A Blueprint for Critical Access Hospital Performance Excellence and Value

Transcription

1 600 East Superior Street, Suite 404 I Duluth, MN I Ph or I A Blueprint for Critical Access Hospital Performance Excellence and Value Terry Hill Kathy Johnson Eric Shell June 24, 2013

2 Purpose The National Rural Health Resource Center is a nonprofit organization dedicated to sustaining and improving health care in rural communities. As the nation s leading technical assistance and knowledge center in rural health, The Center focuses on five core areas: Performance Improvement Health Information Technology Recruitment & Retention Community Health Assessments Networking

3 Blueprint Sources Remaining Relevant: Rural Hospitals Challenge, Louisiana Hospital Association, 2012 Rural Policy Research Institute (RUPRI), U of Iowa Rural Hospital Performance Improvement Project (RHPI) Federal Office of Rural Health Policy (ORHP) National Rural Health Association (NRHA) 2011 CAH Quality Leadership Summit 2012 CAH Financial Leadership Summit 2013 CAH Performance Excellence Summit 2013 Top 100 CAHs, ivantage Health, 2013 Survey

4 It s Complicated! Even small health care institutions are complex, barely manageable places. Large health care organizations may be the most complex organizations in human history. - Peter Drucker

5 Current Health Care Business Model Based on volume, The more you do, the more money you make

6 It s Changing! Triple Aim Better health Better care Lower cost

7 Future Health Care Business Model Based on Patient Value Quality + Service Patient Cost Value = = Patient Value

8 Implementation Framework Implementation phases linked to evolution of payment system incentives over time Current State Phase I Phase II Phase III Phase IV Initiative I Operating Efficiencies Implementation Initiative II Align Primary Care Network Implementation Planning Align Primary Care Network Implementation Initiative III Rationalize Service Network Strategy Rationalize Service Network Implementation Planning Rationalize Service Network Implementation Initiative IV Population Based Payment System Conceptual Plan Population Based Payment System Strategy Population Based Payment System Implementation Planning Population Based Payment System Implementation

9 CAHs Cross The Shaky Bridge Source:

10 Continued relevance for rural hospitals in transformational change will require a systems-based framework to support: Leadership Vision and Strategy Partnerships and focus on the community Use of data and information Change ready adaptable workforce Efficient and effective operations All leading to excellent performance, and success in a value-based system

11 Baldrige Performance Excellence Framework A systems based management tool to align focus on quality and performance A blueprint for rural hospitals

12 Baldrige Performance Excellence Framework Developed in response to a crisis in US competitiveness in 1987 $24.6 billion savings on $120 million cost, a 200:1 ratio Health care added as new criteria in million copies downloaded in 2010

13 Performance Excellence Framework Leadership Strategic Planning Patients, Partners & Communities Workforce and Culture Operations and Processes Impact and Outcomes Measurement, Feedback & Knowledge Management Baldrige Performance Excellence Framework

14 The Framework Increases Health Care Value Reduced mortality & patient safety errors Increased patient satisfaction Population health management Increased staff and provider satisfaction Increased revenue and greater efficiency

15 Purpose: Assessment Methodology To identify the level of importance and the level of ease with implementing Critical Success Factors within the Baldrige Criteria ed the Top 20 CAHs each in finance, quality, and patient satisfaction (60 total)

16 Average Weighted Score Total Average Weighted Scores of Critical Success Factors Level of Importance Level of Ease 1 0 Leadership Customers & Community Workforce Outcomes Baldrige Criteria

17 Digging Deeper On June 5 and 6, 2013, the National Rural Health Resource Center brought a small group of CAH leaders and experts together to gather knowledge and best practices, and to recommend a CAH Performance Excellence Blueprint.

18 Top 20 CAH Critical Success Factors

19 Leadership 1. Educates & engages the hospital board 2. Aligns hospital leaders & managers around value-based strategies 3. Locks in physicians & other primary care providers

20 Leadership is critical to helping organizations understand the WHY of needed change. Leadership

21 GOOD TO GREAT JIM COLLINS

22 Strategic Planning 4. Does meaningful strategic planning at least annually 5. Uses a systems framework for planning to ensure a holistic approach 6. Communicates the plan organization-wide in easy to understand language

23 Strategic Planning

24 Strategy Map

25 Patients, Partners & Communities 7. Measures and publicly reports patient satisfaction and excels at customer service 8. Explores partnerships with larger systems or rural networks 9. Explores partnerships with other types of providers in the service area 10. Engages and educates the community to encourage use of local health services

26 Patients, Partners & Communities It is easy to get feedback from our patients, we need input from our community. Start small focus on employee health improvement, or one primary issue in your community.

27 Measurement, Feedback, & Knowledge Management 11. Uses a strategic framework to manage information and knowledge 12. Evaluates strategic process regularly and shares information organization-wide 13. Gathers and uses data to improve health and safety of patients in the service area

28 Measurement, Feedback, & Knowledge Management If you don t have data, mythology wins.

29 Balanced Score Card

30 Workforce & Culture 14. Develops a workforce that is change ready and customer / patient focused 15. Has an intense focus on staff development and retention

31 Workforce & Culture

32 STUDER GROUP QUINT STUDER

33 Operations & Processes 16. Develops efficient business processes and maximizes revenue cycle management 17. Continually improves quality and safety processes 18. Uses information technology to improve both efficiency and quality

34 Operations & Processes

35 Impact & Outcomes 19. Publically reports and communicates outcomes internally and externally 20. Documents value in terms of cost, efficiency, quality, satisfaction, and population health

36 The only way to remain relevant is to define excellence and achieve it. Impact & Outcomes

37 Performance Excellence Framework Leadership Strategic Planning Patients, Partners & Communities Workforce and Culture Operations and Processes Impact and Outcomes Measurement, Feedback & Knowledge Management Baldrige Performance Excellence Framework

38 The health care market is undergoing transformational change. Leadership awareness and support will be critical in helping rural hospitals stay relevant during the market transformation. The Performance Excellence Blueprint is a tool to help CAH leaders manage system wide improvement and navigate change. Summary

39 Summary The framework is flexible and can be used in multiple ways a starting point is just reviewing the key success factors and taking a critical look at your organization. Tools to support use of the framework broadly, and individual focus areas are being developed and will be available at

40 A Collaborative Effort

41 We are in this Together

42 Terry Hill Executive Director National Rural Health Resource Center 600 East Superior Street, Suite 404 Duluth, MN (218) ext. 232

43 Implementation Framework Implementation phases linked to evolution of payment system incentives over time Current State Phase I Phase II Phase III Phase IV Initiative I Operating Efficiencies Implementation Initiative II Align Primary Care Network Implementation Planning Align Primary Care Network Implementation Initiative III Rationalize Service Network Strategy Rationalize Service Network Implementation Planning Rationalize Service Network Implementation Initiative IV Population Based Payment System Conceptual Plan Population Based Payment System Strategy Population Based Payment System Implementation Planning Population Based Payment System Implementation