1. Welcome to our… Journey to Excellence… An overview Barbara Dumont, RN, VPSS, QRM CAH QI Showcase Fairmont Hot Springs, MT Wednesday, April 21, 2010

2. Agenda Why did we pursue this initiative? A brief introduction to the Studer Group o The Healthcare Flywheel o The Six Pillars o The Nine Principles o The Must-Haves What is next on this Journey?

3. We will provide Excellent Healthcare Close to Home by creating a great place for employees to work, physicians to practice, and patients to receive care.

4. Common Complaints  Courtesy of Care Givers  Waiting Times  Privacy  Explanations of Tests  Courtesy Towards Family  Arrangements for Home Care  Discharge Instructions  Personal Needs

5. Why… “If you do what you’ve always done, you’ll get what you’ve always got!”

6. Seems like the rules are always changing

7. Our old methods won’t work anymore

8. Do more with less… faster… better…

9. Revenues down… Expectations up…

10. And our competition is different than before

11. The Game Has Changed!

12. Word of Mouth 66% of healthcare choice decisions are based on word of mouth  Can’t con the community  Can’t con the employees AHA Reality Check II, AHA, 1998

13. 1 Very Poor Patient Satisfaction Scores 2 Poor 4 Good 5 Very Good 1% 5% 19% 74% 3 Fair 99th Percentile Hospital * Press Ganey Report What percentile would this hospital be in if responses were 74% Good and 19% Very Good?

14. The customer “will” return “Very good care”, “WOW” service. Will recommend to friends and family. Increased market share. The customer “might” return “Good care” “Okay”, “Some were nice.” May or may not tell others. No gain in market share –stays the same! The customer “might not” return “Fair Care”, “Average”, “Could be better” The customer may be complaining about their experience. If another hospital is suggested, the patient may go. The customer “will not” return “Poor”, “Dissatisfied”, “They didn’t care about me.” They are telling others about their poor experience. Customer would go elsewhere if they could. Losing market share. The customer is “gone ” “Very Poor”, “Very Dissatisfied”, “I’m not going back there!” The customer takes 10 customers with them! Losing lots of market share. 5 4 3 2 1 PRESS GANEY SCORES “What do they really mean?

15. Hardwiring Excellence The book!

16. Quint Studer B.A. in Education B.A. in Education M.S. in Education from University of Wisconsin, Whitewater M.S. in Education from University of Wisconsin, Whitewater Special Education Teacher Special Education Teacher Began healthcare career in a staff position Began healthcare career in a staff position COO of Holy Cross Hospital in Chicago COO of Holy Cross Hospital in Chicago President of the Baptist Hospital in Pensacola, FL, President of the Baptist Hospital in Pensacola, FL, At Holy Cross and Baptist, led both organizations to the top one percent in employee and patient satisfaction compared to hospitals nationwide, as ranked by independent health care survey organizations. At Holy Cross and Baptist, led both organizations to the top one percent in employee and patient satisfaction compared to hospitals nationwide, as ranked by independent health care survey organizations.

17. The Studer Group Q. Can we do this change process without Studer Group? A. Yes, organizations throughout the country are striving for service excellence. However, most organizations Studer works with 1.Felt they have gone as far as they can on their own and want to see further progress; or 2.Want to speed up the process and hardwire the changes; or 3.Do not want this to be just another program.

18. The Studer Group Q. Why do hospitals choose to work with the Studer Group? A. Hospitals have found find that they can accelerate organizational change to achieve results faster and systems are hardwired sooner to ensure the gains are not lost but built on for even greater results.

19. Hardwiring Excellence Definition: A task or process is considered to be “hardwired” when 90% of the organization consistently performs the task or process correctly.

20. Healthcare Flywheel - Must Haves - Nine Principles - Six Pillars

21. Commit to Excellence Build a Culture Around Service Measure the Important Things Create and Develop Great Leaders Focus on Employee Satisfaction Build Individual Accountability Recognize and Reward Success Communicate at All Levels Align Behaviors with Goals and Values Nine Principles

22. SJLH Journey to Excellence Pillars Service People Quality FinanceGrowthCommunity Achieve a community benefit amount of 3% of net revenue Exceed budgeted net revenue by 3% 10% EBIDA Days cash on hand of 70 Improve employee & medical staff satisfaction Improve quality indicators Improve safety for employees and patients Improve patient satisfaction Increase patient loyalty 25% 15%20%5%10%

23. 1. Rounding for Outcomes 2. Employee Thank you notes 3. Pre and Post Phone calls 4. Key Words at Key Times / AIDET 5. Selection and the First 90 Days 6. Aligning Leader Evaluations with Desired Behaviors – LEM Module Must Haves

24. Behavior Standards AccountabilityAmbassadorAppearance Communication Confidentiality & Dignity Ethics Patient- Centered Care Safety & Security Teamwork

25. LDI’s…  “Leadership Development Institute”  Teach managers new ways of managing their department  Raise the bar for leader behavior  Consistently reinforce where we are going

26. Communication Boards

27. Key Words at Key Times Things said and done to “connect the dots” and help patients, staff, and physicians understand why we do things and what is going on.

28. AIDET AAcknowledge IIntroduce DDuration EExplanation T Thank You

29. Discharge Phone Calls  Demonstrate empathy  Improve clinical outcomes  Harvest reward and recognition of the staff  Learn about the patient’s perception of service  Gather process improvement suggestions

30.  Define Desired Attributes  Commit to Standards  Leader Screens Candidates  Peers Interview Those OK’d by Leader  Use Behavior Based Questions  Make an Offer  Assign a Preceptor Team Interviewing

31. Decision Matrix Desired Wt 1-3 Candidate #1 Candidate #2 Candidate #3 Experience: Minimum 3 years experience in accounting, finance or health care 33/92/64/12 Diligence: Tell me about a time when you had to work on a project that did not work out the way it should? 35/153/9 Integrity: Describe a situation in which you felt it might be justifiable to break company policy or alter a standard procedure? 3 4/123/94/12 Totals 362433 Weights 1- Preferred, but not necessary 2- Moderately necessary 3- Essential Score: 1: Very Poor 2: Poor 3: Fair 4: Good 5: Excellent

32. 30 and 90-Day Meetings Supervisor asks the following: 1. How do we compare with what we said? 2. What’s working well? Have there been any individuals who have been helpful to you? 3. Based on your prior work, what ideas for improvement do you have? 4. Is there any reason that you feel this is not the right place for you?

33. The Journey means…  We will live our Mission. As measured by: o Patient Satisfaction scores o Physician Satisfaction scores o Employee Satisfaction scores

34. The Journey means…  We will fine tune our operations. As measured by: o Our Quality Program o Our Safety/Risk Management Programs o Creation/revision of our P&Ps

35. The Journey means…  We will build a solid financial foundation. As measured by: o The Bottom line o Our Days Cash on Hand o Our Savings o The Ability to Borrow

36. The Journey means…  We will prepare for the future. As measured by: o Development of a Facility Master Plan and Replacement Plan o Completing needed renovation and remodeling of our physical plant o Our investment in capital equipment

37. Those who say it cannot be done should not interrupt the person doing it. - Chinese Proverb The road is long…

38. “It isn’t hard to be good from time to time, what’s tough is being good every day.” - Willie Mays Hardwiring

39. Questions? Thank you!