All Campus Leadership July 10, 2009.

All Campus Leadership

July 10, 2009

“According to the

cleanliness of my hands, God rewards

me.”Psalms 18:20

All Campus LeadershipLars Houmann

July 10, 2009

2010 PLANNING

• Recession

• Reform

HEALTHCARE REFORM’S BIG TOPICS

• Public Option

• Mandate

• Cost

AHS/FLORIDA HOSPITAL POSITION

• Simple, fair payment system

• “Smart” reimbursement

• Basic coverage for preventive health

• Reform Stark regulations

HOSPITAL INDUSTRY

“Do Our Part” – July 7, 2009

• Cover 95% of Americans

• $155Bn payment reductions

• Public Exchange

• Delivery System Reforms

SURE BETS

• Improve Patient Experience

• Improve Patient Care

• Create Value

• Align Physicians

• Engage Employees

• Innovate

NEJM – Table 3 – Classification Requirements

Adoption Level - % of hospitals 1.5 7.6 10.9

2012 CHALLENGE

• Indisputable market leader• Florida Hospital for Children nationally recognized• Statutory teaching• World leader in training surgeons• FH patient experience as role model• Preventable deaths to zero• Electronic record• Health improvement business model and

economic returns• Cash to long-term debt > 110%

Market Overview

Agenda

Market Demographics & Growth

Competitive Landscape

Market Share

Brand (NRC)

Major Market Messages

Market Demographics & Growth

Population Growth

The Tri-County market is expected to outpace

the US population growth rate

Geographic Area 2008

Population2013

Population5-YearGrowth

AnnualGrowth

United States of America 304,092,641 319,109,046 4.9% 1.0%

Florida 18,599,593 20,253,441 8.9% 1.7%

Tri-County Market 1,768,816 1,985,721 12.3% 2.3%

Orange 1,125,683 1,250,551 11.1% 2.1%

Osceola 258,031 315,254 22.2% 4.1%

Seminole 385,102 419,916 9.0% 1.7%

Source: U.S. Census Bureau and Solucient

Unemployment Trends

Source: Florida Research and Economic Database; Tri-Co includes Seminole, Orange, and Osceola Counties

Orlando Area Uninsured Population

Source: U.S. Census Bureau and Solucient

Florida

2006 315,742

2007 321,741

2008 326,338

2009 P 331,233

2010 P 336,201

Market Growth Total Hospital Admissions by County

Market Growth

County 2008 Market Size ’06 vs.’05 ’07 vs.’06 ’08 vs.’07

Tri County Total 202,211 1.1% 3.7% 4.0%

Orange 132,716 1.1% 3.7% 4.2%

Osceola 27,797 0.1% 9.6% 5.5%

Seminole 41,697 1.7% -0.1% 2.3%

Brevard 70,961 1.8% -2.5% -3.0%

Polk 81,544 -0.2% 3.1% -1.5%

Highlands 16,455 1.6% -2.6% -3.9%

Lake 43,501 2.1% 1.3% 3.4%

Volusia 64,324 -0.4% -2.7% -2.8%

Source: AHCA 2008A discharges, all DRGs except 794-795 and 945-946; 2008A is annualized based on Q1-Q3

Orlando Health Arnold Palmer Hospital for Children completed their $56 million

renovation, increasing their pediatric bed size from 96 to 158. The renovation included the addition of a new children’s kidney center and new IP and OP oncology wings.

Dr. P. Phillips Hospital plans to complete their $175 million

renovation project, increasing bed size from 135 to 240 beds, in 2010.

Dr. P. Phillips Hospital Chest Pain Center recently received full accreditation from the Society of Chest Pain Centers’ Accreditation Review Committee.

South Lake Hospital South Lake Hospital expects to add 54 new beds in 2010.

Nemours Foundation Nemours to build a 550,000 square-foot, 95-bed subspecialty

pediatric hospital on 60-acres in Lake Nona’s Medical City. Completion date expected 2012.

Imaging Centers There are 51 free standing Imaging Centers in the market.

Surgery Centers There are 31 free standing Surgery Centers in the market.

Market Share

1st Qtr 2009 Market Share

• Market Growth 2.7%• FH Growth 4.6%• OH Growth -0.4%

• FH Market Share 47.4% 48.2%

• Market Share Gap 11.1 13.1

In-Patient % Growth2009Q1 vs. 2008Q1

• Obstetrics– Market Growth -4.8%– OH Growth -8.2%– FH Growth 11.7%

• Pediatrics– Market Growth 22.5%– OH Growth 10.1%– FH Growth 35.7%

• Acute– Market Growth 3.6%– OH Growth 1.2%– FH Growth 4.1%

Tri-County Market Share

Orange – 47.2%

Osceola – 28.0%

Seminole – 50.2%

Tri-County Market Share

Northwest – 52.8% Northeast – 61.4%

Southeast – 45.8%

Southwest – 23.0% South –

North – 57.2%

Brand (NRC)

Combined Attributes(Best Doctors, Best Nurses, Best Image / Reputation, Best Overall Quality)

Source: National Research Corporation, Tri-County respondents only; 2009 data is January thru May

Base Size (1,148) (1,240) (1,095) (1,155) (635)

50.2% 47.9% 48.6%44.9%

37.8% 39.1%36.0%

38.8%35.2%

2005 2006 2007 2008 2009*

Florida Hospital Orlando Health

Consumer Preference by Age Group (based on Combined Attributes)

18-34 35-44

45-64 65 and Older

41.8%37.8% 38.3% 37.0%

48.0%43.9% 42.1%

34.1%26.4% 29.7%

2005 2006 2007 2008 2009*

43.4%49.9%

41.8% 43.4% 44.6%43.2%39.0% 40.3%

33.4% 36.8%

2005 2006 2007 2008 2009*

52.3%48.5%

45.4% 42.9%47.0%

36.8% 38.3% 39.5% 38.4% 38.7%

2005 2006 2007 2008 2009*Florida Hospital Orlando Health

49.0%57.1%

34.0%29.6%

2005 2006 2007 2008 2009*Florida Hospital Orlando Health

Consumer Preference by Gender (based on Combined Attributes)

Female Male

49.2% 47.8% 45.2% 45.7%49.7%

38.6% 38.6%35.9% 35.2% 34.6%

2005 2006 2007 2008 2009*

52.6%48.1%

34.5%38.0%

30.1%36.8% 36.4%

2005 2006 2007 2008 2009*

Consumer Preference by Household Income(based on Combined Attributes)

Under $25,000 $25,000 - $49,999

$50,000 - $74,999 $75,000 and Over

52.8%48.1% 46.7% 46.5%

32.8% 33.6% 32.7% 30.4%

2005 2006 2007 2008 2009*

47.3% 46.3%52.6%

49.0% 48.2%43.9% 41.4%

32.5%37.3%

2005 2006 2007 2008 2009*

50.7% 48.8%45.8%

37.7%42.2% 40.3%

34.7% 34.8%

2005 2006 2007 2008 2009*

49.8%47.1%

42.9%39.2%

32.8% 33.6% 32.7% 30.4%36.9%

2005 2006 2007 2008 2009*

Major Market Messages

• Growing Market• Uninsured Population will Continue to Grow• 1st Qtr 2009 – Market Share Gain• Overall Consumer Preference is Strong

– Females

– High Income Groups

• Strong Market Position– Seminole County– North of Hwy 50

• Significant Market Opportunities– South of Hwy 50

– Osceola County

Operational Assessment & Focus

Results

1. Retention• Total• Nursing

2. RN Hires

Campus Separation (Goal – 17.5%)

Altamonte Apopka Celebration Childrens East Orlando Kissimmee Orlando Winter Park

2008 2009

RN Separation (Goal – 15%)

Altamonte Apopka Celebration Childrens East Orlando Kissimmee Orlando Winter Park

2008 2009

• RN Hire Goal – 988

• YTD RN Hires – 597

• Remaining RN’s - 391

RN Hires

Patient Experience

Willingness to Recommend (YTD)

1. Inpatient (n=5,972)• 63% Top Box• 30-40th Percentile

2. Emergency Department (n=2,353)• 53% Top Box• 20-30th Percentile

3. OP Surgery (n=600)• 82% Top Box• 60th Percentile

4. OP Services (n=2,582)• 81% Top Box• 70th Percentile

Altamonte Apopka Celebration East Orlando Kissimmee Orlando Winter Park Children's

Top Box

Patient Experience

IP - Willingness to Rec.- YTD

Patient Experience

IP Service Mix

Maternity Medical Surgical

Orlando 5% 40% 55%

Altamonte 4% 75% 21%

Apopka 0% 100% 0%

East Orlando 0% 85% 15%

Winter Park 17% 50% 32%

Kissimmee 0% 78% 22%

Celebration Health 13% 41% 46%

FH TOTAL 7% 54% 39%

Patient Experience

IP Service Mix - Recommend

Top Box Percentage Maternity Medical Surgical Total

Orlando 79% 63% 71% 68%

Altamonte 76% 63% 69% 65%

Apopka - 38% - 38%

East Orlando - 45% 55% 46%

Winter Park 69% 57% 58% 59%

Kissimmee - 60% 57% 59%

Celebration Health 76% 63% 79% 72%

Total 74% 59% 70% 64%

70-80th 20-30th 60-70th

Patient Experience

ED - Willingness to Rec.- YTD

515353

Altamonte Apopka Celebration East Orlando Kissimmee Orlando Winter Park Children's

Top Box

50th Percentile

Clinical

Patient Care

1. Quantros - Readiness2. Emergency Department

Overall Compliance ResultsCombined Tracers, Record Reviews, Patient Care Interviews

Clinical

3D Performance (Goal = 60/175/360)

Alta. Apopka CH Childrens East Kiss. Orlando WP

Door to Prov. 52 68 81 52 77 68 66 80Door to D/C 215 183 238 198 247 212 266 252Door to Depart 405 487 559 352 445 394 499 478

1st Quarter - 2009

Alta. Apopka CH Childrens East Kiss. Orlando WPDoor to Prov. 44 62 68 40 74 64 56 58

Door to D/ C 196 174 205 158 238 192 233 220

Door to Depart 364 412 453 307 413 369 381 384

2nd Quarter - 2009

Q1 Q2 Change

Door - Prov. 70 61 -9Door to D/C 233 211 -22Door - Depart 466 391 -75

Clinical

3D Performance

Market

Volumes

1. IP Admissions & Surgery2. ED Visits3. Pure Outpatient

2008 2009 Budget Variance % of TargetPrevious Variance

Previous Year %

55,810 58,299 58,630 -331 99.4% 2,489 104.5%

Admissions

SURGERY 2008 2009 Budget Variance % of TargetPrevious Variance

% of Previous

INPT 13,386 13,485 14,554 -1,069 92.7% 99 100.7%

OP 14,952 16,398 15,738 660 104.2% 1,446 109.7%

Market

IP Admissions & Surgery

Market

ED Visits

ED Visits 2008 2009 Budget Variance % of TargetPrevious Variance

% of Previous

Gross 171,025 186,870 177,458 9,412 105.3% 15,845 109.3%

Net 165,571 183,333 172,767 10,566 106.1% 17,762 110.7%

LWBS% 3.19% 1.89% 2.64% 0.75% 139.7% 1.30%

Market

Pure Outpatient

PURE OP 2008 2009 Budget Variance % of Target

CT 17,977 18,250 17,402 848 104.9% 273 101.5%

ENDO 16,314 15,269 15,076 193 101.3% -1,045 93.6%

MRI 10,984 10,582 10,728 -146 98.6% -402 96.3%

Sleep 2,970 2,682 3,392 -710 79.1% -288 90.3%

Cath 687 561 671 -110 83.6% -126 81.7%

7 Areas of Focus

1. Basics of Clinical Care• Admission/Discharge Process• Medication Administration• MDRO• AHS Bundles

2. Volumes• Surgical• Pure OP

3. Patient Experience Projects• Children’s/Orlando/Altamonte – Disney Institute• East Project

7 Areas of Focus

4. Team• Engagement• Labor Management

5. Physician Development• 34 Physician recruitment projects in process

6. Expansion/Growth Projects• Kissimmee – MOB+• Winter Park – Women’s• Orlando – Children's, MOB, Front Entrance, OR’s• Celebration – Tower Planning• East Orlando – ASC

7. 2010 Planning – FOCUS WEEKS

CompliantQuestions Responses Q1 2009

CompliantQuestions Responses Q2 2009 % Change

Orlando 104270 111048 93.9% 128316 133557 96.1% 2.2%Children's 13901 14687 94.6% 12960 13555 95.6% 1.0%Altamonte 37979 40092 94.7% 41342 42566 97.1% 2.4%Winter Park 32190 33842 95.1% 45238 46719 96.8% 1.7%East Orlando 36267 38032 95.4% 44468 45809 97.1% 1.7%Celebration 19911 20604 96.6% 24691 25316 97.5% 0.9%Kissimmee 10008 10301 97.2% 13033 13178 98.9% 1.7%Apopka 12292 12639 97.3% 12207 12356 98.8% 1.5%System 266818 281245 94.9% 322255 333056 96.8% 1.9%

Results are the aggregate of compliant responses (“Yes”) over Observations (“Yes” or “No”) for the following audits:

Tracers: Audits by each unit/department on their own area. Includes environmental/process observations, patient/staff interview questions and some documentation review. Conducted once weekly.Open Record Review: Audits by each unit/department on their own area. Includes documentation review and some environmental observations. Conducted once daily.Patient Care Interviews: Audits by full-time Accreditation Services staff and part-time (loaned) staff from the campuses. Includes staff interview on National Pt. Safety Goals, navigating I-Extend, some documentation review and environmental observations. Conducted once weekly per department/unit.

SIA 4 Extend our Patients’ Continuum of Care

Why the focus on SIA 4

• Mission Extension-Creation Health• Supports our core inpatient services • Future Health care model• Part of Stimulus funding and proposed

health care reform• Dissatisfaction with existing delivery

model– Discharge process

Existing Continuum

• Wide range of existing services:• CentraCare• FPMG• Home Health• Retail Pharmacy• DME• Home Infusion• Others

• Large Amount of Revenue; Over 1million patient contact

Extending the Patients’ Continuum of Care –

a working definition

• Pre and Post Acute Care

• Hand offs to next level of care

• Continuity of Care

• Wellness, Prevention and Education

• Consumer focused thinking

• Elevating the health and healing relationship with our community

2010 Phase 1of the Journey

1. Formulate & Begin deploying Connectivity Strategy

CentraCare (2008)

Home Health (2009)

Rehab (2009)

EMR in clinically aligned physician practices (targeted 2011)

2010 Phase 1of the Journey

2. Continue Elevating Performance of Existing Continuum Services

3. Define and close Continuum Service gaps, were feasible

4. Continue Physician Alignment Strategies

SIA 4 Extending our Patients’ Continuum of Care by extending our Patients’ Experience

SIA & 2010 System Priorities

Purpose

1. Complete SIA Framework2. Affirm 2010 System Priorities3. Prepare for Pacesetter

Performance Measures (PPM’s)4. Say Thank You

Mission…Why We Exist

“To Extend the Healing Ministry of Christ”

Vision…Where We Are Going

“To be a global pacesetter delivering pre-eminent faith based health care”

Values…How We Live Our Mission

Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork

Pacesetter Performance… How we Stay Accountable

Team, Clinical, Service, Market, Finance

Pacesetter Performance…

How we Stay Accountable Team, Clinical, Service, Market, Finance

• Every Person, Every Time

Pacesetter Performance…

How we Stay Accountable Team, Clinical, Service, Market, Finance

• Strategic Innovation Agenda– Always a Journey, Never a Destination

• “You Can Count On Us”

• Holistic Approach (Decathlon Model)

Strategic Innovation Agenda

ELEVATE PATIENT SAFETY and CLINICAL EXCELLENCE

“EXCELERATE” CORE PROCESS IMPROVEMENT

ENRICH our PATIENT’S EXPERIENCE

EXTEND our CARE CONTINUUM

ENGAGE our COMMUNITY

S t r a t e g y

• What is the Center of the Strategic Innovation Agenda?

“Florida Hospital” Experience!

What is at the Heart of the “Florida Hospital” Experience?

CREATION Health!»Passion About»Best At»Creates Value

CREATION

S t r a t e g y C u l t u r e & Care

HEALTH

• What is the best expression of CREATION Health?

Healthy 100!

Why is a Healthy 100 Compelling?

• Its Powerful

• Its Inspiring ANDAND Motivating

• Its Action Oriented

For Appointment

407-303-7500

Healthy 100

• The Power in a Question

• It Engages– Staff

– Patients

– Community

Back to Engagement

Whole People,

Delivering Whole Person Care

The Power of Relationship

Clinical Care

Informative Care

EmpathicCare

APPRECIATED ADMIRED ADOPTED

Level of Connection (not time)

ILYTreating the Patient

Treating the Person

Healing the Individual

Good For Business!

What we have (our core)

What we want (our continuum)

HEALING

HEALTH

S t r a t e g y

Business ModelC u l t u r e & Care

CREATION

HEALTH

Outcome = Community Benefit

We are Relevant in ANY Future

2010 PrioritiesGrow the Market

• Develop New and Strengthen Existing Markets

• Reposition Surgical and Procedural Capability for Growth

• Develop and Implement an Aligned Ambulatory Model

• Grow Philanthropy Market Share and Reach

• Improve Revenue Share• Manage Florida as a Market

2010 PrioritiesImprove the Product

• Safety• Critical Process and Performance Focus• Leverage Clinical Information Technology• Patient Experience• Florida Hospital for Children (Walt Disney

Pavilion)• Strengthen and Support Research and

Medical Education• Value/Efficiency and Stewardship

We Stay on Plan…

We Execute

• Holistic Approach (Decathlon Model)

Organizational Performance

• Single Focused

• Balanced Performance

• Holistic Performance

Definition:“To View as a Single Complete System”

Principles:• One Investment = Many Returns• Improvement in one element doesn’t

harm another• Simultaneous Performance (Decathlon

Model)

Webster

Reasons it will help you

1. Multiyear Targets

2. Align Focus

3. Engage with Staff

2009 Strategic Review2009 Strategic Review

FINANCE

Admissions by CampusJune 2009 YTD

Budget % ofActual Budget Variance Previous Yr

Orlando 23,490 23,219 271 105.3%

Altamonte 9,984 9,738 246 110.3%

Apopka 1,227 1,707 (480) 75.7%

East Orlando 7,924 8,110 (186) 101.0%

Winter Park 8,004 8,133 (129) 103.5%

Kissimmee 2,206 2,100 106 107.2%

Celebration 5,578 5,623 (45) 108.6%

Total 58,425 58,630 (205) 104.7%

7,924 8,110 (186) 101.0%

Admissions by TypeJune 2009 YTD

Previous Actual Variance % Growth

Acute 46,577 49,073 2,496 5.4%

Obstetrics 4,346 4,394 48 1.1%Altamonte 580 580 0 0.0%

Celebration 1,002 1,030 28 2.8%

Orlando 1,371 1,399 28 2.0%

Winter Park 1,393 1,385 (8) (0.6%)

Rehab 353 347 (6) (1.7%)

Psych 1,258 1,099 (159) (12.6%)

Peds 3,030 3,289 259 8.5%

Neonatal 246 223 (23) (9.3%)

Total Adult 55,810 58,425 2,615 4.7%

Previous Actual Variance % Growth

Altamonte 580 580 0 0.0%

Celebration 1,002 1,030 28 2.8%

Orlando 1,371 1,399 28 2.0%

Winter Park 1,393 1,385 (8) (0.6%)

Net ED VisitsJune 2009 YTD

Orlando 33,248 29,621 3,627 118.1%Adults 27,060 116.1%Peds 6,188 127.9%

Altamonte 31,069 27,743 3,326 117.9%

Apopka 16,531 16,379 152 104.1%

East Orlando 36,376 32,680 3,696 113.1%

Winter Park 19,316 19,325 (9) 103.8%

Kissimmee 18,690 18,247 443 108.1%

Celebration 28,096 28,769 (673) 103.5%

Total 183,326 172,765 10,561 110.7%

Total SurgeriesJune 2009 YTD

Orlando 14,251 14,865 (614) 103.2%

Altamonte 4,698 4,882 (184) 105.2%

East Orlando 1,958 1,997 (39) 102.8%

Winter Park 4,533 4,330 203 107.8%

Kissimmee 1,030 989 41 122.6%

Celebration 3,411 3,229 182 109.5%

Total 29,881 30,292 (411) 105.4%

YTD Inpatient Payor Mix

YTD Outpatient Payor Mix

EBDIT by EntityJune 2009 YTD

Actual Budget Variance

Florida Hospital 157,532,168 160,645,041 (3,112,873)

FPMG 992,983 813,937 179,046

FHHS 2,920,899 1,735,941 1,184,958

FHCC 4,348,434 4,109,366 239,068

FRI 1,376,826 1,788,379 (411,553)

Other 703,402 1,013,596 (310,194)

Total 167,874,712 170,106,260 (2,231,548)

2010 Budget Assumptions

Admissions2009 2010 % Growth

Expected Budget

Orlando 46,017 48,055 2,038 4.4%

Altamonte 19,703 20,789 1,086 5.5%

Apopka 2,394 2,441 47 2.0%

East Orlando 15,702 16,272 570 3.6%

Winter Park 15,723 16,061 338 2.1%

Kissimmee 4,256 4,427 171 4.0%

Celebration 11,242 11,856 614 5.5%

Total 115,037 119,901 4,864 4.2%

2009 2010 % Growth

Expected BudgetVolume Growth

Net ED Visits2009 2010 % Growth

Expected Budget

Orlando 62,754 65,264 2,510 4.0%

Altamonte 61,550 64,936 3,386 5.5%

Apopka 31,603 32,172 569 1.8%

East Orlando 71,201 73,666 2,465 3.5%

Winter Park 38,778 39,670 892 2.3%

Kissimmee 35,140 36,560 1,420 4.0%

Celebration 53,858 55,473 1,615 3.0%

Total 354,884 367,741 12,857 3.6%

2009 2010 % Growth

Total Surgeries2009 2010 % Growth

Expected Budget

Orlando 27,817 29,328 1,511 5.4%

Altamonte 9,515 10,043 528 5.5%

East Orlando 3,979 4,001 22 0.6%

Winter Park 8,636 8,667 31 0.4%

Kissimmee 2,058 2,621 563 27.4%

Celebration 6,203 7,310 1,107 17.8%

Total 58,208 61,970 3,762 6.5%

2009 2010 % Growth

2010 Budget Assumptions

Percent Dollars

Medicaid Reduction 8.9% 10.8 M

Medicare Reduction 2.8% 13.0 M

InflationMerit Rate Increase 3.2% 22.7 M

Rate Structure 1.0% 10.0 M

Health Insurance 10.0% 7.5 M

Supply Inflation 5.0% 18.8 M

Other Inflation 3.0% 11.0 M

Total Inflation 70.0 M

Percent Dollars

2010 GAP Distribution

Inflation $ 70 M

Track II Expected Improvement $ 60 M

% of Total Expenses 3.4%

Planning Timeline

Distribute Departmental Operations Plan

Distribute Departmental Budgets

Technical Reviews

Focus Week

July 10, 2009

July 27, 2009

August 17, 2009

September 8 – 18, 2009

September 21 – October 2, 2009

To Access Presentation Visit

http://www.fhleadershipdevelopment.org/

July 10, 2009

All Campus Leadership July 10, 2009.

Documents

Transcript of All Campus Leadership July 10, 2009.

Demonstrating Global Campus Sustainability Leadership

July 17 campus notes 07172013

CELT (Campus Eco-Leadership Training.pptx

Maine Campus July 01 1943

Defense Systems Acquisition LtCol Mike Varmette Capital and Northeast Regional Campus Program Management and Leadership Dept. July 2004.

July 11 campus notes 07112013

Campus Leadership Presentation

ECH Campus Leadership Summit: Ilias Lakovidis

July 24th campus notes 07242012

July 27th campus notes 07272012

Promoting Student Leadership on Campus - idra.org Student Leadership on Campus ... through high school and into higher education. Emerging student leadership is an invaluable resource

Positive Leadership on Campus: Using the Science of ...

Leadership capacity, diversity, and communication in campus sustainability

LEADERSHIP COVENANT & EXPECTATIONSstorage.cloversites.com/campusministrygvsu/documents/CM Leadership... · LEADERSHIP COVENANT & EXPECTATIONS Campus Ministry leadership requires a

LEADERSHIP LESSONS & SUCCESS FACTORS RANEPA SUMMER CAMPUS.

July 26th campus notes 07262012

July 31 campus notes 07312012

How Campus Green Funds Promote Student Leadership

July 20th 2012 campus notes

Campus Resident July 2012