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From Good to Great. Service Excellence University of Missouri Health Care September 1, 2005. The charge for University of Missouri Health Care is to move from a good organization to a great one . We HAVE a sense of urgency to do this.

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From Good to Great

Service Excellence

University of Missouri Health Care

September 1, 2005


The charge for University of Missouri Health Care is to move from a good organization to a great one.

We HAVE a sense of urgency to do this.



Umhc culture
UMHC Culture health system’s top priority.

This commitment requires people to change.


Hardwiring excellence by quint studer
‘Hardwiring Excellence’ by Quint Studer health system’s top priority.

  • Model for organizational excellence

  • Guide for best practices, not a mold


Becoming a world class organization requires
Becoming a World-Class Organization Requires: health system’s top priority.

  • Committing to excellence

  • Measuring the important things

  • Building a culture around excellence

  • Creating and developing leaders

  • Focusing on employee satisfaction

  • Building individual accountability

  • Aligning behaviors with goals and values

  • Communicating at all levels

  • Recognizing and rewarding success


Our commitment to excellence
Our Commitment to Excellence health system’s top priority.

The journey to excellence begins with a firm and measurable commitment from EVERYONE.We no longer want to be good. Our goal is to be Grrrreat!


Our commitment to excellence1
Our Commitment to Excellence health system’s top priority.

There is no ‘THEY’


University of Missouri Health Care health system’s top priority.

Our Mission

As part of a land-grant university, University of Missouri Health Care’s core mission is to provide education, research and service to the residents of Missouri with an emphasis on the needs of rural Missouri.

Our Vision

To offer programs of unsurpassed excellence that will be integrated into a highly efficient, fiscally sound, professionally outstanding, service oriented health system that is unified in a common purpose to be one of the premier comprehensive academic health systems in the nation.


Our values
Our Values health system’s top priority.

Quality.We believe in quality – quality in the patient care we deliver and the people we hire.

Efficiency.Our goal is to provide the highest quality care at the lowest possible price.

Caring Attitude.We care about the people who come here, whether they are patients or visitors. We treat them with courtesy and respect.

Participation. We encourage and depend on our staff to help us guide this organization. Their guidance is accomplished by participating in elected and appointed committees and task forces.


Community health system’s top priority.w Growth w Finance w Quality w People w Service

We identified six Columns of Excellence to provide the foundation for setting goals and direction for service and organizational excellence at University of Missouri Health Care


System approach to columns

Service health system’s top priority.

Quality

People

Growth

System Approach to Columns

Financial

Patient Satisfaction

Key Clinical Indicator Review

Medication Errors

Reduction of Patient Falls

Turnover

Turnover – First 90 Days

Employee Satisfaction & Retention

Employee Evaluation Completion

Wins

Operating Margin (MTD/YTD)

Cash Collection

New Patient Volume Growth

Surgical Growth

No Shows

Examples


Facility approach to columns

Service health system’s top priority.

Quality

People

Growth

Facility Approach to Columns

Financial

Key Clinical Indictors – results for the org

Reward & Recognize leaders

Reward & Recognize staff

Turnover

Staff forums

Upcoming hospital celebrations

Operating Margin

Cash Collections

AR days

Market Share

Specific Service line growth

No Shows

Community Events

Patient Satisfaction

Reward & Recognize leaders of areas scoring well

Standard of the Month Celebration

Patient letters

Examples


Department approach to columns

Service health system’s top priority.

Quality

People

Growth

Department Approach to Columns

Financial

Dept Patient Satisfaction

Patient comments

What we have improved

Where we need to focus

Ideas from staff

Dept Quality Indicators

R&R improved areas

Key action steps for staff to take next 30 days

New tools & equipment

Introduce new employees

New Tools & Equipment

Dept Turnover

Upcoming training activities

Reward & Recognition

Dept Productivity

Dept supply costs

Key actions for staff to take next 30 days

Hospital/Dept financial performance YTD

Dept admissions

Community Events

Hospital growth YTD

Examples


Building a culture around excellence
Building a Culture Around Excellence health system’s top priority.

  • Core Team Formed

    • January 2005

  • Service Teams Formed

    • April 2005

    • Approximately 100 employees involved to date

  • Quarterly Leadership Retreats


Standards team

Standards Team health system’s top priority.

Team Members:

Ben Atwell Shanna Baldridge

Karen Broz Dr Robert Bynum

Dave Geiger Marty Hausman

Michel Hayes Craig Hosey

Pam Mulholland Karen Scott Kay Steward


What We Do health system’s top priority.

Purpose : To create the foundation of our culture of Service Excellence

Goals: We asked ourselves : What kind of behaviors do we need to become a culture of excellence for patients, staff, and physicians?

The answer: The Standards of Performance


The Commitment health system’s top priority.

Current Staff

  • All signing is cascaded down through executive Leadership, then their direct reports, etc…

  • All staff are to have signed by September 30, 2005

    New staff

  • HR – on line Standards prior to application access

  • Departmental signing as well and departmental orientation (added to orientation checklist)


Our Projects health system’s top priority.

Education:

A traveling carnival : UH, CRH, EFCC, QD

  • Positive Learning Environment

  • Fun and Interactive

  • Different Booths to Represent each Standard

  • Prizes, candy, etc. for winners

    Standard of the Month


Patient satisfaction team

Team Members: health system’s top priority.

Patient Satisfaction Team

Laura Phillips

Bonnie Potter

Linda Robb

Dan Smith

Susan Straatmann

Patty Wells

Darian Younger

Barb Barrett

Deb Calder

Jan Degraffenreid

Paula Flandermeyer

Shawn McGrew

Ellen McKenzie

Nakia Moore

Katherine Payne


What We Do health system’s top priority.

Purpose

  • Ensure highest level of service is consistently provided

  • Develop new ideas to continually improve the service and to share best practices among departments to help others learn

    Goals

  • Look for ways to “wow” patients and families

  • Solicit input on ways to improve care

  • Develop & implement “key words at key times”

  • Implement communication boards in patient rooms

  • Implement nurse leader rounding

  • Implement discharge phone calls


Our Projects health system’s top priority.

  • Cascade Learning Packets

    • Interest, Concern, Apologize, Respond, and Educate

  • Quick Wins for specific areas


Physician satisfaction team

Team Members: health system’s top priority.

Physician Satisfaction Team

Pete Ackerman, MD Marty McCormick

Karen Calhoun, MD David Mountjoy

Steve Calloway, RPh Sue Scott, RN

Kevin Dellsperger, MD Tom Selva, MD

Jessica Hardy Beth Van Hove

Nancy Jones, RN Jennifer Wallace, RN

Melissa Lyons, M3 Andrew Wheeler, M3

Dennis McGowan Mary Williamson, RN


What We Do health system’s top priority.

Purpose:

Responsible for “wowing” physicians and improving the level of service to them and their patients

Goals:

  • Implement action steps with outcomes that will be seen by medical staff as a “win”

  • Modify key processes within the institutions that will allow for ease in patient care delivery


Our Projects health system’s top priority.

Quick Wins:

  • House Phone Conversions

  • Replacing Tone Pagers with Text Capabilities

  • On Call Schedules – On Line, One Reference Point

  • Hospital Marketing for Physician Providers

  • Facility Improvements – Hit Squad concept

  • Nurse Call Line


Priority Focus: “Patient Care Made Easier” health system’s top priority.

Hypothesis:

Addressing Patient Care Made Easier will improve physician, staff and patient satisfaction levels

Action Steps:

  • Identified discharge planning process as area for re-design

  • PSTF team joins forces with nursing administration to reach key goals for discharge planning revisions

  • Blitz Session to address key goals scheduled for September 30, 2005


Employer of choice team

Employer of Choice Team health system’s top priority.

Team Members:

Anissa Leaseburg Mindy Cherrington

Lezlie Dahlke Linda Davis

Gayla Maier Ramonna McKinzie

Theresa Nation Brenda Quinlan

Carey Smith Randy Wade

Angela Waller David Wiss


What We Do health system’s top priority.

Purpose

Implement programs and opportunities to help employees feel they are doing meaningful, purposeful and worthwhile work

Goals

To make UMHC the “destination employer”, not a stepping stone


Our Projects health system’s top priority.

Our projects will focus on system wide policies, procedures and programs that can be implemented to make UMHC an Employer of Choice. Future recommendations:

  • Encouraging opportunities for employees to be involved in decision making about issues that affect them, such as hiring decisions and work space and facility decisions

  • Ensuring that UMHC has a market competitive compensation program that encourages and rewards superior performance and shares gains with rank and file employees

  • Enhancing an already strong benefits program

  • Sustaining a culture that holds everyone in the organization, at all levels, accountable for their performance


Measurement team

Measurement Team health system’s top priority.

Team Members:

Kim Bass Amy Camp

Karen Cox Rachel Haverstick

Christine Heath Bruce Horwitz

Will Kiehl Manuel Navarro

Michele Schutte David Sohl

Barb White


What We Do health system’s top priority.

Purpose:

  • To correctly measure, interpret, and communicate progress toward the organization’s objectives

    Goals:

  • To develop and distribute performance data in a clear and useful format to all departments and administration

  • Work with leadership to promote understanding and utilization of data

  • Assist other teams by providing information for planning, decision-making and reward/recognition


Our Projects health system’s top priority.

Current and future projects/actions:

  • Design patient satisfaction reports for each unit, department and facility

  • Create a presentation to provide an overview and explain the data to departments

  • Review/evaluate current survey tools

  • Develop methodology for distribution and review of survey comments


Sample Reports health system’s top priority.


More Sample Reports health system’s top priority.

Five Best - Employee Satisfaction

UHC Employees

Mean

CRH Employees

Mean

Guest House

Human Resources

79.5

88.4

CPG Brookfield

84.7

Ortho Rehab

75.4

Endoscopy

Data Processing, TSS/ITS

71.7

76.4

PM&R Clinic

76.1

Pharmacy

66.6

OMER

73.9

Admitting

66.1


Service recovery team

Service Recovery Team health system’s top priority.

Team Members:

Anita Beall Susan Lee

Kim Brucks Velma Moore

Lorna Carver Carol Nierling

Karen Harris Dan Smith

Candace Hawkes Tracie Wideman

Mickie Kummer Amanda Wood


What We Do health system’s top priority.

  • To provide staff with information to enhance their customer service skills

  • To provide staff with the tools necessary to “recover” when a customer’s expectations have not been met


Our Projects health system’s top priority.

  • Develop a brochure for staff that provides key words/scripting to promote good customer service skills

  • Develop an educational video with case scenarios depicting excellent customer service delivery

  • Provide each department with a “tool kit” that will provide immediate access to resources for service recovery

  • Develop a log for each department to document service recovery occurrences and to determine trends for process improvement


Our Projects health system’s top priority.

  • The educational brochure attached will give staff information to enhance their customer service skills and includes the “I CARE” document

  • This brochure will also list specific measures to take when service recovery is needed

  • It will also be used during new staff orientation to promote appropriate customer service skills with new staff and will reinforce our Standards of Performance


Communications team

Communications Team health system’s top priority.

Team Members:

Cindy Alverson Freese Clay Anderson, M.D.

Jennifer Coffman Rosemary Frank

Janice Gartman Paula Heaviland

Mary Jenkins Julie McKay

Scott Stever Susan Straatmann

Tina Taylor Carol Wilhite


What We Do health system’s top priority.

Purpose:

To encourage and facilitate open, truthful and timely communication using a wide variety of communication sources

Goals:

  • To ensure all University of Missouri Health Care employees have easy and convenient access to both system-wide and department-specific information

  • To help other Service Excellence teams communicate their initiatives, projects and progress with the entire University of Missouri Health Care staff and, when appropriate, the community at large


Team Principles health system’s top priority.

Six principles should guide all communication

Be truthful

Be transparent

Be kind

Be an active listener

Be respectful

Be timely


Our projects
Our Projects health system’s top priority.

Communication Boards:

Step one:Place one public communication board in each of the seven major facilities, including:

  • University Hospital

  • University Physicians Medical Building

  • Columbia Regional Hospital

  • Ellis Fischel Cancer Center

  • Quarterdeck

  • School of Medicine

  • Missouri Rehabilitation Center

    Step two:Place one department-specific communication board in every department within University of Missouri Health Care


Our projects1
Our Projects health system’s top priority.

Public Communication Boards will contain:

System-wide and facility-specific Communication that falls under one of the six columns of Service Excellence

Department Communication Boards will contain:

Department-specific information that falls under one of the six columns of Service Excellence


Future projects
Future Projects health system’s top priority.

Training for Managers:

Cascade learning on how to hold staff meetings

Communication Support:

Help other teams construct communication plans for disseminating information about their programs, plans, progress and people


Reward recognition team

Reward & Recognition Team health system’s top priority.

Team Members:

Kevin Anderson Barb Brucks

Karen Calhoun, MD Carol Clark

Justin Delap Deborah Harvey

Louise Harvey Ron Hausheer

Sarah Knoerr Cheryl Kyle

Jane Nelson Kym Pieper

Catherine Price Wayne Richards

Deneal Sullivan Ceresa Ward


Our Purpose health system’s top priority.

Goal:

Impact staff, physician and patient satisfaction by:

  • Reinforcing desired behaviors by rewarding & recognizing employees

  • Building a culture of ownership and responsibility with regards to reward and recognition

    Actions:

  • Work with leaders to identify recognition opportunities

  • Evaluate and improve existing programs

  • Implement new programs for areas where there are gaps

  • Assist with other celebrations as needed

    “Compensation is a right; Recognition is a gift.”

    - Rosaveth Moss Kanter -


Proposed Basic Structure health system’s top priority.


Department Based Proposal health system’s top priority.

  • Budgeting for department based recognition

  • Spontaneous recognition for “crunch time” effort

  • Other department based activities


Support Requested health system’s top priority.

Making This Work

  • Consistently give verbal Thank You’s and write Thank You Notes

  • Nominate staff, peers, and leaders for Heroes/Legends

  • Tell great stories at meetings and events

  • Harvest the celebrations – collect stories from your direct reports and expect them to collect from their staff

    “Never underestimate the difference you can make!”

    - Quint Studer -


Leadership development team

Leadership Development Team health system’s top priority.

Team Members:

Kevin Anderson Kim Bass

Lynne Hedrick Susan Heimsoth

Linda Lightfoot Juni Muhota

LuAnn Tandy Ceresa Ward

and…

Your Participation is Requested


Leadership Development health system’s top priority.

Goal:

For our organization to go from good to great, we must have great leaders who

  • Learn

  • Grow in their knowledge and role

  • Share information, time and recognition

  • Model the way

  • Lead the charge


Leadership Development health system’s top priority.

Actions:

  • Work with Executive Team to establish Leadership Retreat outcomes

  • Coordinate Leadership Retreat delivery and implementation

  • Communication – Pre and Post Leadership Retreat

  • Ensure that leadership retreats are creative and fun

  • Assist with development of Cascade Learning


Cascade Learning health system’s top priority.

Purpose:

Communication and Training

Goal:

Consistent basic message with ability to meet departmental needs

Delivery:

  • Leaders first learn/hear the message

  • Receive a cascade learning packet

  • Present and discuss the message with department

  • Report completion to Associate Director


Must Haves health system’s top priority.

  • Cascade Learning

  • Employee Thank You Notes

  • Rounding for Outcomes

  • Discharge Phone Calls

  • Key Words / Key Actions

  • Alignment of Organizational Goals

  • Selection and Retention of Staff


Rounding health system’s top priority.

Satisfied employees do a better job. To increase employee satisfaction, we use a process called “rounding for outcomes” involving senior leadership and department managers.

Information will be used to improve the environment.


Rounding health system’s top priority.

When managers make rounds with purpose, they ask:

  • Tell me what is working well today?

  • Are there any individuals I should be recognizing?

  • Are there any physicians I should be recognizing?

  • Is there anything we can do better?

  • Do you have the tools and equipment to do your job?


Renters vs. Owners health system’s top priority.

A sense of ownership in the organization, builds individual accountability. Ways to create a sense of ownership and accountability include:

  • Allowing employees to participate in peer interviews

  • Asking their feedback in 30- and 90-day new employee meetings

  • Requiring them to sign a Standards of Performance Agreement

  • Encouraging employees to share their ideas for best practices


Communication health system’s top priority.

Communication is key to our success. We will employ the following measures to achieve improvement:

  • Managing up – positioning people well

  • Employee forums – quarterly, led by senior leaders

  • Communication boards – department-level, key information on progress toward the organization’s goals

  • Storytelling – sharing stories about everyday acts of heroism that take place in our facilities

    We want to duplicate positive behavior.


The Magic Bus health system’s top priority.

“First, you have to get the right people on the bus, the wrong people off the bus, and the right people in the right seats – and then you figure out where to drive it.”- Jim Collins - Author of “Good to Great”

UMHC

Excellence


Summary health system’s top priority.

Our actions speak much more clearly than our words…

“We are not in the health care business – we are in the life enhancement business.”

- Timothy Jarm -

President /CEO Jewish Hospital


Our Future health system’s top priority.

“A journey of a thousand miles begins with a single step.”

- Confucius -


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