repeatable performance excellence drives profitability for the
TRANSCRIPT
Repeatable Performance Excellence
Drives Profitability
For the 2015 Baldrige Recipient
Glenn Crotty, Jr., MD Executive Vice-President and COO Charleston Area Medical Center John Vinyard Managing Partner Genitect
CAMC SERVICE AREA West Virginia’s Population: 1.8 million Primary and Secondary Service Area: 557,328
Cabell
Mingo
Lincoln Wayne
Wirt
Jackson
Kanawha
Roane
Ritchie Wood
Boone
Raleigh
Wyoming
McDowell
Logan
Mercer
Clay
Gilmer
Upshur
Lewis
Calhoun
Braxton
Webster
Pocahontas Nicholas
Tyler
Doddridge Harrison Taylor
Barbour
Monroe
Greenbrier
Summers
Fayette
Ohio
Monongalia
Wetzel
Marshall
Brooke
Hancock
Marion
Preston
Pendleton
Mineral
Grant
Hardy
Tucker
Randolph
Jefferson
Berkeley
Morgan
Hampshire
Mason
Pleasants
Putnam
Primary Service Area
Secondary Service Area
• 48 Ambulatory Sites • Provider Based
• Imaging, Urgent Care, Laboratory
• 40,000 Inpatient Visits
• 690,000 Outpatient Visits
• 115,000 Emergency Department Visits
• 4 Acute Care Hospitals • 908 Total Beds
MISSION AND VISION
Mission: Striving to provide the best health care to every
patient, every day.
Vision: Charleston Area Medical Center, the best health
care provider and teaching hospital in West Virginia, is
recognized as the:
• Best place to receive patient-centered care.
• Best place to work.
• Best place to practice medicine.
• Best place to learn.
• Best place to refer patients.
VALUES
Quality
Service with compassion
Respect
Integrity
Stewardship
Safety
PERFORMANCE IMPROVEMENT
JOURNEY
2000
Six Sigma
2005
Baldrige
Journey
Begins
2007
Lean
2008
Transforming
Care Together
2012
Focus On
Baldrige
Processes &
Systems
2015
Malcolm
Baldrige
National
Quality Award
2011
Started
Using
Critical
Systems
Importance of Organizational Learning
and Agility . . .
. . . a Baldrige Core Value
“If the rate of change on the outside exceeds the rate of change on the inside, the end is
near.” Jack Welch, Former Chairman and CEO
General Electric Corp.
Why Improve?
According the latest research,
Baldrige hospitals were recording faster five-year performance improvement than peers
and were 83% more likely to be among Truven Health 100 Top Hospitals®.
Truven Health
7
• Covers six sectors: • Manufacturing
• Service
• Small business
• Health Care
• Education
• Not-for-Profit
• Since 1988 • 1,639 Baldrige applications
• Over 10,000 applications to state quality awards
• 109 award recipients (including several twice) • 18 in Health Care
Why Baldrige?
• 368 applications since healthcare became
eligible under its own sector (1999)
• The most of any sector, even though Health Care was not
eligible for the first 11 years!
• 18 Recipients
• Last Year --- 2015 --- Health Care was:
• 62% of the Applications
• 50% of the Site Visits
• 25% of the Winners (CAMC Health System)
Baldrige Healthcare History
Baldrige Aligns The Focus
Adapted from Applied Strategic Planning, Goodstein, Nolan, and Pfeiffer, 1993
Near Term
Direction
Future
Vision
(Year 1) (Year 2-3) (Year 3-4)
A Typical Organization
Work Group
Individual
1000 Unaligned
Projects Malcolm Baldrige
Principles
Planned Journey
The Final Outcome
Baldrige Aligns the
Organization and Creates
Accountability
- John Vinyard
- Marlene Yanovsky
Health Care Criteria for Performance Excellence Overview and Structure
The leadership triad
(Leadership, Strategy, and
Customers) emphasizes
the importance of a
leadership focus on
strategy and customers.
The Organizational Profile sets the
context for your organization. It serves as
the background for all you do. The results triad
(Workforce, Operations,
and Results) includes
your workforce-focused
processes, your key
operational processes,
and the performance
results they yield.
All actions lead to
Results – a composite
of health care and
process, customer-
focused, workforce-
focused, leadership
and governance, and
financial and market
results.
The basis of the Health Care Criteria is a set of Core Values and
Concepts that are embedded in high-performing organizations.
The system foundation
(Measurement, Analysis,
and Knowledge
Management) is critical to
effective management and
to a fact-based, knowledge-
driven, agile system for
improving performance and
competitiveness.
Clarity of Alignment & Relationships
Strategic
Challenges
Work
Process
Design
Key Work
Processes
Short-Term
Actions
Long-Term
Actions Strategic
Objectives
Critical
Success
Factors
Strategic
Advantages
Strategic
Opportunities
Measures
(BSC)
Key Work
Systems
What We Called The “Mother of All Charts”
Today’s Focus
Baldrige:
Example: Senior Leadership ‘Hows’
Example: Senior Leadership ‘Hows’
We Use An Approach of Critical Systems
SO … For Leadership …
Option 1: 20+ Small systematic approaches to
accomplish what we need in leaders
(and try to tie these together)
OR……
Option 2: One approach to Leadership
which addresses most of the
20 small systematic approaches
(the hows) for all leaders
19
The Critical Systems: (Baldrige Users Guide)
1. Leadership
Leadership System
Communication System
Governance System
Organizational Sustainability System
Legal Compliance & Ethical System
Support To Key Communities System
2. Strategic Planning
Strategy Development System
Manage Innovation System
Strategy Deployment System
3. Customer Focus
Customer Communication & Response System
Customer and Market Knowledge System (Voice of the Customer)
Customer Satisfaction Determination System
Customer Relationship System (includes customer segmentation)
Complaint Management System
4. Measurement,
Analysis, and
Knowledge Management
Performance Measurement Selection System
Comparative Data Selection & Use System
Performance, Data Analysis & Use System
Data Availability System
Organizational Knowledge System
Data, Information & Knowledge Quality System
5. Workforce Focus
Workforce Capability & Capacity System
Hiring & Career Progression System
Workforce Work Environment System
Workforce Benefit System
Workforce Enrichment & Engagement System
Workforce Performance Management System
Workforce & Leadership Development System
Workforce Engagement Assessment System
6. Operations Focus
System & Work Process Design System
Process Management System
Process (Performance) Improvement System
Supply Chain Management System © 2016
CAMC in
2011
CAMC in
2013
CAMC in
2016
VIDEO
ENTERPRISE MODEL
LEADERSHIP SYSTEM
Set Direction
Align and Cascade
Implement Action Plans
Achieve the Plan
DEPLOYMENT PROCESS
Pillars Strategic Objectives
BIG DOTS (4 Year)
System Goals
BIG DOTS (1 Year)
Entity Action Plans
Entity Scorecard (1 Year)
Department Action Plans
Department Scorecard (1 Year)
Individual Performance Planner (All Employees)
Individual Scorecard (Managers)
SYSTEM LEVEL
Strategic
SYSTEM LEVEL
Operational
ENTITY LEVEL
Operational
DEPARTMENT LEVEL
Operational
INDIVIDUAL LEVEL
Operational
TOP 5 BOARD
A3 PROBLEM SOLVING
TOP 5 BOARD SAFETY CROSS
• Effectiveness: An important tool to know if the safety bundle is being followed on each shift.
• Only green if all parts of the bundle are completed; serves as an internal audit tool for key processes of care. A magical tool
• Addresses accountability as the issue is discussed with the involved individual(s) that day.
Video nicu nurse
IMPLEMENTATION OF STRATEGY AND ACTION PLANS RESULTS
PERFORMANCE IMPROVEMENT
BREADTH AND DEPTH
FOUNDATION FOR LEAN
5S Workplace Organization
Standardization
Visual Management
Problem Solving
Human Centered Work
5S Workplace
Organization Standardization
Visual
Management
Problem Solving
Just in
Time
Built in
Quality
Continuous Improvement
Highest Quality
Healthcare
Human Centered Work
FOUNDATION FOR LEAN
5S Principles
1. Sort (Removal)
2. Set In Order (Orderliness)
3. Shine (Cleanliness)
4. Standardize (Adherence)
5. Sustain (Self-Discipline)
5S is the key to Workplace Organization
FOUNDATION FOR LEAN
RN DIRECT PATIENT CARE TIME
Improving the health and economics of our
community.
CORE COMPETENCY
Improving the
health and
economics of
our community.
CORE COMPETENCY
Uncompensated Care Percentage of WV Total
Cumulative Savings = $177,019,702
FY 2015 Annualized Savings = $21,216,254
SUSTAINABILITY Cost Reductions
2011 2012 2013 2014 2015 0.0
0.2
0.4
0.6
0.8
1.0
OB
SE
RV
ED
TO
EX
PE
CT
ED
RA
TIO
CAMCHS
G
OO
D
RESULTS
Inpatient Mortality Inpatient Overall Quality - Local Competitors
COMPARION
1,923 lives
saved from
2011 to 2015
2011 2012 2013 2014 2015 1
2
3
4
5
SC
OR
E
CAMCHS Top 10%
G
OO
D
Employee Satisfaction Overall
OUR LEARNING… • Identify key organizational issues and systems that need improvement.
•Create line of sight from strategic plan to everyday work.
•Focus on the few (Top 5)
•Use culture to drive change.
• Innovate for the future.
ROLE MODEL PRACTICES
• Leadership System
• Strategic Planning Process
• Core Competency
• Performance Improvement Culture
[email protected] 304-388-5000