Health Commission | November 5, 2019

SF Health Network Update

July 12, 2017

DPH Leadership

2

SFHN Leadership Org Chart

3

4

True North and the X-Matrix

True North

• Our set of universal ideals that

describe DPH’s future state

X-Matrix

• The product of our discussions and decisions can be summarized in this Strategic Plan document,

also known as an X-Matrix.

• The X-Matrix is designed to provide a visual description of our high level strategic initiatives, our

accountability mechanisms, anticipated outcomes and how it all ties into our True North.

☐ 3 ☐ ☐ ☐ ☐ ☐

☐ 2 ☐ ☐ ☐ ☐ ☐ ☐

☐ ☐ 1 ☐ ☐ ☐ ☐

Safe

ty: A

ctio

nab

le k

no

wle

dge

an

ytim

e, a

nyw

her

e

Qu

alit

y

Car

e E

xpe

rie

nce

: Act

ion

able

kn

ow

led

ge a

nyt

ime,

anyw

her

e

Wo

rkfo

rce

: Dev

elo

p o

ur

peo

ple

Fin

anci

al S

tew

ard

ship

Equ

ity

100%

of

EHR

“D

esig

n an

d B

uild

” de

cisi

ons

are

com

plet

ed

on t

ime

(1/1

/19)

75%

of

DPH

& U

CSF@

ZSFG

em

ploy

ees

are

conf

iden

t th

at

DPH

will

be

prep

ared

& e

nab

led

to

mee

t EH

R G

o Li

ve

75%

of

end-

user

s &

man

ager

s/su

perv

isor

s re

por

t th

ey

have

the

rig

ht in

form

atio

n to

cre

ate

val

ue f

or p

atie

nts

and

DPH

(1/

1/20

)

By

5/20

18, D

PH h

as a

def

ined

mod

el D

MS

and

prod

ucti

on

line

sche

dul

e pl

an

By

8/20

19 a

ll de

sign

ated

uni

ts g

oing

live

in E

PIC

are

trai

ned

in D

MS

By

8/20

19, 8

0% o

f un

its

in D

MS

achi

evin

g 80

% o

n D

MS

asse

ssm

ent

tool

By

12/2

019,

adh

eren

ce t

o EP

IC w

orkf

low

s is

pra

ctic

ed 7

5%%

of t

he t

ime

thro

ugh

proc

ess

obse

rvat

ion

By

12/2

019,

uni

ts in

DM

S m

eeti

ng 6

0% o

f KP

IS

By

6/30

/19,

mai

ntai

n st

able

Med

i-Ca

l en

rollm

ent

of S

FHN

PC e

nro

llee

s fr

om 4

8,00

0 to

50,

000

By

6/30

/19d

ecre

ase

% o

f en

rolle

d b

ut n

ot y

et s

een

(EN

YS)

to 2

5% f

rom

28%

By

6/30

/19,

dec

rea

se P

RIM

E CC

M h

igh

risk

sub

grou

p

Pati

ent

ED &

Inp

atie

nt

Uti

lizat

ion

By

6/30

/201

9, %

/$ a

ttai

nmen

t of

Med

i-Ca

l PR

IME

& Q

IP w

ill

decr

ease

fro

m 9

0% t

o 85

%

Pick

ens

(Dir

ecto

r, S

FHN

)

Alic

e C

hen

(Dep

uty

Dir

ecto

r, S

FHN

)

Alb

ert

Yu (

CH

IO, S

FHN

)

Gre

g W

agne

r (C

FO, D

PH)

Val

erie

Ino

uye

(Dir

, Fin

ance

, SFH

N)

Susa

n Eh

rlic

h (C

EO, Z

SFG

)

Jim

Mar

ks (

Chi

ef P

erf

Exc,

ZSF

G)

Miv

ic H

iros

e (E

xec

Adm

in, L

HH

)

Kelly

Hir

amot

o (D

irec

tor,

Tra

nsit

ions

)

Hal

i Ham

mer

(D

ir, P

rim

ary

Car

e)

Lisa

Gol

den

(Dir

, KPO

, DPH

)

Mar

y H

anse

ll (D

ir, M

CA

H)

Kav

oo

s G

han

e B

assi

ri (

Dir

, Beh

avio

ral H

ealt

h)

Lisa

Pra

tt -

Dir

, Jai

l Hea

lth

Jenn

y Lo

uie

(DPH

Bud

get

Dir

/SFH

N B

IU)

Rho

nda

Sim

mon

s (D

ir, H

R W

kfor

ce D

vlpm

t

Aya

nna

Ben

nett

(D

ir, I

nter

div

Init

iati

ves)

Ree

na

Gup

ta (

Med

Dir

, PR

IME)

FY'17-'18 FY'18-'19 FY'19-'20 FY'20-'21 1 2 3 4 5 6 7 8 9 10

11

12

☐ Financial Stewardship: 70% of targets 70% 70% TBD TBD

☐ Quality: 70% of targets 70% 70% TBD TBD

☐ Safety: 70% of targets 70% 70% TBD TBD ☐ =

☐ Care Experience: 70% of targets 70% 70% TBD TBD =

☐ Workforce: 70% of targets 70% 70% TBD TBD r =

☐ Equity: 70% of targets 70% 70% TBD TBD

Value-based care (revenue, cost/value optimization)

EHR readiness

Develop our people through lean

correlation / contribution

correlation / contribution

weak correlation or rotating team member

important correlation or core team member

strong correlation or team leader

strategic initiatives

True North outcomes

Tru

e N

ort

h t

hem

es

per

form

ance

m

easu

res

© 2017 rona consulting group

MISSION: We provide high quality health care that enables San Franciscans to live vibrant, healthy lives. VISION: To be every San Franciscan’s first choice for health care and well-being.

Last updated 9/11/2018

A3-X - Strategic Plan

Strategic Priority: X-Matrix

5

27% 36%Total measures that hit target:

True North Evolution

49 metrics20% on target

FY15-16 FY16-17 FY17-18 FY18-19 FY19-20

47 metrics27% on targetA3 report outs

Financial Stewardship

Workforce

Safety

Equity

Quality

Care Experience

SynergyAlignment & Focus

FY 18/19transition year

Quality Safety CareExperience

WorkforceFinancial

StewardshipEquity

33 metrics36% on targetA3 report outs

FY19/20Epic stabilization year

1 metric focus (Workforce)A3 report outs

FOCUS:

Workforce

FY 17/18FY 16-17

6

QUALITY SAFETYCARE EXPERIENCE

WORKFORCEFINANCIAL STEWARDSHIP

EQUITY

Division/Section Metrics

ZSFG

Decrease readmissions among the PRIME population

Increase readiness for eHRImplementation

Increase iCare adoption

Increase the # of depts.with DMS Implementation

Decrease capital project slippage days

Increase REAL data completeness

Decrease % of time on diversion

Increase QIP measure reporting

Increase the % of Exec Leadership with at least 1 PDP A3 Targets

Decrease salary variance Increase PIPS reporting

Increase preparedness for EHR implementation

LHH

Decrease pressure ulcers and falls with major injury

Decrease employee recordable injuries

Likelihood to recommend care

Likelihood to recommend working at LHH

Decrease overtime variance

Adequate treatment of hypertension for Black/African American residents

PC

Increase Behavioral HealthSigns screenings Increase 7-day post

discharge follow up

Improve patient satisfaction ratings Improve staff coaching for

progressDecrease the time for unlocked notes

Improve BP control among African American patients with hypertension

Increase adolescent immunizations

Improve timely access to Primary care services

JHS Improve the rate of time of

charting Increase overall patient satisfaction score

Decrease workplace stressDecrease mandated overtime

Increase gonorrhea and chlamydia screening in African American population

BH

S Improve completion of IIPP activities

Improving timely access to care

Improve staff perceivedsupport for their professional development

Increase the % of non-enrolled Medi-Cal eligible clients who enroll in Medi-Cal

Increase % of clinicians who have completed SO/GI training

MC

AH

Increase % of enrollment in prenatal programs

Increase IIPP trainingsMaintain enrollment in WIC program for children over 1 years of age

Increase staff ratings of race equity in the workplace

Decrease redundancies in ordering through 5S

Increase the recruitment/retention of African American field nurses

True North: FY18/19

True North: FY18/19 Scorecard

8

True North: FY18/19 Scorecard

9

Quality

Safety

Care Experience

13.50%

14.00%

14.50%

15.00%

15.50%

16.00%

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Decrease readmissions among PRIME population

35.00%

40.00%

45.00%

50.00%

55.00%

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Decrease % of time on diversion

Target: 40%

0.00

20.00

40.00

60.00

80.00

100.00

120.00

Baseline Q12018

Q22018

Q32019

Q42019

LHH: Reduce pressure ulcers and falls with major injury

Target: 93

0.0%

10.0%

20.0%

30.0%

40.0%

Baseline Q12018

Q22018

Q32019

Q42019

PC: Increase Behavioral Health Vital Signs screenings

Target: 36.2%

61.0%62.0%63.0%64.0%65.0%66.0%67.0%68.0%69.0%

Baseline Q12018

Q22018

Q32019

Q42019

PC: Increase adolescent immunizations

Target: 67%

40.0%

45.0%

50.0%

55.0%

60.0%

65.0%

Baseline Q12018

Q22018

Q32019

Q42019

MCAH: Increase % of enrollment in prenatal programs

Target: 54%

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

JHS: ---

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Baseline Q12018

Q22018

Q32019

Q42019

BHS: ---

0

5

10

15

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase QIP measure reporting

Target: 12

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase readiness for EHR Implementation

Target: 8

0.0

5.0

10.0

15.0

20.0

Baseline Q12018

Q22018

Q32019

Q42019

LHH: Decrease employee recordable injuries

Target: 9.975

60.00%62.00%64.00%66.00%68.00%70.00%

Baseline Q12018

Q22018

Q32019

Q42019

PC: Increase 7-day post discharge follow up

Target: 69.40%

80%

85%

90%

95%

100%

Baseline Q12018

Q22018

Q32019

Q42019

JH: Improve the rate of time of charting

Target: 98%

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

Baseline Q12018

Q22018

Q32019

Q42019

BHS: Improve completeion of IIPP activities

Target: 90%

0

5

10

15

20

25

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase iCare Adoption

Target: 12

80.0%

85.0%

90.0%

95.0%

100.0%

105.0%

Baseline Q12018

Q22018

Q32019

Q42019

LHH: Likelihood to recommend care

Target: 100%

65.0%

66.0%

67.0%

68.0%

69.0%

70.0%

Baseline Q12018

Q22018

Q32019

Q42019

PC: Improve patient satisfaction ratings

Target: 70%

14

19

24

29

Baseline Q12018

Q22018

Q32019

Q42019

PC: Improve timely access to primary care services

Target: 14

0.00

2.00

4.00

6.00

8.00

Baseline Q12018

Q22018

Q32019

Q42019

JH: Increase overall patient satisfation score

Target: 6.8

0.0%

20.0%

40.0%

60.0%

80.0%

Baseline Q12018

Q22018

Q32019

Q42019

MCAH: Maintain enrollment in WIC program

Target: 58%

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

MCAH: Increase IIPP trainings

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

BHS: Improve timely access to care

Target: 14.32%

True North: FY18/19 Scorecard

10

Equity

Workforce

Financial Stewardship

0

1

2

3

4

5

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase departments w/ DMS implementation

Target: 5

0%

20%

40%

60%

80%

100%

Baseline Q12018

Q22018

Q32019

Q42019

LHH: Likelihood to recommend working at LHH

0%

20%

40%

60%

80%

Baseline Q1

2018

Q2

2018

Q3

2019

Q4

2019

PC: Improve staff coaching for progress

Target: 63.5%

0%

2%

4%

6%

8%

10%

Baseline Q12018

Q22018

Q32019

Q42019

JH: Decrease workplace stress

Target: 10%

9.50

11.50

13.50

15.50

17.50

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Reduce capital project slippage days

Target: 10

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

Baseline Q12018

Q22018

Q32019

Q42019

LHH: Decrease overtime variance

Target: 2%

150

250

350

450

550

Baseline Q12018

Q22018

Q32019

Q42019

PC: Decrease time for unlocked notes

Target: 180

0.0%0.5%1.0%1.5%2.0%2.5%3.0%3.5%

Baseline Q12018

Q22018

Q32019

Q42019

JH: Decrease overtime

0%

20%

40%

60%

80%

100%

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase expanded executives w/ PDP A3 targets

Target: 85%

0%

20%

40%

60%

80%

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase preparedness for EHR implementation

Target: 60%

40.0%45.0%50.0%55.0%60.0%65.0%70.0%75.0%

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase REAL data completeness

Target: 60%

60.0%

65.0%

70.0%

75.0%

80.0%

85.0%

Baseline Q12018

Q22018

Q32019

Q42019

LHH: Adequate treatment of hypertension for Black/African American residents

58.0%59.0%60.0%61.0%62.0%63.0%64.0%65.0%66.0%67.0%68.0%

1 2 3 4 5

PC: Improve blood pressure control among African American patients with

hypertension

Target: 65.3%

($10.00)

($8.00)

($6.00)

($4.00)

($2.00)

$0.00

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Decrease salary variance

Target: $0.00

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

Baseline Q12018

Q22018

Q32019

Q42019

ZSFG: Increase PIPS reporting

Target: 35%

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

BHS: Improve staff percieved support for their professional development

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

MCAH: Increase staff ratings of race equity in the workplace

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

BHS: Increase Medi-Cal enrollment

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

MCAH: Decrease redundancies in ordering through 5S

0

5

10

Baseline Q12018

Q22018

Q32019

Q42019

JH: Increase gonorrhea and chlamydia screening in African American

population

0

5

10

Baseline Q12018

Q22018

Q32019

Q42019

MCAH: Increase the recruitment/retention of African

American field nurses

0

2

4

6

8

10

Baseline Q12018

Q22018

Q32019

Q42019

BHS: Increase % of clinicians who have completed Transgender 101

Target: 75%

True North: FY18/19 Scorecard