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Building A Healthy Work Environment. Who Is HCA?. Nation’s leading provider of healthcare services 182 locally managed hospitals 94 outpatient surgery centers Imaging centers Physician clinics and offices 22 states, England & Switzerland Revenues exceeding $24.5 Billion (2005)

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Who Is HCA?

  • Nation’s leading provider of healthcare services

  • 182 locally managed hospitals

  • 94 outpatient surgery centers

  • Imaging centers

  • Physician clinics and offices

  • 22 states, England & Switzerland

  • Revenues exceeding $24.5 Billion (2005)

  • Assets of more than $22 billion (2005)

  • 190,000 employees


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What are we trying to achieve?

  • Stronger retention

  • Greater productivity

  • Better place to work

 PatientSatisfaction

  • Increased Quality & Service

  • Reduced claims risk

  • Expanded volumes

  • Higher revenue

HEALTHCAREPROVIDEROF CHOICE

 Physician Satisfaction

EMPLOYEROF CHOICE

 Employee

Engagement


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So How Do We Get There

  • Establish High Performance Criteria

    • Balanced focus

      • Patient/Physician Satisfaction (Top Quartile)

      • Productivity/Retention

      • Financial Indicators (EBDITA, Operating Expense/Adjust Admit)

      • Employee Engagement Rankings

    • Consistent or Improving over multiple years

  • Identify High Performing Facilities Within The System

  • Research differentiating practices and behaviors


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Much Lower Turnover

Turnover at HPFs decreased 3.9% while increasing 1.4% at low performers


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Lower levels of riskHigher Patient Safety

Source: HCI – Issues in Review – 2004 & 2005. Risk level determined by and representative of actual claims for incidents that occurred over a three year period from January 1, 2002 and December 31, 2004


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Financial Performance

$15m more in average EBDITA per facility



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What We Learned

The basic leadership and workplace behaviors and practices we’ve said for years matter . . . really do impact a hospital’s success.

  • External Consultants

  • Internal OE Team


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Healthy Work Environment

Doing well in these five areas is key to transforming good places to work into GREAT places to work


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Leadership Effectiveness

Senior Leadership Vision/Direction

  • Distinct leadership styles practiced

  • Leaders available and approachable

  • Clear vision communicated and shared

    Supervisor/Management

  • Coach

  • Work/Life Balance

  • Skills/Career Development

  • LESSONS

  • Philosophy that drives decision making and communication

    • Prototype for selection/cultural fit

    • Balance Scorecard Accountability

    • Effective visibility


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Voice/Communication

  • Two-way communication

  • Willingness to share good and bad news

  • Employee Advisory Groups exist

  • HR is perceived to be employee advocate

  • LESSONS

    • Employee Advisory Groups

    • Communication Toolkits

    • No Employment At Will


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Staffing and Workload

  • Quality drives staffing decisions

  • Resources/Technology support caregivers

  • Selection based on behavioral fit

  • Solid focus on learning and development

  • LESSONS

    • Role clarity

    • Management Development

    • Staffing Models


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Compensation Practices

  • Market competitive pay practices

  • Flexibility is rewarded

  • Understanding of total compensation

  • Fair and equitable rewards

  • LESSONS

    • Articulated Philosophy to include market position/communication strategy

    • Leveling

    • Recognition Programs

    • Variable pay practice guidelines


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Recognition/Service Culture

  • Recognition and appreciation occurs formally and informally at all levels

  • Regular and frequent activities to promote community

  • Strong standards put patients first, and include family, physicians and colleagues

  • Physicians take ownership for facility outcomes and accountability for behaviors

  • LESSONS

    • Diversity Management

    • Medical Staff Leadership Consultation/Support

    • Community Involvement Programs

    • Longevity/Retention Programs


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High Performance

sustainable outcomes

The #s

People

Culture

balanced focus


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