DSHS Executive Retreat April 12, 2006

1
DSHS Executive RetreatApril 12, 2006

• Summary

2
Purpose

• Identify DSHS priorities.
• Strengthen executive relationships.
• Increase communication and collaboration within
  DSHS.

3
Executive Retreat Attendees

• Stephen Anfinson
• Robert Arizpe
• Richard Bays
• Cathy Campbell
• Zulema Carrillo
• Nick Curry
• Rick Danko
• Ted Debbs
• Evelyn Delgado
• Kenny Dudley
• Jim Elkins
• Greta Etnyre
• Olivia Flourney
• Randy Fritz
• Herman Greenfield
• Sandra Guerra-Cantu
• Fred Hale
• Sonia Hernandez-Keeble
• Janet Lawson

• Tom Martinec
• Paul McGaha
• James Morgan
• Jayne Nussbaum
• Peter Pendergrass
• Peggy Perry
• Machelle Pharr 
• Elaine Powell
• Eduardo Sanchez
• Carl Schock
• Blanca Serrano
• Brian Smith
• James Smith
• Mary Soto
• Debra Stabeno
• Tom Thornton
• Joe Vesowate
• Dave Wanser
• James Zoretic

4
Discussion Framework

• Where are we, post-consolidation?
• What have we accomplished?
• What are our challenges?
• Where are we going?

5
Leaders see the forest, the trees, and the
surrounding hills and valleys
6
How can we break down silos?

• Communicate
• Collaborate
• Establish strategic direction
• Recalibrate

7

• I skate to where the puck is going to be, not
  where it is.
  
• Wayne Gretzky

8
Collaborative Leadership

• Uses supportive and inclusive methods
• Ensures that people affected by a decision are
  part of the process
  
• Enhances the capacity of others to achieve a
  common purpose and benefit mutually

9
Glass Half Full Celebrating Successes

• With more than 100 examples lining the walls, the
  executive team acknowledged many large and small
  successes for DSHS, accomplished by hospitals,
  regions, divisions, COO, and CFO over the past
  months.

10
Celebrating Successes

• With a more holistic and compassionate approach
  to patient care, Rusk State Hospital decreased
  seclusion and restraint, patient injuries,
  Medicare complaints, abuse and neglect
  allegations/confirmations, workers-comp claims,
  and outside medical costs.

11
Celebrating Successes

• DSHS Hurricane Response 2005
• HSR 7 strengthened public health partnerships
  with multi-community collaborative in Brazos
  Valley and Highland Lakes.

12
Celebrating Successes

• Mental health hospitals added 96 forensic beds in
  record time and are bringing online 100
  civil-commitment beds.
  
• Implementing Regulatory Automation System in June
  2006, on schedule and slightly under budget

13
Celebrating Successes

• Health Services Region 11s binational
  Tuberculosis program invested 200,000 and
  avoided 4M in hospitalization costs by treating
  and preventing the spread of TB.
• Cancer Registry earned gold standard rating.

14
Celebrating Successes

• Texas Center for Infectious Disease and San
  Antonio State Hospital, along with San Antonio
  State School, established new relationships and
  gained significant efficiencies in their
  consolidation of financials, operations and
  productions, staff support, and other services.

15
Celebrating Successes

• Title V maternal and child health grant contracts
  realized improved birth outcomes, using
  evidence-based practices.
  
• Expanded basic training for staff on accounts
  payable, account coding, data-warehouse
  information, query/reporting, and HHSAS training
  for hospital accounting staff

16
Celebrating Successes

• Strategic National Stockpile Exercise, through a
  massive intra- and inter-agency effort, earned
  Texas a top-tier green rating for
  preparedness.
• Completed 7th floor of DSHS Lab organic chemistry
  lab and Emergency Operations Center on time and
  under budget.

17
Celebrating Successes

• HSR 2/3 achieved a more than 50 response rate in
  a survey of county judges to determine local
  public health priority needs, and increased
  designations of local health authorities to about
  35.
• Building Healthy Texans worksite-wellness program.

18
DSHS Priorities

• Based on the most important issues to start
  working on in 2006 that will help us realize our
  vision of a healthier Texas

19
DSHS Priorities

• Establish a work environment in which employees
  feel valued, productive, and supported.
  
• DSHS to become a recognized leader in innovative
  and streamlined business practices.
  
• Seek universal adoption and fidelity of
  evidence-based practices.
  
• Ensure that the agency is prepared to respond to
  emergencies.
  
• Catalyze and facilitate partnerships.

20
The Role of the Champion
To help facilitate the already existing DSHS
processes, and to act as a change agent within
the organization.

• Executive Leadership Team members choose to
  broaden and diversify their learning by engaging
  in issues outside their traditional areas.

21
PriorityEstablish a work environment in which
employees feel valued, productive, and supported.
Champion Dave WanserDebra StabenoTom
ThorntonZulema CarrilloStephen AnfinsonJames
MorganBlanca Serrano
22
Glass Half Full

• Feeling powerless to change what isnt working
• Employee input not valued
• Too little reward and recognition
• No process for making suggestions
• Bureaucracy kills us

23
90-Day Plan

• Reward and recognition
• Payroll-issue workgroup
• Instituting regional and hospital get-togethers
• Utilizing videoconferencing technology
• Publicizing minutes from all meetings
• Acknowledging the accomplishments

24
PriorityDSHS to become a recognized leader in
innovative and streamlined business practices
Champion Eduardo SanchezJoe VesowateTom
MartinecCathy CampbellJames Smith (Jim)Ted
DebbsRobert ArizpePeter Pendergrass
25
Glass Half Full

• Inadequate resources to do the job
• Business processes too complicated
• Improvements dont involve the end user
• Slow to fix mistakes
• Training on business practices not available

26
90-Day Plan

• Focus on budget-related issues
• Reduce decision making to the lowest level
• Reduce handoffs to complete an assignment
• Simplify processes for the end user

27
Priority Seek universal adoption and fidelity
of evidence-based practices
Champion Nick Curry Evelyn DelgadoRick
DankoFred HaleHerman GreenfieldPeggy
PerryJames ZoreticGreta Etnyre
28
Glass Half Full

• Decision making not always based on data
• Databases not linked
• Fear of change
• Unrealistic timelines
• Limited analysis

29
90-Day Plan

• Inventory evidence-based and best
  practices.
  
• Strategic plan for data
• Community Health Index
• Users group
• Designated leader
• State epidemiologist
• Partner with academics for data sources and
  analysis assistance

30
PriorityEnsure that the agency is prepared to
respond to emergencies
Champion Randy Fritz Janet LawsonMary
SotoJim ElkinsOlivia FlournoyKenny
DudleySandra Guerra-Cantu
31
Glass Half Full

• Emergency powers of DSHS
• Compassion fatigue
• Surge issues (not enough resources)
• Mismatch between expectations and capabilities
• Lack of training

32
90-Day Plan

• Clarify lines of authority.
• Clarify the health and medical role of DSHS in an
  emergency.
  
• Address surge capacity issues.

33
Priority Catalyze and facilitate partnerships
Champion Machelle Pharr J Richard BaysJayne
NussbaumCarl SchockSonia Hernandez-KeeblePaul
McGahaBrian SmithElaine Powell
34
Glass Half Full

• Lack of time and resources to develop
  partnerships
  
• Very diverse partners
• Some stakeholders have single-issue priorities.
• DSHS missions are too ambiguous.
• Lack of proven and reliable tools to work with
  partners

35
90-Day Plan

• Improve staff communications.
• Educate staff about programs.
• Develop communications plan for elected
  officials.
  
• Define partnership types/categories.
• Inventory of toolkits.
• Assign executive leaders to be primary contacts
  for each regional community.

36
Next Steps

• Champion will work with existing leadership
  structure of that priority.
  
• Present to Senior Management .
• Present to DSHS Council.
• DSHS Executive retreat in mid summer to review
  progress and focus on 1 priority.