1. Performance Excellence Engage for the New Age Rulon F. Stacey, PhD, FACHE President, University of Colorado Health © Copyright PVHS 2012 All Rights Reserved

2. Poudre Valley Health System Private, locally owned, not-for-profit, integrated health system Full spectrum of healthcare services –2 tertiary hospitals (420 beds), outpatient campus, growing number of physician practices & outpatient facilities –Joint ventures: Surgery centers, home care, sub-acute care, third-party administrator

3. Poudre Valley Health System Service area: Northern Colorado, Wyoming & Nebraska 5,300 employees, 600 physicians & 1,000 volunteers $1.4 billion in annual revenue

4. Where Our Journey Started Poudre Valley Health System, 1997 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

5. Leadership: Find an improvement model The Work Horse Philosophy Performance Excellence Journey

6. Systems approach Feedback –Measures progress –Notes major strengths –Guides improvements Why Baldrige?

7. Our Vision To provide world-class health care Wendy Oncology patient

8. Definition of World-Class Striving for results in the 90 th percentile or top 10% of available national comparative databases Craig Trauma patient

9. Core Competencies

11. Customer-Focused Outcome s Top Box Scores for Patient Satisfaction 10 years of consistent improvement

12. Workforce-Focused Outcomes Staff Voluntary Turnover

13. Workforce-Focused Outcomes Employee Engagement

14. Workforce-Focused Outcomes Physician Engagement Scorecard

15. Healthcare Outcomes Risk-Adjusted Mortality Rate

16. What’s Next? How do you sustain world-class performance?

17. Wave of Change in 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 Challenge for healthcare providers –New reimbursement model –Higher accountability for quality

18. Engage for the New Age New physician model New partners Lean thinking

19. New Physician Model Colorado Health Medical Group 27 clinics, 180+ clinicians, 600 support staff Growing integration 2008: Nearly 100% independent practice 2012: 25% in CHMG, 75% independent

20. New Partners The perfect partner: University of Colorado Hospital Magnet #1 Academic Medical Center, U.S. News and World Report Academic medicine and research Continuous care for patients all over Colorado New partners across the region Memorial Health System, Colorado Springs, Colorado Ivinson Memorial, Laramie, Wyoming

21. From Independent to Inter-Dependent A collection of providers taking shared responsibility for patients over a period of time Remove cost without compromising quality Integrate between facilities, between providers Improve what you’re already supposed to be doing well Why Partner?

22. Emergency Department length of stay down 72 minutes Clinic registration times down 50% Time for surgery pre-admit appointments down 50% Design for new cancer center based on patient preferences OR turn-around times in national top 1% Lean Thinking

23. Performance Excellence is not about: –Being average –Being perfect Performance Excellence is: –Asking the right questions –Continuing to improve –Having the right people around the table –Sharing and learning from others Lessons Learned

24. Work with state quality program Must have commitment from senior leaders and Board Don’t give up Stop cramming for the test: Live it! Consider it productive time Make it how you do your business It can’t be about the award

25. Health Care Moving Forward

26. Two Curves The challenge of a 2 curve problem is to prosper in the 1 st while you prepare for the 2 nd Curve 1 Curve 2

27. Dramatic Changes to the Competitive Landscape The blurring of lines between not-for-profit and for-profit health care creates new and more pragmatic competitors The blurring of lines between health care’s traditional participants – insurers, hospitals, and physicians – resulting in new market entrants Joint Venture to Form New System Joint Venture to Acquire Catholic Hospitals acquires Copyrighted by Kaufman, Hall & Associates, Inc. 2012

28. Throughout All of These Challenges and Changes, Performance Excellence Still Saves Lives! Molly 4th generation treated at PVH