NEWS FOR EMPLOYEES AND FRIENDS OF WAKEMED SPECIAL EDITION: 2018 FISCAL YEAR IN REVIEWwww.wa

kemed.org

Raleigh CampusRaleigh Campus had an incredibly busy year – with high volumes across the board, and numerous projectsunderway to improve the patient and family experience. The main corridors – from the E-Tower to Café 3000 andfrom the A/B elevators to the Health Park – got a full refresh, including new flooring, paint, wall coverings andtrim. Many patient rooms also had repairs and updates made as part of Operation Tidy, a team effort involvingNursing and clinical staff, Environmental Services and Facilities, among others. This year marked several notableheart-centered anniversaries for Raleigh Campus – it was the 50th anniversary of the first open-heart surgery atWakeMed and the 20th anniversary of the opening of the Heart Center. Building on this legacy, this year, RaleighCampus became the first hospital in the nation to receive the V3 Advanced Heart Failure Accreditation from theAmerican College of Cardiology, due in part to our HeartCare Plus+ collaboration with Duke Health.

Cary HospitalExpanded services was a continued theme for Cary Hospital. The endoscopy unit was renamed the AdvancedGastrointestinal Center for Digestive Disorders and began offering new procedures such as ESG, a new, minimallyinvasive weight loss procedure. Additional resources allowed for expanded surgical services in thoracic and breasthealth. Supporting the community by improving access to quality health care, Cary Hospital began pursuit of statedesignation as a Level III Trauma Center and received conditional approval on a Certificate of Need (CON)application to move 30 beds and an operating room from Raleigh Campus to Cary. Additionally, the facility wasreaccredited as a Chest Pain Center by the American College of Cardiology Accreditation Services, an AdvancedPrimary Stroke Center by The Joint Commission, and a comprehensive Bariatric Surgery Center by the AmericanCollege of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, inpartnership with the American Society for Metabolic and Bariatric Surgery.

North HospitalNorth Hospital had a very successful and busy year, with record-setting patient volumes in August (for surgicalprocedures) and September (deliveries) and for the year in the Emergency Department. North also became NorthCarolina’s first and only milk bank depot site which supports our mothers’ milk bank.  Several key services wereexpanded this year including developing an interventional pain program, adding 3D mammography, expandingMRI services and developing a comprehensive joint program. North Hospital also received the prestigious level ofLeadership in Energy and Environmental Design (LEED) Healthcare Gold, becoming the 9th hospital in thecountry and 15th in the world to achieve this rating. 

Ambulatory Facilities Ambulatory Facilities and WakeMed PhysicianPractices continued to grow in key strategic areas,welcoming 42 new physicians and 40 advancedpractice providers. We opened numerous newpractice locations and broadened our specialtyofferings to include advanced heart failure,pulmonary rehab and cardiopulmonary therapy,orthopaedic urgent care and three pulmonaryfunction labs. We also welcomed two existingcommunity practices that chose to join ourgrowing family: Bariatric Specialists of NC andMidtown Vascular Surgery.

Our Healthplexes continue to serve an important role by providing convenient access to high-quality carethroughout Wake County.

• The Apex Healthplex Emergency Department saw over 19,000 patients throughout the year and welcomed anew ENT – Head & Neck Surgery practice as well as a pediatric multispecialty practice, bringing cardiology,surgery, endocrinology, gastroenterology and weight management together under one roof.

• At the Brier Creek Healthplex, a Pediatric Cardiology practice opened and the Emergency Department treatednearly 21,000 patients.

• It was a busy year at Garner Healthplex, where the Emergency Department saw over 32,000 patients and thephysician practices continued to see high volumes.

2018Caring for Our CommunityFiscal Year 2018 was an exciting year for WakeMed – one where we expanded our services, improved facilitiesand launched several major initiatives to help us achieve our mission of improving the health and well-being ofthose we serve. In this special issue of Microscope, we invite you to look back at the past year as we celebrate ourmany successes and say THANK YOU to everyone who helps make WakeMed the community treasure it is today!

O ce Surgical Medicine DeliveriesVisits Procedures Encounters

2017

2018

311,061

367,499

102,528

112,678

365,087

374,934

5,899

6,533

2016 272,747 94,795 338,880 5,310

Hospital

WakeMed Physician Practices Growth

Expanding and building on the Wake Way Behaviors and ourWW2E journey, significant work was done this year to lay thegroundwork for Leader Standard Work, which will be an area offocus in 2019. Work groups have been developed to focus onleadership development coaching, rounding and patient and familyexperience. We continued offering the Communication inHealthcare course – more than 800 physicians, 500 non-physicianleaders and 1,700 nurses have completed training to date – and anew experiential First Impressions training was introduced.

Left: As part of Diversity & Inclusion Month, diverse food trucksvisited Raleigh Campus and North Hospital. At the Raleigh CampusFood Truck Fair, attendees shared what they are #ProudToBe!

As we work to develop and retain our exceptional team, WakeMedimplemented a new performance management program that

allows staff to set goals and create development plans for their individual roles. Our annual employee and physicianengagement surveys yielded excellent results and revealed areas of opportunity for continued improvement.

WakeMed was proud to continuesupporting employees as they pursuedtheir educational and professional goals –investing over $905,000 in tuitionreimbursement. The WakeMedFoundation supported many more withgrants and scholarships:

• Helton Scholarship Fund: 23 studentsreceived $55,829

• Helton Awardee Fund: $10,350 wasdistributed to three departments

• Continuing Education: 24 employeesreceived $36,769

The Center for Innovative Learningprovided education to 5,079 people in1,042 educational sessions. We also sawan increase in nurses earning advanceddegrees (goal: 66.4%; actual 69.18%)and achieving national certification (goal:40.37%; actual: 41.91%).

As we continue pursuing the highestethics and standards in all we do, two newdepartments were established to monitorand promote compliance with HIPAAprivacy requirements and informationsystems security standards. In atremendous undertaking, all WakeMedpolicies and procedures were transitionedto PolicyTech, a new, easy-to-search web-based policy management system.Additionally, April 2018 marked thesuccessful completion of WakeMed’sCorporate Integrity Agreement.

Kudos to You!There were manyopportunities to recognizeour outstanding employeesthroughout the year.Seventy-three employeeswere awarded Pyramid Society Awardsfor going above and beyond their jobdescriptions in support of our AspirationalGoals. Our annual Service Awardsprogram recognized an impressive groupof 227 employees who have provided 20+years of service at WakeMed. The Divisionof Nursing recognized 130 nurses and theinterprofessional colleagues who supportthem during their annual NursingExcellence Awards program.

Employees showed their commitment toour patients and their families throughthe annual WakeMed Gives campaign,held in October 2017. Over 1,000employees donated, raising over$620,000 – including $166,000 for ourEmployee Emergency Assistance Fund.

Further supporting our patients and theirfamilies, WakeMed’s volunteerscontributed more than 134,400 hours ofservice and raised $92,684 to supportequipment purchases, projects andprograms.

We are WakeMed!WA K E W A Y, E X T R A O R D I N A R Y T E A M , H I G H E S T E T H I C S & S T A N D A R D S

PARTICIPATION

79%up from 72% last year

RANKING

92.7percentile

of organizations surveyed by Success Profiles

PARTICIPATION

93%up from 92% last year

RANKING

88thpercentile

of organizations surveyed by Success Profiles

Employee Survey Physician/APP Survey

Growth was the theme of our fourth year ofthe Wake Way 2 Excellence journey. Weadded two new value streams – RevenueCycle and Strategic Sourcing – andintroduced Kaizen events as anotheropportunity to achieve change in a focusedway. We continued to expand our LeaderTraining and Ambulatory Flow Bootcampofferings, enabling more leaders and teammembers to take an active role in WW2E intheir work areas.

WW2E By the Numbers• Value Streams: 6

• RPIWs: 11

• Kaizen Events: 7

• Overall staff participation: 1,795 (since FY2015)

• WW2E Leader Training: 32 leaders(manager and above) completed; 134leaders in process

• WW2E Ambulatory Flow Bootcamp: 74physicians and office staff attended

Aspirational Goal Metric FY 2018 Target Result

Leapfrog Group Safety Scores Raleigh A; Cary A Raleigh A; Cary C

Leapfrog Survey Score 72.00% 77.00%

Serious preventable harm events (rate per 10K adjusted patient days) 0.10 0.120

Catheter-Associated Urinary Tract Infections (CAUTI) 67 87

Central Line-Associated Bloodstream Infections (CLABSI) 36 35

Total operating expense per adjusted discharge $12,256 $11,924

Medicare readmisison rate for acute myocardial infarction (AMI) 4.80% 7.16%

Medicare readmission rate for total joint replacement (hip and knee) 4.00% 4.00%

Patient falls with injury 87 120

Overall perception of safety on AHRQ survey 69.00% 68.00%

Lost work days due to workplace injury 83 57

Employer of Choice percentile ranking on employee engagement survey 95.00% 92.70%

Employer of Choice percentile ranking on physician engagement survey 90.00% 88.10%

Staff turnover rate 10.50% 11.89%

Annual savings tied to Community Case Management program $1,500,000 $1,753,000

Percent of deliveries via C-section 21.50% 19.30%

MyChart activation by patients 30.00% 30.70%

Healthy Planet populations 5 7

Quality of Doctor rated "Excellent" on PRC survey 55.00% 44.10%

Overall HCAHPS Rating (percent of 9 and 10 scored) 74.00% 74.63%

Departments earning PRC 5-Star Awards 10 11

Investments in innovation 5 6

Employees involved in WW2E work 1,680 1,858

Staff provided formal training in the WW2E tenets and behaviors 450 497

EPIC dashboard measures (CAUTI, CLABSI, Falls &

MyChart activation and utilization) that have been validated 100.00% 50.00%

Annual donations to the WakeMed Foundation $2,961,000 $2,848,330

WakeMed staff on community Boards of Directors 140 151

Annual cash donations to non-profits that support our mission $400,000 $432,293

Primary care provider market share 28.00% 24.23%

MDs/APPs who state on engagement survey that administration listens to them 82.00% 86.20%

Operating cash flow margin 9.50% 11.07%

Cash to total debt ratio 127.00% 132.30%

Operating revenue per adjusted discharge $13,455 $13,408

Ethical employer rating on physician engagement survey 88.00% 86.77%

Ethical employer rating on employee engagement survey 84.00% 83.05%

* As with all data reporting, numbers vary based on when data is pulled and/or made available from various sources. ** Pre-WakeShare

Checking in on Our Aspirational GoalsWe made great progress against our Aspirational Goals metrics in FY18. Check out the chart below to see how we fared against our goals for the year.* Results in green indicate we reached or exceeded our target.

Highest Ethics & Standards

Quality

Value Leader

Culture of Safety

ExtraordinaryTeam

Healthy Community

Wake Way

Innovation

Preferred Partner

Financial Health

Striving for Top 10V A L U E L E A D E R , Q U A L I T Y, S A F E T YThis summer, we embarked on an ambitious – and incredibly important – new patientsafety initiative aimed at achieving zero instances of preventable patient harm within ourfacilities. Chasing Zero challenges us to come together to prevent:

• Hospital acquired infections (CAUTI, CLABSI, C. difficile, etc.)• Surgical site infections• Falls with injury• Preventable sepsis• Wrong site/wrong patient/wrong procedure

surgeries, retained foreign objects• Medication errors• Pressure ulcers• Preventable blood clots

Kick off events were heldthroughout the health systemand thousands of employeessigned the pledge committingto help eliminate preventableharm events. Several ChasingZero Hero awards have beengiven out in recognition ofthose who have gone above and beyond to help us reachour goals.

Joint Commission surveyorsvisited WakeMed this summerfor our three-year accreditationreviews. The survey teams wereextremely complimentary ofour staff, physicians, leadershipand facilities and both siteswere recommended forreaccreditation. WakeMed alsoreceived numerous awards andaccolades related to our qualityof care and safety practices – allof which are listed on the lastpage of this issue.

Our annual Hospital Survey on Patient Safety Culture was conducted this summer,measuring hospital staff and provider perspectives on patient safety. Participation droppedslightly, but we saw strong improvement in results – scoring above benchmark on almostevery measure, with specific improvements related to Overall Perception of Safety, Non-punitive Response to Error and Teamwork (both within and between units). Our GoodCatch program continued to grow – with 569 Good Catches reported (up from 500 lastyear) and 21 individuals recognized with Good Catch pins.

Our transition to providing value-based care continued to be a focus in 2018 and we sawcontinued improvement in our Centers for Medicare and Medicaid Services (CMS) 30-dayreadmission rates. Both Raleigh Campus and Cary Hospital ranked “Better thanNational” for all readmissions by CMS and Raleigh Campus’ AMI readmission rate is in thetop 2 percent in the country. WakeMed Key Community Care (WKCC), our AccountableCare Organization (ACO), had another successful year, earning shared savings for thesecond year in a row and claiming national recognition as one of the Top ACOs To Knowaccording to Becker’s Hospital Review. 

State-of-the-Art Patient CareI N N O V AT I O N

WakeMed Innovationslaunched in December 2017with a goal of fostering anenvironment that supportsstrategic innovation efforts tostreamline workflow, improveprocesses, develop devices andcreate new technologies. Thefirst major project of the newdepartment – a partnership withthe North Carolina Departmentof Transportation to testopportunities for drones inhealth care – took flight inSeptember.

Throughout the year, manyWakeMed physicians, clinicalstaff and others shared theoutstanding and innovativework they are doing throughpapers, posters andpresentations at conferencesnationwide.

Left: The Cardiovascular &Thoracic Surgery Research Teamenrolled their first patient in theVEST clinical trial in July, whichwas also the first patient enrolledin North Carolina.

As WakeMed continues toembrace and leveragetechnology solutions, thePatient Engagement UsingTechnology committee wasformed and helped improvepatient access in several ways:

• MyChart Bedside wasexpanded to more inpatientunits, providing patients witheasy access to educational

resources and information about their medical care.

• Online Scheduling for nearly all WakeMed Physician Practices

• Reserve Your Spot for Urgent Care

• eVisits

• eCheck In

• Text message reminders

Thanks to a team effort from all staff, we made outstanding improvements in our MyChartactivation rate – increasing from 23% in FY17 to 30.7% in FY18, beating our goal of 30%.

A Strong Bottom LineF I N A N C I A L H E A LT H

In addition to the many successes we saw, we ended the year ahead of targets for both cash flow andoperating margins. These strong operating results are thanks in part to a focus on labor management andcost control along with strong volumes and continued improvement of our revenue cycle processes.

$1,400

1,300

1,200

1,100

1,000

900

800

700

600

500

MILL

IONS

FY 2018FY 2015 FY 2016 FY 2018FY 2015 FY 2016*

160

140

120

100

80

60

40

20

0

MILL

IONS

$1,321

$1,049 $1,168

$146

$36

$103

FY 2017

$1,260

FY 2017*

$153

Operating Revenue Operating Cash Flow* excludes WakeShare

Discharges Adjusted ED Visits Deliveries Surgeries Cath & EP CT & MRI Discharges

2017

2018

43,890

45,574

94,943

98,532

287,836

287,864

7,725

8,137

35,917

36,503

8,059

8,265

143,903

150,826

2016 42,837 91,132 286,295 7,856 27,187 8,045 131,665

Chasing

C

Non profitOrganizationU.S. PostagePAIDRaleigh, NCPermit NO. 1307

3000 New Bern AvenueRaleigh, NC 27610

ADDRESS SERVICE REQUESTED

© WakeMed Marketing & Communications, November 2018

Microscope is a monthly newsletter written by and for the employees of WakeMed. Our goal is to provide

employees and friends of WakeMed with the most up-to-date news on all of the hospital system’s activities.

The Public Relations department thanks all of theemployees who contributed to this publication.

We welcome comments and suggestions on this publication and its content. Call (919) 350-8120,

e-mail microscope@wakemed.org, or write Microscope, Wake Med Marketing & Communications

Department, 3000 New Bern Avenue, Raleigh, NC 27610.

Kate Wilkes, EditorWakeMed Employees, Photos

Partnering for a Healthier CommunityH E A LT H Y C O M M U N I T Y & P R E F E R R E D P A R T N E RAs we continue striving to make Wake County a healthier place to live, WakeMed is making it easier for community members tobe engaged and involved in their own health and well-being. Some examples include:

• Health Lives Here, a mobile health vehicle enabling our Corporate & Community Health team to bring medical andoccupational health services directly to employers. Since it was unveiled in May, the Health Lives Here vehicle has attendednearly 40 events, reaching 1,498 community members, andproviding services including vascular screenings, flu shots,nutrition information and more.

• OB Emergency Departments opened at Raleigh Campus,Cary Hospital and North Hospital, providing dedicatedemergency care for women who are 20 weeks pregnant ormore.

• The WakeMed Foundation funded several educationprograms for Wake County School System staff, includingType 1 Diabetes education for school nurses and CPR andAED training for coaches. Thanks to WakeMed staff forproviding the education.

• WakeMed’s Trauma Services and CapRAC partnered to teach Stop the Bleed to hundreds of people.

Behavioral Health continued to be a focus area for WakeMed and several initiatives have significantly improved care for thisvulnerable population:

• With funding from the WakeMed Foundation, psychologists are now staffing our emergency departments to supportbetter care decision making.

• Behavioral Health Counselors at Raleigh Campus complete first-level patient assessments to improve the efficiency andefficacy of behavioral health services.

• WakeMed was the first health system in the nation to receive a Projects for Assistance in Transitions from Homelessness(PATH) grant, which funds a team who works to connect homeless individuals to resources.

• WakeMed is leading the Network for Advancing Behavioral Health, a new collaborative that brings together local providersand resources to help patients and families meet their health and wellness needs and improve outcomes.

FY 2018 was also a year of continued growth and development in our collaborations with Duke, with positive results withinboth Heart Care Plus+ and Cancer Care Plus+ for the benefit of the patients we serve.

Our relationships with our clinical teaching partners continue to flourish as well, with WakeMed hosting 44 medical studentsfrom the Campbell University School of Osteopathic Medicine and 12 University of North Carolina (UNC) School ofMedicine students for their entire third-year. We also partnered with Campbell University to create a clinical campus for theirPhysician Assistant (PA) program, which will eventually host 10 students for the entirety of their clinical training, as well asstudents on rotations.

WakeMed was out and about in the community throughout the year hosting a variety of community events, including LadiesDay and Men’s Health Night at North Hospital, Ladies Day at Cary Hospital and much more. We also continued our presence atcommunity events such as Go Red for Women day, SAS Championship, the March of Dimes, Heart Walk, JDRF, and others.

Awards & AccoladesLeapfrog Safety Scores

Spring Fall

Raleigh Campus B A

Cary Hospital C C

PRC RecognitionFive Star Winners• Brier Creek Healthplex – Emergency

Department• Cary Hospital – 2 West CVIC• Cary Hospital – Outpatient Laboratory• North Hospital – Women’s Pavilion &

Birthplace• North Hospital – Outpatient Surgery• North Hospital – Outpatient Lab• Pediatric Endocrinology• Heart & Vascular Physicians – Complex

Arrhythmia• Heart & Vascular Physicians – Apex• Heart & Vascular Physicians – Cary• Heart & Vascular Physicians – Heart Center• Plus 29 Physician Five-Star Awards

Institute for Healthcare Excellence Award• Culture of Excellence Award

Association of Talent Development (ATD) • BEST Award

Harry E. Dascomb, MD, Award• Ritu Sandhu, MD, (WakeMed Physician

Practices – OB-GYN)

Local Recognition• News & Observer Hearts of Healthcare:

Donna Lane, RN, (manager, Labor &Delivery) was selected as the 2018 winnerout of 20 finalists and 200 nominations

• Great 100 Nurses of North Carolina:Jessica Dixon (Infection Prevention)

• Triangle Business Journal> Healthiest Employers> C-Suite Awards: Susan James, Vice

President & Chief Legal Officer> Health Care Heroes Awards: Michele

Florence (WPP – Pediatrics), Phil Greco(Volunteer), Shannon Holt (Pharmacy)and Dr. Doug Trocinski (WEPPA)

> Women in Business Awards: Cindy Boily,Senior Vice President & Chief NursingOfficer

• Wake Living Magazine: Reader’s ChoiceAwards – Best ED: WakeMed Children’sEmergency Department

Academy of Medical-Surgery Nurses (AMSN)PRISM Award • 6C Surgery & Trauma

American Heart Association/American StrokeAssociation • Raleigh Campus: Get With The Guidelines®-

Stroke Gold Plus Quality Achievement • Cary Hospital: Get With The Guidelines-

Stroke Silver Plus Quality Achievement

National Committee on Quality Assurance • Eight WakeMed Physician Practices - Primary

Care locations re-designated as Patient-Centered Medical Homes (PCMH)

For a complete list, visitwww.wakemed.org/about-wakemed