All Campus Leadership July 10, 2009.

133
All Campus Leadership July 10, 2009

Transcript of All Campus Leadership July 10, 2009.

Page 1: All Campus Leadership July 10, 2009.

All Campus Leadership

July 10, 2009

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“According to the

cleanliness of my hands, God rewards

me.”Psalms 18:20

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All Campus LeadershipLars Houmann

July 10, 2009

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2010 PLANNING

• Recession

• Reform

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HEALTHCARE REFORM’S BIG TOPICS

• Public Option

• Mandate

• Cost

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AHS/FLORIDA HOSPITAL POSITION

• Simple, fair payment system

• “Smart” reimbursement

• Basic coverage for preventive health

• Reform Stark regulations

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HOSPITAL INDUSTRY

“Do Our Part” – July 7, 2009

• Cover 95% of Americans

• $155Bn payment reductions

• Public Exchange

• Delivery System Reforms

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SURE BETS

• Improve Patient Experience

• Improve Patient Care

• Create Value

• Align Physicians

• Engage Employees

• Innovate

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NEJM – Table 3 – Classification Requirements

Adoption Level - % of hospitals 1.5 7.6 10.9

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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%

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All Campus Leadership

Market Overview

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Agenda

Market Demographics & Growth

Competitive Landscape

Market Share

Brand (NRC)

Major Market Messages

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Market Demographics & Growth

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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

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Unemployment Trends

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

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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

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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

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Competitive Landscape

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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.

Competitive Landscape

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Competitive Landscape

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.

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Market Share

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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

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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%

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Tri-County Market Share

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

Orange – 47.2%

Osceola – 28.0%

Seminole – 50.2%

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Tri-County Market Share

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

Northwest – 52.8% Northeast – 61.4%

Southeast – 45.8%

Southwest – 23.0% South –

32.9%

North – 57.2%

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Brand (NRC)

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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%

49.5%

37.8% 39.1%36.0%

38.8%35.2%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*

Florida Hospital Orlando Health

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Consumer Preference by Age Group (based on Combined Attributes)

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

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%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

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%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

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%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*Florida Hospital Orlando Health

69.5%

49.0%57.1%

48.4%

58.0%

19.1%

37.6%

22.1%

34.0%29.6%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

2005 2006 2007 2008 2009*Florida Hospital Orlando Health

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Consumer Preference by Gender (based on Combined Attributes)

Female Male

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

49.2% 47.8% 45.2% 45.7%49.7%

38.6% 38.6%35.9% 35.2% 34.6%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*

Florida Hospital Orlando Health

52.6%48.1%

53.0%

39.2%

49.0%

34.5%38.0%

30.1%36.8% 36.4%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*

Florida Hospital Orlando Health

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Consumer Preference by Household Income(based on Combined Attributes)

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

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

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

52.8%48.1% 46.7% 46.5%

49.3%

32.8% 33.6% 32.7% 30.4%

38.9%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*

Florida Hospital Orlando Health

47.3% 46.3%52.6%

49.0% 48.2%43.9% 41.4%

32.5%37.3%

35.5%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*

Florida Hospital Orlando Health

50.7% 48.8%45.8%

42.6%

52.4%

37.7%42.2% 40.3%

34.7% 34.8%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*

49.8%47.1%

42.9%39.2%

45.8%

32.8% 33.6% 32.7% 30.4%36.9%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

2005 2006 2007 2008 2009*

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Major Market Messages

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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

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Operational Assessment & Focus

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TEAM

Results

1. Retention• Total• Nursing

2. RN Hires

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TEAM

Campus Separation (Goal – 17.5%)

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Altamonte Apopka Celebration Childrens East Orlando Kissimmee Orlando Winter Park

Sepa

ratio

n Pe

rcen

tage

2008 2009

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TEAM

RN Separation (Goal – 15%)

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Sepa

ratio

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rcen

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• RN Hire Goal – 988

• YTD RN Hires – 597

• Remaining RN’s - 391

TEAM

RN Hires

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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

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

Pe

rce

nt

To

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ox

Top Box

Patient Experience

IP - Willingness to Rec.- YTD

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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%

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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

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Patient Experience

ED - Willingness to Rec.- YTD

71

515353

45

62

50

58

30

35

40

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50

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

Perc

ent T

op B

ox

Top Box

50th Percentile

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Clinical

Patient Care

1. Quantros - Readiness2. Emergency Department

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Overall Compliance ResultsCombined Tracers, Record Reviews, Patient Care Interviews

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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

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Q1 Q2 Change

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

Clinical

3D Performance

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Market

Volumes

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

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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

Year

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

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Market

ED Visits

ED Visits 2008 2009 Budget Variance % of TargetPrevious Variance

% of Previous

Year

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%

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Market

Pure Outpatient

PURE OP 2008 2009 Budget Variance % of Target

Previous

Variance

% of

Previous

Year

Rad Onc 65,829 73,347 68,237 5,110 107.5% 7,518 111.4%

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%

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2009

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

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2009

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

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END

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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.

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SIA 4 Extend our Patients’ Continuum of Care

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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

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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

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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

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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)

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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

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

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SIA & 2010 System Priorities

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Purpose

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

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

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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

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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

• Every Person, Every Time

Mission…Why We Exist

“To Extend the Healing Ministry of Christ”

Page 87: All Campus Leadership July 10, 2009.

Mission…Why We Exist

“To Extend the Healing Ministry of Christ”

Values…How We Live Our Mission

Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork

Pacesetter Performance…

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

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

Vision…Where We Are Going

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

Page 88: All Campus Leadership July 10, 2009.

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”

Pacesetter Performance… How we Stay Accountable

Team, Clinical, Service, Market, Finance

Values…How We Live Our Mission

Integrity, Compassion, Balance, Excellence, Stewardship, Teamwork

• “You Can Count On Us”

Page 89: All Campus Leadership July 10, 2009.

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

• Holistic Approach (Decathlon Model)

Page 90: All Campus Leadership July 10, 2009.
Page 91: All Campus Leadership July 10, 2009.

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

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Strategic Innovation Agenda

• What is the Center of the Strategic Innovation Agenda?

“Florida Hospital” Experience!

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Strategic Innovation Agenda

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

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

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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

CREATION

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

HEALTH

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Strategic Innovation Agenda

• What is the best expression of CREATION Health?

Healthy 100!

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Why is a Healthy 100 Compelling?

• Its Powerful

• Its Inspiring ANDAND Motivating

• Its Action Oriented

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For Appointment

407-303-7500

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Strategic Innovation Agenda

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Strategic Innovation Agenda

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Healthy 100

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Strategic Innovation Agenda

• The Power in a Question

• It Engages– Staff

– Patients

– Community

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Back to Engagement

Whole People,

Delivering Whole Person Care

Strategic Innovation Agenda

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The Power of Relationship

Clinical Care

Informative Care

EmpathicCare

APPRECIATED ADMIRED ADOPTED

Level of Connection (not time)

FAM

ILYTreating the Patient

Treating the Person

Healing the Individual

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Good For Business!

What we have (our core)

What we want (our continuum)

Strategic Innovation Agenda

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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

HEALING

HEALTH

S t r a t e g y

Business ModelC u l t u r e & Care

CREATION

HEALTH

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Outcome = Community Benefit

Strategic Innovation Agenda

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We are Relevant in ANY Future

Strategic Innovation Agenda

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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

Page 109: All Campus Leadership July 10, 2009.

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

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We Stay on Plan…

We Execute

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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

• Holistic Approach (Decathlon Model)

Page 112: All Campus Leadership July 10, 2009.

Organizational Performance

• Single Focused

• Balanced Performance

• Holistic Performance

Most

Some

Few

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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

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Reasons it will help you

1. Multiyear Targets

2. Align Focus

3. Engage with Staff

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2009 Strategic Review2009 Strategic Review

FINANCE

Page 118: All Campus Leadership July 10, 2009.

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%

Budget % ofActual Budget Variance Previous Yr

7,924 8,110 (186) 101.0%

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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%)

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Net ED VisitsJune 2009 YTD

Budget % ofActual Budget Variance Previous Yr

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%

Budget % ofActual Budget Variance Previous Yr

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Total SurgeriesJune 2009 YTD

Budget % ofActual Budget Variance Previous Yr

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%

Budget % ofActual Budget Variance Previous Yr

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YTD Inpatient Payor Mix

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YTD Outpatient Payor Mix

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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)

Page 125: All Campus Leadership July 10, 2009.

2010 Budget Assumptions

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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

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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

Expected BudgetVolume Growth

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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

Expected BudgetVolume Growth

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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

Page 130: All Campus Leadership July 10, 2009.

2010 GAP Distribution

Inflation $ 70 M

Track II Expected Improvement $ 60 M

% of Total Expenses 3.4%

Page 131: All Campus Leadership July 10, 2009.

Planning Timeline

All Campus Leadership

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

Page 132: All Campus Leadership July 10, 2009.

To Access Presentation Visit

http://www.fhleadershipdevelopment.org/

Page 133: All Campus Leadership July 10, 2009.

All Campus Leadership

July 10, 2009