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Sherry Marshall

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Title: Sherry Marshall


1
Sherry Marshall
Integrating the Baldrige Business Model in
Healthcare A Focus on Measurement and
Process Management
  • Vice President, Quality
  • Saint Lukes Hospital of Kansas City

2
Saint Lukes HospitalKansas City, Missouri
3
Where 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

4
Saint 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

5
Mission
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.
6
Vision
Saint Lukes Hospital
The Best Place to Get Care,The Best Place to
Give Care
7
The Best Place to Get Care
Saint Lukes Hospital
Most Preferred in Kansas City
NRC 1997, 1998, 1999, 2000, 2001, 2002, 2003,
2004
8
The 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

9
What 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
10
Saint Lukes HospitalOrganizational Milestones
  • Received third Missouri Quality Award
  • Site visit by MBNQA
  • Third refinement of the Balanced Scorecard
  • Deployed 90-Day Action Planning Process

11
Saint 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

12
Agility Continuous Learning Innovation
Information Sharing
Saint Lukes Hospital
Leadership for Performance Excellence Model
13
Saint Lukes Hospital
Performance Measurement
Balanced Scorecard
  • Primary measurement tool
  • 5 perspectives
  • 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

14
Saint Lukes Hospital
Performance Measurement
Balanced Scorecard Trend Charts
15
Saint Lukes Hospital
Performance Measurement
16
Physicians as Partners
Saint Lukes Hospital
17
90-Day Action Plans
Saint Lukes Hospital
  • Making it real for leaders
  • Operating margin
  • Patient Safety index
  • Overall satisfaction
  • Revenue growth
  • Retention

18
Saint 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

19
Saint Lukes Hospital
Performance Analysis
BSC Departmental Report Form
20
Performance 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

21
Saint 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?

22
Saint 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

23
Saint Lukes Hospital
Managing and Improving Processes Process Level
Scorecards
  • How do you know youve had a good day?

24
Saint Lukes Hospital
Achieving Strategic Alignment Throughout the SLHS
25
Saint 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

26
Saint 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

27
Relationships
Saint Lukes Hospital
Organizational Scorecard
Process Scorecard
Provides Inputs
Enables Drill Down Into Processes
28
Relationships
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

29
Saint 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

30
Level 1 Processes
Saint Lukes Hospital
  • Perform Financial Management
  • Satisfy Customers
  • Enhance Growth and Development
  • Provide Clinical and Administrative Services
  • Manage Human Resources

31
Level 2 Processes Manage Human Resources
Saint Lukes Hospital
  • Hire staff
  • Orient new employees
  • Train staff
  • Develop staff
  • Motivate staff

32
Level 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

33
Process Scorecard Results
Saint Lukes Hospital
34
Saint Lukes Hospital
Process Scorecard Results
35
Saint Lukes Hospital
Process Scorecard Results
36
Saint 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

37
Saint 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

38
Saint 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?

40
Organizational Rewards
Baldrige Business Model
  • Improved Clinical Outcomes

Patients Receiving tPA Following Ischemic Stroke
41
Baldrige Business Model
Organizational Rewards
  • Improved Customer Satisfaction

Patient Satisfaction
42
Baldrige Business Model
Organizational Rewards
  • Sustained High Levels of Consumer Perception

NRC Perception Rankings vs. Top Competitors
43
Baldrige Business Model
Organizational Rewards
  • Improved Financial Performance

Days Cash on Hand
44
Baldrige Business Model
Organizational Rewards
  • High Levels of Employee Satisfaction

Employee Satisfaction
45
Baldrige Business Model
Organizational Rewards
  • High Employee Retention

SLH Retention
46
Baldrige Business Model
Organizational Rewards
  • Improved Productivity

Human Capital Value Added
47
Saint 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

48
Saint 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!

49
Baldrige 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

50
Baldrige 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

51
Saint Lukes Hospital
Our People Make the Difference
They Are Our Competitive Advantage!
52
Saint Lukes HospitalKansas City, Missouri
THE BEST PLACE TO GET CARE
THE BEST PLACE TO GIVE CARE!
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