Service Excellence

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From Good to Great
Service Excellence University of Missouri Health
Care September 1, 2005
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• The charge for University of Missouri Health Care
  is to move from a good organization to a great
  one.
• We HAVE a sense of urgency to do this.

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Our employees, our physicians and our patients
ARE our health systems top priority.
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UMHC Culture

• This commitment requires people to change.

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Hardwiring Excellence by Quint Studer

• Model for organizational excellence
• Guide for best practices, not a mold

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Becoming a World-Class Organization Requires

• Committing to excellence
• Measuring the important things
• Building a culture around excellence
• Creating and developing leaders
• Focusing on employee satisfaction
• Building individual accountability
• Aligning behaviors with goals and values
• Communicating at all levels
• Recognizing and rewarding success

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Our Commitment to Excellence
The journey to excellence begins with a firm and
measurable commitment from EVERYONE.We no
longer want to be good. Our goal is to be
Grrrreat!
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Our Commitment to Excellence
There is no THEY
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University of Missouri Health Care

• Our Mission
• As part of a land-grant university, University
  of Missouri Health Cares core mission is to
  provide education, research and service to the
  residents of Missouri with an emphasis on the
  needs of rural Missouri.
• Our Vision
• To offer programs of unsurpassed excellence that
  will be integrated into a highly efficient,
  fiscally sound, professionally outstanding,
  service oriented health system that is unified in
  a common purpose to be one of the premier
  comprehensive academic health systems in the
  nation.

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Our Values

• Quality. We believe in quality quality in the
  patient care we deliver and the people we hire.
• Efficiency. Our goal is to provide the highest
  quality care at the lowest possible price.
• Caring Attitude. We care about the people who
  come here, whether they are patients or visitors.
  We treat them with courtesy and respect.
• Participation. We encourage and depend on our
  staff to help us guide this organization. Their
  guidance is accomplished by participating in
  elected and appointed committees and task forces.

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We identified six Columns of Excellence to
provide the foundation for setting goals and
direction for service and organizational
excellence at University of Missouri Health Care
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System Approach to Columns
Financial
Patient Satisfaction
Key Clinical Indicator Review Medication
Errors Reduction of Patient Falls
Turnover Turnover First 90 Days Employee
Satisfaction Retention Employee Evaluation
Completion Wins
Operating Margin (MTD/YTD) Cash Collection
New Patient Volume Growth Surgical Growth No Shows
Examples
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Facility Approach to Columns
Financial
Key Clinical Indictors results for the
org Reward Recognize leaders
Reward Recognize staff Turnover Staff
forums Upcoming hospital celebrations
Operating Margin Cash Collections AR days
Market Share Specific Service line growth No
Shows Community Events
Patient Satisfaction Reward Recognize leaders
of areas scoring well Standard of the Month
Celebration Patient letters
Examples
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Department Approach to Columns
Financial
Dept Patient Satisfaction Patient comments What
we have improved Where we need to focus Ideas
from staff
Dept Quality Indicators RR improved areas Key
action steps for staff to take next 30 days New
tools equipment
Introduce new employees New Tools
Equipment Dept Turnover Upcoming training
activities Reward Recognition
Dept Productivity Dept supply costs Key actions
for staff to take next 30 days Hospital/Dept
financial performance YTD
Dept admissions Community Events Hospital growth
YTD
Examples
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Building a Culture Around Excellence

• Core Team Formed
• January 2005
• Service Teams Formed
• April 2005
• Approximately 100 employees involved to date
• Quarterly Leadership Retreats

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Standards Team
Team Members
Ben Atwell Shanna Baldridge Karen Broz Dr
Robert Bynum Dave Geiger Marty Hausman Michel
Hayes Craig Hosey Pam Mulholland Karen Scott
Kay Steward
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What We Do

• Purpose To create the foundation of our culture
  of Service Excellence
• Goals We asked ourselves What kind of
  behaviors do we need to become a culture of
  excellence for patients, staff, and physicians?
• The answer The Standards of Performance

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The Commitment

• Current Staff
• All signing is cascaded down through executive
  Leadership, then their direct reports, etc
• All staff are to have signed by September 30,
  2005
• New staff
• HR on line Standards prior to application
  access
• Departmental signing as well and departmental
  orientation (added to orientation checklist)

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Our Projects

• Education
• A traveling carnival UH, CRH, EFCC, QD
• Positive Learning Environment
• Fun and Interactive
• Different Booths to Represent each Standard
• Prizes, candy, etc. for winners
• Standard of the Month

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Patient Satisfaction Team
Team Members
Laura Phillips Bonnie Potter Linda Robb Dan
Smith Susan Straatmann Patty Wells Darian
Younger
Barb Barrett Deb Calder Jan Degraffenreid Paula
Flandermeyer Shawn McGrew Ellen McKenzie Nakia
Moore Katherine Payne
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What We Do

• Purpose
• Ensure highest level of service is consistently
  provided
• Develop new ideas to continually improve the
  service and to share best practices among
  departments to help others learn
• Goals
• Look for ways to wow patients and families
• Solicit input on ways to improve care
• Develop implement key words at key times
• Implement communication boards in patient rooms
• Implement nurse leader rounding
• Implement discharge phone calls

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Our Projects

• Cascade Learning Packets
• Interest, Concern, Apologize, Respond, and
  Educate
• Quick Wins for specific areas

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Physician Satisfaction Team
Team Members

• Pete Ackerman, MD Marty McCormick
• Karen Calhoun, MD David Mountjoy
• Steve Calloway, RPh Sue Scott, RN
• Kevin Dellsperger, MD Tom Selva, MD
• Jessica Hardy Beth Van Hove
• Nancy Jones, RN Jennifer Wallace, RN
• Melissa Lyons, M3 Andrew Wheeler, M3
• Dennis McGowan Mary Williamson, RN

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What We Do

• Purpose
• Responsible for wowing physicians and
  improving the level of service to them and their
  patients
• Goals
• Implement action steps with outcomes that will be
  seen by medical staff as a win
• Modify key processes within the institutions that
  will allow for ease in patient care delivery

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Our Projects

• Quick Wins
• House Phone Conversions
• Replacing Tone Pagers with Text Capabilities
• On Call Schedules On Line, One Reference Point
• Hospital Marketing for Physician Providers
• Facility Improvements Hit Squad concept
• Nurse Call Line

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Priority Focus Patient Care Made Easier

• Hypothesis
• Addressing Patient Care Made Easier will improve
  physician, staff and patient satisfaction levels
• Action Steps
• Identified discharge planning process as area for
  re-design
• PSTF team joins forces with nursing
  administration to reach key goals for discharge
  planning revisions
• Blitz Session to address key goals scheduled for
  September 30, 2005

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Employer of Choice Team
Team Members

• Anissa Leaseburg Mindy Cherrington
• Lezlie Dahlke Linda Davis
• Gayla Maier Ramonna McKinzie
• Theresa Nation Brenda Quinlan
• Carey Smith Randy Wade
• Angela Waller David Wiss

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What We Do

• Purpose
• Implement programs and opportunities to help
  employees feel they are doing meaningful,
  purposeful and worthwhile work
• Goals
• To make UMHC the destination employer, not a
  stepping stone

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Our Projects

• Our projects will focus on system wide policies,
  procedures and programs that can be implemented
  to make UMHC an Employer of Choice. Future
  recommendations
• Encouraging opportunities for employees to be
  involved in decision making about issues that
  affect them, such as hiring decisions and work
  space and facility decisions
• Ensuring that UMHC has a market competitive
  compensation program that encourages and rewards
  superior performance and shares gains with rank
  and file employees
• Enhancing an already strong benefits program
• Sustaining a culture that holds everyone in the
  organization, at all levels, accountable for
  their performance

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Measurement Team
Team Members

• Kim Bass Amy Camp
• Karen Cox Rachel Haverstick
• Christine Heath Bruce Horwitz
• Will Kiehl Manuel Navarro
• Michele Schutte David Sohl
• Barb White

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What We Do

• Purpose
• To correctly measure, interpret, and communicate
  progress toward the organizations objectives
• Goals
• To develop and distribute performance data in a
  clear and useful format to all departments and
  administration
• Work with leadership to promote understanding and
  utilization of data
• Assist other teams by providing information for
  planning, decision-making and reward/recognition

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Our Projects

• Current and future projects/actions
• Design patient satisfaction reports for each
  unit, department and facility
• Create a presentation to provide an overview and
  explain the data to departments
• Review/evaluate current survey tools
• Develop methodology for distribution and review
  of survey comments

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Sample Reports
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More Sample Reports
Five Best - Employee Satisfaction
Mean
CRH Employees
Mean
UHC Employees
79.5
Human Resources
Guest House
88.4
75.4
Ortho Rehab
84.7
CPG Brookfield
71.7
Data Processing, TSS/ITS
Endoscopy
76.4
66.6
Pharmacy
76.1
PMR Clinic
66.1
Admitting
73.9
OMER
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Service Recovery Team
Team Members

• Anita Beall Susan Lee
• Kim Brucks Velma Moore
• Lorna Carver Carol Nierling
• Karen Harris Dan Smith
• Candace Hawkes Tracie Wideman
• Mickie Kummer Amanda Wood

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What We Do

• To provide staff with information to enhance
  their customer service skills
• To provide staff with the tools necessary to
  recover when a customers expectations have
  not been met

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Our Projects

• Develop a brochure for staff that provides key
  words/scripting to promote good customer service
  skills
• Develop an educational video with case scenarios
  depicting excellent customer service delivery
• Provide each department with a tool kit that
  will provide immediate access to resources for
  service recovery
• Develop a log for each department to document
  service recovery occurrences and to determine
  trends for process improvement

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Our Projects

• The educational brochure attached will give staff
  information to enhance their customer service
  skills and includes the I CARE document
• This brochure will also list specific measures to
  take when service recovery is needed
• It will also be used during new staff orientation
  to promote appropriate customer service skills
  with new staff and will reinforce our Standards
  of Performance

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Communications Team
Team Members

• Cindy Alverson Freese Clay Anderson, M.D.
• Jennifer Coffman Rosemary Frank
• Janice Gartman Paula Heaviland
• Mary Jenkins Julie McKay
• Scott Stever Susan Straatmann
• Tina Taylor Carol Wilhite

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What We Do

• Purpose
• To encourage and facilitate open, truthful and
  timely communication using a wide variety of
  communication sources
• Goals
• To ensure all University of Missouri Health Care
  employees have easy and convenient access to both
  system-wide and department-specific information
• To help other Service Excellence teams
  communicate their initiatives, projects and
  progress with the entire University of Missouri
  Health Care staff and, when appropriate, the
  community at large

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Team Principles

• Six principles should guide all communication
• Be truthful
• Be transparent
• Be kind
• Be an active listener
• Be respectful
• Be timely

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Our Projects

• Communication Boards
• Step one Place one public communication board
  in each of the seven major facilities, including
• University Hospital
• University Physicians Medical Building
• Columbia Regional Hospital
• Ellis Fischel Cancer Center
• Quarterdeck
• School of Medicine
• Missouri Rehabilitation Center
• Step two Place one department-specific
  communication board in every department within
  University of Missouri Health Care

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Our Projects

• Public Communication Boards will contain
• System-wide and facility-specific Communication
  that falls under one of the six columns of
  Service Excellence
• Department Communication Boards will contain
• Department-specific information that falls under
  one of the six columns of Service Excellence

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Future Projects

• Training for Managers
• Cascade learning on how to hold staff meetings
  
• Communication Support
• Help other teams construct communication plans
  for disseminating information about their
  programs, plans, progress and people

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Reward Recognition Team
Team Members

• Kevin Anderson Barb Brucks
• Karen Calhoun, MD Carol Clark
• Justin Delap Deborah Harvey
• Louise Harvey Ron Hausheer
• Sarah Knoerr Cheryl Kyle
• Jane Nelson Kym Pieper
• Catherine Price Wayne Richards
• Deneal Sullivan Ceresa Ward

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Our Purpose

• Goal
• Impact staff, physician and patient satisfaction
  by
• Reinforcing desired behaviors by rewarding
  recognizing employees
• Building a culture of ownership and
  responsibility with regards to reward and
  recognition
• Actions
• Work with leaders to identify recognition
  opportunities
• Evaluate and improve existing programs
• Implement new programs for areas where there are
  gaps
• Assist with other celebrations as needed
• Compensation is a right Recognition is a gift.
  
• - Rosaveth Moss Kanter -

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Proposed Basic Structure
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Department Based Proposal

• Budgeting for department based recognition
• Spontaneous recognition for crunch time effort
• Other department based activities

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Support Requested

• Making This Work
• Consistently give verbal Thank Yous and write
  Thank You Notes
• Nominate staff, peers, and leaders for
  Heroes/Legends
• Tell great stories at meetings and events
• Harvest the celebrations collect stories from
  your direct reports and expect them to collect
  from their staff
• Never underestimate the difference you can
  make!
• - Quint Studer -

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Leadership Development Team
Team Members

• Kevin Anderson Kim Bass
• Lynne Hedrick Susan Heimsoth
• Linda Lightfoot Juni Muhota
• LuAnn Tandy Ceresa Ward
• and
• Your Participation is Requested

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Leadership Development

• Goal
• For our organization to go from good to great,
  we must have great leaders who
• Learn
• Grow in their knowledge and role
• Share information, time and recognition
• Model the way
• Lead the charge

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Leadership Development

• Actions
• Work with Executive Team to establish Leadership
  Retreat outcomes
• Coordinate Leadership Retreat delivery and
  implementation
• Communication Pre and Post Leadership Retreat
• Ensure that leadership retreats are creative and
  fun
• Assist with development of Cascade Learning

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Cascade Learning

• Purpose
• Communication and Training
• Goal
• Consistent basic message with ability to meet
  departmental needs
• Delivery
• Leaders first learn/hear the message
• Receive a cascade learning packet
• Present and discuss the message with department
• Report completion to Associate Director

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Must Haves

• Cascade Learning
• Employee Thank You Notes
• Rounding for Outcomes
• Discharge Phone Calls
• Key Words / Key Actions
• Alignment of Organizational Goals
• Selection and Retention of Staff

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Rounding

• Satisfied employees do a better job. To
  increase employee satisfaction, we use a process
  called rounding for outcomes involving senior
  leadership and department managers.
• Information will be used to improve the
  environment.

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Rounding

• When managers make rounds with purpose, they
  ask
• Tell me what is working well today?
• Are there any individuals I should be
  recognizing?
• Are there any physicians I should be recognizing?
• Is there anything we can do better?
• Do you have the tools and equipment to do your
  job?

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Renters vs. Owners

• A sense of ownership in the organization, builds
  individual accountability. Ways to create a
  sense of ownership and accountability include
• Allowing employees to participate in peer
  interviews
• Asking their feedback in 30- and 90-day new
  employee meetings
• Requiring them to sign a Standards of Performance
  Agreement
• Encouraging employees to share their ideas for
  best practices

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Communication

• Communication is key to our success. We will
  employ the following measures to achieve
  improvement
• Managing up positioning people well
• Employee forums quarterly, led by senior
  leaders
• Communication boards department-level, key
  information on progress toward the organizations
  goals
• Storytelling sharing stories about everyday
  acts of heroism that take place in our facilities
• We want to duplicate positive behavior.

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The Magic Bus
First, you have to get the right people on the
bus, the wrong people off the bus, and the right
people in the right seats and then you figure
out where to drive it. - Jim Collins - Author of
Good to Great
UMHC
Excellence
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Summary

• Our actions speak much more clearly than our
  words
• We are not in the health care business we are
  in the life enhancement business.
• - Timothy Jarm -
• President /CEO Jewish Hospital

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Our Future

• A journey of a thousand miles begins with a
  single step.
• - Confucius -