Performance ExcellenceEngage for the New Age

Rulon F. Stacey, PhD, FACHEPresident, University of Colorado Health

© Copyright PVHS 2012 All Rights Reserved

Poudre Valley Health System• Private, locally owned, not-for-profit, integrated

health system• Full spectrum of healthcare services

– 2 tertiary hospitals (420 beds), outpatient campus, growing number of physician practices & outpatient facilities

– Joint ventures: Surgery centers, home care, sub-acute care, third-party administrator

Poudre Valley Health System

• Service area: Northern Colorado, Wyoming & Nebraska• 5,300 employees, 600 physicians & 1,000 volunteers• $1.4 billion in annual revenue

Where Our Journey StartedPoudre Valley Health System, 1997

• Community hospital serving Fort Collins, Colorado

• 1,500 employees, 300 independent physicians & 575 volunteers

• 24% annual employee turnover• 5 CEOs in 4 years• $250 million in annual revenue• Changing healthcare market• Demand for physician integration

• Leadership: Find an improvement model• The Work Horse Philosophy

Performance Excellence Journey

• Systems approach• Feedback

– Measures progress– Notes major strengths– Guides improvements

Why Baldrige?

Our Vision

To provide

world-class health care

WendyOncology

patient

Definition of World-Class

Striving for results in the 90th percentile

or top 10% of available national

comparative databases

CraigTrauma patient

Core Competencies

Customer-Focused OutcomesTop Box Scores for Patient Satisfaction

10 years of consistent improvement

Workforce-Focused OutcomesStaff Voluntary Turnover

Workforce-Focused OutcomesEmployee Engagement

Workforce-Focused OutcomesPhysician Engagement Scorecard

Healthcare OutcomesRisk-Adjusted Mortality Rate

What’s Next?• How do you sustain world-class performance?

Wave of Change in U.S. Healthcare• Patient Protection & Affordable Care Act• Future Trends

– Integration: Coordinate care, patient is the customer– Value: Deliver quality outcomes and high levels of

service at a reasonable cost – Transparency: Learn, grow and respond

• Challenge for healthcare providers– New reimbursement model– Higher accountability for quality

Engage for the New Age

• New physician model• New partners• Lean thinking

New Physician Model

• Colorado Health Medical Group

27 clinics, 180+ clinicians, 600 support staff

• Growing integration

2008: Nearly 100% independent practice

2012: 25% in CHMG, 75% independent

New Partners

• The perfect partner: University of Colorado Hospital • Magnet• #1 Academic Medical Center, U.S. News and World Report• Academic medicine and research• Continuous care for patients all over Colorado

• New partners across the region• Memorial Health System, Colorado Springs, Colorado• Ivinson Memorial, Laramie, Wyoming

From Independent to Inter-Dependent

• A collection of providers taking

shared responsibility for patients

over a period of time• Remove cost without

compromising quality• Integrate between facilities,

between providers• Improve what you’re already

supposed to be doing well

Doctors

Acute Care Hospitals

PharmaciesRehabilitation

Providers

Other Providers

Why Partner?

• Emergency Department length of stay down 72 minutes• Clinic registration times down 50%• Time for surgery pre-admit appointments down 50%• Design for new cancer center based on patient preferences• OR turn-around times in national top 1%

Lean Thinking

• Performance Excellence is not about:– Being average– Being perfect

• Performance Excellence is:– Asking the right questions– Continuing to improve– Having the right people around the table– Sharing and learning from others

Lessons Learned

Lessons Learned

• Work with state quality program• Must have commitment from senior leaders and Board• Don’t give up• Stop cramming for the test: Live it!• Consider it productive time• Make it how you do your business• It can’t be about the award

Health Care Moving Forward

Two Curves

The challenge of a 2 curve problem is to prosper in the

1st while you prepare for the 2nd

Cur

ve 1

Curve

2

Dramatic Changes to the Competitive Landscape

The blurring of lines between not-for-profit and for-profit health care creates new and more pragmatic competitors

The blurring of lines between health care’s traditional participants – insurers, hospitals, and physicians – resulting in new market entrants

Joint Venture to Form New System

Joint Venture to Acquire Catholic Hospitals acquires

acquires

Copyrighted by Kaufman, Hall & Associates, Inc. 2012

Throughout All of These Challenges and Changes,Performance Excellence Still Saves Lives!

Molly 4th generation treated at PVH