it’s all about vision, expectations, and...

Institute for Healthcare Improvement

It’s all about VISION, EXPECTATIONS,

AND ACCOUNTABILITY

Anne Lang, Vice President for Human Resources and Legal Services

Lauren Reardon, Director of Guest Services and Service Excellence

OUR PROFILE

229-bed community hospital,11 miles north of Boston

Services: critical care, medical-surgical, cancer center, maternal/child, pediatrics, emergency

Over 30 satellite locations Over 2700 employees-non-unionized Over 750 Medical Staff Over 800 volunteers


ACHIEVEMENTS

First and only hospital in Massachusetts to achieve Magnet designation three times

Top employer awards: Boston Business Journal, Boston Globe

Local and nationalrecognition for quality, patient and physiciansatisfaction

VISION


To ensure that the highest quality care continues to be delivered through the coordination of available resources for the purpose of improving the health of the communities we serve.

VISION

To care. To heal. To excel. In service to our community.

VISION


VISION

Selected Preventable Harm Events

Patient Safety

Inpatient Falls with Serious

Injury

2

Ventilator Associated

Pneumonia (ICU)

0

Serious Medication

Errors

0

Surgical Site

Infections

3

Central Line Associated

Bloodstream Infections (ICU)

0

108

54

0

Baseline 2008

Goal for FY2009

Goal for FY2010

Goal for Q1 FY2012

27

Exceeded our 2009 Goal*

Exceeded our2010 Goal*

4

38

FY2011 October 2010 through September 2011Updated through August 31, 2011

*Data subject to validation

5 Current Total*


OUR JOURNEY

Leadership Excellence

ServiceExcellence

PerformanceExcellence

LEADERSHIP EXCELLENCE

How many you have heard this comment: “Employees do not leave an organization, they leave a supervisor.”


VISION

Make our leaders the best possible leaders they can be.

Make every employee feel valued.

EXPECTATIONS

Leadership Competencies Organization Orientation, Goal Achievement,

and Accountability Commitment to Service Excellence and

Continuous Improvement Problem Solver and Decision Maker Relationship and Team Builder People Developer and Communicator


EXPECTATIONS

Organizational Orientation Makes decisions that best serve the organization

rather then areas of responsibility or self Holds self and others accountable for producing

high quality work and work within specified timelines

Exemplifies a vision of organizational success that sparks excitement in others.

Places a high priority on safety ensuring self and staff role model safety behaviors and tools

Establishes and achieves goals

EDUCATION

Leadership ForumsLeadership CoursesLeadership OrientationLaunching Leaders


ACCOUNTABILTY

Accountability: “Everyone knows David is a negative force. All he does is complain. Why isn’t his supervisor doing anything about it? ”

ACCOUNTABILTY

Value: “Why doesn’t my supervisor ever listen to me? Why can’t I have input into decisions?”


ACCOUNTABILTY

Value: “They treat people differently here.”

REINFORCEMENT

Leadership Recognition“Likes” Card


RESULTS

Employee Partnership Survey Results:

99th percentile overall for AHA Region 1

99th percentile for “Leaders do a good job of communicating major developments.”

99th percentile for “I think this organization is highly regarded in the community.”

SERVICE EXCELLENCE


VISION

To demonstrate the PROMISE of Winchester Hospital in every encounter with patients, co-workers and the community.

EXPECTATIONS

When you are at your very best, what do you:

DOSAYACT

To make your patient’s experience the every best it can be?


EXPECTATIONS

Promoting Teamwork RespectOwnershipMaintaining a Positive Attitude Initiative Safety and QualityEmpathy

Look, I can’t promise I’ll change, but I can

promise I’ll pretend to change.”


EMPATHY

We take care, and we take time to use our best

observation skills to anticipate how a patient

or coworker would feel in any given circumstance.

We put ourselves “in their shoes” and respond to needs and concerns before they grow into

larger issues. We have compassion for others, whether it is a patient or coworker, by taking the time to listen, care and offer encouragement.

Empathy: The Human Connection to Patient Care

Courtesy of Cleveland Clinic


Patient ExperienceCommunication

ResultsCommentsWeekly TipsService Excellence Response

Team (SERT) RoundsSatisfaction Teams

SERVICE EXCELLENCE


SERVICE EXCELLENCE

It’s all about CommunicationIt is about how you make the patient and

their family feel

Not what you say; it’s what people hear

How you say what you say

INITIATIVES

Ear PlugsWhite Noise Machines and Radios Bereavement Bags and Carts ED Hold Bags Thank you cards New White Boards And more…


Our Promise to our Patients


ACCOUNTABILITY

Recruitment and OrientationHire for Attitude and Train for SkillDay is dedicated to Service Excellence

Education

Evaluations50% PROMISE

Dave:Everyone loves

Dave, but we are not really sure

what he does all day?

Jane: Everybody knows she treats people

terribly!

The Best

Needs to be fired

PRO

MIS

E

Job Results


ACCOUNTABILITY

Reward and RecognitionComment ReportsPROMISE CardsPROMISE MomentsCompassionate Caregiver AwardSchwartz Rounds

RECOGNITION


RELATE ModelRecognize Concern Empathize Listen Apologize Take

Responsibility Explain what you are going to do

RECOVERY

RECOVERY

Phone CallsVisit PatientsED letter


PHYSICIAN ENGAGEMENT

Medical Executive Committee Department Meetings MD Champions

ED Satisfaction Team

Recognition Accountability: Goals set in contracts

So... How are we doing?


60%

65%

70%

71%

74%

83%

84%

74%

74%

82%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Robert Wood Johnson University Hospital, NJ

Heartland Regional Med Ctr, MO

Atlanticare Regional Med Ctr, NJ

National

Massachusetts Hospitals

Baptist Hospital , FL

Advocate Good Samaritan, IL

Poudre Valley Hospital, CO

Winchester Hospital, MA

Sharp Memorial Hospital, CA

Results taken from hospitalcompare.hhs.gov website (release date April 2013)Data from July 1, 2011 through June 30, 2012 Patient Discharges

■ Winchester Hospital ■ Massachusetts Hospitals ■ National

Would patients recommend the hospital to friends and family?Bars below tell the percent of patients who reported YES, they would definitely recommend.

RESULTS

■ Winchester Hospital ■ State ■ National

Would patients recommend the hospital to friends and family?Bars below tell the percent of patients who reported YES, they would definitely recommend.

Results taken from hospitalcompare.hhs.gov website (release date April 2013)Data from July 1, 2011 through June 30, 2012 Patient Discharges

RESULTS

70%

71%

72%

72%

74%

79%

80%

83%

86%

89%

91%

81%

78%

74%

74%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Hallmark Health

National

Boston Medical Center

Holy Family

State

Beverly Hospital

Tufts Medical Center

Lahey Clinic

Newton‐Wellesley Hospital

Beth Israel Deaconess Medical Ctr

Faulkner Hospital

Winchester Hospital

Brigham and Women Hospital

Mass General

New England Baptist


72%

76%

78%

79%

79%

81%

81%

79%

80%

80%

66% 68% 70% 72% 74% 76% 78% 80% 82%

Robert Wood JohnsonUniversity Hospital, NJ

Atlanticare Regional Med Ctr,NJ

National

Baptist Hospital, FL

Massachusetts Hospitals

Poudre Valley Hospital, CO

Advocate Good Samaritan, IL

Heartland Regional Med Ctr,MO

Sharp Memorial Hospital, CA

Winchester Hospital, MA

How often did nurses communicate well with patients?Bars below tell the percent of patients that their nurses "ALWAYS" communicated well.

■ Winchester Hospital ■ Massachusetts Hospitals ■ NationalResults taken from hospitalcompare.hhs.gov website (release date April 2013)

Data from July 1, 2011 through June 30, 2012 Patient Discharges

RESULTS

71%

78%

78%

78%

79%

80%

80%

82%

84%

85%

79%

79%

80%

80%

80%

60% 65% 70% 75% 80% 85% 90%

Boston Medical Center

Lahey Clinic

National

Tufts Medical Center

Beth Israel Deaconess Medical Ctr

Beverly Hospital

State

Brigham and Women Hospital

Hallmark Health

Holy Family

Mass General

Newton‐Wellesley Hospital

Winchester Hospital

Faulkner Hospital

New England Baptist

How often did nurses communicate well with patients?Bars below tell the percent of patients that their nurses "ALWAYS" communicated well.

■ Winchester Hospital ■ State ■ NationalResults taken from hospitalcompare.hhs.gov website (release date April 2013)

Data from July 1, 2011 through June 30, 2012 Patient Discharges

RESULTS


Percent of Winchester Hospital patients who reported that their Nurses communicated well

Usually – Sometimes - Always81% ofPatients

Always16% of Patients

Usually

3% of Patients

Sometimes

“Always” is the Key Word


PERFORMANCE EXCELLENCE

• The latest step in our journey.• Let us tell you our Emergency Department

story.

INTRODUCTION OF LEAN

• Knew we had to begin piloting Lean principles and tools.


EMERGENCY DEPARTMENT

Lean Initiatives:Value Stream5SGreen belt projects

RESULTS

Shift Mar4-10, 2012

Mar 4-10 2011

% Reduction

1 19 minutes

59 minutes

67%

2 29 minutes

73 minutes

60%

3 13 minutes

36 minutes

63%

Wait time from Door to ED room


EMERGENCY DEPARTMENT

Service Excellence Initiatives:Hospitality Associates, 1-9:pm, 7 days/weekCall BacksBedside report with nurses and physicians: PPD

(Pain, Plan, Delay)Team nursing

ED RESULTS: LIKELIHOOD TO RECOMMEND


KEY TAKEAWAYS

It is all about consistency It’s the little thingsIt is always about striving to be the best

it’s all about vision, expectations, and...

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