Saving Lives through Performance Excellence
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Saving Lives through Performance Excellence. Rulon F. Stacey, PhD, FACHE President/CEO, Poudre Valley Health System. Private, integrated health system locally owned, not-for-profit Full spectrum of healthcare services

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Saving Lives through Performance Excellence

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Saving Lives through Performance Excellence

Rulon F. Stacey,PhD, FACHE

President/CEO, Poudre Valley Health System

Private, integrated health system locally owned, not-for-profit

Full spectrum of healthcare services

2 tertiary hospitals, outpatient campus, numerous satellite clinics

Regional medical hub for cardiac & trauma services, orthopedics, oncology, neonatal intensive care & bariatric surgery

Poudre Valley Health System

Service area: Northern Colorado, Wyoming & Nebraska

5,300 employees, 600 physicians & 1,000 volunteers

$1.4 billion in annual revenue

Poudre Valley Health System

Community hospital serving Fort Collins, Colorado

1,500 employees, 300 independent physicians & 575 volunteers

24% annual employee turnover

5 CEOs in 4 years

$250 million in annual revenue

Changing healthcare market

Demand for physician integration

Where Our Journey Started - 1997

Performance Excellence Journey

  • Leadership: Find an improvement model

  • The Work Horse Philosophy

To provide


health care

Our Vision


Oncology patient

Striving for results in the 90th percentile

or top 10% of available national

comparative databases

Definition of World-Class


Trauma patient

Communicate Direction

Set Direction

Our Beliefs

New Employee Orientation

Forums for Employees & Volunteers

Quarterly updates on performance & action plans that support each Strategic Objective

Name Badges

Meeting Templates

Learn & Lead Program

Vision/Mission/Values Team

Leadership Meetings

Medical Executive Committees

Communicate Direction

Plan & Align

Core Competencies

Identify strategic opportunities

How can we provide a lifetime of care?

Align economic incentives & build relationships

Outpatient services, home health, sub-acute care, third-party administrator, strategic vendor relationships

Win-win for PVHS, other healthcare providers, patients & community

Improve clinical quality

Partnering: An Innovative Strategy

Rural dilemma

Insufficient volumes to ensure quality

Choice: Revenue or optimal outcomes?

New alternative

PVHS + Regional West Medical Center = Medical Center of the Rockies

Improved outcomes & revenues for all

The Ultimate PartnershipPVHS & Regional West Medical Center

Poudre Valley Medical Group (PVMG)

27 Clinics, 180 clinicians, 600 support staff

Physician Changing Model

2008: nearly 100% independent practice

2011: 25% in PVMG, 75% independent

University of Colorado Hospital

Share overall management structure

Pool revenue and expenses

Partnering: Next Generation

Execute the Plan & Drive Performance

Execute the Plan & Drive PerformanceBalanced Scorecard Process

Develop People

Performance Review Process

Reward & Recognition, including Peer-to-Peer Coupons

Optional Performance Plan

Learn & Lead, Building Blocks of Leadership

Learn & Grow

Grand Rounds, Tuesday Afternoon Conferences

Mentoring Program

Tuition Reimbursement

Professional Associations, Conferences

Develop People

Performance Review Process

Best Practice: Integration of Values, Behavior Standards, Core Competencies, Key Customer Requirements & Personal Goal Cards

Develop People

Execute the Plan & Drive PerformancePersonal Goal Cards

Learn, Share & Innovate

Performance Excellence Teams

Baldrige-driven improvements

PDCA Model for Process Improvement

LEAN Transformation

Process Design

Best practices: Stakeholder involvement & Voice of the Customer

Learn, Share & Innovate

20 interdisciplinary teams with staff, physicians, partners, vendors & community members

Community focus groups

Wayfinding, spirituality, furniture, menus, naming

National site visits with physicians, staff & vendors

Mock-ups for OR, trauma suite, patient room & elevator

Day-in-a-Life Scenarios

An Example: Medical Center of the Rockies


Gabriel, NICU “Graduate”

Healthcare Outcomes

Risk-Adjusted Mortality Rate

Customer-Focused Outcomes

Top Box Scores for Patient Satisfaction

9 years of consistent improvement

Customer-Focused Outcomes


*Hospital Consumer Assessment of Healthcare Providers & Systems

Financial & Market Outcomes

Patient Discharges

59% increase in PVHS discharges

from 2000 to 2010

19% population growth in Larimer

County from 2000 to 2010

15% increase in Competitor

discharges from 2000 to 2010

40% population growth in Competitor’s

home county from 2000 to 2010

Workforce-Focused Outcomes

Staff Voluntary Turnover

Workforce-Focused Outcomes

  • Staff: 93rd percentile for employee satisfaction (MSA)

  • Volunteers: 99% satisfaction on internal survey

  • Physicians: 96th percentile for physician loyalty (Gallup)

    • Top 100 Best Places to Work, 2008, 2009, 2010

    • Modern Healthcare

Workforce-Focused Outcomes

Physician Engagement Scorecard

Remaining CompetitiveHospital Charges

Community Benefit

  • Charity Care

  • Family Medicine Center

  • Community Case Management

  • Patient Navigators

  • Poudre Valley Nurse Line

  • Mental Health & Substance Abuse Partnership

  • Lifestyle Challenge

  • Healthy Kids Club

  • Well City Initiative

  • Poudre Valley Prenatal

  • Aspen Club

  • Safe Kids Coalition

  • Teen Motor Vehicle Safety Coalition

Increased hospital discharges almost 50% with only 11% population growth

Doubled the workforce

Added 2nd hospital, outpatient campus & numerous offsite clinics

Expanded service area from Fort Collins community to 50,000 square miles in Colorado, Wyoming, Nebraska

Challenging Times…

Challenging Times Continue

U.S. Healthcare

Patient Protection & Affordable Care Act

Future Trends

Integration: Coordinate care, patient is the customer

Value: Deliver quality outcomes and high levels of service at a reasonable cost

Transparency: Learn, grow and respond

Top 10% for Inpatient Mortality, Patient Satisfaction, Employee Satisfaction & Physician Engagement (PVHS) 2008, 2009, 2010

Top 100 Best Places to Work, Modern Healthcare (PVHS) 2008, 2009, 2010

Magnet designation PVH since 2000, MCR 2010

NDNQI Outstanding Nursing Quality Award for last 3 years

World-Class Results

To provide


health care

Our Vision


4th generation treated at PVH

Additional Information:

PVHS Center for Performance Excellence

Priscilla Nuwash: [email protected]

Sonja Wulff: [email protected]

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