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Nashville, TN May 14 – 15, 2013

Welcome!

Copyright © Studer Group. Please do not quote, cite, or disseminate without Studer Group authorization.

Housekeeping Tips

Breaks provided throughout

each day – times are listed on

agenda

Breakfast and Lunch are

located in the Cumberland

Ballroom

Take your belongings with

you when breaking for lunch.

Networking Reception is

also located in the

Cumberland Ballroom

Chimes – please listen for

the chimes as a signal to

return to session

Temperature of the room

please tell Stephanie Barbee

at Registration desk

Reserve Classroom Seat

Restrooms

Books and Resources: Fire

Starter Publishing area open

Day 1 and 2


Continuing Education Credit Studer Group® is accredited by the Accreditation Council for Continuing Medical

Education (ACCME) to provide continuing medical education for physicians.

Studer Group designates this educational activity for a maximum of 11 AMA PRA

Category 1 CreditsTM.

This educational offering has been approved for 11 Contact Hours by Sacred Heart

Health System, Organization Development and Education, Pensacola, FL.

**Please sign in at the CME Area each day located at the Registration Desk.

Certificates will be available for download when post-link is sent. • Dan Collard, Coach for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Karen Cook, Coach and National Speaker for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Bob Murphy, national speaker for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Lyn Ketelsen, national speaker and coach for Studer Group, has disclosed that she has no relevant financial relationships with commercial interests related to this educational event.

• Barbara Hotko, national speaker and coach for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Julie Kennedy, national speaker and coach for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Keith Gregory, Keith Granger, President/CEO of Trinity Medical Center (Birmingham, Alabama), Studer Group Partner, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Stephanie Barbee, Certified Meeting Planner for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Tasha Wells, Curriculum Lead for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.

• Mallory Studer, Webinar & Events Support for Studer Group, has disclosed that he has no relevant financial relationships with commercial interests related to this educational event.


Materials Provided At your Seat

Welcome Letter and Agenda

Action Planning Worksheet

Studer Group Notepad

Day 1 Evaluation

The HCAHPS Handbook – including the

addendum / whitepaper inserted in the book


Day One Agenda At-A-Glance

8:00am – 11:45am

General Session

Lunch 11:45am – 1:00pm

Breakout Sessions

1:00pm – 3:15pm

3:35pm – 4:35pm

General Session

4:35pm – 5:30pm

Networking Reception Cumberland Ballroom


Dine with Experts Day 1 and Day 2

We invite you to dine with experts during

lunch. Tables are set up by HCAHPS

Composites and other topics of interest with

an expert available to ask questions, seek

insight and work planning.

Tuesday – 5/14

Doctor Communication

Discharge Instructions

Clean / Quiet

Why ED Matters

Goals and Alignment

Wednesday – 5/15

Nurse Communication

Responsiveness

Pain Management

Communicating Medication

**Tables are limited and are first come, first serve.


Action Planning Worksheet

List your top composite scores and three ways

you will celebrate results

List your lowest composite scores and three

ways you will improve for better results

HCAHPS / Tactic Crosswalk Tool


Day #1 Evaluation

What 3 things did you find most important

about today

What 3 things are you going to start to do

or increase doing after today?

Do you have a question from Day 1 that

you would like addressed?

What 3 things are you going to quit or

decrease doing after today?

Please Rate:

• Day 1 Sessions and presenters

• Rate Value of Today’s Learning

• Rate yourself as an Adult Learner


Our Gift to You

Filled with actionable tips proven to improve patient

perception of care. A “PDR” for healthcare

professionals

Broken out by composite so readers can zero-in on

specific parts of the survey

Tactics align with work you are already doing. Work

smarter, not harder

Gain the keys to sustaining gains to create a culture

of always and maximize reimbursement

Hardwire Your Hospital for Pay-for-Performance Success

The HCAHPS Handbook and New Addendum

Whitepaper that covers the new questions added

to the survey.


Post HCAHPS Summit Resource Link –

www.studergroup.com/05tnhcahps

You will receive an email within 7 to 10 days after the event

sharing all of the presentation slides, tools, workbooks and

resources mentioned over the next two days. The web address

below will be shared in the email once the web page is live.

http://www.studergroup.com/05tnhcahps


www.studergroup.com The Studer Group website is packed with new and updated resources and tools to help you and your organization succeed. Visit often, learn more, and succeed ALWAYS.


Execution company focused on

achieving and sustaining

exceptional clinical, operational &

financial outcomes

Work with over 850 healthcare

organizations in the US and

beyond

> 60 Coaches and Speakers

Educational Resources – Books,

Training Videos, Webinars and

Institutes

Web-based software solutions for

operational alignment and process

efficiency/ improvement

Recipient of the 2010 Malcolm

Baldrige Quality Award

Ranked #4 Great Small

Workplace in America

Evidenced-Based tactics that

produce:

Accelerated rate of

improvement and efficiency in

clinical quality (core measures,

hospital acquired conditions,

and readmissions)

Favorable HCAHPS results

Maximized reimbursement

Increased physician loyalty

Improved ED flow, operational

metrics and patient experience

About Studer Group


Studer Group Mission and Vision

Mission:

To make healthcare a better place for

employees to work, physicians to practice

medicine and patients to receive care.

Vision: To be the intellectual resource for

healthcare professionals, combining

passion with prescriptive actions and tools,

to drive outcomes and maximize the human

potential within each organization and

healthcare as a whole.


Academic / Teaching

Hospitals

Community Hospitals /

Emergency Departments

Children Hospitals

Physician Groups

Rural and Critical Access

Hospitals

Veterans Administration /

FQHCs

Other

We Get to Keep Good Company…

http://www.stdavids.com/


…and the Company We Keep Does Well


Organizations Coached by Studer Group Outperform the Nation across HCAHPS Composites

5

5.5

10

12

16

17

17

19

20

0 5 10 15 20 25

Doctor Communication

Clean and Quiet

Responsiveness of Staff

Willingness to Recommend

Pain Management


Communication of Medications

Overall Rating

Nursing Communication

Studer Group Difference over Non-Partnersin National Percentile Ranking

Studer Group Difference over Non-Partners in National Percentile Ranking

percentile points higher

Source: The graph above shows a comparison of the average percentile rank for Studer Group Partners that have received EBL coaching since Oct 2008 and non-partners for each composite; updated 5.2.13 using 3Q11-2Q12 CMS data.


Organizations Coached by Studer Group Outpace the Nation in HCAHPS Improvements

1.0

1.2

1.3

1.3

1.5

1.6

1.6

2.3

2.5

0.80

1.0

0.7

1.1

1.2

1.4

1.3

1.8

2.0

0.20 0.70 1.20 1.70 2.20 2.70

Doctors always communicated well

Pain was always well controlled

Yes, patients would definitely recommend the hospital

Clean and Quiet


Nurses always communicated well

Patients who gave a rating of 9 or 10 (high)

Staff always explained about medicines before giving…

Patients always received help as soon as they wanted

Average Change in Top Box Results in One YearStuder Group Partners vs. Non Partner

Non-Partner Change SG Partners Change

Source: The graph compares the change In one year in “top box” results achieved by Studer Group partners vs. non-partners. Change is from 3Q10-2Q11 to

3Q11-2Q12. The “top-box” is the most positive response to HCAHPS survey questions.


Who Does it Well… Overall Rating 9s and 10s

Top Organizations in Attendance

90 88 86 85 83 81 81 80 80 79

0

10

20

30

40

50

60

70

80

90

100Top Box Results

90th

%tile

Data Based on 3Q11-2Q12 CMS Update, by Discharge Date

*90th %tile is equivalent to top box score of 80

Studer Group

Partners in Teal


Pre-Conference Survey Results

HCAHPS Summit

May 14-15, 2013


Top 3 Learning Objectives

After attending the HCAHPS Summit, please select the top 3 items you would like to learn related to:

Total

Employee Engagement and Buy-in

Responsiveness

Nurse Communication


Barriers and Challenges

Please mark the top three (3) barriers/challenges you face that keep you from achieving your results in your area of responsibility at your organization.

Total

Employee engagement/buy-in

Inconsistency/Lack of Standardization and Hardwiring

Patient Satisfaction/Perception of Care


What’s Happening @ HCAHPS Summit!

Follow us on Twitter and “Like us” on Facebook to stay

connected and receive live updates from HCAHPS Summit.

Join in on the fun by posting your team pictures and key

takeaways from the conference!

www.facebook.com/studergroup

www.twitter.com/studergroup

Use @studergroup and #hcahpssummit when tweeting

http://www.facebook.com/studergroup

http://www.twitter.com/studergroup

Nashville, TN May 14 – 15, 2013

Mission, Margin and the Future of Value Based Purchasing

Dan Collard

Studer Group Senior Leader

May 14th, 2012


When you know you

have a solution to a

problem that is causing

pain for someone –

you have a human

responsibility to act,

and to do so with all

urgency.

~ Quint Studer

Human Responsibility


Execution Framework Evidence-Based LeadershipSM

Standardization Accelerators Must

Haves®

Performance

Management

Objective

Evaluation

System

Leader

Development

Foundation

STUDER GROUP®:

Agreed upon tactics and behaviors to achieve goals

Principle 3, 5, 6, & 9

Re-recruit high and middle/solid performers

Move low performers up or out

Principle 4

Processes that are consistent and standardized

Process Improvement

PDCA Lean Six Sigma Baldrige Framework Principle

1 & 2

Software

Aligned Goals Aligned Behavior Aligned Process

Create process to assist leaders in developing skills and leadership competencies necessary to attain desired results

Principle 4 & 8

Implement an organization-wide staff/leadership evaluation system to hardwire objective accountability

Principle 1, 2, & 7

Rev 4.8.11


Operational Outcomes Quality People Finance Service Growth Community

VBP- Improved

HCAHPS

VBP-Improved

Overall Core

Measures

Decreased

Preventable

Readmissions

Increased

Surgical Care

Improvement

Decreased

Healthcare-

Associated

Infections

Reduced LOS

Improved

Mortality

Decreased Med

Errors

Increased

Employee

Engagemen

t

Reduced

turnover

Reduced

vacancies

Reduced

agency

costs

Reduced

overtime

Reduced

physicals &

cost to

orient

Maximize

Reimbursemen

t

Improved

operating

income

Decreased cost

per adjusted

discharge

Improved

collections

Reduced

accounts

receivable days

Reduced

advertising

costs

Improved

Patient

Perception

of Care

Reduced

claims

Reduced

legal

expenses

Reduced

malpractice

expense

Physician

Engagemen

t

Higher

volume

Increased

revenue

Decrease

d left

without

treatment

in the ED

Reduced

outpatient

no-shows

Increased

physician

activity

Increased

Philanthropy


“May You Live in Interesting Times” ~ Ancient Chinese Curse

Environmental Drivers: The Game Changers

- Weak Economy

- Changing Demographics

- Increased Regulation

- Politics of Deficit Spending & Reduction

Industry Pressure Points

- Increased Uncompensated Care

- Declining Commercial Volumes

- More Physician Employment

- Reimbursement Cuts

The New

Operating

Reality


2.2%

-16.8%

The average hospital

has a 2.2% operating

margin.

Looking at

reimbursement cuts,

2.2% will be a

16.8% deficit.

Operating Margin Outlook

2011

2021


The Normal Toolkit

Squeeze vendors

Stop Travel

Eliminate Overtime

Slow Down Capital Expenditures

Reduction in Force

Not filling opened positions

Supply Chain Management

Revenue Cycle

Managed Care Negotiations


2010 2011 2012 2013 2014 2015 2016 2017 2018

REPORTING HOSPITAL QUALITY DATA FOR ANNUAL PAYMENT UPDATE

VALUE-BASED PURCHASING

READMISSIONS

2% of APU

2%

3%

CMS quality-based payment initiatives will put more than 11% of payment at risk

HOSPITAL-ACQUIRED CONDITIONS 1%

MEANINGFUL USE 5%

1% 1.25% 1.5% 1.75% 2%

1% 2% 3% 3% 3%

1% 2% 3% 4% 5%

Value-Based Purchasing Roadmap


Maybe a Better Definition:

No Outcome, No Income


The Cost Reality…

$55/dozen

$134/bag

$48/gallon


®

Healthcare Flywheel®

Bottom Line

Results

(Transparency and

Accountability)

Self-

Motivation

Prescriptive

To Do’s

Winning

Courage

Execution

Purpose,

worthwhile work

and making

a difference


WHAT

HOW

WHY

The Typical Sequence


WHY

WHAT

HOW

The Suggested Sequence


A Better Approach: Accomplish more with less pain

Capture Withheld Reimbursement

Increase Market Share

Become more efficient and

effective (work process

improvement)

Eliminate Never Events


Condition $ / Stay

Stage III & IV Pressure Ulcers $43,180

Falls & Trauma $33,894

Deep Vein Thrombosis/Pulmonary Embolism $50,937

Vascular Catheter-Associated Infection $103,027

Certain Manifestations of Poor Control of Blood Sugar Levels Range: $35k-45,989

Catheter-Associated Urinary Tract Infections $44,043

Foreign Object Retained After Surgery $63,631

Surgical Site Infections Following Certain Elective Procedures Range: $63k-180,142

Infection after Coronary Artery Bypass Graft $299,237

Air Embolism $71,636

Blood Incompatibility $50,455

Source: CMS Fact Sheet, “CMS PROPOSES ADDITIONS TO LIST OF HOSPITAL-ACQUIRED CONDITIONS FOR FISCAL YEAR 2009”

Never Events: Financial Impact


Patients’ Perception of Care = Quality Pressure Ulcer Stages III and IV


Patients’ Perception of Care = Quality Vascular Catheter-Association Infection


Patients’ Perception of Care = Quality Manifestations of Poor Glycemic Control


Value Drivers

Financial Performance & Patient Experience

Safety

Quality

Engagement

Hardwiring

Excellence


Straight A Leadership Assessment

Survey data collected 2009-2012, database of 26,386 leader responses, >400 hospital systems, located in 44 different states,

ranging in bed size from 11 beds to 719 beds.


Executive Summary: Straight A Leadership

What organization does well: Leader perception of organizational

strengths are not always supported

by the data.

Alignment: The more aligned the

senior team is, the more positive

HCAHPS and process of care

outcomes.

Objective Evaluation System: High ratings on leadership

evaluation systems positively affect

HCAHPS and process of care

outcomes.

Leadership Development: High

ratings on leader training positively

affect HCAHPS outcomes.

Patient/Physician Perception: High ratings on patient/family point of

view and ease of practicing medicine

for physicians both positively affect

HCAHPS outcomes.

Consistency of Leadership: High

ratings on consistency of leadership

positively affect HCAHPS outcomes.

Standardization of Best Practices: High ratings on standardization of best

practices positively affect HCAHPS

outcomes.

Performance Management: Fewer

low performers positively affect

HCAHPS and process care outcomes.


4%

5%

5%

7%

8%

10%

10%

19%

19%

20%

21%

23%

25%

27%

28%

31%

36%

0% 10% 20% 30% 40%

Focus on Mission/Vision/Values

Patient Safety

Measurement

Quality of Care

Financial Performance/Fiscal Responsibility (net revenue, EBDITA,…

Goal Setting and Strategic Planning

Community Outreach

Technology

Leadership (engagement, visibility, and support)

Education, Training, and Skill Development

Employee Compensation and Benefits

Physician Engagement and Satisfaction


Employee Engagement and Satisfaction

Communication (transparent & open)

Accountability

Dealing with Low Performers

Percent

Please list the top three (3) opportunities for improvement at your organization

Opportunities for Improvement

Top 3 Opportunities: Dealing with Low

Performance Accountability Communication


0%

1%

5%

6%

9%

10%

11%

13%

14%

17%

18%

21%

24%

25%

30%

45%

48%

0% 10% 20% 30% 40% 50%

Patient Safety

Quality of Care


Leadership Development and Skill

Leadership (engagement, visibility, and support)

Employee Turnover

Education, Training, and Skill Development Gaps

Physician Engagement and Satisfaction

Time Management

Low Performers

Communication

System/Silo Thinking

Employee engagement/buy-in

Inconsistency/Lack of Standardization and Hardwiring

Financial Constraints and Industry Pressures

Resource Limitations (staffing,equipment,space, etc.)

Too Many Priorities

Percent

Please list the top three (3) barriers/challenges you face that keep you from achieving your results in your area of responsibility at your

organization

Barriers and Challenges

Top 3 Barriers: Too Many Priorities Resource Limitations Financial Constraints

and Industry Pressures


External Environment

37% of the leaders who took the survey feel if the organization stays the same, the results will be the

same, better or much better.

If your organization continues to act/perform exactly as it does today (with the same processes, same cost structure, same efficiencies, same patient care volume, same productivity,

same techniques) your results over the next five years will be: (1=Much Worse, 2=Worse, 3=Same, 4=Better, 5=Much Better)


52%

41% 39%

48% 45%

36%

45% 44% 45%

35%

64% 64% 62%

66% 63%

59% 59%

65%

55%

50%

30%

35%

40%

45%

50%

55%

60%

65%

70%

Quiet atNight

DoctorComm

NurseComm

PainMgmt

Responsive-ness

Rating of9 or 10

RoomCleanliness

ExplainedMeds

DischargeInfo

Recommend

Ave

rage

Per

cen

tile

Ran

k

HCAHPS Average Percentile Rank by Response to Question. Lowest Quartile Responses vs. Highest Quartile Responses

Lowest Quartile Responses Highest Quartile Responses

Objective Evaluation: HCAHPS Lowest vs. Highest Responses

Organizations who gave high ratings on their leadership evaluation systems had better HCAHPS outcomes.

How well does your leadership evaluation system help build leadership accountability today?

(1=Very Poor, 2=Poor, 3=Fair, 4=Good, 5=Excellent)


48% 42%

37% 43%

46%

32%

46% 45% 46%

28%

68% 66% 70% 71%

67% 64%

61% 68%

56% 52%

20%

30%

40%

50%

60%

70%

80%

Quiet atNight

DoctorComm

Nurse Comm

PainMgmt

Responsive-ness

Rating of9 or 10

RoomCleanliness

Explained Meds

DischargeInfo

Recommend

Ave

rage

Per

cen

tile

Ran

k



Leader Development: HCAHPS Lowest vs. Highest Responses

Organizations where leaders felt their leader training well prepared them for success had higher average HCAHPS outcomes.

How well does your current leader training prepare you to lead for success in the organization today?

(1=Very Poor, 2=Poor, 3=Fair, 4=Good, 5=Excellent)


51%

40% 33%

44% 40%

27%

38% 42%

38%

25%

57% 55%

63% 60% 57% 61% 58%

62% 60% 55%

0%

10%

20%

30%

40%

50%

60%

70%

Quiet at Night

DoctorComm

NurseComm

PainMgmt

Responsive-ness

Rating of9 or 10

RoomCleanliness

ExplainedMeds

DischargeInfo

Recommend

Ave

rage

Per

cen

tile

Ran

k



Leadership Consistency: HCAHPS Lowest vs. Highest Response

Organizations whose leaders rated consistency of leadership highly had higher average HCAHPS outcomes.

Rate your perception of the consistency in the leadership throughout the organization today.

(1=Worst to 10=Best in Class)


56%

43% 36%

42% 42%

32% 40% 43%

39%

27%

66% 64% 62% 63% 63% 61% 60% 65%

54% 53%

0%

10%

20%

30%

40%

50%

60%

70%

Quiet atNight

DoctorComm

NurseComm

PainMgmt

Responsive-ness

Rating of9 or 10

RoomCleanliness

Explained Meds

DischargeInfo

Recommend

Ave

rage

Per

cen

tile

Ran

k



Organizations whose leaders gave high ratings to the ability to implement and standardize best practices had higher average HCAHPS outcomes.

Standardization of Best Practices: HCAHPS

Lowest vs. Highest Response

Rate the skill set at your organization in implementing and standardizing best practices throughout the organization today.

(1=Worst to 10=Best in Class)


55% 51% 45% 48%

54%

39% 44%

48% 42%

29%

55% 55% 60% 63%

56% 53% 58% 61%

55% 48%

0%

10%

20%

30%

40%

50%

60%

70%

Quiet atNight

DoctorComm

NurseComm

PainMgmt

Responsive-ness

Rating of9 or 10

RoomCleanliness

ExplainedMeds

DischargeInfo Recommend

Ave

rage

Per

cen

tile

Ran

k

HCAHPS Average Percentile Rank by Response to Question. High % of Low Performers vs. Low % of Low Performers

Most Low Performers Least Low Performers

Performance Management: HCAHPS - Highest vs. Lowest % of Low Performers

Organizations reporting the fewest low performers have higher average HCAHPS outcomes across all composites.

* According to the results, when the % of low performers is below 5% you should see improved results. When the % of low performers increases to 9.5%, you can expect to see poor HCAHPS results.

How many of the employees that you directly supervise are not meeting performance expectations?


Building a Culture…


An “Always” Culture As a Business Leader

Always

Usually

Sometimes

Never

HCAHPS Quality Safety Staffing

Expense

Supply

Costs

Finding

Efficiencies


“Always bring it back to

values . . .”

Quint Studer


Thank You !

Dan Collard

[email protected]

www.studergroup.com

welcome! [8aa2679ff4850707cd54 …8aa2679ff4850707cd54... · the hcahps handbook – including the...

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