don’t stop believin’! - s3.amazonaws.com€¦ · betsy scroggins, rn, avp nursing...
TRANSCRIPT
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
DON’T STOP BELIEVIN’!
By:
Betsy Scroggins, RN, AVP Nursing &
Jayme Tubbs, Service Excellence Coach
Jennie Stuart Health
Hopkinsville, KY
Our Journey to Excellence
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
Execution Framework: Evidence-Based LeadershipSM
2
LEADER EVALUATIONImplement an organization-wide
leadership evaluation system to
hardwire objective accountability
LEADER DEVELOPMENTCreate process to assist leaders in
developing skills and leadership
competencies necessary to attain
desired results
MUST HAVES®
Rounding, Thank You Notes, Employee
Selection, Pre and Post Phone Calls, Key
Words at Key Times
PERFORMANCE GAPRe-recruit high and middle performers,
Move low performers up or out
STANDARDIZATIONAgendas by pillar, peer interviewing, 30/90 day
sessions, pillar goals
ACCELERATORSLeader Evaluation Manager®
Validation MatrixSM
Provider Feedback SystemSM
Studer Group Rounding
Patient Call ManagerTM
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
DON’T STOP BELIEVIN’!
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
Jennie Stuart Health
• Who we are:
• Acute care, community hospital
• Private
• Not for profit
• Licensed for 194 beds
• Located in Hopkinsville, KY
• Celebrating 102 years of service to our community
• Partnered with the Studer Group in 2012
• 700 employees
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
5
Our Journey to Excellence
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Culture Specific Progress
• We learned we didn’t always have to travel the journey like we originally
planned!
• Ensure that each step you take is the best step for your organization!
• Dress Code Update and Implementation
• The focus on quality and patient experience had to be
exemplified by how we looked!
• We are proud that we not only look professional but our
clinical teams are easily identified by patients
and their family members.
6
What we have done well….
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• RIF
• Financial environment of healthcare forced us to go through this financial
restructuring which was imperative to our survival
• 13% reduction in force
• Didn’t cut service lines!
• We used this incredibly difficult situation to utilize our HighMiddleLow© training
to make strategic choices regarding who remained on our team.
• Having the RIGHT coach on our bus!
• From each coach along our journey, we have learned a great deal!
• Cara joined our team in Q3 2014 and she has been paramount to our success
and how quickly we have progressed since then!!!
7
What we have done well….
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Building the right Senior Team
• Service Excellence focus in Orientation—both General and Clinical
• High/Middle/Low (HML)
• Hourly Rounding / Nurse Leader Rounding / Handoff Communication
• Skills Labs for Training
• Reward and Recognition focus
• Leadership Development Institutes(LDI’s)
• Leader Evaluation Manager® (LEM)
• Patient Call ManagerSM (PCM)
• Validations/Coaching
• Conference Attendance
8
Must Haves® we have learned to do well….
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• 2 days, each quarter since July 2012
• Content expert’s present:
• Eric Lee, CEO opens with current issues affecting JSMC
• Updates on previously trained tactics
• New tactics are presented
• Break out sessions
• Group discussions
• Have FUN!!!
9
Leadership Development Institutes
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Goals are aligned with organizations annual business plan.
• Merit increase is tied directly to LEM performance
• Data is reviewed in Monthly Meetings
• 2 senior team review meetings happen annually:
• Year-end review meeting:
• Discuss each manager’s final score and performance
• Upcoming year review
• Review the upcoming year LEM for each manager before locking goals
10
Leadership Evaluation Manager®
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Unit Specific Roll-Out and Execution!
• All Areas, Jan.2016-April 2016
• Contact Rate: 95.04%
• Completed Rate: 67.53%
11
Patient Call ManagerSM
Patients
AttemptedPatients
Completed
Count Percent Count Percent
Total 6260 95.04% 4448 67.53%
Unit
5Th/Med 546 91.76% 384 64.54%
7Th/Surg 365 89.68% 220 54.05%
8Th/Surg 69 84.15% 57 69.51%
Asc 993 98.41% 769 76.21%
Conv Care 2632 96.76% 1706 62.72%
Icu 33 86.84% 31 81.58%
Ob/Gyn 280 94.92% 258 87.46%
Pcu 94 78.99% 81 68.07%
Sleep Lab 133 67.86% 117 59.69%
Surgery 1115 99.02% 825 73.27%
WILL UPDATE WITH CURRENT
DATA PRIOR TO SUBMISSION
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Primarily focused on Must Haves®
• Multiple layers!
• VP of Nursing
• AVP of Nursing
• Nurse Managers
• House Supervisors
• Service Excellence Coach
• Studer Coach
12
Validations/Coaching
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Evolution of our HCAHPS Scorecard!
13
Score Transparency
HCAHPS MEASURE
2010
3rd quarter
FINAL
2011
3rd quarter
FINAL
2012
3rd quarter
FINAL
2013
3rd quarter
FINAL
2014
3rd quarter
FINAL
2015
3rd quarter
FINAL
2016
1st quarter
FINAL
Communication with Nurses 70.70% 76.10% 73.12% 77.21% 79.07% 80.83% 83.26%
33
Communication with Doctors 77.00% 79.50% 79.23% 80.64% 76.99% 80.65% 81.88%
Responsiveness of Hospital Staff 55.60% 68.20% 62.71% 66.71% 65.35% 75.52% 73.83%
Pain Management 63.20% 69.50% 68.82% 68.65% 69.72% 72.44% 74.48%
Communication About
Medicines54.10% 59.90% 55.59% 69.22% 67.26% 67.62% 65.43%
Cleanliness of Hospital
Environment66.70% 76.00% 71.51% 70.22% 78.05% 75.63% 79.21%
Quietness of Hospital
Environment63.60% 64.80% 56.52% 56.25% 59.51% 61.25% 63.84%
Discharge Information 82.60% 82.40% 83.44% 84.02% 86.36% 86.53% 90.52%
Overall Rating of Hospital 54.40% 56.90% 55.62% 62.64% 65.64% 68.79% 65.71%
Care Transition Measure 48.31% 52.12% 57.69% 54.63%
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Since 2012:
• 31 different attendees
• 49 total attendees
• Senior team, board members, managers, and front line staff attend!
• Used strategically:
• as a reward and recognition tool
• To reach those who just need a little push and connection to purpose!
14
Conference Attendance
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
15
But, it’s not always unicorns and butterfly's!!
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• “Studer Lite”
• Trying to take this journey without real guidance is incredibly difficult. Like
trying to cross the country on a road trip without a map.
• We had “buy-in” from a few leaders, but not everyone—and it takes everyone—
starting at the top!
• RIF
• Though looking back this was something we ended up doing pretty well, this
was still a very difficult time for our organization!
• A lot of experience was lost with the offer of early retirement that was offered
during the RIF
Our Bumps in the Road…
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Physician Alignment
• This is still under construction!
• Physicians are resistant to change and finding it difficult to deal with the
external pressures that are forcing them to make changes.
• Medicare Readmissions
• Physician alignment lacking
• Need right docs on our bus and accountability!
Our Bumps in the Road…
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Turnover
• Improving our interviewing and hiring processes.
• We face a challenge of relocation due to our close proximity to Ft. Campbell
• Nursing shortage!
• Service Teams (aka Quality Impact Teams) Roll-Out
• This was one of the early bumps that taught us about culture specific progress
that we talked about earlier!
• We were not culturally ready to take this exit!
Our Bumps in the Road…
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Dress Code Implementation
• We updated both the general dress code as well as standardizing the scrub
colors by discipline.
• Implementation was a major challenge for us!.....
• But accountability has been the biggest challenge!
• Ransomware – May 2016
• We learned a LOT!
• Immediate Town Hall meetings a must
• Needed an incident commander center.
Our Bumps in the Road…
Slide 20
20
Celebrate the Successes You Have
Along the Way!
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
Q1
2012Q4
2012
Patient Call Manager
Leader Evaluation Manager
Leader Rounding on Employees
Q1
2013
Dedicated
Discharge
Education
Nurse
Q3
2013
Interdepartmental Rounding
Interdepartmental Surveys
Service Excellence/AIDET in General
Orientation
Q4
2013
Hourly Rounding
Q2
2014
HighMiddleLow©
Q3
2014
Handoff
Communication
Standardization
Q4
2014
Studer Group Partnership
Q3
2015
Q4
2015
Year 2:
HighMiddleLow©
Q1
2015Q3
2012
Quarterly
2 Day/Off-Site
LDI’s
Service Excellence/Tactics
in Clinical Orientation
Q2
2016
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
76.11%
82.33%83.26%
70.00%
72.00%
74.00%
76.00%
78.00%
80.00%
82.00%
84.00%
86.00%
Q1 2014 Q1 2015 Q1 2016
Communication with Nurses
59.46%
70.98% 73.83%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
Q1 2014 Q1 2015 Q1 2016
Responsiveness of Hospital Staff
66.74%
75.67%74.48%
62.00%
64.00%
66.00%
68.00%
70.00%
72.00%
74.00%
76.00%
78.00%
Q1 2014 Q1 2015 Q1 2016
Pain Management
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
87.02%
88.41%
90.52%
84.00%
85.00%
86.00%
87.00%
88.00%
89.00%
90.00%
91.00%
92.00%
Q1 2014 Q1 2015 Q1 2016
Discharge Information
72.98%
79.88%
81.88%
66.00%
68.00%
70.00%
72.00%
74.00%
76.00%
78.00%
80.00%
82.00%
84.00%
Q1 2014 Q1 2015 Q1 2016
Communication with Doctors
65.95%
63.85%
65.43%
62.50%
63.00%
63.50%
64.00%
64.50%
65.00%
65.50%
66.00%
66.50%
Q1 2014 Q1 2015 Q1 2016
Communication About Medicines
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
65.31%
68.96%
71.53%
61.00%
63.00%
65.00%
67.00%
69.00%
71.00%
73.00%
Q1 2014 Q1 2015 Q1 2016
Environment of Care
43.08%
54.54% 54.63%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
Q1 2014 Q1 2015 Q1 2016
Care Transition Measures
59.15%
67.98%
65.71%
54.00%
56.00%
58.00%
60.00%
62.00%
64.00%
66.00%
68.00%
70.00%
Q1 2014 Q1 2015 Q1 2016
Overall Rating of Hospital
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
HCAHPS MEASURE
2010
3rd quarter
FINAL
2011
3rd quarter
FINAL
2012
3rd quarter
FINAL
2013
3rd quarter
FINAL
2014
3rd quarter
FINAL
2015
3rd quarter
FINAL
2016
1st quarter
FINAL
Communication with Nurses 70.70% 76.10% 73.12% 77.21% 79.07% 80.83% 83.26%
33
Communication with Doctors 77.00% 79.50% 79.23% 80.64% 76.99% 80.65% 81.88%
Responsiveness of Hospital Staff 55.60% 68.20% 62.71% 66.71% 65.35% 75.52% 73.83%
Pain Management 63.20% 69.50% 68.82% 68.65% 69.72% 72.44% 74.48%
Communication About
Medicines54.10% 59.90% 55.59% 69.22% 67.26% 67.62% 65.43%
Cleanliness of Hospital
Environment66.70% 76.00% 71.51% 70.22% 78.05% 75.63% 79.21%
Quietness of Hospital
Environment63.60% 64.80% 56.52% 56.25% 59.51% 61.25% 63.84%
Discharge Information 82.60% 82.40% 83.44% 84.02% 86.36% 86.53% 90.52%
Overall Rating of Hospital 54.40% 56.90% 55.62% 62.64% 65.64% 68.79% 65.71%
Care Transition Measure 48.31% 52.12% 57.69% 54.63%
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
• Return to consistent profitability!
• 7 out of 10 HCAHPS Composites are improving at a
75th-90th percentile Rate of Change
• Strategic Affiliation with Vanderbilt Medical Center
26
Successes of our Journey so far…..
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
27
Our TRUE success…our Patient’s
Experience at JSMC!
"Upon arrival to the 7th floor the staff made
me feel like they were very concerned
about me." I did not receive much rest, but
it was because the staff was so attentive
and concerned about me." On the 7th floor
they did their job. When they left my room
they informed me when they would be
coming back. All the staff and Respiratory
Therapy on the 7th floor did their job. I
received outstanding care, always on time
with my treatments. The care I received
makes me want to come back to the 7th
floor!!”
Care was excellent. Best
care I have received in a
very long time, and I
have been in a lot of
hospitals.
The entire nursing staff
was excellent everyone
was patient, polite, and
concerned. Just flat out
GREAT and the best
care I have received!!
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
28
Our TRUE success…our Patient’s
Experience at JSMC!
"I've been in the hospital in
Alabama, Nashville, Bowling
Green and Jennie Stuart is the
best hospital I've
ever been in. Everybody did a
really good job."
"I wasn't a fan of Jennie Stuart due to my
experience in the past but I have no
complaints about my stay this time.
They were very nice to me. Gina my nurse
the first night helped calm me down and
took great care of me. Jennifer was my
nurse the day I left and she was very
helpful with my dressing change and
making sure I felt comfortable with it before
I left. I would
recommend you to anyone now. I was very
happy with my stay. I received good care.
Everyone was very attentive. There are
some awesome nurses on the 7th floor.
Ya’ll have made some great changes. I had
a wonderful stay."
Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization
29
We have not arrived at our destination yet—
but we are more determined than ever! We
must keep reminding ourselves---
DON’T STOP BELIEVIN’!!
We are
here!
Slide 30
Betsy Scroggins, RN, AVP Nursing
Jayme Tubbs, Service Excellence Coach