FY 12 Pillar Goal Update - Vanderbilt University Medical ...

FY 12 Pillar Goal Update

Fall Leadership Assembly
September 11, 2012

C. Wright Pinson, MD, MBA
Deputy Vice Chancellor for Health Affairs
CEO of the Vanderbilt Health System

People Pillar We nurture a
FY12 Results caring, culturally

 Year End Results sensitive, and
 Successes professional
atmosphere as

we
continuously

invest
in the individual

and
collective
aspirations
of our people

People FY12 Year End Performance

FY2012 GOAL FY2012 Year FY2012 FY2012 FY2012
End Threshold Target Reach

Improve retention rate 71.2% 71% 72% 73%
VUMC hires at 18 12.2% 12.3% 12.1% 11.9%
months: 14.2% 13.7% 13.2%
Improve VUMC
employee turnover: 70% 75% 80%

Improve VUMC nurse 14.2%
turnover: 73%/51%
Employees responding
to and departments
acting on engagement
survey results:

10 South Renal Transplant and Dialysis

 Service Pillar Collegiality is a
central
FY12 Results
characteristic
 Year End Results of our culture
 Successes
and
defines how we

serve our
patients,
those we teach,
and the local
and worldwide
community

Service FY12 Year End Performance

Goal YTD Baseline Threshold Target Reach
FY2012 58.7%
Access: % Of New Results (Jul 58% 60% 62%
Patients Seen within – Jun) 74.1% 60% 75% 90%
15 Days 75.1% 76.1% 77.1%
Provider 61 % 67.9% 68.9% 69.9%
Communication
Wizard Adoption 79%
% Excellent Overall 75%
Quality of Care

% Excellent 68.4% 66.9%
Teamwork

Overall Teamwork
FY2012 Pillar Goal Results

Overall Jan-Jun Jan-Jun % Point Change
Teamwork 2011 2012 from Baseline

Ambulatory Surgery % Excellent % Excellent Performance
VMG Clinic and 2012
Provider (Baseline) (Performance) + 1.8
OP Technical + 1.7
Threshold: 1% 73.7 75.5 - 1.9
Target: 2% 68.7 70.4
Reach: 3% 69.0 67.1

Baseline 65 % Children’s Inpatient 64.6 66.4 +1.8
Adult Inpatient 63.8 65.0 +1.2
Threshold: 3% Urgent Care 54.6 57.5 +2.9
Target: 4% Pediatric ED 57.1 59.2 +2.1
Reach: 5%
Adult ED 51.8 54.3 +2.5

Psychiatry Inpatient 47.7 45.9 - 1.8

Pediatric Speech & Language
Pathology & National Center
for Deafness – Dual Clinic

Occupational
Health Clinic

Quality Pillar We relentlessly
FY12 Results pursue and
measure
 Year End Results ourselves
 Successes against
the highest
quality

performance in
all

areas, from
patient
care to

scholarship

Quality FY12 Year End Performance

Goal YTD FY2012 Threshold Target Reach
Results
Reduce O/E Mortality (Jul-Jun) 0.73 0.71 0.69
Reduce Healthcare 0.73
Associated Infections 0.91 0.86 0.76
Reduce Adverse Events 0.75
Achieve Top Performance in 1.28 1.28 1.20 1.13
Clinical Programs (Jan – Jun)
Improve System Reliability 89% 88% 90% 95%

8 6-7 8-9 10-12
Refine & Verify Develop or Adopt Reduce Readmissions by
Reduce Readmissions in PN, 2 Predictive Models &
HF and AMI patients Baseline Target Improvement 10% for each clinical
condition
Efforts

Advance a Culture of Patient 3 Enlist & Prepare Initiate Two Projects per Increase Safety Climate
Safety, Improvement and Three Pioneer Program from Menu Survey Response Rate to
Reliability 65% in targeted programs
Programs

Sleep Apnea
Improvement

2012-13 U.S. News & World
Report “Best Hospitals” Rankings

Nationally Ranked in 11 Ranked # 1 in Tennessee
and #1 in Metro Nashville
Specialties: Area

 Cancer
 Cardiology & Heart Surgery
 Diabetes & Endocrinology
 Ear, Nose & Throat
 Gastroenterology
 Gynecology
 Nephrology
 Neurology & Neurosurgery
 Orthopaedics
 Pulmonology
 Urology

Innovation Pillar We seek
FY12 Results excellence
and leadership
 Year End Results
 Successes as
we advance our
systems of care,

educational
practices and

our
commitment to

discovery

Innovation FY12 Year End Performance

Goal Threshold Target Reach

Expand Diagnostic • Stabilize and expand to 1- • Model clinical and • Identify priority areas and
Management Teams 2 areas financial impact and magnitude for patient care
(DMTs) identify leading indicators impact FY13-14
• Develop Phase 3 plan
• Identify targeted area in • Identify implications for
Oncology clinic encounter redesign

• Design Phase 3
implementation plan

Expand MyHealthTeam Document steady state Document steady state Adapt financial model to
@VU while value and cost at 21st value and cost at Edward incorporate community cost
documenting value and Avenue; expand to the rest Curd Lane; Operationalize structure; Operationalize
costs of Suite 4 and two Doctors enrollment throughout ECL enrollment in one additional
at ECL clinic site (100 oaks or Suite
III)

Expand PREDICT and Implement Begin to measure leading Complete a preliminary
characterize Vanderbilt pharmacogenomic-guided Quality Improvement assessment of financial and
Health System effects decision support congruent indicators related to 3 clinical safety improvement
with FDA labeling for 3 drugs using rigorous for PREDICT
widely used drugs measurement design

FY12 Innovation Pillar: Value Based Care $10,440
($870)

+8%

$9,671
($806)

+8% Threshold $8,979 ($748)
+4%
$8,955 +2%
($746)
Target $8,807 ($734)
$8,612
($718) Reach $8,634 ($720)

$8,634 Reach $8,496
($720) ($708)
FY 11
Year End
Results

FY08 FY09 FY10 FY11 FY12

2008 2009 2010 2011 2012

Fiscal Year (FY) PEPY (PEPM) $8,955 ($746) $9,313 ($776) Threshold
FY12 VBC Pillar Goal Metrics Based on May 2010 4% increase Target
Memo – AON March Reach
Actual Fiscal Year Results $7,726 ($664) $8,156 ($680) 15 Forecast thru Feb TARGET
$8,496 ($708)
$8,612 ($718) $8,634 ($720) Actual
Actual Actual

MyHealthTeam@Vanderbilt

• CMS Health Care Innovation Grant
– Collaborative effort between IT, Department of
Medicine, Institutes of Medicine and Public
Health, our Affiliates and more
– Focuses on readmissions and treatment of
hypertension and other chronic diseases across
our Affiliates
– $18.8M Award from CMS will
support implementation and
evaluation of the program

Break Time!

Clinical Enterprise
FY 13 Pillar Goals

C. Wright Pinson, MD, MBA
Deputy Vice Chancellor for Health Affairs
CEO of the Vanderbilt Health System

People Pillar We nurture a
FY13 Goals caring, culturally

 FY 13 Goals sensitive, and
 Action Steps professional
atmosphere as we
continuously

invest
in the individual

and
collective
aspirations
of our people

FY13 People Pillar Goals: Overview

Theme Measure

Improve retention rate VUMC
New Hire Retention hires at 18 months

Overall Turnover Improve VUMC employee
turnover

Nurse Turnover Improve VUMC nurse turnover

Action Steps

• Remember the basics
– Rounding for outcomes
– Recognition
– Key words at key times

• One-on-one talks with your staff
– About work needs
– About opportunities

• Celebrate your successes!

 Service Pillar Collegiality is a
FY13 Goals central

 FY13 Goals characteristic
 Action Steps of our culture and
defines how we
serve our patients,
those we teach,

and the local
and worldwide

community

FY13 Service Pillar Goals: Overview

Theme Measure

New Patients Improve the percentage of new patients
Appointments seen within 15 days
Patient Satisfaction • Improve % “Excellent” Overall Quality of

Cleanliness Care
Clinic Summary • Improve % “Excellent” Teamwork
Improve Patient Satisfaction response to
Cleanliness question in each survey
Improve the percent of providers who
complete a clinical summary on same day
as the patient visit

Action Steps

• Treat patients like you want your family treated
• Take steps to ensure your area is clean and safe for

patients
• Communicate with patients and their family
• Provide patients with a clinic summary of the visit
• Increase teamwork—get everyone involved
• Develop processes/procedure to make

it easy to do the “right thing”

Quality Pillar We relentlessly
FY13 Goals pursue and
measure
 FY13 Goals
 Action Steps ourselves against
the highest quality
performance in all

areas, from
patient

care to scholarship

FY 13 Quality Pillar Goals: Overview

Theme Measure

Mortality O/E mortality and mortality rate
Culture Pioneer Programs
Safety Climate Survey
Safety Healthcare Acquired Conditions
• Infections
Reliability • Falls
Consistent performance to expected standards
• Hand Hygiene
• Core Measures (AMI, HF, PN)
• Blood management
• Universal Protocol
• Readmissions

Action Steps

• Continuously review processes for improvement
and safe care

• Encourage better communications
• Be sure patients know what to expect after

discharge
• Wash your hands
• Get a flu vaccination

Quality is never an accident; it is always the result of
high intention, sincere effort, intelligent direction and
skillful execution; it represents the wise choice of many
alternatives.” --William A. Foster [New York Times June 10,

1939]

Growth & We invest our
Finance Pillar resources in a
FY13 Goals manner that

 FY13 Goals supports
 Action Steps our long-term
obligation to

society;
to achieve local,

national and
worldwide impact

in
improving health

Action Steps

• Everything adds up—review supply
utilization

• Ensure that the processes in your
area are as efficient as possible

• Manage the use of temporary
staffing resources

• Ensure that patients are ready to
leave as early as possible on
discharge day

Innovation Pillar
FY13 Goals

 FY13 Goals
 Action Steps

FY13 Innovation Pillar Goals: Overview

Project Measure

Length of Stay O/E Index Improve the ratio of observed to expected length
Diagnostic Management Teams of stay (LOS) for hospital patients
(DMTs)
MyHealthTeam@Vanderbilt Expand DMTs to multiple areas
PREDICT
Vanderbilt Health Benefit Plan Expand and improve using resources from the CMS
Innovation Grant
Better Integration of Patient • Expand into different Drug-Gene Interactions
Data (Integrated Presence) • Prove value to payors for reimbursement
• Improve performance of the Health Benefit

Plan
• Collaborate with the Plan to reduce costs
• A tool make it easier for care providers to

quickly get critical patient information
• Will allow caregivers to look at the same

information regardless of the provider’s
location

Action Steps

• Learn more about the innovation
programs

• Share information with your staff
• If you are in an area that is directly

connected or involved in an
innovation project
– Participate
– Share information about the

innovation effort with staff and
encourage them to participate

It’s who we are…

We are what we repeatedly do. Excellence, therefore, is not
an act but a habit. – Aristotle

Good leaders make people feel that they're at the very heart of
things, not at the periphery. Everyone feels that he or she makes a
difference to the success of the organization. When that happens
people feel centered and that gives their work meaning. –
Warren Bennis, Organizational Behavior Leader

Never tell people how to do things. Tell them what
to do and they will surprise you with their
ingenuity. – George S. Patton, US Army General