1. VA Nebraska-Western Iowa Health Care System New Employee Orientation

2. Your NWI Executive Team Al Washko Director Nancy Gregory Associate Director, Operations Cindy Sestak Assistant Director Dr. Tom Lynch Acting Chief of Staff Eileen Kingston Associate Director, Patient Care

3. Our Mission To honor America's veterans by providing exceptional health care that improves their health and well being.

4. Our Vision To be a patient centered, integrated health care organization for veterans providing excellent health care, research and education An organization where people choose to work An active community partner and a back up for National emergencies.

5. The NWI Way Ownership to embrace your work process as yours Improve your work processes Transformational leadership behaviors Transfer of ownership to utilize employee talent Continuous performance improvement

6. FY2009 NWI Healthcare Value = Quality+Access+Satisfaction Cost Cost Value Cost Satisfaction AccessQuality/Safety The NWI Way – ownership and leadership through a culture of continuous improvement using tools of improvement. Patient Safety Evidence-Based Medicine Patient Throughput Rural Health Veteran Satisfaction Employee Climate Physical Resources

7. Levels of Ownership Territorial  Feel the need to protect my resources from being used by others in this organization Accountability  I would challenge anyone in my organization if I thought something was done wrong Sense of Belonging  I feel I belong to this organization Identification  I feel this organization’s success is my success

8. Leadership All employees have individual strengths Any employee can lead when they are allowed to use their strengths Leadership behaviors drive success

9. Transformational Leadership: Individual Consideration Spend time teaching and coaching Help others to develop their strengths Develop mutual respect and trust Recognize individual and team accomplishments

10. Transformational Leadership: Intellectual Stimulation Question status quo Innovation Leads to creative thinking A pile of rocks ceases to be rock when somebody contemplates it with the idea of a palace in mind. Antoine de Saint-Exupery

11. Transformational Leadership: Inspirational Motivation Positive vision Interpret present/future Leads to willingness to excel

12. Transformational Leadership: Idealized Influence Competent Self-sacrificing Ethical Earns trust and emulation Abraham Lincoln

13. Value Improvement You will want to look for ways to improve process flow. The desire to spend time on improving comes naturally to those who own their work processes. This will soon be you!

14. Summary NWI Healthcare Value: Quality + Access + Satisfaction Cost  Focus on outcomes  Own your work processes  Develop Transformational Leadership behaviors Welcome to the NWI Team!

15. NWI Way VA Nebraska-Western Iowa Health Care System Quality/Patient Satisfaction Quality Management (O) Ext 4745 (GI) Ext 2202

16. Value Improvement Continuously looking for opportunities for improvement View from perspective of our customers  Who are your customers?

17. Value Improvement Components Structure Patterns Process Information

18. Value Improvement Components

19. Elements of Value Improvement Data driven Small tests of change Improvement results from changes Results of changes are measured Improvement sustained over time

20. Evidence Based Decisions Based on tool  DEDISS D = Define the problem E = Evaluate the current state D = Design small tests of change I = Implement small tests of change S = Sustain the changes made S = Spread the changes to other parts of the organization

21. Value Improvement Activities Performance Measure workgroups Rapid Process Improvement Workgroups (RPIW) 100 Day Projects Transforming Care at the Bedside (TCAB) Research Fellowships

22. Change Facilitator Training Offered monthly  Led under guidance of Dr. Peter Woodbridge  Two day class with interactive group activities  Preregistration Contact Elizabeth Yearwood, Administrative Officer  Extension 4268

23. Your Contributions to Value Improvement Fresh eyes  Are there other ways to do…..? New Ideas  Have you thought about………? Questions  Why do we do it this way? Challenges  What about exploring………?

24. Patient Satisfaction “Coming together is a beginning. Keeping together is progress. Working together is success.” Henry Ford To be successful we have to work together.

25. Customer Service Values What characteristics should all NWI employees demonstrate when working with our customers?

26. On-going Patient Satisfaction “A lot of people have fancy things to say about customer service, including me, but it’s just a day-in, day-out, ongoing, never-ending, unremitting, persevering, compassionate type of activity.” - Leon Gorman, L.L. Bean

27. Patient Satisfaction Concepts Our patients are our most important people. Our patients are not an interruption to our work---they are the purpose for everything we do. You’re part of a long-term relationship with our patients.

28. Service Recovery Everyone has a role in service recovery.  Listen  Ask questions  Apologize  Provide a solution  Refer to others for assistance Service line advocates Patient Advocates

29. Omaha  Danielle Powell Extension 3477 Grand Island  Kent Engelhardt 8-864-2132

30. Patient Satisfaction Value Improvement Patient Satisfaction committees  Inpatient  Outpatient Patient surveys  Questions asked Communication Quietness Responsiveness of hospital staff Shared decision making Privacy