1. Pullman Regional Hospital June 30, 2010 Culture Trumps Strategy The Impact of Leadership on Patient Safety

2. http://www.youtube.com/watch?v=kiFMJfrCO_0

3. A Learning Organization “A place where people are continually discovering how they create their reality. And how they can change it.” –Personal Mastery –Shared Vision –Mental Models –Team Learning –Systems Thinking

4. Developing a Culture - A Strong Foundation Values: personal integrity and commitment to provide compassionate, responsible, quality services to our community an environment that allows individuality, team work, and communication to flourish the enriching nature of diversity, creativity, and innovation honesty and leadership in an atmosphere of mutual respect and trust. Vision: Pullman Regional Hospital is a community leader of integrated health and healing activities where our values guide and inspire, and science and technology quietly enable people to comfort, encourage, and heal. Mission: Pullman regional Hospital exists to nurture and facilitate a healthier quality of life for our community

5. Supporting Structures Patient Care Philosophy (1995) Customer Service Philosophy (1996) Leadership Philosophy (1997) Strategic Focus Areas (2005) Commitment to Accountability (2007) Commitment to Philanthropy (2008) Employment Commitment (2009) Cultural Traits (2009)

6. Patient Care Philosophy It is our belief that all individuals are active partners in their own health and healing. We support this belief with flexible care environments where information is shared while participation and personal choice are encouraged.

7. Customer Service Philosophy Each of us at Pullman Regional Hospital is sincerely interested in exceeding the expectations of others in a courteous, respectful and friendly manner. We accept personal responsibility to understand each person’s needs and provide individualized service.

8. Cultural Traits

9. Employee Work Groups Quality Outcome Partnerships Financial Effectiveness Employee Satisfaction Customer Satisfaction Superior Clinical Outcomes Superior Clinical Outcomes New/Improved Services Organizational Overview All Staff Meetings

10. Infrastructure Reorientation Budgeting process Performance appraisal system Compensation Staffing No mandatory “low census” Leadership norms Hiring process Orientation New hospital Overhead paging Personal appearance Mandatory is a “four letter word”

11. Learning from Others Culturally consistent Customization Adaptable Willing to abandon

12. External Supporting Structures Six Sigma Magnet Status Relationship Based Care Washington State Quality Award (WSQA) Healthy Work Environment Press Ganey Surveys (patients, staff, physicians) Culture of Safety

13. External Infrastructure Efforts Hand Hygiene VAP Heart Failure Pneumonia AMI TCAB Surgical Checklist SCOAP Flu Vaccination TICC Rapid Response Teams 100,000 lives CUSP 5,000,000 lives

14. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) HCAHPS is a standardized survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience. The “State of WA Ranking’s” are obtained from the Washington State Hospital Association (WSHA) website. At the time of this report, the WSHA website lists data from patients who were discharged from July 2008-June 2009. TABLE 4 – HCAHPS Scores Category Current Period Mean Score State of WA Mean Score State of WA Ranking National Average Percent of patients who gave their hospital a rating of 9 or 1087.065.0#165.0 Percent of patients who reported YES, they would definitely recommend the hospital89.071.0#168.0 Percent of patients who reported that their nurses ALWAYS communicated well84.072.0#175.0 Percent of patients who reported that their doctors ALWAYS communicated well86.078.0#180.0 Percent of patients who reported that they ALWAYS received help as soon as they wanted 79.061.0#163.0 Percent of patients who reported that their pain was ALWAYS well controlled77.068.0#168.0 Percent of patients who reported that staff ALWAYS explained about medicines before giving it to them 75.059.0#159.0 Percent of patients who reported that their room and bathroom were ALWAYS clean84.069.0#170.0 Percent of patients who reported that the area around their room was ALWAYS quiet at night 71.050.0#157.0 Percent of patients at each hospital who reported that YES, they were given information about what to do during their recovery at home 86.083.0#12 81.0

15. Inpatient Satisfaction Scores The mean score is calculated on a 1 – 100 scoring average. The scores from each survey are totaled and then divided by the sample size of the survey. A small sample size can significantly alter the mean scores from one period to the next. If the sample size is <7, Press Ganey does not calculate a score. TABLE 1 – Pullman Regional Hospital’s Customer Satisfaction Scores - Inpatient Category 1/10 – 3/10 Mean Score 1/10 – 3/10 Ranking 10/09-12/09 Mean Score 10//09-12/09 Ranking Overall Customer Satisfaction (n = 161)92.298 th percentile91.697 th percentile Overall Customer Satisfaction for Med/Surg Unit (n = 74)92.899 th percentile91.296 th percentile Overall Customer Satisfaction for BirthPlace (n = 39)91.397 th percentile92.699 th percentile Overall Satisfaction With Physicians (n = 124)93.698 th percentile92.396 th percentile Overall Satisfaction With Nursing (n = 121)94.598 th percentile92.994 th percentile Likelihood of Recommending Hospital (n = 160)95.999 th percentile95.197 th percentile ( n = sample size of most recent reporting period (1/1/10 – 3/31/10 ) PRESS GANEY “TOP BOX” SATISFACTION RESULTS FOR PULLMAN REGIONAL HOSPITAL (For Period January 1 – March 31 2010)