1. WELCOME AHCJ

2. BANNER HEALTH OVERVIEW
April 14th, 2018
Charlie Agee, MD
Vice President, Care Management
Chief Medical Officer, Academic Delivery

3. Agenda About Banner Health
Care Management and Clinical Consensus Groups
Outcomes and Sustainability Examples

4. About Banner Health

5. “Making health care easier,
Mission & Values
Our Nonprofit Mission
“Making health care easier,
so life can be better.”
Our Values
Customer Obsessed
Relentless Improvement
Courageously Innovate
Disciplined Focus
Foster Accountability
Continuously Earn Trust
This Mission statement drives reinvention focused on the consumer. It is our call to action and how Banner is going to win the heart of Sofia, and those we serve.
Banner’s Values define the culture of Banner and how these values are demonstrated through actions and behaviors. We've simplified our values and created six new values to define the culture we want at Banner and expected behaviors to focus on consumers.

6. Banner at a Glance

7. Banner Health Operating Model
Key Descriptors
Banner Health Operating Model
An Operating Company
Performance-based, data-driven, outcomes focused
Clinical quality focus
Standardized best-practice operations and care delivery
Continuously improving
A Strong, Scalable Foundation Talent Mapping
IT – a single, scalable IT platform – get the right people in the right place
Centralized Support Services
- for economies of skill and services

8. CARE MANAGEMENT & CLINICAL CONSENSUS GROUPS
Governance structure Physician involvement with design and implementation of an EMR

9. Care Management Structure
Medical Leadership is focused leading and supporting the delivery of consistently superior outcomes for patients
Care Practice Support provides the structure and the function to allow our providers and clinicians to deliver consistently reliable care.
Process Design and Improvement functions help design and improve care processes and practices.
Clinical Innovation, Education, and Research function synergistically to provide standardized, accountable, consistent, and evidence-based clinical practice, educational, and research programs for Banner Health.

10. Clinical Consensus Groups (CCG)
Purpose: Define expected clinical practices for Banner Health based on best available evidence, including practice- based evidence.
Clinical Consensus Groups
Many teams support the design and build of reliable systems for that standard of care
Program management
CCGs and Clinical Practice Development
Process Engineering
Clinicians and Engineers assist with Design
Informatics
Clinical & Medical Professionals assist with design & build
Quality
CPA
Clinical Performance Analytics
Clinical Education
Translating the scientific understanding in the medical field to direct patient care has historically taken 17 years from proof of practice.
Banner’s Clinical Consensus Groups, known as CCSs aim to shorten that time frame significantly.
To support the CCG structure we have program management, process engineering, Informatics, Quality, Clinical Performance Analytics and Clinical education.

11. Clinical Consensus Group Accountabilities
Identify opportunities for improving clinical care:
Define expected clinical practices for Banner Health based on best available evidence including practice based evidence
Approve clinical practice designs
Charter define and design workgroups to operationalize how the clinical practices will be performed and implemented
Review, revise and approve Computerized Provider Order Entry (CPOE) caresets, powerplans, etc…
Attain appropriate collaboration and approvals for clinical practices
Measure and monitor the success of the clinical practice

12. Clinical Consensus GroupsED
Pulmonary
Palliative Care
NICU/Newborn
Neurosciences
Critical Care
Behavioral Health
Anesthesia
Pediatrics
Women’s Health
Post Acute Care
Medical Imaging
Primary Care
Hospital Medicine
Cardiology
Nephrology
Surgery
Pharmacy & Therapeutics
Infectious Disease
CV Surgery
Oncology
Ortho
Clinical Leadership Team

13. “Engineering” New Models
Research Practices
Reach Consensus on requirements
Define
Describe reliable workflow and roles
Develop tools
Design
Communicate and train
Address issues
Monitor
Implement

14. Related Groups

15. Outcomes and Sustainability Examples

16. 2017 Clinical Reliability Strategic Initiative
Measure
Definition
Target/Stretch
Desired Direction
YTD
Improve Care Reliability
Reliability Achievement in Defined Care Domains Index
1/1.1 ↑
1.114
Patient/Member Engagement Reliability
Advance Directive Banner Employees*
14.9/16.5%
18.98%
Acute Care Reliability
Medication Reconciliation
76.1/79.7%
77.9%
Care Practice Adherence for Observation Patients
48.0/53.0%
56.7%
Preventive Care Reliability
Care Practice Adherence for BHN Composite
67.0/71.3%
64.04%
Chronic Care Reliability
Chronic Care Practice Adherence for BHN Composite
77.3/81.2%
92.75%
Complex Chronic Care Reliability
Post-Acute Alignment
44.1/46.2%
46.0%
2017 Clinical Reliability Strategic Initiative

17. Strategic Initiative Trends

18. Care Practice Adherence Impact on Observation LOS

19. Central Line Associated Blood Stream Infections (CLABSI)
Per 1000 patient days with a central line
Source: Acute Care Board Report, 1/17/2018

20. Primary Stroke Center
Time to Intravenous Thrombolytic Therapy Times - Median
Added Tucson data, starting 4Q 2017
Linda Miller, CPA, 1/24/2018
Cerner, TSI

21. Blood Utilization for Hip/Knee Replacement
BI Mature Initiatives Dashboard
Cerner, 2/18/2017

22. C-sections for full term, singleton babies
Obstetrical Care
Early Elective Deliveries
C-sections for full term, singleton babies
All Data from Data Abstraction Midas
2/18/2017

23. Standardized Infection Ratio (SIR)
CAUTI Results
Standardized Infection Ratio (SIR)
2014
1.175
2015
0.657
2016
0.566
Source: Infection Prevention

24. QUESTIONS Charlie Agee, MD Vice President, Care Management
Chief Medical Officer, Academic Delivery