1. Children’s Health System 2009 Strategic Plan

2. Vision To be nationally recognized as a comprehensive regional and national pediatric healthcare center providing one class of excellent patient care.

3. During 2008, we used the Strategic Plan to guide our efforts. As we begin 2009, a fresh look at our “roadmap” with input from employees, members of the Board of Trustees, results of the Employee Opinion Survey and results from the Medical Executive Committee’s Survey of Physicians made our 2009 Strategic Plan more “bottom-up”. This process will continue to be refined but we are making progress. An important element is tying the Plan to the Budget and then to the Incentive Compensation opportunity. The Goals are by definition long-term, not achievable in one year or even several years and they do not change quickly. Look carefully at the Goals listed below—they will be our guide for our focus as an organization. On the other hand, the Objectives listed under each of the six Goals are designed to be achieved this year. They are more specific, measurable and quantifiable. Most have dates associated with the activity. At the same time, the list is illustrative, not exhaustive or limiting. In other words, there are other appropriate Objectives not listed which will support each Goal. As we consider and measure our performance as an organization against these Goals and Objectives during 2009, we will report to you quarterly on our progress. You should remember from last year that each Goal is weighted separately and for there to be an incentive payout, a minimum level of financial performance is required first—when that threshold is achieved, the amount of incentive payment will increase or decrease depending on our performance on the objectives. Also, remember we are all in the same boat-no incentive for me unless you earn one too—and earn is the appropriate word. So, study the 2009 Strategic Plan. Working together, we can make 2009 the best year ever for Children’s. Mike Mike Warren, CEO

4. Goals  Provide safe and effective care meeting the expectations of patients, families and physicians  Consistently maintain financial stability  Create and maintain a state-of-the art-campus  Collaborate with our academic partners to support pediatric training, research and clinical excellence  Be a healthcare advocate for children  Be a great place to work

5. Objectives Provide Safe and Effective Care  Achieve a Patient Satisfaction score of 90% (Likely to Recommend); review quarterly; identify areas of improvement and address on a continuing basis  Support the hospitalist’ reorganization efforts by July 1, 2009  Complement the McWane Quality Initiative by providing support for at least two quality improvement and/or safety efforts during the year; finalize the metrics to be used to measure success.  Complete planning for moving cardiovascular surgery by year-end  Move Solid Organ Transplant to CHS by/or before the opening of the replacement facility.  Provide funding and support for a Medication Stewardship effort  Develop and implement a palliative care program by year-end  Develop and implement a Pain Management Program by April 1, 2009  Coordinate efforts with Children’s Harbor by establishing a taskforce by February 1 to assess and make recommendations for improvement by October 1, 2009

6. Financial Stability  Achieve a 3.5% operating margin  Have 170 days cash on hand  Cost per unit of service below $4500 (budget level)  Successfully negotiate rates with Blue Cross/Blue Shield to support budget expectations  Maintain appropriate reimbursement from Medicaid  Achieve $5.4 million in GME funding for 2009  Maintain capital spending at budget levels  Develop plans to promote efficiency and reduce waste to achieve effective, affordable care

7. State-of-the-art-Campus  Continue with major building expansion preparation – break ground in Spring 2009; stay on schedule and on budget  Implement a financing plan to support of the major expansion by September 1, 2009  Complete the $100M Keeping Promises capital campaign by June 1, 2009  Plan an on-going effort to raise funds to support programs and research and implement by year-end  Raise additional support from federal, state, county and city governments  Complete Phase I of i-Connect project by December 31, 2009  Maintain Joint Commission readiness  Establish a committee to review Access Center operations by February 1, 2009 and recommend improvements by July 1, 2009  Begin adaptive reuse planning for the existing facility by year-end

8. Collaborate with Academic Partners  Continue to improve relationship with Department of Pediatrics, Department of Surgery, Department of Psychiatry, School of Medicine, Health Services Foundation, and UAB  Continue implementation of the plan for better IT coordination  Continue implementation of the plan for better Risk Management coordination  Coordinate recruiting efforts to attract and retain needed specialists

9. Advocacy for Children  Support advocacy efforts of others on behalf of children by providing leadership in targeted areas and making strategic investments in 2 - 3 activities in 2009  Support and promote wellness and prevention efforts  Support the City school insurance program

10. Great Place to Work  Keep personnel voluntary turnover below 15%  Achieve an active Leadership score of 85%  Maintain Magnet Status  Review the physician survey, target an area for improvement, develop a plan, and determine metrics that will be used to determine the success of the improvement effort  Review the employee attitude survey; consider areas of improvement and make adjustments by July 1, 2009