cases. ~$856k
$805K total - 2 wireless EEG $50k; $50K in operations for TMS machine lease; $25K for gait lab; FTE salaries;MRgFUS included in ‘15 budget, TMS covered by Foundation funds
$16K contribution margin/case
Notes: Brain Wellness/Neuro: 0.5 social worker, 0.5 child life, 0.5 radiology neuroscientist, 1 neurodiagnostics specialist, 0.25 psychologist, 1 ARNP, 1 Pt. navigator, 0.5 nutritionist;Stroke and cerebrovascular; 5 FTEs by 2018 (1 physicians, 1 PA, 1 ARNP, Secretary and Procedural tech)Neuro Oncology: oncologist with brain tumor focus/neuro oncologist with research interest (hired by NNP so not included here), 0.3 neuropsychologist, 1 clinical research coordinator, 1 dedicated research nurse -study funds available external funds from current methotrexate study to cover part of the research nurse hire
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 62
Improve quality outcomes; Enhance breadth and depth of careDevelop centers of excellence around key service lines for common, and rare and complex diseases (Cardiac)
Description of Goal Interdependencies 2016 2017 2018Business Impact FTEs
The inability to care for heart failure patients limits the scope and perception of the program to the community, the country and the world
Fills up CICU, occupies OR13.5 FTEs*
Provide lifelong continuum of care for complex pediatric patients to maintain within NCH revenue stream which results in significant downstream ancillary services
Strong fetal program as feeder and multidisciplinary complement of cardiac services to manage complex patients with comorbidities
15 FTEs
Fetal program preempts NICU to feed cardiac program
L&D program
Not expanding will result in “closing” the referral base in this market with significant loss of downstream revenue from tertiary care
Expansion into west coast at Golisano, West Palm and Aventura
$250K for EKG equipment and build out at Cleveland Clinic to include echo and office equipment
$360k in equipment (2 echo machines @ $180K each
Revenue loss of ($5M) in 2016, 8 new cases in 2017, annual income of $1.5MM 2017-18 results in net loss of ($2MM) total
$1.1M (year 1; included in kidney/heart transplant program)
6 incremental cases from new physicians = $120K contribution margin in 2016 + (5*$30k additional CM per year)
Kidney and heart failure: 2 transplant coordinators to provide shared coverage, 2 shared admin support, 0.5 genetic counselor, 1 heart surgeon, 1 kidney surgeon, 1 nephrologist, 1 pathologist, 1 immunologist, 1 psychologist, 1 pharmacy, 1 social worker, 1 medical assistant Adult congenital: 0.5 FTE adult congenital physician leader (20% admin); 2 RNs, 1 patient care coordinatorHeart: $1.1MM capital for dedicated heart unit basic remodeling. Equipment; OR slush machine and VAD-2 ($1MM) all in 2016. Year 1 expense is $5.3MM (including $400K transplant surgeon per year), net loss is ($2.5MM) by 2018.Fetal program/OP clinics: 2 FTE ambulatory cardiologists, 2 PAs, 4 sonographers, 2 admin support, 1 nutritionist (for all programs), 2 RNs, 1 practice manager to be shared across other services at West Palm, 1 clinical research coordinator; $30k cm per neonate case after first year for subsequent five years
Adult congenital heart disease (started in 2014)
Heart failure/heart transplant
Fetal program (started in 2014)
Development of outpatient clinics to achieve clinical differentiation in following programs:
neuro cardiac, electrophysiology, adult congenital, single ventricle survivorship,
transition, congenital valve, coronary health
By 2018 - secure 50% of pediatric ACHD cases into adulthood, 50% of our current cases will stay with NCH at an adult for their care
3.5 FTEs
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Costs(exclude FTE salaries)
Proprietary and Confidential Miami Children’s Health System | 63
Improve quality outcomes; Enhance breadth and depth of careDevelop centers of excellence around key service lines for common, and rare and complex diseases (Ortho)
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Expand sports program into Broward
Lease space in conjunction with ASC
Redirect cases to non-operative clinic to relieve pressure from surgeons allowing them to focus on high acuity patients
Hired non-op pediatric ortho specialist
3.5-4 FTEsPerfect fracture care model, expand services within OP centers
Cast techs, or orthotechs, PA, mobile cast carts
Expand spine service in Broward. Low dose radiation x-ray provides competitive advantage as Joe D. doesn’t have this, also increases efficiency faster imaging
Dedicated MRI block time, additional OR block time, EOS technology
No additional equipment
EOS ($775K includes room prep) + $527K shell space build out at Miramar
2,600 new office visits/year in Aventura/Miramar combined
$527K shell space build out at Miramar
TBD
Note: Ortho Hub: 2 licensed trainers, 1 clinical coordinator, 1 cast tech; Fracture care: 2-2.5 cast techs or ortho techs and 1.5 PAs to expand to two locations. Spine market share in Broward was 33% for 2014, target of 50% for 2018; contribution margin per surgical spine case of $76K. Contribution margin of $76k per case for ortho surgical procedures;
Spine Center
Ortho hub in
Broward
Limb lengthening program
Hip program
Non-operative
clinics (back pain, feet,
intoeing and out-toeing)
Expand fracture care services off site
Develop hip preservation program Develop current surgeon
Further expansion of limb lengthening service
Develop current surgeon
No additional equipment
No additional equipment
No additional equipment
Increase surgical spine by 24 cases in Broward by 2018 resulting in total contribution margin of $1.8M
n/a
n/a
n/a
n/a
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
4 FTEs
2016-35 cases =$175K CM
2016-35 cases =$150K
Proprietary and Confidential Miami Children’s Health System | 64
Improve quality outcomes; Enhance breadth and depth of careDevelop centers of excellence around key service lines for common, and rare and complex diseases(Oncology)
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
This is required to compete nationally and will have impact on USNWR rankings;
Potential for increased sponsored activity if we have the phase I capability
5 FTEs
Improved space to enhance patient experience
Roll up IP/OP oncology procedures and downstream ancillaries by tumor site to demonstrate comprehensive service line view
Provision of radiation therapy services to patients
Additional IT infrastructure, hardware/software TBD
No additional equipment
$600K/annual operating budget
Phase I clinical trials: 2 FTEs - research nurse, 1 clinical coordinatorsDefined OP oncology cancer center and program: Associate Medical Director of Clinical Oncology Research in Oncology (60% research/40% clinical, oversees phase I clinical trial program); 1 physician leader palliative care, 2 ARNPs, 2 social worker, 1 certified teacher, 2 RNs; $6.2M in costs = $400/sf * 15,550 sf in KIDZ Medical hallway; Vaccine therapy-research nurse or clinical coordinator
Expanded hours for RNs for OP cancer services
Improve national prestige, impact on USNWR rankings
Partnership collaboration with lab for tissue transfer and vaccine development
$6.2M renovation costs for dedicated cancer center
No additional equipment
No additional equipment
9 FTEs
n/a
n/a
1 FTE
Dedicated OP infusion clinic
Phase I clinical trial program
Achieve CoCaccreditation
with commendation
Defined OP cancer center and clinical program to include
survivorship and late effects clinic
Strategic alignment with rad onc provider/program
Oncology S/L P&L
Vaccine therapy program
Dedicated oncology space with collocated services and multidisciplinary approach to care yields enhanced patient experience
Relocation to cancer center
Improve national prestige, impact on USNWR rankings
No additional equipment
n/a
n/a
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 65
$2,830 CM per case * 60 cases/doc/year = $340K in contribution/year
Improve quality outcomes; Enhance breadth and depth of careDevelop centers of excellence around key service lines for common, and rare and complex diseases (Common Diseases)
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Profitable service which drives its own patients and produces downstream ancillary volumes, is currently at capacity
Diabetes center
Provide care for chronic patients in appropriate community setting to reduce frequent flier ED visits
276 new cases per doc * $360K CM per new doc *4-$1.4M value of new FTEs
2 FTEs + (6 support staff for clinicians)
Gastroenterology COE
Endocrinology-Diabetes COE
Chronic care model
rehab/OT, PPEC and home health
Development of Inflammatory bowel disease program
1 FTEs + 1.5 support staff for clinicians
$520k
$280K
Profitable service which drives its own patients and produces downstream ancillary volumes, is currently at capacity
Note: PSA recruitment plan through 2018. Diabetes Center: Year 1 revenue of $459k, net loss of ($28k); Year 2 revenue of $603k, net income of $107K. Business Impact: CM per case and caseload per doc for all patient type and payor class from Finance based on 2014 service line report. Endocrinology downstream value stream CM per case based on 2013 revenues for hospital encounters=$1,305 CM per encounter, benchmark of 276 new patients per FTE per year = $360K total value a new FTE will bring in terms of downstream ancillaries for new patients
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 66
Improve quality outcomes; Enhance breadth and depth of care Develop centers of excellence around key service lines for common, and rare and complex diseases (Rare and Complex)
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Provide subspecialty services to enhance clinical care capabilities; enhance NCH prestige nationally and internationally
Glassoplasty for treatment of Beckwith Widerman syndrome
$1M total op. margin by 2018 + $146K contribution margin (12maxillofacial cases/year); + $263 CM per hand surgery case
Plastics COE: 1 hand surgeon and 1 FTE maxillofacial surgeon. Business Impact assumes 12 maxillofacial cases/year based on Dr. Perlyn’s 25 cases in 2014 with CM of $12,189 per case.
2 FTEs +(2*1.5 support staff for clinicians)
Plastics COE
$575k (C-Arm, 3D printer and marketing)
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 67
Improve quality outcomes; Enhance breadth and depth of careDevelop foundational services to support hallmark service lines
Description of Goal Interdependencies 2016 2017 2018 Business Impact
FTEs
Provide subspecialty services to enhance national reputation
Development of lab services
Heart: ($2.5M) total net loss by 2018; Kidney: ($1.4M) total net loss by 2018
Kidney and heart: 2 transplant coordinators to provide shared coverage, 2 shared admin support, 0.5 genetic counselor, 1 heart surgeon, 2 kidney surgeons, 1 liver surgeon, 1 nephrologist, 1 pathologist, 1 immunologist, 1 psychologist, 1 pharmacy, 1 social worker, 1 medical assistant; human milk depot: 2 formula techs.Fellowship assumes 2 fellows per year per specialty; professional development and education: $15k annually for monthly speakers for faculty development. Kidney: capital costs: No construction for OR, slush machine ($70K) and kidney unit construction of $30K; operating costs are for transplant surgeon ($225k/per year) and drugs. Net loss is ($1.4M) by 2018. Heart: $1.1MM capital for dedicated heart unit basic remodeling. Equipment; OR slush machine and VAD-2 ($1MM) all in 2016. Year 1 expense is $5.3MM (including $400K transplant surgeon per year), net loss is ($2.5MM) by 2018.Maternal/fetal partnership: $26M contribution margin assumes 30 referral cases for 161 PCPs within MSO and Vital at CM per case of $5,385 (CM per case for existing docs based on data for surgical procedures for IP, OP and observation units). Existing referrals total 4,830, incremental opportunity is 2,756 totaling 4,830 surgical procedure referrals
$100k kidney/$1.1MHeart +$530K for legal and consulting fees for each; $475K for liver
Develop depot for human milk
Identify solid organ transplant opportunities (kidney, heart
and liver)14.5 FTEs
Nutrition services($500K) total net loss
$105K2 FTEs
Expand lactation services
($5M) net loss by 2018
L&D unit: 2016: $1.2MM, 2017: $11M, 2018: 143K
Split admin/clinicalOB/GYN
partner, CIN
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Align with maternal/fetal
physician partners and
develop high risk labor and
delivery unit
Solidify referral volumes from existing physician partners and increase referral volumes from physicians currently referring elsewhere; incremental referrals have halo effect on OP and ED visits; Operationalize adult (OBGYN) services to feed referrals to NCH
Achieve coveted quality
designations/accreditations
n/aOutcomes reporting
National/international prestige
$60-70K annually for site surveys
Proprietary and Confidential Miami Children’s Health System | 68
Manage provision of care along care continuum Achieve complete management of patient across care settings via interdisciplinary collaboration
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Improve readmission rates, decrease length of stay, achieve cost savings, as well as improve patient satisfaction
Development of case management team, LACE and BOOST readmission tools
Case Management Development resources: 1.5 pre admit case managers + 3 service line specific case managers (pre admission, concurrent and post discharge follow up) in 2016, 2 IP case managers in 2017, 2 case managers for pre & post discharge across care continuum by 2017 (1.5 for neuro services, 0.5 for oncology and 1 for ortho)
n/a
Development of case management team to optimize
transition of care (pre, concurrent and post discharge) to improve
patient satisfaction and outcomes
Develop cross continuum care pathways to connect across settings (includes post acute care provider
partnerships)
Dedicated patient care team and support resources for key service
lines to include patient care coordinator/nurse navigator, social worker, financial counselor, patient
advocate, behavioral and mental health, etc..
8.5 FTEsCollaboration with service lines and case management to develop cross functional care teams, ambulatory planning
n/aProvide patient centered care, apply multidisciplinary approach to care
n/a n/a
Implement services across care continuum to maintain patients in house
Provider collaboration, workforce model to address shift from IP to OP
1-2%/year reduction in ALOS
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 69
Manage provision of care along care continuum Create infrastructure to operationalize and scale CIN
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Increase patient lives under management, achieve interdisciplinary approach to patient care, manage patients along care continuum; Acquisition of four geographic practices and one CIN partner; Improve access to care close to home
PCP network, ambulatory strategy
Included in population health IT initiative ($1m/year) +$3.5M for practice acquisition (estimate)
Enhance data and technology to equip physicians to provide continuous care - ensure access to patient info
and transferability across care settings
Integrate community primary care, subspecialty physicians and other health organizations into CIN
population health model through alignment or acquisition of practices; develop standard physician
rounding and needs based physician distribution
16 physicians + 26 supporting FTEs (3 geographic practices)
Collaboration with providers
TBD TBDApply multidisciplinary approach to care and implement best practices to improve quality outcomes and cost reduction
TBDImprove IT infrastructure
TBDEstablish the use
of evidence-based IP/OP best
practices in collaboration
with community physicians
TBD
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 70
No additional equipment
Excel in customer service and experience by delivering compassionate care, affordability and access Enhance ambulatory services
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Target high concentration population areas to a). provide early intervention (prevention and treatment) and b).
capture high acuity inpatient admissions In conjunction with development of OP centers and
physician distribution strategy
Complete planning and feasibility analyses
Apply multidisciplinary, patient centered approach to care
$3M net margin by 2018; $100K net income in 2016, $800k in 2017, $1M in 2018 for ASC)
$21M aggregate by 2018Add $7.7M for ASC in 2017
Achieve formalized approach to development of ambulatory network
Optimize physician distribution, identify strategic partners or develop new facilities: (OP centers, big box, ASCs UCC, specialty practices); physician recruitment plan identified space needs of 90k sf
TBD
Expand telehealth capabilities within ambulatory network
Develop one stop shop center (MOB style facility) to provide holistic, comprehensive service offerings to
achieve enhanced patient experience and economies of scale through aggregated physician practices and
centralized support
Collaboration with providers (JMC), Early steps program in FL. Keys
TBDTBD
TBD5% annual telehealthservice line domestic/international consult volume growth
Improve access to care close to home, grow international and domestic consults
TBD
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Note: pro-formas developed by ambulatory team for OP future projects and includes development of new ED, one ASC in 2017, 4 small boxes and incorporating fracture care at UCCs; Measures of success: $1.4 M net margin by end of 2016 (Pinecrest location – UCC and Sports Destination Center & Aventura location – UCC only) Aventura proforma will need to be refreshed with “actual” location. Proforma utilized previous site being considered
Proprietary and Confidential Miami Children’s Health System | 71
Excel in customer service and experience by delivering compassionate care, affordability and access Exponentially grow and develop global health to drive tertiary and quaternary volumes
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Collaboration with quality, finance, legal
5 FTEs
Develop competitive material/prices for targeted countries to form collaboration, execute affiliation agreements
Achieve 5%+ annual growth in international patient admissions
n/a
Achieve 10 additional Global Health affiliations by year end
Optimize registration and intake process to improve turn around times and prevent leakage, emphasize “same day” culture for global patients
Dedicated space within main building to be used as a welcome center for international families and to accommodate staff expansion with conference
$250K
n/aSecure additional
international Global Health
affiliations
Activate alumni network, expand telehealth services globally, increase presence in local markets and engage international physicians via continuing
education and teaching seminars to grow international volumes
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 72
TBD
Excel in customer service and experience by delivering compassionate care, affordability and access Focused marketing around outreach, education and communication internally (staff and physicians) and externally (patients) to improve delivery of patient care and patient engagement
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Sponsorship by charities
4 FTEs
Improved satisfaction scores; 15% yoy growth in patient volume
Centralized scheduling, consolidated/online billing, mHealth
$650K/year IT patient engagement
Scale concierge services utilizing shared infrastructure with global
health
Development of on-site 3 floor guest accommodations in
conjunction with Live Like Bella and Ronald McDonald House
campaigns
Develop data-driven, user-friendly, consumer-centric tools (such as customer relationship management) and information to facilitate and streamline access,
engagement, education, communication and experience
Develop Smart Hospital capabilities (integrated vital sign monitors, infusion pumps, RFID recognition of
team members) including alerting clinicians and care teams of changes in patient condition
Utilize IT capabilities to improve patient care and engagement
Collaboration among providers, global health infrastructure
Improve patient experience
Improve patient experience
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Note: Costs derived from IT strategic priorities budget; Note: Marketing FTEs: marketing analyst, web content developer, multimedia producer, PSA marketing specialist, resources cross functional for patient engagement as well
$700K/year IT Smart Hospitals
Quality
Utilize IT capabilities to improve patient care, quality and safety
Collaboration with service lines and marketing/medical education designated space in centers for community education rooms
Patient and community outreach and education
Additional budget for publications
n/a
Improved satisfaction scores; 15% yoy growth in patient volume
Integrate marketing and education capabilities to develop a
collaborative, system-wide education plan including a system-wide yearly
calendar of events in each center (with physician presence) and
corresponding monthly publications to highlight educational topics and
promote awareness and community engagement
TBD TBD
TBD TBD TBD
TBD
Proprietary and Confidential Miami Children’s Health System | 73
Quality and personalized care; Enhance breadth and depth of careIncrease focus on research and develop outreach/education programs
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
1 FTEn/aService line advanced clinical care needs
$55k in program expenses
9FTEs$300K in recurring infrastructure expenses (excluding project costs) + $1M/year for personalized medicine IT initiative
Interdisciplinary teams comprised of service line leaders, genetics, pharmacy and biostatistics
Enhance clinical care capabilities
Tailor medical care to the individual characteristics, needs, and preferences of a patient during all stages of care, including prevention, diagnosis, treatment, and follow-up.
Emphasize precision and personalized medical management and customized medical interventions by
hiring experts in genomics and population health outcomes and utilizing data to customize medical
interventions
Explore academic and research affiliations to
complement or enhance clinical
capabilities/services, provide
support/internships to a breadth of
services
Note: Precision and personalize management: 9 total FTEs 2 Epidemiologists; RedCAP Data Manager; 2 Post Docs; Data Coordinator; Genetic Counselor; Biostatistician; Admin, will be covered in part by sponsored activity - we already have pending grants for 2-3 of these positions; academic and research affiliations: 1 FTE; Coordinator for internships and Fellows. Population health IT initiative: Facilitate bi-directional flow of patient information from disparate systems to create a collaborative and cohesive model. Incorporate predictive modeling to determine financial risk and prevent readmissionsPrecision and personalized medicine IT initiative: Design medical interventions customized to the patient; implement genomics analytics platform; offer remote biomedical device solutions through MCHAnywhere apps
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 74
Enhance revenue streams, manage risk and optimize marginAdopt vision driven philanthropy
Description of GoalInterdependencies 2016 2017 2018
Business Impact
FTEs
Engrain a philanthropic mentality within our culture
Increase unrestricted funds
MCHS programs and services
Engrain a philanthropic mentality within our culture
$86K
Promote growth and development of internal fundraising infrastructure (development officers,
physician leaders, volunteers and senior leaders) to increase annual targets of $1.15M for development
officers
Align donor campaigns to foster clinical, research and education enhancements around centers of
excellence and special projects to achieve tiered growth in annual campaign targets over time ($25M
annually, increasing from there)
Elevate level of engagement of all board members: foundation, hospital and system to actively support
the philanthropic initiatives
Progressively increase the unrestricted cash flow by
2-3% per year until
50% is achieved
Engrain a philanthropic mentality within our culture
$1.15 annual target per development officer
6
$25M annual campaign target
$614K
n/a
n/a n/a n/a
MCHS programs and services
MCHS programs and services
MCHS programs and services
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 75
Enhance revenue streams, manage risk and optimize margin Develop value based payor models and identify, quantify and budget alternative revenue streams
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Increase the efficiency and volume of sponsored projects, increase sponsored funding and address a compliance issue from prior audit outcomes.
Development of case management, demonstration of clinical quality outcomes
Achieve value based payormodels
n/a
Quantify and budget alternative revenue streams
Revenue neutral
7 FTEs
$500K in recurring expenses ($260K recurring comp + space + $190K in admin expenses)
n/a 3 FTEs
n/a n/a n/a
Sponsored programs IT system, confirm which platform to use: InfoEd or Click
MCHS programs and services
Identify and systematically plan for investments in projects that will yield alternative sources of revenue
Develop sponsored programs department to increase revenue
from grants
Achieve revenue neutral transition of 20-
40% of commercial charges to
MSDRG
Transition any
remaining commercial charges to
MSDRG
Note: Transition of commercial payor contracts to MSDRG: Case Management Development resources: 2 ED case managers in 2016, 2 IP case managers in 2017, 2 case managers for pre & post discharge across care continuum by 2017 (1.5 for neuro services, 0.5 for oncology and 1 for ortho), 1 managed care FTE in 2016Sponsored programs FTEs: Grants Manager; Pre award Coordinator; Post Award Coordinator; 1 Managed care FTE
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Proprietary and Confidential Miami Children’s Health System | 76
Advance the engagement and empowerment of our people Develop culture of empowerment and engagement to achieve strong recruits, employee retention and high performing leaders
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Compensation and benefits
n/a
n/a
Employee appreciation and benefits, Idea Machine
Enhance recurring training &
development for professional conduct,
MCH Way, & leadership protégés through experiential
training and simulation
Engage employees by incentivizing quality
ideas, expanding benefits and appreciation
initiatives and increasing focus on employee wellness
Crisis management/conflict resolution, emotional intelligence, appointment of role models; sponsor certifications/training programs
Improve staff development and groom appointed successors by increasing their authority, responsibilities and mentorship
Drive empowerment / engagement among staff at every level
$190k annually
1 FTE
$90k
Incentive comp tied to organization’s goals to promote empowerment and engagement
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Note: Cost saving of achieving 95% retention: 2 VPs-$1.2M, 15 Director/Managers-$$427k, 293 Supervisor/employees - $2.9M based on Bersin Consulting and ATD salary benchmarks; 1 FTE to manage/facilitate all training @$70k/year. Cost of training hourly employees 500 employees x 3 hours x$25 = $37,500 annually
Personal connections, MCHS alumni network, university/alumni associations, social media
Focus on recruitment of top talent and expand geographic reach of recruiting efforts
$405K
Emphasize active recruiting and determine best fit based on psychometrics defined for
each position; Enhance onboarding through experiential training
6
n/a
Reduce leader transition to 15% for those that undergo the cross functional process; 3% HCAP-specific Qs rating improvement overall
Drive empowerment among staff increasing service levels -ensure that executive actions are consistent with MCHS’ mission and
values; leadership promotes communication, accountability and transparency; Develop career pathways aligning employees’ goals,
skills and aspirations, align incentive compensation with organization’s goals
Proprietary and Confidential Miami Children’s Health System | 77
Develop interoperable data analytics & IT capabilities to produce real time, actionable information Utilize data analytics to improve clinical outcomes and achieve customized approach to clinical care
Description of Goal Interdependencies 2016 2017 2018Business Impact
FTEs
Convert systems to improve functionality; Focus on data accuracy and visualization, distribute data internally to promote transparency and cross check for errors, provide decision support and outcomes reporting
n/a n/aEnterprise Resource Planning
$2M/yrFinancial reporting
Costs(exclude FTE salaries)
Note: Costs and FTEs are spread over timeframe of implementation of Goal except otherwise noted
Note: Costs derived from IT strategic priorities budget. Patient experience and satisfaction captures other two IT initiatives: Patient Engagement through mHealth ($650K/year) and Smart Hospitals ($700k/year)
Business Intelligence $2M/yr n/a n/a
Predictive and prescriptive analytics; incorporate big data solutions to produce quality outcomes reporting
USNWR reporting, research, payormodels, population health
top related