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Aligning Lifelong Learning and Continuous Improvement with the Business Direction

at SSM Health Care

Dawn Runge, Ph.D.

Corporate Vice President – Organizational Effectiveness

Russ Scalpone, Ph.D.

Corporate Director – Organizational Effectiveness

October 2012

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SSM Health Care Mission

Through our exceptionalhealth care services,we reveal the healing presence of God.

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Mission Defined: Characteristics of Exceptional Health Care Services

Exceptional Patient Care

Clinical: Clinical Composite Indicators

Patient Satisfaction: Likelihood to Recommend

Safety: Patient Serious Event Rate

Exceptional Commitment

Employee Engagement

Physician Overall Satisfaction

Exceptional Financial Performance/ Growth

Financial: Operating Margin

Growth: Net Patient Revenue

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SSM Health Care System

• Based in St. Louis, Mo., with facilities located in four Midwest states including Missouri, Illinois, Wisconsin, Oklahoma

• Provides services in inpatient, outpatient, outpatient surgery and emergency department hospital settings, two nursing homes, and home care

• Traces its roots back to 1872, when Mother Mary Odilia Berger and four sisters migrated to the United States from Germany– The congregation, now known as the Franciscan Sisters of Mary,

sponsors SSM Health Care– 25,600 employees, 7,300 employed and affiliated physicians,

6,750 nurses and nearly 2,400 volunteers all working together to provide exceptional health care services

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More About SSM Health Care

• First health-care recipient of the Malcolm Baldrige Award• First large health system to go tobacco-free inside and out• SSM is implementing an electronic health record in all its

hospitals– Top 6 percent of hospitals to implement electronic

health records• Core Competencies:

– We know how to improve– We use values to guide decision-making– We take advantage of being a system

Leadership Concept

WH

Y

How are we going to improve?

Mission & Strategic Direction

H

OW

WH

AT

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SSM Health Care Corporate Organizational Effectiveness

Corporate Vice President – Organizational Effectiveness

Corporate Director – OE/CQI

• Curriculum Development and Instruction

• Education Strategy• Evaluation and Assessment• Design CQI Effectiveness

Measures• System CQI Projects• MBNQA Category Five• Co-Manage CQI Workgroup• Knowledge Sharing

Reports to Senior Vice President – Human Resources

Corporate Manager – OE


• Manage SMEs & Faculty• Physician Leadership

Development • CME Process for System• Member of Physician

Leadership Council• Manage Leadership

Pathways & OD Roundtable Team

Corp. EducationConsultant – OE

Corp. EducationSpecialist – OE

• Curriculum Development Create Online Courses

• Integrate Online Courses with LMS Function

• Maintain all Online Programs

• Member of LMS Team• Web 2.0 Teamwork• Quality Companion

Database

Corporate Director – CQI


• Manage SMEs & Faculty• Support CQI Effectiveness

Measures• Manage Corporate Office

CQI Projects• MBNQA Category Six• Co-Manage and Support

CQI Workgroup• CQI Website• Quality Companion • Database• CQI Knowledge Sharing

Corp. SystemsSpecialist – OE

Create Courses in LMSCreate & Maintain CatalogSystem Admin – Performance Development Track Training MetricsLive Meeting AdministratorMember of LMS TeamMember of Performance Development Teams

AdministrativeEducation Assistant


• Manage SMEs & Faculty

• Administer School at Work

• Manage Emerging Leaders

• Member of Performance Development Teams and Educator’s Roundtable

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Purpose of the Learning Function

Help SSMHC achieve its mission of exceptional healthcare services by developing leadership and serving as a

resource for leaders throughout the System.

“At SSM Health Care, we have a saying that was coined by our former President/CEO Sister Mary Jean Ryan: ‘No matter what your title, no matter what your job…you are an SSM Health Care leader.’ For us, leadership is the process of achieving the goals of the organization in a way that reflects our history, heritage, mission and values. Education and training is an integral part of SSM’s culture, and we continue to invest our resources into developing and retaining our employees because we want to further their intellectual, spiritual and emotional well-being at work and home.”

Bill Thompson, President/CEOMarch 2012

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4: Measurement, Analysis, and Knowledge Management

3: Customer Focus

6: ProcessManagement

2: Strategic Planning

5: WorkforceFocus

7: Results1: Leadership

Organizational Profile:Environment, Relationships, and Challenges

Baldrige Performance Excellence Model

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Workforce Management

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• Leadership Development

• Performance Development Process

• Succession Planning Programs

• Process Improvement Methodology

• Other

Areas of Organizational Effectiveness (OE)

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• Other


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Core Curriculum at SSM University

• Built on our Leadership Competency Model and past accomplishments

• Designed for leaders who drive 85% of organizational change

• Uses internal resources in design and as faculty• Links courses to our Mission, Values, the

“Exceptionals,” Competency Model, and MBNQA• Updated continuously via a range of needs

analysis inputs

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Needs Diagnosis Process

Organizational Development & Curriculum Plan• 101 Leader Series• 201 Leader Series• Leader Development

Programs• Physician Leadership• Other

SSM University Policy Board

SSM University Policy Board

Organization Capabilities To Implement SSM

Strategies

Organization Capabilities To Implement SSM

Strategies Special Needs Surveys &

Executive Fact-Finding

Special Needs Surveys &

Executive Fact-Finding

SSM Satisfaction Results & Drivers

SSM Satisfaction Results & Drivers

SSM Health CareLeadership Competency Model

UniversitiesUniversities Professional Organizations

Professional Organizations

LMS Performance Development

Results

LMS Performance Development

Results

SSM Functional

Groups

SSM Functional

Groups

SSM Educator & OD Roundtables; CQI Workgroup

SSM Educator & OD Roundtables; CQI Workgroup

• Fontbonne University• ACHE• Health Care Advisory Board• Press Ganey• Healthstream• ASQ

• Nursing• Physicians• Human Resources • IHT• CQI• Other

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Level 2: Learning

Level 3: Behavior

Level 4: Results

SSM Training Effectiveness

• Feedback surveys for all coursesOverall SatisfactionRelevancy/

applicability to jobAccomplishment of

learning objectives• Semi-annual survey of

titled leaders• CQI needs

assessments• Special needs

assessments

• Testing (certain courses)

• Performance demonstration (some courses)

• Learning applications (most courses)

• Performance demonstrations (some courses)

• Documenting, tracking and sharing of learning applications All CQI coursesAll leader

development programs

• Conduct surveys to assess behavioral change associated with learning objectives

• Document and track learning goals within the Performance Development Process

• Assess changes in organizational performance metrics (e.g. financial, operational, patient, and employee measures, etc.)

• Special studies on Employee and Physician metrics

• Document improvements in organizational metrics linked to training application All CQI course

applications All leader development

programs

Level 1: Reactions

Mission & Values Based Leadership

Gives and Receives Feedback

Communicates Effectively Coaches & Mentors

Others Promotes Teamwork &

Achieves Results through Others

Addresses & Resolves Conflict

Develops Others & Builds Trust

Holds Self & Others Accountable for Physician and Employee Satisfaction

Participates with Clinical and Admin Leadership in Setting Direction & Goals

Demonstrates Critical Thinking Skills

Sets Priorities & Allocates Resources

Develops / Organizes / Implements Strategic Plans

Holds Self & Others Accountable for Achieving Strategic Initiatives

Champion for Clinical Quality, Patient Safety, Physician Professionalism, and Support of Code of Conduct

Leads and Manages Change and Ability to Influence Others Committed to Achieving Results Models AEPC Service Standards Demonstrates Integrity & Courage Develops Self through Personal Growth/Learning Maintains Optimistic (Can Do) Attitude Demonstrates Knowledge of SSM History, Traditions and

Catholic Social Teachings Demonstrates Flexibility with Industry Changes Holds Self and Others Accountable

Comprehends & Utilizes CQI Plus

Makes Decisions Based on Data

Achieves Results through Process Analysis & Modification

Holds Self & Others Accountable For

Exceptional Clinical Outcomes, Safety and Patient Satisfaction

Understands Health Care Finance Principles Appropriate to Role

Comprehends & Utilizes Budgets & Financial Reports

Assumes Risk & Responsibility for Financial Decisions

Holds Self & Others Accountable for Financial Results

Exceptional Process Improvement

ExceptionalPlanning

Exceptional Financial Stewardship

Engaging an Exceptional Workforce

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Growth of Leadership Development at SSM

• Goal is to develop leaders at ALL levels, regardless of title• Tuition reimbursement is available for ALL employees after

6 months of employment

20 63189 278

7501000

1600

25

12

35

45

65

75

0

10

20

30

40

50

60

70

80

2006 2007 2008 2009 2010 2011 20120

200

400

600

800

1000

1200

1400

1600

1800

Co

urs

es

Year

Cla

sses

Growth in Courses and ClassesClasses Courses

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Leadership Development

• SSM University– Goal is 1,600 courses in 2012 with 95% satisfaction rate with current series

(3rd gen) with ILT, on-line and mobile learning options– Continuing 2012 School at Work program in all regions – Collaboration with

STLCC for courses beyond graduation (pilot in STL)– Informal learning programs very successful with increase in hours

• “Inside Leadership Council” = 4 hrs• “Read to Lead” = 36 hrs• “Leaders for Lunch” = 24 hrs

– “Lifelong Learning” policy increase to 80 hrs in 2013 with more opportunities for hours

– Physician Leadership Development Program has four levels:• New Physician Orientation – Pilot Underway at St. Clare• New Physician Leader – Curriculum done July 2012• Ongoing Physician Development – September 2012• Advanced Physician Development – Planning in Progress

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• School at Work (SAW) – Nine-month program for entry level employees to attend courses during work hours to develop leadership & technical skills – Upon graduation, they move to degree-seeking status

• STLCC & SSM – Created program (pilot) to prepare SAW graduates for college entrance exams through enrollment

• Emerging Leaders – 10-month leadership development program tailored to the needs of staff and front line leaders to grow into future managers – 95% satisfaction rate with 90% promotion rate upon completion

• Leadership Pathways – Rigorous, two year development program designed for the top 25 directors to become future executives – 98% satisfaction rate with 92% promotion rate upon completion

• Executive Integration – Created for new executives to ensure a consistent understanding of our history, mission, values and philosophy of SSM Health Care; and are clear on executive expectations, key operational processes and performance metrics


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• Other


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What is the Performance Development Process?

360 DEGREE FEEDBACKGOAL SETTING

• Departmental to Support Mission

• Individual to Develop Leader

ANNUAL PERFORMANCE REVIEW

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Translating Mission into Strategy and Action

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Mission Statement

Network Goals

Entity Goals

Department Goals

PerformanceDevelopment

Process (Goals, 360And Evaluations)

Strategic/Operational Plans

Department Plans, Posters & Graphs

Passports

Alignment of Performance Development Process with Strategic/Operational Plans

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Connecting Our Work

What “I” will do to support the department’s

improvement goals

What “we” will do as a department to improve

performance

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• Other

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Succession Planning Programs

• Emerging Leaders – In third year, with approximately 150 participants each cycle– Approximately two additional training programs per year for alumni

• Leadership Pathways – In fourth year, with approximately 25 participants at one time– Alumni enter the ACEs Program

• Advancement of Careers & Education (ACEs)– Began March 2011 – Will continue to grow due to incoming LP

graduates – Program changes include two courses per year – Success is dependent upon the individual

• Executive Integration – Program for new executives to better understand expectations of

their role, SSM history, governance, key operational & strategic processes, etc.

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Purpose of Emerging Leaders & Leadership Pathways

• Improve overall quality of high potential leaders • Provide overview of talent in the organization

– Repository of information regarding employee ability and performance coupled with career interests

• Provide recruiting information when key positions are open• Identifies key developmental areas• Provides opportunity for long term development of high potential

individuals:– Training – Coaching– Developmental assignments– Networking and visibility

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• Other


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Continuous Process Improvement (CQIplus)• SSM utilizes the CQIplus model for designing, innovating and

improving work processes to meet key customer/patient requirements and achieve better performance, reduce variability, and improve outcomes.

• This model is based on SSM’s five quality principles:– Patients and other customers are our first priority– Quality is achieved through people– All work is part of a process– Decisions should be based on facts– Quality requires continuous improvement


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We Use CQIplus to Improve

The Science of Becoming Exceptional

Applied CQIplus Education

Tit

led

Lea

der

s

Team

s an

d D

epar

tmen

ts

Exe

cuti

ves

Ind

ivid

ual

Co

ntr

ibu

tors

Ph

ysic

ian

s

CQIplus Overview & Simulation

Applying Lean Principles for Process Improvement Process

Management (Module 5)

Operational Team Leader Training (OTL)

Project Team Leader Training (PTL)

Advanced Project Team Leader Training (APTL)

CQIplus for Executives

CQIplus for Physicians

• Creativity & Innovation• Leading and Managing Change

• Key Process Metrics• Measuring Health Care Quality Through Statistical Process Control

32Additional CQI Related Training – All Staff

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Workforce-Level Integration

Training in CQIplus Tools & Methods

Training in CQIplus Tools & Methods

Improvement Goals included

in Passport

Improvement Goals included

in Passport

Participates in CQI Teams

Participates in CQI Teams

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Entity/Region Level Integration

CQI Director Input into

Strategic & Operational

Plans

CQI Director Input into


Plans

PTL Projects in Every

Department

PTL Projects in Every

DepartmentCQI Projects

Support Strategic & Operational

Plans

CQI Projects Support


PlansCQI Metrics

Monitored by AC

CQI Metrics Monitored by

AC

Entity Teams Participate in Regional &

System Level Sharing Events

Entity Teams Participate in Regional &

System Level Sharing Events

All AC members Champion

CQI Projects

All AC members Champion

CQI Projects

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System-Level Integration

CQI Project Tracking &

Metrics

CQI Project Tracking &

Metrics

Educational Curricula:

• Staff• OTL• PTL/ATL

Educational Curricula:

• Staff• OTL• PTL/ATL

Training Policy

Training Policy

Organizational Learning/Performance

Improvement Interventions

• Entity-Level • Unit/dept.-level

Organizational Learning/Performance

Improvement Interventions

• Entity-Level • Unit/dept.-level

Community Building & Knowledge Transfer

• CQI Directors• CQI Practitioners/PTLs

Community Building & Knowledge Transfer

• CQI Directors• CQI Practitioners/PTLs

Train-The Trainer,

Curriculum Administration, & Evaluation

Train-The Trainer,

Curriculum Administration, & Evaluation

CQI Mentoring & Coaching

CQI Mentoring & Coaching

Science in a Toolbox

Team Facilitation Tools

Lean Tools

Six-Sigma Tools

Change Management Tools

CQIplus is a set of tools, techniques and training to improve processes. Depending on the problem or opportunity identified, teams use the appropriate mix of tools to achieve the project objectives. This “Mix” is the Methodology.

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Why Focus on Variation?

Our patients and other customers don’t feel the

average they feel the variation !

S

P

R Average

E

A

D

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How Do We Know We Are Effective?

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Performance Management: Linkage of PIR to Other Performance Reports

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Performance Management: How Our Data Links With Our Planning Process

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More Than Just Data…

• Why do we collect the information we do?• What do we do with it?• How do we use it to set goals? • How do we share it? • How do we ensure that it is accurate and timely?

Data Information Knowledge Wisdom

Analysis Communication Application

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• Other


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Other

• ICD-10 training under way• Created ‘LMS Road Show’ to educate new and current

users on system functionality• Installation of Badge Card Readers for easy course

registration & influenza vaccination processing• Working with IHT on single sign-on for all physicians into

LMS• Training effectiveness measures noted as strength on

MQA & MBNQA Feedback Reports – Continue to refine the way in which we measure &

deliver training so as to assess the business effects of the training

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