Title: Sherry Marshall
1Sherry Marshall
Integrating the Baldrige Business Model in
Healthcare A Focus on Measurement and
Process Management
- Vice President, Quality
- Saint Lukes Hospital of Kansas City
2Saint Lukes HospitalKansas City, Missouri
3Where We Came From
Saint Lukes Hospital
- Founded in 1882
- Articles of Agreement dated October 3, 1882
- Charity care was an important aspect of the
agreement - New hospital was designated a teaching institution
4Saint Lukes Hospital
Who We Are Today
- 582 beds
- 3186 employees
- 500 physicians
- Not for profit
- Tertiary care referral
- Protestant Episcopal Church
- Primary teaching hospital UMKC School of
Medicine - Level I Trauma Center
- Level III Neonatal care
- Centers of Excellence
5Mission
Saint Lukes Hospital
Committed to the highest levels of excellence in
providing health services to all patients in a
caring environmentdedicated to medical research
and education.
6Vision
Saint Lukes Hospital
The Best Place to Get Care,The Best Place to
Give Care
7The Best Place to Get Care
Saint Lukes Hospital
Most Preferred in Kansas City
NRC 1997, 1998, 1999, 2000, 2001, 2002, 2003,
2004
8The Best Place to Give Care
Saint Lukes Hospital
Our People Make the Difference
- That is why
- High retention
- High employee satisfaction
- Highly dedicated and engaged workforce
9What We Stand For
Saint Lukes Hospital
- Our Core Values
- Quality/Excellence
- Customer Focus
- Resource Management
- Team Work
Be the Best Identify/Analyze Problems High
Quality Corporate Compliance Courtesy/Respect Cust
omer Satisfaction Ethics/Confidentiality Celebrate
Diversity Cost Effective Flexibility Cooperation
Honest Communication Team Culture Recognize
Achievement
O R G A N I Z A T I O N A L E X C E L L E N C E
122 Years Serving Kansas City and the Region
10Saint Lukes HospitalOrganizational Milestones
- Received third Missouri Quality Award
- Site visit by MBNQA
- Third refinement of the Balanced Scorecard
- Deployed 90-Day Action Planning Process
11Saint Lukes HospitalOrganizational Milestones
- Developed and deployed process level scorecards
in key areas - Began preparation to achieve Nursing Magnet
designation - Selected as a Malcolm Baldrige National Quality
Award recipient
12Agility Continuous Learning Innovation
Information Sharing
Saint Lukes Hospital
Leadership for Performance Excellence Model
13Saint Lukes Hospital
Performance Measurement
Balanced Scorecard
- Financial
- Customer Satisfaction
- Growth Development
- Clinical and Administrative Quality
- People
- Key measures linked to strategy
- Operating Margin
- Overall Customer Satisfaction
- Profitable Market Share
- Patient Safety Index
- Retention
- Scoring criteria set by statistical methods and
benchmarks
- Tracks overall organization performance
- Provides organizational alignment
14Saint Lukes Hospital
Performance Measurement
Balanced Scorecard Trend Charts
15Saint Lukes Hospital
Performance Measurement
16Physicians as Partners
Saint Lukes Hospital
1790-Day Action Plans
Saint Lukes Hospital
- Making it real for leaders
- Operating margin
- Patient Safety index
- Overall satisfaction
- Revenue growth
- Retention
18Saint Lukes Hospital
Performance Analysis
BSC Departmental Report Form
- One BSC measure from each perspective is selected
(Strategic Focus Area SFA) - Managers develop department 90-day action plans
for each SFA
- Provides alignment of Hospital strategic plan at
the department level - Provides focus for managers
- Results reported monthly and trended over time
19Saint Lukes Hospital
Performance Analysis
BSC Departmental Report Form
20Performance Management Cycle
Saint Lukes Hospital
- Planning goal setting at start of the year
- Coaching through the year
- Review at the end of the year, with merit
increase awarded
21Saint Lukes Hospital
Performance ManagementProcess by Core Value
- Shared Behaviors What is expected of me as an
employee of Saint Lukes Health System? - Job Specific Accountabilities What am I
accountable for because of the job I hold? - Personal Commitments What goals will I commit
to for the coming year based on my own individual
talents?
22Saint Lukes Hospital
Alignment of Strategy with the Performance
Management Process (PMP)
- Assure financial stability by SLH departments and
services collectively achieving operating margin
goal. - Department Director Personal Commitment
- Assure financial stability of East 3 by meeting
budgeted gross revenue and maintaining supplies,
salaries and other expenses within 2003 budget.
Measured with the monthly flex budget report. - Registered Nurse I Personal Commitment
- Achieve 100 accuracy on charge entry and
documentation measured by quarterly unit audits
23Saint Lukes Hospital
Managing and Improving Processes Process Level
Scorecards
- How do you know youve had a good day?
24Saint Lukes Hospital
Achieving Strategic Alignment Throughout the SLHS
25Saint Lukes Hospital
Why Process Level Scorecards?
- Recognition that all work is a process designed
to meet customers needs - Do we really understand how well our processes
are working? - Serves to link daily operations, in-process
measures and BSC outcomes measures - Used by process owners to monitor overall process
performance
26Saint Lukes Hospital
Why Process Scorecards?
- MQA and Baldrige feedback
- SLH focus is on continuous improvement
- Processes are not well-defined, documented and
identified in many areas - Better definition of processes and better
measurement of processes can yield even greater
improvement opportunities
27Relationships
Saint Lukes Hospital
Organizational Scorecard
Process Scorecard
Provides Inputs
Enables Drill Down Into Processes
28Relationships
Saint Lukes Hospital
- Organizational Scorecard
- Is focused on key performance indicators
- Enables determination of organizational health
- Enables focus on improving in key areas
- Process Scorecard
- Defines the activities within processes and
handoffs - In-process measures identify key control data
points - Enables drill-down to areas affecting performance
- Outcomes of processes feed the Organizational
Scorecard - Becomes the foundation for process improvement
activities
29Saint Lukes Hospital
ApproachDeveloping Process Level Scorecards
- Senior leaders identified key processes and
process owners by balanced scorecard perspective - Defined a plan for building a process level
scorecard
30Level 1 Processes
Saint Lukes Hospital
- Perform Financial Management
- Satisfy Customers
- Enhance Growth and Development
- Provide Clinical and Administrative Services
- Manage Human Resources
31Level 2 Processes Manage Human Resources
Saint Lukes Hospital
- Hire staff
- Orient new employees
- Train staff
- Develop staff
- Motivate staff
32Level 3 Processes Motivate Staff
Saint Lukes Hospital
- Segment employees
- Determine employee satisfaction
- Recognize employees
- Provide and administer benefits and compensation
- Provide a safe work environment
33Process Scorecard Results
Saint Lukes Hospital
34Saint Lukes Hospital
Process Scorecard Results
35Saint Lukes Hospital
Process Scorecard Results
36Saint Lukes Hospital Process Scorecards
- Phase 1 Processes
- Manage Suppliers and Partners
- Admit Patients
- Initial Assessment of Patients
- Manage BSC Process
- Manage Hotel Services
- Reward and Recognize Employees
37Saint Lukes Hospital Process Scorecards
- Phase 2 Processes
- Manage Surgery Capacity
- Manage Inpatient Capacity
- Manage Facilities and Equipment
- Recruit New Staff
- Capture Accurate Transfer Admitting
- Information
- Manage Complaints
38Saint Lukes HospitalEnd Result
- Process scorecards provide useful sets of
measures - Allow us to take a proactive rather than a
reactive approach to care/services we provide - Allows us to take action based on fact-based
evidence rather than anecdotal information - Knowledge to develop additional scorecards
- Helps us to answer the question Are we meeting
our customers needs?
39- So, Has the Baldrige Management Model Made a
Difference?
40Organizational Rewards
Baldrige Business Model
- Improved Clinical Outcomes
Patients Receiving tPA Following Ischemic Stroke
41Baldrige Business Model
Organizational Rewards
- Improved Customer Satisfaction
Patient Satisfaction
42Baldrige Business Model
Organizational Rewards
- Sustained High Levels of Consumer Perception
NRC Perception Rankings vs. Top Competitors
43Baldrige Business Model
Organizational Rewards
- Improved Financial Performance
Days Cash on Hand
44Baldrige Business Model
Organizational Rewards
- High Levels of Employee Satisfaction
Employee Satisfaction
45Baldrige Business Model
Organizational Rewards
SLH Retention
46Baldrige Business Model
Organizational Rewards
Human Capital Value Added
47Saint Lukes HospitalSustaining Performance
Excellence
Lessons Learned
- Leadership drives and sustains the process
- Leadership at all levels is important
- More difficult to change the culture than to
learn the tools - Valuable team building experience
- Trust is extremely important
48Saint Lukes HospitalSustaining Performance
Excellence
Lessons Learned
- There are no quick fixes
- Must always focus on the customer
- Should never be satisfied with the present level
of quality - Decisions must be driven by data and compared to
best - Employees make it happen!
49Baldrige Business Model
Next Steps
- Study our feedback report
- Celebrate our strengths
- Prioritize our OFIs
- Use feedback to improve
- Continue to share what weve learned
- Continue to learn from others
50Baldrige Business Model
The Value
- Feedback, Feedback, Feedback!
- Criteria is the Best Way to Get Better, Faster
- Enhanced Our Internal Pride
- Positions Us Ahead of Our Competition
- Recognized as an Industry Leader
- Raises Healthcare Industry to Higher Levels of
Performance
51Saint Lukes Hospital
Our People Make the Difference
They Are Our Competitive Advantage!
52Saint Lukes HospitalKansas City, Missouri
THE BEST PLACE TO GET CARE
THE BEST PLACE TO GIVE CARE!