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All Campus Leadership July 10, 2009.

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Presentation on theme: "All Campus Leadership July 10, 2009."— Presentation transcript:

1 All Campus Leadership July 10, 2009

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17 “ According to the cleanliness of my hands, God rewards me. ” Psalms 18:20

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24 All Campus Leadership Lars Houmann July 10, 2009

25 2010 PLANNING Recession Reform

26 HEALTHCARE REFORM’S BIG TOPICS Public Option Mandate Cost

27 AHS/FLORIDA HOSPITAL POSITION Simple, fair payment system “Smart” reimbursement Basic coverage for preventive health Reform Stark regulations

28 HOSPITAL INDUSTRY “Do Our Part” – July 7, 2009 Cover 95% of Americans $155Bn payment reductions Public Exchange Delivery System Reforms

29 SURE BETS Improve Patient Experience Improve Patient Care Create Value Align Physicians Engage Employees Innovate

30 NEJM – Table 3 – Classification Requirements Adoption Level - % of hospitals

31 2012 CHALLENGE Indisputable market leader Florida Hospital for Children nationally recognized Statutory teaching World leader in training surgeons FH patient experience as role model Preventable deaths to zero Electronic record Health improvement business model and economic returns Cash to long-term debt > 110%

32 All Campus Leadership Market Overview

33 Agenda Market Demographics & Growth Competitive Landscape Market Share Brand (NRC) Major Market Messages

34 Market Demographics & Growth

35 Population Growth The Tri-County market is expected to outpace the US population growth rate Geographic Area 2008 Population 2013 Population 5-Year Growth Annual Growth United States of America 304,092,641319,109,0464.9%1.0% Florida 18,599,593 20,253, %1.7% Tri-County Market 1,768,8161,985, %2.3% Orange 1,125,6831,250, %2.1% Osceola 258,031315, %4.1% Seminole 385,102419,9169.0%1.7% Source: U.S. Census Bureau and Solucient

36 Unemployment Trends Source: Florida Research and Economic Database; Tri-Co includes Seminole, Orange, and Osceola Counties

37 Orlando Area Uninsured Population Source: U.S. Census Bureau and Solucient Florida , , , P331, P336,201

38 Market Growth Total Hospital Admissions by County Market Growth County2008 Market Size’06 vs.’05’07 vs.’06’08 vs.’07 Tri County Total202, %3.7%4.0% Orange132, % 3.7% 4.2% Osceola27, % 9.6% 5.5% Seminole41, % -0.1% 2.3% Brevard70, % -2.5% -3.0% Polk81, % 3.1% -1.5% Highlands16, % -2.6% -3.9% Lake43, % 1.3% 3.4% Volusia64, % -2.7% -2.8% Source: AHCA 2008A discharges, all DRGs except and ; 2008A is annualized based on Q1-Q3

39 Competitive Landscape

40 Orlando Health  Arnold Palmer Hospital for Children completed their $56 million renovation, increasing their pediatric bed size from 96 to 158. The renovation included the addition of a new children’s kidney center and new IP and OP oncology wings.  Dr. P. Phillips Hospital plans to complete their $175 million renovation project, increasing bed size from 135 to 240 beds, in  Dr. P. Phillips Hospital Chest Pain Center recently received full accreditation from the Society of Chest Pain Centers’ Accreditation Review Committee. South Lake Hospital  South Lake Hospital expects to add 54 new beds in Competitive Landscape

41 Nemours Foundation  Nemours to build a 550,000 square-foot, 95-bed subspecialty pediatric hospital on 60-acres in Lake Nona’s Medical City. Completion date expected Imaging Centers  There are 51 free standing Imaging Centers in the market. Surgery Centers  There are 31 free standing Surgery Centers in the market.

42 Market Share

43 1 st Qtr 2009 Market Share Market Growth2.7% FH Growth4.6% OH Growth-0.4% FH Market Share47.4%  48.2% Market Share Gap11.1  13.1

44 In-Patient % Growth 2009Q1 vs. 2008Q1 Obstetrics –Market Growth-4.8% –OH Growth-8.2% –FH Growth11.7% Pediatrics –Market Growth22.5% –OH Growth10.1% –FH Growth35.7% Acute –Market Growth3.6% –OH Growth1.2% –FH Growth4.1%

45 Tri-County Market Share Source: AHCA 2008A discharges, all DRGs except and ; 2008A is annualized based on Q1-Q3 Orange – 47.2% Osceola – 28.0% Seminole – 50.2%

46 Tri-County Market Share Source: AHCA 2008A discharges, all DRGs except and ; 2008A is annualized based on Q1-Q3 Northwest – 52.8% Northeast – 61.4% Southeast – 45.8%Southwest – 23.0% South – 32.9% North – 57.2%

47 Brand (NRC)

48 Combined Attributes (Best Doctors, Best Nurses, Best Image / Reputation, Best Overall Quality) Source: National Research Corporation, Tri-County respondents only; 2009 data is January thru May 50.2% 47.9% 48.6% 44.9% 49.5% 37.8% 39.1% 36.0% 38.8% 35.2% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * Florida HospitalOrlando Health

49 Consumer Preference by Age Group (based on Combined Attributes) Source: National Research Corporation, Tri-County respondents only; 2009 data is January thru May and Older 41.8% 37.8% 38.3% 37.0% 48.0% 43.9% 42.1% 34.1% 26.4% 29.7% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * 43.4% 49.9% 41.8% 43.4% 44.6% 43.2% 39.0% 40.3% 33.4% 36.8% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * 52.3% 48.5% 45.4% 42.9% 47.0% 36.8% 38.3% 39.5% 38.4% 38.7% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * Florida HospitalOrlando Health 69.5% 49.0% 57.1% 48.4% 58.0% 19.1% 37.6% 22.1% 34.0% 29.6% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% * Florida HospitalOrlando Health

50 Consumer Preference by Gender (based on Combined Attributes) Female Male Source: National Research Corporation, Tri-County respondents only; 2009 data is January thru May 49.2% 47.8% 45.2% 45.7% 49.7% 38.6% 35.9% 35.2% 34.6% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * Florida HospitalOrlando Health 52.6% 48.1% 53.0% 39.2% 49.0% 34.5% 38.0% 30.1% 36.8% 36.4% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * Florida HospitalOrlando Health

51 Consumer Preference by Household Income (based on Combined Attributes) Under $25,000 $25,000 - $49,999 $50,000 - $74,999$75,000 and Over Source: National Research Corporation, Tri-County respondents only; 2009 data is January thru May 52.8% 48.1% 46.7% 46.5% 49.3% 32.8% 33.6% 32.7% 30.4% 38.9% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * Florida HospitalOrlando Health 47.3% 46.3% 52.6% 49.0% 48.2% 43.9% 41.4% 32.5% 37.3% 35.5% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * Florida HospitalOrlando Health 50.7% 48.8% 45.8% 42.6% 52.4% 37.7% 42.2% 40.3% 34.7% 34.8% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% * 49.8% 47.1% 42.9% 39.2% 45.8% 32.8% 33.6% 32.7% 30.4% 36.9% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% *

52 Major Market Messages

53 Growing Market Uninsured Population will Continue to Grow 1 st Qtr 2009 – Market Share Gain Overall Consumer Preference is Strong –Females –High Income Groups Strong Market Position –Seminole County –North of Hwy 50 Significant Market Opportunities –South of Hwy 50 –Osceola County

54 Operational Assessment & Focus

55 TEAM Results 1.Retention Total Nursing 2.RN Hires

56 TEAM Campus Separation (Goal – 17.5%)

57 TEAM RN Separation (Goal – 15%)

58 RN Hire Goal – 988 YTD RN Hires – 597 Remaining RN’s TEAM RN Hires

59 Patient Experience Willingness to Recommend (YTD) 1.Inpatient (n=5,972) 63% Top Box th Percentile 2.Emergency Department (n=2,353) 53% Top Box th Percentile 3.OP Surgery (n=600) 82% Top Box 60 th Percentile 4.OP Services (n=2,582) 81% Top Box 70 th Percentile

60 Patient Experience IP - Willingness to Rec.- YTD

61 Patient Experience IP Service Mix

62 Patient Experience IP Service Mix - Recommend

63 Patient Experience ED - Willingness to Rec.- YTD

64 Clinical Patient Care 1.Quantros - Readiness 2.Emergency Department

65 Overall Compliance Results Combined Tracers, Record Reviews, Patient Care Interviews

66 Clinical 3D Performance (Goal = 60/175/360) 1st Quarter nd Quarter

67 Clinical 3D Performance

68 Market Volumes 1.IP Admissions & Surgery 2.ED Visits 3.Pure Outpatient

69 Market IP Admissions & Surgery

70 Market ED Visits

71 Market Pure Outpatient

72 Areas of Focus 1.Basics of Clinical Care Admission/Discharge Process Medication Administration MDRO AHS Bundles 2.Volumes Surgical Pure OP 3.Patient Experience Projects Children’s/Orlando/Altamonte – Disney Institute East Project

73 Areas of Focus 4.Team Engagement Labor Management 5.Physician Development 34 Physician recruitment projects in process 6.Expansion/Growth Projects Kissimmee – MOB+ Winter Park – Women’s Orlando – Children's, MOB, Front Entrance, OR’s Celebration – Tower Planning East Orlando – ASC Planning – FOCUS WEEKS

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75 Compliant QuestionsResponsesQ Compliant QuestionsResponsesQ2 2009% Change Orlando % %2.2% Children's % %1.0% Altamonte % %2.4% Winter Park % %1.7% East Orlando % %1.7% Celebration % %0.9% Kissimmee % %1.7% Apopka % %1.5% System % %1.9% Results are the aggregate of compliant responses (“Yes”) over Observations (“Yes” or “No”) for the following audits: Tracers: Audits by each unit/department on their own area. Includes environmental/process observations, patient/staff interview questions and some documentation review. Conducted once weekly. Open Record Review: Audits by each unit/department on their own area. Includes documentation review and some environmental observations. Conducted once daily. Patient Care Interviews: Audits by full-time Accreditation Services staff and part-time (loaned) staff from the campuses. Includes staff interview on National Pt. Safety Goals, navigating I-Extend, some documentation review and environmental observations. Conducted once weekly per department/unit.

76 SIA 4 Extend our Patients’ Continuum of Care

77 Why the focus on SIA 4 Mission Extension-Creation Health Supports our core inpatient services Future Health care model Part of Stimulus funding and proposed health care reform Dissatisfaction with existing delivery model –Discharge process

78 Existing Continuum Wide range of existing services: CentraCare FPMG Home Health Retail Pharmacy DME Home Infusion Others Large Amount of Revenue; Over 1million patient contact

79 Extending the Patients’ Continuum of Care – a working definition Pre and Post Acute Care Hand offs to next level of care Continuity of Care Wellness, Prevention and Education Consumer focused thinking Elevating the health and healing relationship with our community

80 2010 Phase 1 of the Journey 1.Formulate & Begin deploying Connectivity Strategy CentraCare (2008) Home Health (2009) Rehab (2009) EMR in clinically aligned physician practices (targeted 2011)

81 2010 Phase 1 of the Journey 2.Continue Elevating Performance of Existing Continuum Services 3.Define and close Continuum Service gaps, were feasible 4.Continue Physician Alignment Strategies

82 SIA 4 Extending our Patients’ Continuum of Care by extending our Patients’ Experience

83 SIA & 2010 System Priorities

84 Purpose 1.Complete SIA Framework 2.Affirm 2010 System Priorities 3.Prepare for Pacesetter Performance Measures (PPM’s) 4.Say Thank You

85 Mission…Why We Exist “To Extend the Healing Ministry of Christ” Vision…Where We Are Going “To be a global pacesetter delivering pre-eminent faith based health care” Values…How We Live Our Mission Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork Pacesetter Performance… How we Stay Accountable Team, Clinical, Service, Market, Finance

86 Vision…Where We Are Going “To be a global pacesetter delivering pre-eminent faith based health care” Values…How We Live Our Mission Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork Pacesetter Performance… How we Stay Accountable Team, Clinical, Service, Market, Finance Every Person, Every Time Mission…Why We Exist “To Extend the Healing Ministry of Christ”

87 Mission…Why We Exist “To Extend the Healing Ministry of Christ” Values…How We Live Our Mission Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork Pacesetter Performance… How we Stay Accountable Team, Clinical, Service, Market, Finance Strategic Innovation Agenda –Always a Journey, Never a Destination Vision…Where We Are Going “To be a global pacesetter delivering pre-eminent faith based health care”

88 Mission…Why We Exist “To Extend the Healing Ministry of Christ” Vision…Where We Are Going “To be a global pacesetter delivering pre-eminent faith based health care” Pacesetter Performance… How we Stay Accountable Team, Clinical, Service, Market, Finance Values…How We Live Our Mission Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork “You Can Count On Us”

89 Mission…Why We Exist “To Extend the Healing Ministry of Christ” Vision…Where We Are Going “To be a global pacesetter delivering pre-eminent faith based health care” Values…How We Live Our Mission Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork Pacesetter Performance… How we Stay Accountable Team, Clinical, Service, Market, Finance Holistic Approach (Decathlon Model)

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91 Strategic Innovation Agenda ELEVATE PATIENT SAFETY and CLINICAL EXCELLENCE “EXCELERATE” CORE PROCESS IMPROVEMENT ENRICH our PATIENT’S EXPERIENCE EXTEND our CARE CONTINUUM ENGAGE our COMMUNITY S t r a t e g y

92 Strategic Innovation Agenda What is the Center of the Strategic Innovation Agenda? “Florida Hospital” Experience!

93 Strategic Innovation Agenda What is at the Heart of the “Florida Hospital” Experience? CREATION Health! »Passion About »Best At »Creates Value

94 Strategic Innovation Agenda ELEVATE PATIENT SAFETY and CLINICAL EXCELLENCE “EXCELERATE” CORE PROCESS IMPROVEMENT ENRICH our PATIENT’S EXPERIENCE EXTEND our CARE CONTINUUM ENGAGE our COMMUNITY CREATIONCREATION S t r a t e g y C u l t u r e & Care HEALTHHEALTH

95 Strategic Innovation Agenda What is the best expression of CREATION Health? Healthy 100!

96 Why is a Healthy 100 Compelling? Its Powerful ANDIts Inspiring AND Motivating Its Action Oriented

97 For Appointment

98 Strategic Innovation Agenda

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100 Healthy 100

101 Strategic Innovation Agenda The Power in a Question It Engages –Staff –Patients –Community

102 Back to Engagement Whole People, Delivering Whole Person Care Strategic Innovation Agenda

103 The Power of Relationship Clinical Care Informative Care Empathic Care APPRECIATEDADMIREDADOPTED Level of Connection (not time) FAMILY Treating the Patient Treating the Person Healing the Individual

104 Good For Business! What we have (our core) What we want (our continuum) Strategic Innovation Agenda

105 ELEVATE PATIENT SAFETY and CLINICAL EXCELLENCE “EXCELERATE” CORE PROCESS IMPROVEMENT ENRICH our PATIENT’S EXPERIENCE EXTEND our CARE CONTINUUM ENGAGE our COMMUNITY HEALING HEALTH S t r a t e g y Business Model C u l t u r e & Care CREATIONCREATION HEALTHHEALTH

106 Outcome = Community Benefit Strategic Innovation Agenda

107 We are Relevant in ANY Future Strategic Innovation Agenda

108 2010 Priorities Grow the Market Develop New and Strengthen Existing Markets Reposition Surgical and Procedural Capability for Growth Develop and Implement an Aligned Ambulatory Model Grow Philanthropy Market Share and Reach Improve Revenue Share Manage Florida as a Market

109 2010 Priorities Improve the Product Safety Critical Process and Performance Focus Leverage Clinical Information Technology Patient Experience Florida Hospital for Children (Walt Disney Pavilion) Strengthen and Support Research and Medical Education Value/Efficiency and Stewardship

110 We Stay on Plan… We Execute

111 Mission…Why We Exist “To Extend the Healing Ministry of Christ” Vision…Where We Are Going “To be a global pacesetter delivering pre-eminent faith based health care” Values…How We Live Our Mission Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork Pacesetter Performance… How we Stay Accountable Team, Clinical, Service, Market, Finance Holistic Approach (Decathlon Model)

112 Organizational Performance Single Focused Balanced Performance Holistic Performance Most Some Few

113 Definition: “To View as a Single Complete System” Principles: One Investment = Many Returns Improvement in one element doesn’t harm another Simultaneous Performance (Decathlon Model) Webster

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116 Reasons it will help you 1.Multiyear Targets 2.Align Focus 3.Engage with Staff

117 2009 Strategic Review 2009 Strategic Review FINANCE

118 Admissions by Campus June 2009 YTD

119 Admissions by Type June 2009 YTD

120 Net ED Visits June 2009 YTD

121 Total Surgeries June 2009 YTD

122 YTD Inpatient Payor Mix

123 YTD Outpatient Payor Mix

124 EBDIT by Entity June 2009 YTD

125 2010 Budget Assumptions

126 Admissions

127 Net ED Visits

128 Total Surgeries

129 2010 Budget Assumptions

130 2010 GAP Distribution

131 Planning Timeline All Campus Leadership Distribute Departmental Operations Plan Distribute Departmental Budgets Technical Reviews Focus Week July 10, 2009 July 27, 2009 August 17, 2009 September 8 – 18, 2009 September 21 – October 2, 2009

132 To Access Presentation Visit

133 All Campus Leadership July 10, 2009


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