ZSFG Strategic Direction: X-Matrix

Transcription

1 ZSFG Strategic Direction: X-Matrix Joint Conference Committee March 27, 2018 Susan P. Ehrlich, MD, MPP

2 TRUE NORTH 2

3 X-MATRIX Building Our Future: Optimizing Clinical and Academic Space at ZSFG Implementing Enterprise-wide Electronic Health Record The ZSFG Way Equity Safety Quality Care Experience Developing Our People Baseline (FY16/17) FY 17/18 Target FY 18/19 FY 19/20 By 6/30/19, Increase % of unique patients seen at ZSFG with REAL (40%) and SOGI (10%) data completion By 6/30/19, Increase Departmental PIPS reporting with at least one metric stratified by REAL to 35% By 6/30/2019, Achieve % of EHR implementation defined by phase - Groundwork, Direction, Adoption, Testing, Training, Go-Live By 6/30/2019, Reduce total number of patient harm events to less than 10/month. By 6/30/2019, Reduce hospital readmission from 14.46% to 14.32% True North Goals By 6/30/2019, Reduce ambulance diversion from 52.8% to 40% Performance By 6/30/2019, Increase % ICARE adoption and adherence through daily status sheets, staff celebrations and driver or watch metric to 16 departments Star Rating 1 Star 2 Star 2 Star 3 Star Financial Stewardship "Would Recommend Hospital" (HCAHPS) Strategies / A3 True North Outcomes Equity Safety By 6/30/2019, Increase the number of ZSFG departments that have implemented DMS to 14 By 6/30/2019, Increase % of ZSFG expanded executive leaders with one identified PDP A3 target to 85% By 6/30/2019, Achieve % staff satisfaction and readiness for EHR by phase - Groundwork, Direction, Adoption, Testing, Training, Go-Live 78.3% 80.0% 82.0% 84.0% Quality Care Experience Developing Our People Financial Stewardship By 6/30/2019, Reduce # of days slippage for completion of capital projects to 0/month By 6/30/2019, Decrease salary variance Aiyana Johnson Brent Andrew Dave Woods Rajiv Pramanik Jennifer Boffi Jim Marks Karen Hill Kim Nguyen Margaret Damiano Sue Carlisle Susan Ehrlich Terry Dentoni Todd May Tosan Boyo Troy Williams SFHN True North Outcomes FY 17/18 FY 18/19 FY 19/20 Reduce Harm Events EMP: 433 ZSFGComp: 112 "Likelihood to Recommend 78.3% Hospital to Friends and Family" 1 "Would Recommend Provider's Office" (CG- CAHPS) 65.4% 67% 69.0% 71% 1 "Likelihood to Recommend Provider's Office to Friends and Family" (Specialty Clinics) 71.5% 75% 77% Limit Percent Spend of General Fund to Total Budget "Likelihood to Recommend ZSFG to Friends and Family as a Place to Work" Reduce BAA heart failure readmissions (vs hospitalizations) 17% 17% 17% 17% % (CY 15) 40% 45% 50% % Reduce Reliance on General Fund (Growth) Likelihood to Recommend Working Here BAA Cardiovascular - All Hospitalizations Legend 4.4% 38% 45% 60% 1 = 2 = 3 = strong correlation or team leader important correlation or core team weak correlation or rotating team 3

4 Performance measured throughout 2018 to drive outcomes Building Our Future: ACHIEVING OUR OUTCOMES Optimizing Clinical and Academic Space at ZSFG Implementing Enterprise-wide Electronic Health Record The ZSFG Way Equity Safety Quality Care Experience Developing Our People Financial Stewardship By 6/30/19, Increase % of unique patients seen at ZSFG with REAL (40%) and SOGI (10%) data completion True North Goals By 6/30/19, Increase Departmental PIPS reporting with at least one metric stratified by REAL to 35% Performance Strategies / A3 True North Outcomes Equity Safety By 6/30/2019, Achieve % of EHR implementation defined by phase - Groundwork, Direction, Adoption, Testing, Training, Go-Live By 6/30/2019, Reduce total number of patient harm events to less than 10/month. Outcomes measured Baseline over 5 years FY (FY16/17) FY 17/18 Target 18/19 FY 19/ Star Rating Zuckerberg San Francisco 1 Star General 2 Star 2 Star 3 Star 1 4

5 2017 TRUE NORTH STRATEGIES 6 TRUE NORTH GOALS 8 Equity STRATEGIES A d v a n c i n g E q u i t y Safety Quality I m p r o v i n g Va l u e a n d P a t i e n t O u t c o m e s E n s u r i n g F l o w a n d A c c e s s Care Experience O p t i m i z i n g C a r e E x p e r i e n c e Developing our People Financial Stewardship O p t i m i z i n g W o r k f o r c e C a r e & D e v e l o p m e n t T h e Z S F G Wa y B u i l d i n g f o r t h e F u t u r e I m p l e m e n t i n g a n e n t e r p r i s e - w i d e E l e c t r o n i c H e a l t h R e c o r d 5

6 2017 SUCCESSES ACHIEVING TARGETS IN QUALITY AND SAFETY QUALITY EMERGENCY DEPARTMENT FAST TRACK (FT) SAFETY COMPREHENSIVE JOINT REPLACEMENT (CJR) PROGRAM Emergency Department Fast Track (mean minutes) % 50% Comprehensive Joint Replacement Program (Percent) 89% 89% 91% 64% 53% 53% 44% 125 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 ESI 4/5 0% Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 FY1617 Baseline 6

7 2017 LESSONS LEARNED 67% of the True North metrics were off target Realign and refocus True North goals and metrics Move the focus to operational level 7

8 2018 TRUE NORTH OVERVIEW 6 TRUE NORTH GOALS STRATEGIES 12 PERFORMANCE METRICS 6 OUTCOMES METRICS Goals are defined by our mission, vision, values, tactics, and metrics that represent the direction we are heading in. Each True North Goal has 1-2 improvement strategies to guide the work. Performance measured throughout 2017 to drive outcomes Outcomes measured over 5 years. Hoshin Nov 2017 created focus 8

9 TRUE NORTH GOALS STRATEGIES PERFORMANCE METRICS OUTCOMES METRICS 8 A d v a n c i n g E q u i t y I m p r o v i n g Va l u e a n d P a t i e n t O u t c o m e s E n s u r i n g F l o w a n d A c c e s s 3 The ZSFG Way A d v a n c i n g E q u i t y I m p r o v i n g Va l u e a n d P a t i e n t O u t c o m e s E n s u r i n g F l o w a n d A c c e s s O p t i m i z i n g C a r e E x p e r i e n ce F i n a n ci a l S t e w a r d s h i p O p t i m i z i n g C a r e E x p e r i e n c e O p t i m i z i n g W o r k f o r c e C a r e & D e v e l o p m e n t Building for the Future T h e Z S F G Wa y B u i l d i n g f o r t h e F u t u r e I m p l e m e n t i n g a n e n t e r p r i s e - w i d e E l e c t r o n i c H e a l t h R e c o r d Implementing an enterprise-wide Electronic Health Record 9

10 TRUE NORTH GOALS STRATEGIES PERFORMANCE METRICS OUTCOMES METRICS Executive Key Performance Indicators Equity Safety Quality Care Experience Developing our People Financial Stewardship The ZSFG Way Marks & Nguyen Boyo Dentoni & Williams Marks & May Johnson Marks & Nguyen Boffi By 6/30/19, By 6/30/2019, Reduce By 6/30/2019, By 6/30/2019, By 6/30/2019, Increase By 6/30/2019, By 6/30/2019, By 6/30/2019, Increase total number of patient Reduce hospital Reduce % ICARE adoption and Increase the number Increase % of ZSFG Decrease salary Departmental PIPS harm events to less than readmission from ambulance adherence through of ZSFG departments expanded executive variance to 0 reporting with at 10/month % to diversion from daily status sheets, staff that have leaders with one least one metric 14.32% (Prime) 52.8% to 40% celebrations and driver implemented DMS to identified PDP A3 stratified by REAL to or watch metric to target to 85% 35% department Strategic A3s Building Our Future Implementing an Electronic Health Record Boyo & Damiano Dentoni & May By 6/30/19, Increase % of unique patients seen at ZSFG with REAL (40%) and SOGI (10%) data completion By 6/30/2019, Achieve % of EHR implementation defined by phase - Groundwork, Direction, Adoption, Testing, Training, Go- Live By 6/30/2019, Achieve % staff satisfaction and readiness for EHR by phase - Groundwork, Direction, Adoption, Testing, Training, Go- Live By 6/30/2019, Reduce # of days slippage for completion of capital projects to 60/month 10

11 HOW WILL WE CREATE FOCUS? Executive Key Performance Indicators Equity Safety Quality Care Experience Developing our People Financial Stewardship The ZSFG Way Marks & Nguyen Boyo Dentoni & Williams Marks & May Johnson Marks & Nguyen Boffi By 6/30/19, By 6/30/2019, Reduce By 6/30/2019, By 6/30/2019, By 6/30/2019, Increase By 6/30/2019, By 6/30/2019, By 6/30/2019, Increase total number of patient Reduce hospital Reduce % ICARE adoption and Increase the number Increase % of ZSFG Decrease salary Departmental PIPS harm events to less than readmission from ambulance adherence through of ZSFG departments expanded executive variance to 0 reporting with at 10/month % to diversion from daily status sheets, staff that have leaders with one least one metric 14.32% (Prime) 52.8% to 40% celebrations and driver implemented DMS to identified PDP A3 stratified by REAL to or watch metric to target to 85% 35% department Strategic A3s Building Our Future Implementing an Electronic Health Record Boyo & Damiano Dentoni & May By 6/30/19, Increase % of unique patients seen at ZSFG with REAL (40%) and SOGI (10%) data completion By 6/30/2019, Achieve % of EHR implementation defined by phase - Groundwork, Direction, Adoption, Testing, Training, Go- Live Operational A3s By 6/30/2019, Achieve % staff satisfaction and readiness for EHR by phase - Groundwork, Direction, Adoption, Testing, Training, Go- Live By 6/30/2019, Reduce # of days slippage for completion of capital projects to 60/month Equity Safety Quality Care Experience Developing our People Financial Stewardship Advancing Equity Improving Value and Patient Outcomes Ensuring Flow and Access Optimizing a Care Experience Model Daily Management System Financial Stewardship 11

12 TRUE NORTH GOALS STRATEGIES PERFORMANCE METRICS OUTCOMES METRICS Equity Safety Quality Care Experience Developing our People Financial Stewardship Boyo Dentoni & Williams Marks & May Johnson Marks & Nguyen Boffi Outcome Metrics Reduce BAA heart failure readmissions Star Rating "Would Recommend Hospital" (HCAHPS) "Would Recommend Provider's Office" (CG- CAHPS) "Likelihood to Recommend ZSFG to Friends and Family as a Place to Work" Limit Percent Spend of General Fund to Total Budget 12

13 Cascading information HOW DO WE ALIGN WITH THE ORGANIZATION? Executive Key Performance Indicators Equity Safety Quality Care Experience Developing our People Financial Stewardship The ZSFG Way Marks & Nguyen Boyo Dentoni & Williams Marks & May Johnson Marks & Nguyen Boffi By 6/30/19, By 6/30/2019, Reduce By 6/30/2019, By 6/30/2019, By 6/30/2019, Increase By 6/30/2019, By 6/30/2019, By 6/30/2019, Increase total number of patient Reduce hospital Reduce % ICARE adoption and Increase the number Increase % of ZSFG Decrease salary Departmental PIPS harm events to less than readmission from ambulance adherence through of ZSFG departments expanded executive variance to 0 reporting with at 10/month % to diversion from daily status sheets, staff that have leaders with one least one metric 14.32% (Prime) 52.8% to 40% celebrations and driver implemented DMS to identified PDP A3 stratified by REAL to or watch metric to target to 85% 35% department Strategic A3s Building Our Future Implementing an Electronic Health Record Periop Boyo & Damiano Dentoni & May By 6/30/2019, Reduce # of days slippage for completion of capital projects to 60/month By 6/30/19, By 6/30/2019, Achieve By 6/30/2019, Achieve Increase % of % of EHR % staff satisfaction unique patients implementation defined and readiness for EHR seen at ZSFG with by phase - Groundwork, by phase - REAL (40%) and Direction, Adoption, Groundwork, SOGI (10%) data Testing, Training, Go- Direction, Adoption, completion Live Testing, Training, Go- ALIGNMENT Live Unit-Level Key Performance Indicators: Drive (D) or Watch (W) Equity Safety Quality Care Experience Developing our People Financial Stewardship The ZSFG Way 1 Metric Stratified SSI (e.g skin cleansing) Add-On Wait Times ICARE Key Behavior 1 Department Dept. Salary Variance Building Our Future 100%/phase Implementing an 100% Electronic Health Record 13

14 DAILY MANAGEMENT SYSTEM DEPARTMENTS 4A Skilled Nursing Facility Care Coordination Critical Care and Respiratory Emergency Finance (Health Information System) Imaging Inpatient (Med/Surg Nursing) Inpatient and Outpatient Pharmacy Peri-Operative Perinatal (incl OBGYN/ Nursery/ NICU) Psychiatry Rehabilitation Services Specialty Care Urgent Care Center 14

15 HOW DO WE PREPARE OUR LEADERS? TOOLS Daily Status Sheets E m e r g e n c y D e p a r t m e n t Huddles Plan-Do-Study-Act H e a l t h I n f o r m a t i o n S e r v i c e s Leadership team 15

16 NEXT STEPS A3 Team Meetings Teams to develop strategy to achieve metrics and performance outcomes Operational A3 Development Align with Strategic A3 Strategic and operational A3s presented at JCC over the year True North Scorecard presented at JCC quarterly Strategic A3 Development JCC Updates 16