Town Hall MeetingsSeries 19

May 2011

2

Acknowledge

Introduce

Duration

Explain

Thank

1. Vision, Mission, Values

2. SC State Budget Update – Howell Clyborne, VP for Government and Community Relations

3. Campus President Update

4. System Goals and other Updates

5. Employee Opinion Survey Results

6. Wrap-Up, Questions, and Surveys

AGENDA

Our VisionTransform health care for the benefit of the people

and communities we serve.

Our MissionHeal compassionately. Teach innovatively. Improve

constantly.

Who We Are

GHS Values

Our core values are compassion, respect, caring, honesty, integrity, and trust. We live

our values through open communication, forward thinking, creativity, continually striving to

improve, responsiveness, a willingness to change, education, research, and clinical quality.

What We Stand For

State of South Carolina Economic Overview

Howell ClyborneVP, Community and Government Affairs

7

South Carolina’s Economy

Budget Year SC State Budget Date

FY2008/2009 Budget $7.1 Billion July 2008

FY 2011/2012 Projected $5.9 Billion * Feb 2011

A $1.2 billion drop in South Carolina’s State Budget over three years.

Source: South Carolina Board of

Economic Advisors*Includes Trust Funds

SC Department of Health and Human Services (“HHS”) FY 11-12

8

SC House budget line for HHS:

$ 947,371,086SC Senate budget line for HHS:

$ 917,279,786

Specific Impact to Hospitals• Reducing growth rate from 10% to 8%• $125 million from a reduction in provider rates• Cuts will not be across the board.• Estimated cuts to hospitals 10% or higher!

Specific Impact to GHS: $20 Million

House Passed Their Version of Budget in March

We anticipate the Senate will pass their version in early May

The Budget will go to a Conference Committee

The Governor will have veto option

Where Are We In the Process?

9

Campus President’s Update

10

FY 2011 Goals Update

11

Pillar Frameworkfor FY 2011

GHS Total Health PhilosophyThe GHS Total Health philosophy is central to our

approach to health care delivery, work force development and medical education. We value interdisciplinary

collaboration throughout a highly integrated delivery structure using patient-centered, standardized, and evidence-based

practices with reportable quality and financial outcomes.

GHS Pillars of Excellence

People Service Quality Growth Finance Academics

Measured by: 2011 Employee Opinion Survey – Commitment Index Score

Target: 4.29 (85th Percentile)

Result: 4.21 (72nd Percentile)

We work to transform health care.

Measured by: HCAHPS Overall Rating* (Percent 9’s and 10’s)

Press Ganey Overall Mean Scores**

Patients and families are the focus of everything we do.

FY 2011Targets

YTDResults

*Inpatient 74.0%78th %-tile

73.0%

**Ambulatory Surgery

93.783rd %-tile

93.4

**Emergency Services.

86.465th %-tile

83.4

3

We provide right care at the right time and in the right place.

2

Measured By Targets YTD Results

CMS All Care Measures

93.0%75th %-tile

93.4%

Patient Safety Culture Survey

67%75th %-tile

Not yet available.

Hand Hygiene

80%(Year Two)

89.3%

A great example of personal commitment to our culture of patient safety.

Spotlight on “Owner” Behavior

• Kathy Taylor, RN NICU• Identified a safety risk with

identical clear tubing for IV fluids and humidifying mist in incubators

• Raised the issue with her nurse manager, Jennifer Griffin and they contacted the manufacturer

• RESULT: blue tubing for humidifier/clear for IV fluids.

16

We develop our System to meet the needs of our communities.

Measured By

AnnualTarget

YTDTarget

YTD Results

Net Revenue

$1,363 M $670.0 M $678.0 M

New Patient Visits

146,195 72,604 68,534

1

1

Through March 2011

Measured by: Operating Margin

We responsibly direct our resources to support our mission.

AnnualTarget

YTDTarget

YTD Results

1.5%($21.0 M)

0.9% 1.7%

Through March 2011

Measured by: Implementation of strategic initiatives that advance our Academic Health System model.

Target:Achieve preliminary accreditation of USCSOM-Greenville during October, 2011.

YTD RESULT: LCME application submitted. Site visit scheduled for July.

We educate to transform health care.

FY 2011 Employee IncentiveMid-Year Projection

0.15* 0.25*0.30*0.30* ------

Linked to GHS Organizational Goals• All employees share these goals• Same calculation for all levels in the organization

Potential Employee Incentive:• Up to 1% of FY 2010 earnings; maximum of $1,000

FY 2011 Financial Trigger – No payout if payment would result in an operating margin of less than 1.5%.

*Weighting

0.0 0.0 0.20 0.25

Mid-Year Projection: 0.45 of a possible 1.0% of earningsDashed lines indicate scores that could still change as the fiscal year progresses.

Two More Quick Updates

21

US News & World ReportBest Hospitals

Greenville Memorial Hospital

#25 #39 #45

Drill-Down

How We Did It

• Commitment to being a highly integrated delivery system:– Specialty hospitals– Regional referral center– Physician practices (employed/affiliated)– Clinical staff

• Ranking Criteria – reputation, mortality, patient safety, and other (technology, patient services, presence of intensivists, palliative care…)

Heart & Heart Surgery

Hospital

U.S. News Score

Reputation

Mortality (below 1 is better)

Patient Safety Max=5

Discharges (3 years)

Nurse Staffing

Nurse Magnet

Technology (of 7)

Patient Svc. (of 8)

GMH(#45)

31.2 0.0 .62 5 5,907 2 No 4 6

Cleve-landClinic

(#1 )100.0 70.8 .47 3 12,433 2.2 Yes 7 7

Heart and Heart Surgery

Technology

Cardiac ICU Multi-slice spiral CT PET/CT scanner× Robotic surgery Single-photon-emission CT Transplant services*

*Hospitals can get 2 points for transplant services if they perform both tissue & heart transplants.

Patient Service

Cardiac Rehab Hospice× Pain management Palliative care Patient-controlled

analgesia Translators Wound-management

services

Related UMG physician group – Carolina Cardiology and Dept. of Surgery/Cardiothoracic Surgery

Greenville Pitches Infor GHS MedEx Academy

• June 29th at Flour Field• Come out and throw a “first

pitch” and maybe see some of the Drive players up close and personal

• Pitching Time: 4:00 -6:00 p.m.• Game Time: 7:00 p.m.• $1.00 from each game day

ticket purchased will be donated to GHS MedEx Academy

• Enjoy the game and support our MedEx program.

26

2011 Employee Opinion Survey Results

27

2828 28

Morehead’s National Healthcare Average

Updated annually and reflective of over 350 organizations, more than 800 healthcare facilities and over one million healthcare workers, Morehead’s National Healthcare Average is a benchmark designed to mirror the distribution (geography and sector) of the U.S. healthcare labor force.

Representative clients include:

Advocate Healthcare Carolinas HealthCare System Catholic Health East Cedars-Sinai Medical Center Children’s Hospital of Philadelphia Cincinnati Children's Hospital Legacy Health System (OR) NYU Medical Center

Provena Health Rehabilitation Institute of Chicago Scottsdale Healthcare (AZ) Texas Children’s Hospital The Methodist Hospital System

(TX) Univ. of California Medical Centers Univ. of Chicago Medical Center

2929

29

GHS System Results

30

Employee Participation

80% 81% 79%

0%

20%

40%

60%

80%

100%

2009 2010 2011

HistoricalResponse

Rate Trend

Administration Period: March 2011

Administration Mode: Online Survey

9,978Employees

Invited

7,842EmployeesResponded

7,8427,048 7,894

31

Domain Scores

4.314.29

4.21

4.164.18 4.17

4.14

4.07

4.15

4.104.07

4.05 4.05 4.04

3.97 3.96

3.50

3.60

3.70

3.80

3.90

4.00

4.10

4.20

4.30

4.40

Commitment Indicator Employee Manager Organization

GHS 2009 GHS 2010 GHS 2011 Natl HC Avg

32

Key Findings

Accomplishments

Workforce commitment continues to score significantly (+.05) above National Healthcare (NHC) Average

Strongest aspect of commitment is “I would recommend this organization to family and friends who need care.”

Over 60% (7 out of 11) of the facilities scored above the NHC Average

Highest performing item is “My work unit works well together.”

Most improved item is “Employees in my work unit help customers, clients, patients even when it's not part of their job.”

Opportunities

Employee respect and fair comp/benefits performed below NHC Average (both previously significantly above)

Number of Tier I work units decreases to 230 (39%) and Tier III increases to 123 (21%)

Lowest performing item is “I am satisfied with my benefits.”

Items with greatest decline is “My pay is fair compared to other healthcare employers in this area.”

Lack of employee involvement cited the most (+60%) as a reason to leave

33

Overall Workforce Commitment*

2011GreenvilleHospitalSystem

4.21

Performance Difference:

NationalHealthcare

Average

+.05

WorkforceCommitment

Percentile Ranking

72nd

2010GHS

-.08

2009GHS

-.10

Note – In this presentation GREEN/ RED notes a statistically significant difference.

•National Healthcare Average +/- .03

•Greenville Hospital System 2010 +/- .03

•Greenville Hospital System 2009 +/- .03*This is the GHS system measure

for our People Goal.

34

Difference from:

Workforce Commitment Item 2011 GHS

%Unfav

Natl HC Avg

2010 GHS

2009 GHS

40. I am proud to tell people I work for this organization. 4.36 2% +.01 -.07 -.08

46. I would recommend this organization to family and friends who need care.

4.42 3% +.09 -.02 +.03

54. I would like to be working at this organization three years from now.

4.40 4% +.14 -.07 -.08

59. I would stay with this organization if offered a similar job elsewhere for slightly higher pay.

3.75 15% +.04 -.12 -.12

63. I consider this organization the healthcare employer of choice in this area.

4.26 4% +.05 -.06 -.08

66. I would recommend this organization as a good place to work.

4.19 5% +.02 -.10 -.19

67. Overall, I am a satisfied employee. 4.09 7% +.02 -.11 -.19

Measuring Workforce Commitment

35

Workforce Commitment by Facility

91st% tile

72nd% tile

99th% tile

94th% tile

78th% tile

63rd% tile

94th% tile 90th

% tile

99th% tile

79th% tile

98th% tile

34th% tile

3.50

3.75

4.00

4.25

4.50

GHS Overall Corporate Services Greenville Memorial Greer Memorial Hillcrest Pickens

CI Score 2010CI Score 2011

36

Workforce Commitment by Facility (continued)

98th% tile 94th

% tile

99th% tile

93rd% tile

72nd% tile

72nd% tile

74th% tile

24th% tile 14th

% tile

1st% tile

95th% tile

84th% tile

3.50

3.75

4.00

4.25

4.50

North Greenville Patewood Roger C. Peace The Children’sHospital

The Cottages atBrushy Creek

University MedicalGroup

CI Score 2010CI Score 2011

37

Workforce Commitment by Position

-0.20 0.00 0.20 0.40 0.60 0.80

+.29

Natl HC AvgCI = 4.16

Centerline is 2011 GHS Workforce Commitment Score 4.21

Senior Management (11)

Management (469)

Registered Nurse (1,979)

Clinical Professional (491)

Non-clinical Professional (253)

Clinical Technician (1,035)

Other Non-clinical Support (534)

Employed Physician (271)

Leadership Team (115)

Physician Resident (40)

Administrative/Fiscal (1,668)

Non-clinical Technician (194)

Other Clinical Support (782)

+.20

+.19

+.15

-.01

-.02

-.02

-.06

-.08

-.12

-.13

+.62

+.39

38

Workforce Commitment by Tenure

The GHS 2011 Average is 4.21

4.50

4.32

4.18

4.11 4.124.09

4.174.19

4.34

4.27

4.37

3.60

3.80

4.00

4.20

4.40

4.60

<90 days(208)

90 days-1 yr

(594)

1 yr(768)

2 yrs(893)

3 yrs(772)

4 yrs(403)

5-9 yrs(1,706)

10-14 yrs(1,062)

15-19 yrs(390)

20-24 yrs(425)

25+ yrs(621)

Natl HC AvgCI = 4.16

39

Workforce Commitment by Shift

-0.15 -0.10 -0.05 0.00 0.05

Centerline is 2011 GHS Workforce Commitment Score 4.21

Day shift (6,427)

Evening shift (509)

Night shift (906)Natl HC AvgCI = 4.16

+.03

-.11

-.14

40

Workforce Commitment by Gender

-0.02 0.00 0.02 0.04

Centerline is 2011 GHS Workforce Commitment Score 4.21

Female (6,467)

+.03Male (1,375)

Natl HC AvgCI = 4.16

-.01

41

Workforce Commitment by Race

-0.40 -0.30 -0.20 -0.10 0.00 0.10 0.20

Centerline is 2011 GHS Workforce Commitment Score 4.21

Black or African American (1,203)

White (6,320)

Hispanic or Latino (169)

Asian (107)

Two or more races (26)

American Indian or AK Native (12)

+.14Native Hawaiian or other Pacific Islander (5)

Natl HC AvgCI = 4.16

+.11

.00

-.01

-.04

-.08

-.36

42

Workforce Commitment by Age

The GHS 2011 Average is 4.21

4.34

4.14 4.144.21 4.25

4.364.31

2.50

2.75

3.00

3.25

3.50

3.75

4.00

4.25

4.50

<20 (17) 20-29(1,110)

30-39(1,780)

40-49(2,092)

50-59(2,089)

60-69 (698) 70+ (56)

Natl HC AvgCI = 4.16

43

Difference from:

KEY DRIVERS of Workforce Commitment (in order of influence)

Domain2011GHS

%Unfav

.

Nat’l HC Avg

2010GHS

60. I feel like I belong in this organization. EMP 4.03 7% -.04 -.07

53. I selected this organization as a place to work because its values reflect my own.

EMP 4.08 4% +.05 -.03

27. I like the work I do EMP 4.57 1% +.07 -.03

22. This organization provides high-quality care and service. ORG 4.35 2% +.04 -.01

65. I have confidence in senior management’s leadership. ORG 3.93 9% +.11 -.10

49. Patient safety is a priority in this organization. ORG 4.46 2% -.01 -.02

62. The environment at this organization makes employees in my work unit want to go above and beyond what’s expected of them.

EMP 3.68 16% +.11 -.07

Key Driver Analysis

44

Difference from:

Model Domain 2011 GHS

Natl HC Avg

2010 GHS

2009 GHS

Organization Domain 3.97 +.01 -.07 -.08

Manager Domain 4.07 +.02 -.03 -.08

Employee Domain 4.14 +.07 -.03 -.04

Measuring Domain Performance

45

Diff. from:

HIGHEST PERFORMING ITEMS Compared to the National Healthcare Average

Domain

2011 GHS

% Unfa

v

Natl HC Avg

2010 GHS

1. My work unit works well together. EMP 4.26 6% +.15 .00

51. The person I report to follows up on my concerns/questions from rounding.

MGR 4.04 11% +.15 -.03

11. This organization contributes to the community. ORG 4.40 1% +.13 -.03

24. Physicians and staff work well together. ORG 4.03 6% +.13 +.01

19. This organization cares about employee safety. ORG 4.32 4% +.12 -.03

Highest Performing Items

46

Diff. from:

LOWEST PERFORMING ITEMS Compared to the National Healthcare Average

Domain

2011 GHS

% Unfa

v

Natl HC Avg

2010 GHS

21. I am satisfied with my benefits. ORG 3.34 26% -.33 -.19

36. I am satisfied with my job security. ORG 3.83 12% -.07 -.02

16. I am involved in decisions that affect my work. MGR 3.64 18% -.06 -.04

60. I feel like I belong in this organization. EMP 4.03 7% -.04 -.07

13. Different levels of this organization communicate effectively with each other.

ORG 3.42 22% -.03 -.02

50. I can report patient safety mistakes without fear of punishment. ORG 4.15 7% -.03 -.02

2. This organization cares about its customers. ORG 4.29 3% -.03 -.03

Lowest Performing Items

47

Diff. from:

MOST IMPROVEMENT Compared to Greenville Hospital System 2010

Domain

2011 GHS

% Unfav

2010 GHS

Natl HC Avg

10. Employees in my work unit help customers/clients/patients even when it's not part of their job.

EMP 4.34 3% +.01 +.08

7. Employees’ actions support this organization’s mission and values. EMP 4.11 4% +.01 +.06

24. Physicians and staff work well together. ORG 4.03 6% +.01 +.13

14. There is a climate of trust within my work unit. EMP 3.73 18% +.01 +.01

Most Improved Items

48

Diff. from:

GREATEST DECLINE Compared to Greenville Hospital System 2010

Domain 2011 GHS

% Unfav

2010 GHS

Natl HC Avg

29. My pay is fair compared to other healthcare employers in this area.

ORG 3.46 22% -.31 +.06

21. I am satisfied with my benefits. ORG 3.34 26% -.19 -.33

31. My work unit is adequately staffed. ORG 3.41 27% -.17 +.02

30. The employee incentive (bonus) encourages me to do a better job.

ORG 3.65 18% -.14 N/A

26. Information from this survey will be used to make improvements.

ORG 3.78 12% -.14 +.09

Items with Greatest Decline

49

Open-ended Comment Items

4,904respondents

providedfeedback

What do you like best about working for this organization?

63% ofrespondents

providedfeedback

Percent of total comments by theme:

26

18

17

10

10

8

The people

Quality leadership

Outstanding patient care provided here

Teamwork

Opportunities for learning and career advancement

My job

50

Open-ended Comment Items

5,200respondents

providedfeedback

66% ofrespondents

providedfeedback

Percent of total comments by theme:

Please provide one suggestion on how to make this organization a better place to work.

29

18

11

9

8

7

Improve pay and benefits

Address staffing issues

Promote leadership development

Open lines of communication

Update the facility, equipment, and technology

Respect and listen to employees

51

Work Unit Results(Tiers 1, 2 and 3)

52

Morehead’s Tier Classifications

High Survey Scores: minimal action planning activities

Average Survey Scores: action planning activities typically required

Low Survey Scores: significant action planning activities

Typical Expectations: Maintain Tier 1 status, assist Tier 3 and Tier 2 managers with action planning best practices

Typical Expectations: Achieve Tier 1 status through action plan development/implementation

Typical Expectations: Achieve Tier 2 status through action plan development/implementation and support by senior leadership and HR/OD

53

Greenville Health SystemTier Results

18% 21%

36%40%

46%

39%

0%

20%

40%

60%

Tier 3 Tier 2 Tier 1

2010 2011Tier 1 = Power Items Score™ ≥ 4.15Tier 2 = Power Items Score™ ≥ 3.80 and < 4.15Tier 3 = Power Items Score™ < 3.80

235 WU

HistoricalTier Movement

107 WU 123 WU 217 WU 276 WU 230 WU

54

A Few Last Observations

2006/7 2008 2009 2010 20110

20

40

60

80

100

Percentile Ranking

62nd

99th

GHS Employee Survey Results

Five-Year Trend

55

16th

91st

72nd

Press Ganey

Survey Question2010 AnnualEmp Survey

May 2010

Aug 2010

Nov 2010

Feb 2011

2011 AnnualEmp Survey

Confidence in Senior Management’s leadership 4.03 402 4.20 4.12 4.21 3.93

Different levels communicate effectively 3.44 3.55 3.54 3.36 3.59 3.42

Proud to tell people I work for this organization 4.43 4.39 4.47 4.39 4.43 4.36

Recommend GHS to family and friends 4.44 4.41 4.56 4.45 --- 4.42

Would work at GHS three years from now 4.47 4.44 4.61 4.44 4.46 4.40

Stay if offered job elsewhere for slightly higher pay 3.87 4.08 4.29 4.05 4.04 3.75

Healthcare employer of choice in this area 4.32 4.38 4.56 4.40 4.44 4.26

Recommend GHS as a good place to work 4.29 4.35 4.46 4.34 4.37 4.19

Overall, I am a satisfied employee 4.20 4.26 4.37 4.22 4.28 4.09

Town Hall Surveys Offer a Snapshot Between Annual Surveys

56

Town Hall Survey Results Compared to Selected Questions from the Annual Employee Opinion Survey

Higher scores among Town Hall Attendees.

A Theory and a Quick Small Group Discussion

57

Our TheoryEmployees who attend Town Hall Meetings are generally more engaged and have a better understanding of what’s

happening at GHS.

A Theory and a Quick Small Group Discussion

58

Our TheoryEmployees who attend Town Hall Meetings are generally more engaged and have a better understanding of what’s

happening at GHS.

Discussion

Does this theory make sense to you?

How could you help generate more participation in Town Hall Meetings?

Please record you thoughts on the Town Hall Survey Question 4.3 (additional comments)

• Departmental Meetings– Zero-In on your work unit’s results– Develop department-specific action plans

• System-Level Action Planning– Detailed review of system results by Senior

Leadership– System-level action plan will be developed to include

planned and new initiatives

Next Steps

59

Questions

Please Complete the TOWN HALL

Survey

61

62Please complete BOTH sides of survey formAnswers to many of your questions are in the Town Hall Q&A handout.

Please Complete the Survey

63

Acknowledge

Introduce

Duration

Explain

THANK YOU!