Henry Ford Health System s Baldrige Journey: Driving Accountability for Excellence. June 25, Kathy Oswald Chief Human Resources Officer

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Henry Ford Health System s Baldrige Journey: Driving Accountability for Excellence June 25, 2012 Kathy Oswald Chief Human Resources Officer

Henry Ford Health System Core Services: Four acute med/surg and two behavioral health hospitals Henry Ford Medical Group 32 Medical Centers 1200 physicians & scientists 2200 private physicians 1500 MD & DO physician trainees Health Alliance Plan

Henry Ford Health System Pre- and Post-acute services: 2 Skilled nursing facilities Home Health Care Outpatient Dialysis Home Products Retail Pharmacies Vision Centers

Henry Ford Health System Other Statistics (annual): 24,000 employees 102,000 admissions to 2200 beds 418,000 ED visits 3.2 million office visits 88,000 surgeries

The Henry Ford Experience 7 Pillars of Performance

Mission, Vision, and Values Mission To improve people s lives through excellence in the science and art of health care and healing Values Each Patient First Respect for People High Performance A Social Conscience Learning and Continuous Improvement

Mission, Vision, and Values Vision Transforming lives and communities through health and wellness one person at a time

What Differentiates Our Workforce? Diversity Culture of development Community Integration Innovation Leadership Walks the Talk Leaders as Teachers Commitment to our People, especially during difficult economic times (Job Preservation)

HFHS Leadership System

Sustainability Through Workforce culture Relentless focus on improvement Accountability for results ongoing performance reviews are standard agenda items Succession planning & leader development Patient safety culture

Economic Driver Community Support $5.82 billion in direct/indirect economic benefits Live Midtown Neighborhood development Community Leader Serve in leadership roles in key organizations, such as Detroit Chamber of Commerce, Detroit Convention & Visitors Bureau Leadership volunteer hours exceed 12,000 annually

Leveraging Core Competencies Innovation Discovering and applying new knowledge in techniques, technology, processes, services, and structures Clinical Research & Technology Facilities Services and Access Points Processes Care Coordination Proficiency in coordinating care across the continuum, teams Partnering/Collaborating Relationship- building with patients, stakeholders, others

Innovation Making meaningful change to improve products, processes, or organizational effectiveness and creating new value for stakeholders. Innovation involves the adoption of an idea, process, technology, product, or business model that is either new or new to its proposed application. Baldrige Criteria for Performance Excellence

From the Start: A Hospital for the Everyday Man

Clinical Services, Research, & Technology Innovation New techniques, new cures Robotic ultrasound probe Deep brain stimulation inside imri Simulation Center TechTown incubator with Wayne State University Innovation Institute led by Henry Ford Medical Group Early adopter of integrated health record for ambulatory care

Innovative Facilities West Bloomfield Hospital Henry Ford Hospital Henry Ford II Pavilion Ambulatory Centers Henry Ford Self Health Centers

Unique Customer Services Referring Physician Office and Concierge Service Pharmacy Advantage Home Prescription Delivery Demonstration Kitchen Home Health Tele-health Farmer s Markets and Retail Stores

Henry Ford West Bloomfield Hospital Example of Deploying Best Practices Hospital rooms designed with input from all stakeholders Rooms duplicated at Henry Ford Hospital s new Henry Ford II pavilion Talent based employee selection tool piloted to select new hospital staff Now selecting a tool for all business units Focus on high-touch service and first impressions Training for all employees on first impressions and service recovery Percentile Ranking 100 90 80 70 HFWBH Inpatient Overall Satisfaction Above 95 th Percentile nationally since opening 2009 2010 9/2011 YTD National Press Ganey Percentile Ranking SE MI Press Ganey Percentile Ranking

New Patient Portals and Outreach Henry Ford OptimEyes Centers CVS Minute Clinic partnerships Journey to Wellness health kiosks in community faith-based organizations Inside Connection employee ambassador program

Process Innovation No Harm Campaign Integrated Care across the Continuum (including new Henry Ford Physician Network) HAP collaborations on e-prescribing and chronic disease management Clinical team communications, including ORtv

Ideas + Execution = Innovation Innovation + Accountability = Sustainable Results

Results Achieved in Economic Crisis People Gallup scores showed improved employee engagement for each Q12 item Service HAP rated highest in member satisfaction in Michigan for 5 th consecutive year Quality - Harm rate dropped by 31% in three years vs. next best of 6%

Reducing Harm Events and Deaths 23

Results Achieved in Economic Crisis Finance & Growth: In past decade, doubled revenue to $4.2 billion; increased inpatient market share from 11% to 18% Mkt Share Up 3.9% in 6 yrs; Surpassing Closest Competitor in '10 18% 16% 14% 12% 10% 8% 2004 2005 2006 2007 2008 2009 Q1-Q2 HFHS Competitor A 2010 Competitor C Competitor B Market Share %

Turning Points in HFHS s Baldrige Journey

Seven Years of Learning

Baldrige at HFHS: A Journey of Discovery 2004 Increasing attention within health care; our CEO ready 2005-2006 Self-assessment, with support from consultants Established the 7-pillar framework Other, more modest changes to leadership processes; reassessment of improvement approaches 2007 1 st applied to State and National Programs Each application was for the entire System October 2007 Site visit by Michigan Quality Council Earned Michigan Quality Leadership Award

Baldrige at HFHS: A Journey of Discovery (cont.) 2008-2010 Applied to National Program each year; no site visits Continuous improvement work based on feedback Strengths and OFIs, as well as best-practice research Significant revisions to application in 2010 based on changes Better at anticipating strengths and opportunities 20+ examiners trained Michigan and National 2011 Fifth application submitted, selected for Site Visit Notified November 21, 2011 WE GOT IT! Feedback report received December 14, 2011

Creation of The Pillars Mission & Vision are supported equally by all 7 the pillars Values, Core Competencies, and Organizational Framework provide the foundation The Henry Ford Experience is high performance for our customers across all 7 pillars Broad communication reinforced this new framework for the organization Formally organized strategies and performance targets by pillar

Michigan Quality Council Leadership Award Inspired great pride and optimism Site visit experience built tremendous learning How to communicate/translate Baldrige-speak to HFHS activities for employees How many documents are requested! How to prepare and organize supporting documents How to help design a useful site visit for examiner team Celebrated award System-wide But we didn t even get a national site visit

Created Performance Council and New Leadership Processes Feedback showed incomplete strategic planning steps, deployment, and alignment Many performance targets and results remained the responsibility of a few vs. everyone Evaluated all current leadership teams: membership, roles and responsibilities, meeting frequency, and perceived effectiveness Created a picture of our Leadership System Launched the new HFHS Performance Council

Performance Council Comprised of leaders of every Business Unit, pillar team, and key Corporate area Charged with overseeing the Strategic Planning Process and Organizational Performance Review Provides clear direction and decision making process to those seeking approval of or input to projects, policies, and initiatives (clarifies role of all leadership teams) HFHS Board of Trustees Executive Cabinet Performance Council Business Unit Leadership Teams Pillar Teams

Improved Strategic Planning and Implementation Multiple refinements to the Strategic Planning Process New processes focused on the criteria New common vocabulary: Strategic Objectives Strategic Initiatives Action Plans Performance Targets Aligned the strategic planning and budgeting processes Clear expectations for aligned action planning Review Organizational Performance COMMUNITY Develop Action Plans & Set Targets Affirm MVV & Environmental Assessment PATIENTS Conduct Scenario Planning & Develop Strategic Objectives PURCHASERS Develop & Prioritize Strategic Initiatives

Inclusive and Transparent Performance New Metrics Committee: Measurement Comprised of operational, financial, and pillar leaders Provide oversight and expertise to pillar teams and the Performance Council on definition, display (dashboards), comparisons, and analysis of organizational performance New HFHS Analytics department to drive information and knowledge management System-wide Transparency of results for greater knowledge transfer and better future planning

Leadership Competencies & Standards: Aligned to Baldrige 40% of Leader and Staff evaluations tied to leader/team standards Incentives aligned with organizational goals Leadership Patient/ Strategic Customer Planning Focus Performance Analysis & Staff Focus Knowledge Management Accountability Process for Results/ Management/ Execution Focus on Safety

2012: The Journey Continues Key System-wide priorities based on examiner feedback and pre-/post-visit self-assessments: Refine our approaches for identifying and spreading improvements, innovations, and best practices; learn from others at Quest Continue to communicate and connect System goals and current performance, opportunities, and responsibilities to individuals and front line teams; refine strategic planning process steps to hard-wire tight-loose-tight Re-evaluate and re-align key processes, owners, and measures at all business units and work systems

Leadership s Role Setting the stage learning from others Senior Leadership: More than just a yes. Involvement led to Engagement. Not about Baldrige, but about improving performance to provide the best experience - one person at a time Creating a performance culture that permeates all aspects of the organization

Lessons Learned Essential for senior leaders to drive, support and actively participate in Baldrige improvements CEO commitment and involvement Leaders as Champions, Category Co-leads The Baldrige Framework has to be integrated into everyday business not a separate project to build sustainable improvements The writing (and associated self-evaluation) generates as much learning as the feedback reports Spread the knowledge build examiner competency across the organization (we started at the State level) It s OK to use the B word builds common understanding Winning does not mean perfection Clarify and communicate: award or strategy?

We re Henry Ford, We Can