1. Copyright © 2008. All Rights Reserved. Carpédia International Ltd. Performance Excellence Approach Blake McDonell Sr, Director, Operations bmcdonell@carpedia.com c. (416) 705-3846 David Rubenstein Partner drubenstein@carpedia.com c. (416) 524-9586

2. Copyright © 2008. All Rights Reserved. Over 400 successful projects since 1994 Multi-industry experience including; Hospitality, Healthcare, Manufacturing, Retail, Energy, Logistics, Insurance Clients include: Yale New Haven Health Network, Bloomsburg Hospital, Ritz Carlton, New York Presbyterian Hospital, Yale Center for Clinical Investigation, Hospital For Special Surgery (HSS), Manulife Financial, MGM Grand, Mandarin Oriental, Medical Resources, Constellation, H.J. Heinz Offices in New York, Chicago, Toronto, Houston Carpédia helps companies implement changes that improve their operational and financial performance without the need for capital expenditure 93% of Projects meet or exceed targets Better than 3:1 ROI 98% of Clients are ongoing references Carpédia – Who we are:

3. Copyright © 2008. All Rights Reserved. Carpédia - How our clients work with us: Most client relationships go through three basic phases Opportunity Analysis Project Delivery Needs Identification 123 Understand your environment and current situation Determine your key objectives and decision process Match Carpédia capabilities, approach, and experience Performed with little investment from you Deliver proof of claim with detailed assessment of opportunity Deliver project design, resource needs and cash flow Observation based analysis and change recommendations Implementation execution Results measurement and sustainability Implementation planning, coaching

4. Copyright © 2008. All Rights Reserved. Carpédia’s approach aligns with organization’s key objectives and their critical success factors Our methodology is based on addressing processes, management systems and organizational behaviors concurrently to ensure sustainable performance improvement Notes  Process refers to the operational procedures and methods employed  System refers to management systems that are used to plan, schedule, execute and measure performance  Behavior refers to the mindsets and behaviors of managers and staff  Each element is reinforcing Product Process SystemBehavior Product Service Quality Process SystemBehavior

5. Copyright © 2008. All Rights Reserved. Process problems are most easily observed Patient Scheduling Manage Diagnosis & Treatment Accrue Patients Establish Treatment Schedule Begin Treatment Assess Treatment Outcomes Poor communication Patient cancellations Lack of role clarity Inaccurate / missing information Poor coordination Lack Visibility Slow response Follow-on Studies Deliver Treatment Patient Accrual Principal Investigator Support Personnel Trial Support

6. Copyright © 2008. All Rights Reserved. System problems are more difficult Measure Execute Plan  Identify clear strategy  Define requirements through budgets  Accurate Forecast & Resource Planning Tools  Schedule equipment, staff, and material resources  Follow up schedule with regular frequency  Daily Operational Reporting  Weekly Management Reporting  Monthly Financial Reporting

7. Copyright © 2008. All Rights Reserved. Behavior problems are the most difficult BehaviorConsequenceTrigger 123 BehaviorTrigger 123

8. Copyright © 2008. All Rights Reserved. Manager’s perceptions are often not very accurate Actual Perceived Managing Training Admin Direct work Fire-fighting

9. Copyright © 2008. All Rights Reserved. Carpédia – Performance Excellence Project Approach: We work side-by-side with our clients at the point of execution, coaching and training, to ensure changes are implemented and sustainable TIME INVOLVEMENT  Design Profit Driver  Identify strategic gaps  Establish requirements Develop Target Focus Install  Design process changes  Design system:  Problem solving and decision making  Align requirements & consequences  Prototype changes  Train management and staff  Install new methods  Install new tools  Install new behaviours  Install new skills  Improve systems  Modify processes  Update Performance Plans Sustain Carpedia involvement Management involvement

10. Copyright © 2008. All Rights Reserved. Carpédia – Performance Excellence “Application Tips” Involve employees Focus on constraint Eliminate work-arounds Involve employees Focus on constraint Eliminate work-arounds Engage all levels Align rewards Manage perceptions Engage all levels Align rewards Manage perceptions Establish standards Perform timely follow-up Measure key performance indicators Establish standards Perform timely follow-up Measure key performance indicators

11. Copyright © 2008. All Rights Reserved. A sampling of Carpédia’s diverse client base