Creating a Different Future Through the Pursuit of Performance Excellence February 2018 Pattie Skriba, Vice President Business Excellence
Advocate Good Samaritan Hospital ▪ Part of Advocate Health Care – One of the Top 15 health systems ▪ Faith-based – UCC & ELCA ▪ 300-bed community hospital (15,500 admissions) ▪ 1,600 associates, 900 physicians & 500 volunteers ▪ Level I Trauma Center (44,000 ED visits) ▪ Advanced Perinatal Services (1,800 births) ▪ Clinical strengths: Cardiology, Neurosurgery, Surgery, Emergency, Trauma, High-risk Obstetrics 2
Advocate Good Samaritan Hospital 3
In November 2010, Advocate Good Samaritan Hospital was recognized with a Malcolm Baldrige National Quality Award, joining 100 other businesses, including 17 from health care, to have received this award since 1988. 4
BUT GOOD SAMARITAN’S QUALITY WASN’T ALWAYS SO GOOD 5
Good Samaritan – True To Its Name – A “GOOD” Hospital ▪ Physician satisfaction was mixed ▪ Quality that was generally perceived as good ▪ Nursing Care seen as ‘uneven’ ▪ Patient satisfaction that was at best mediocre ▪ Quality medical staff of mostly ‘splitting’ physicians ▪ Technology and facilities that were increasingly perceived as slipping behind ▪ Associate satisfaction that was pretty good, but not exceptional ▪ A PHO that was struggling financially 6
Bloomingdale Glendale Heights Addison Carol Stream PSA 1 (50% of admissions) PSA 2 (25% of admissions) SSA Elmhurst Villa Park Lombard Glen Ellyn Westchester Wheaton In a Highly Good Samaritan Hospital Oak Brook Warrenville Competitive Downers Grove Hinsdale Westmont Naperville Lisle La Grange Market Aurora Naperville Woodridge Darien Willowbrook Naperville Naperville Bolingbrook Bolingbrook Lemont Plainfield Romeoville Lockport 7
Why Companies Don’t Become Great Good is the enemy of great. And that is one of the key reasons why we have so little that becomes great. The vast majority of companies never become great, precisely because the vast majority become quite good – and that is their main problem. -- Jim Collins (from Good to Great ) 8
Change Versus Transformation ▪ CHANGE is about doing or having something better, different, or more with what is already possible or already exists. ▪ TRANSFORMATION is about doing what isn’t currently possible, unless or until, you change how you are BEING. 9
Organizational Transformation Requires Transformational Leadership ▪ Achieve breakthrough improvement versus incremental change ▪ Make happen what would not have happened without their leadership 10
Rationales for Organizational Transformation Mission Rationale ▪ To make good on our promise to be ‘a place of healing’ Operational Rationale ▪ To create a framework for inspiring and integrating our efforts to build loyal relationships and provide great care Strategic Rationale ▪ To differentiate ourselves and ensure future success by becoming the best place for physicians to practice, associates to work and patients to receive care 11
2004 An Intentional Decision to Create a Different Future Moving from Good to Great 12
Key Steps in Transformation 1. Establish an inspiring vision and enroll leaders – create ownership 13
Establishing An Inspiring Vision To provide an exceptional patient experience marked by superior health outcomes, service and value To BE the best place for physicians to practice, associates to work and patients to receive care 14
Leaders Must Go First ▪ Leaders must first enroll themselves in the vision before others will follow. ▪ “What you are passionate about foretells your future.” (Kaiser) ▪ “Leaders get the behavior they exhibit and tolerate.” (Jim Collins) 15
Leadership’s Greatest Opportunity “Changing behavior is less a matter of giving people analysis to influence their thoughts than helping them to see a truth to influence their feelings…” -- John Kotter , The Heart of Change 16
Creating Ownership ▪ To create alignment and ownership, the Leader must routinely enroll others in the WHY of the strategy or project – context is decisive. ▪ We enroll and lead others through communication. Communication is the action of Leadership. ▪ The leader’s job is to enroll, inspire and engage others to voluntarily and passionately do what the leader is asking them to do. Achieving compliance is not enough. 17
Key Steps in Transformation 1. Establish an inspiring vision and enroll leaders – create ownership 2. Create alignment and transparency to drive improvement focus 18
Alignment Creates Possibility For Success “The most successful companies, across all industries, have a cohesiveness of purpose, unity of effort, and clarity of direction that are created and driven by their leadership.” -- Stephen Beeson MD, Sharp Healthcare 19
Our Need for Alignment and Integration ONE OF THE JOBS OF LEADERS IS TO MAKE AN ALIGNED AND INTEGRATED PICTURE THAT CAN BE UNDERSTOOD AND EMBRACED 20
A Plan to Shape Our Future Launched Moving From Good to Great (G2G) A BALANCED COMMITMENT TO EXCELLENCE Funding Associate Patient Physician Health Our Engagement Satisfaction Engagement Outcomes Growth Future 21
Create Alignment through Cascading of Goals Advocate Goals / GSAM ET Determines Preliminary Strategy Goals & Targets GSam Strategy Goal Deployment Worksheet Completed Regulatory Directors Provide Input into Goals/Targets Goals/Targets Finalized Goals: Online Tracking System Organizational and Department Action Plans Created Goals Assigned to Frontline, Action Plans Defined Performance Boards 22
Creating Transparency Distributed to over 300 Leaders Monthly 23
Key Steps in Transformation 1. Establish an inspiring vision and enroll leaders – create ownership 2. Create alignment, ownership and transparency to drive improvement focus 3. Deploy evidence-based practices 24
2005-06: Path to Achieving Operational Excellence Deeper Deployment of Evidence-based Practices Leadership Development Institutes (LDIs) Goal Alignment & Accountability System Pillar Boards Leader Rounding (Associates & Physicians) Thank You Notes Physician Bookmarks 5 Fundamentals of Service (AIDET) Hourly Rounding Discharge Call Manager Behaviors of Excellence Peer Interviewing High / Solid / Low Conversations (HSL) 25
U.S. Employee Engagement: 2016* (Gallup) 52 % 30% 18% Engag gaged Not t Engag gaged Activel ely y Dise seng ngag aged ed “start not with “where” but with “who”… get the right people on the bus in the right seats and the wrong people off the bus… stick with that discipline no matter how dire the circumstances.” Evidence-Based Practice: Peer Interviewing 26
Evidence Based Practice: HSL Build Culture: Differentiate Low, Solid, High Performance to Move the Performance Curve S L H 27
By 2006, The G2G Transformation Had Achieved Breakthrough Results ICU Ventilator-Associated Pneumonia Outpatient Satisfaction Per 1,000 Device Days 6 120 5.48 98 96 99 97 100 5 91 87 91 86 83 78 80 4 67 65 3.29 60 55 3 48 37 40 2 31 29 24 20 19 19 17 20 12 11 1 7 7 7 0 0 0 2004 2005 2006 Mortality Index (Actual/Expected) ICU Central Blood Stream Infections Per 1,000 Device Days 0.80 3 0.73 2.70 0.75 2.62 0.70 0.65 0.63 0.65 2 0.60 0.55 0.50 1 0.85 0.45 0.40 0.35 0 0.30 2004 2005 2006 2004 2005 2006 28
2006: At a Crossroad… • G2G journey led to: – Operational Excellence – Superior Outcomes Innovator – Cultural Transformation MVP • With Vision & Values as our moral compass, we asked … How will we achieve repeatable excellence? 29
A Culture of Compassionate Service 30
Key Steps in Transformation 1. Establish an inspiring vision and enroll leaders – create ownership 2. Create alignment, ownership and transparency to drive improvement focus 3. Deploy evidence-based practices 4. Foster a process-honoring culture 31
What You Don’t Know That You Don’t Know = Baldrige Opportunity “What You Don’t KNOW Know – and You “What You Know KNOW Know That You THAT YOU – and You Know THAT YOU Don’t Know” That You Know” DON’T KNOW KNOW DON’T KNOW Baldrige THAT YOU Opportunity DON’T KNOW “What You Don’t Know – and You Don’t Know That You Don’t Know” 32
The Baldrige Criteria Framework
Key Steps in Transformation 1. Establish an inspiring vision and enroll leaders – create ownership 2. Create alignment and transparency to support the vision 3. Deploy evidence-based practices 4. Foster a process-honoring culture 5. Fully deploy a performance improvement approach 34
GSAM’s Performance Improvement Approach: PDSA-A3 PLAN PLAN DO Box 1: Box 4 Box 7: Completion Problem Statement Root Cause Analysis Plan PLAN PLAN STUDY Box 2: Box 8: Confirmed Box 5: Solutions Current State State PLAN DO ACT Box 3: Box 6: Box 9: Ideal State Rapid Experiments Insights Create a community of problem-solvers 35
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