Our Journey to Performance Excellence€¦ · · 2005-06-21Our Journey to Performance Excellence 14th Annual MIDAS+ Symposium June 2005 1 Tucson, Arizona Integrating the Baldrige

Presented by:

E. E. Fibuch, MDAssoc. Dir. Medical Affairs, Medical Dir. for QualitySaint Luke’s Hospital, Kansas City, Missouri

Our Journey to Performance Excellence

Track Session DescriptionDr. Eugene Fibuch will present the experience of St. Luke’s Kansas City as they prepared for and received the coveted Malcolm Baldrige National Quality Award in the health care sector in 2003. He will explain how successful, sustained improvement requires broad organizational change that goes beyond the traditional tools of performance improvement, and how organizations can create this change.

Dr. Fibuch is Professor and Chairman of the Department of Anesthesiology at the University of Missouri at Kansas City, and is the Associate Director of Medical Affairs and Medical Director for Quality at Saint Luke’s Hospital in Kansas City, MO.

Post-Symposium AvailabilityShortly after the conclusion of the Symposium, most General Session and Track Session presentations will be available for viewing and downloading by licensed MIDAS+ clients from our Web site: www.midasplus.com. The presentations are available both in PDF and native Microsoft PowerPoint format.


14th Annual MIDAS+ Symposium June 2005 1Tucson, Arizona

Integrating the Baldrige Integrating the Baldrige

Management Model in Healthcare:Management Model in Healthcare:Our Journey to Performance ExcellenceOur Journey to Performance Excellence

This presentation contains information and data that is proprietary and confidential and is the sole property of Saint Luke’s Hospital.

These slides are not to be reproduced for use in any publication or promotion without the written permission of Saint Luke’s Hospital/ Saint Luke’s Health System, Kansas City, Missouri.

This presentation contains information and data that is proprietThis presentation contains information and data that is proprietary and confidential and is the sole property of Saint Luke’s Hoary and confidential and is the sole property of Saint Luke’s Hospitalspital..

These slides are not to be reproduced for use in any publicationThese slides are not to be reproduced for use in any publication or promotion without the written permission of Saint Luke’s Hosor promotion without the written permission of Saint Luke’s Hospital/ pital/ Saint Luke’s Health System, Kansas City, Missouri.Saint Luke’s Health System, Kansas City, Missouri.

E. E. Fibuch, MDProfessor and Chairman,

Department of Anesthesiology

University of Missouri-Kansas City School of Medicine

Associate Director of Medical Affairs,

Medical Director for Quality

Saint Luke’s Hospital, Kansas City, Missouri

E. E. E. E. FibuchFibuch, MD, MDProfessor and ChairmanProfessor and Chairman,,

Department of AnesthesiologyDepartment of Anesthesiology

University of MissouriUniversity of Missouri--Kansas City School of MedicineKansas City School of Medicine

Associate Director of Medical Affairs,Associate Director of Medical Affairs,

Medical Director for QualityMedical Director for Quality

Saint Luke’s Hospital, Kansas City, MissouriSaint Luke’s Hospital, Kansas City, Missouri

ACS MIDAS Symposium

2005

ACS MIDAS SymposiumACS MIDAS Symposium

20052005

ORGANIZATIONAL PROFILEORGANIZATIONAL PROFILE

Saint Luke’s HospitalSaint Luke’s HospitalKansas City, MissouriKansas City, Missouri

Where We Came From…Where We Came From…

•• Founded in 1882Founded in 1882

•• Articles of Agreement Articles of Agreement ––

dated October 3, 1882dated October 3, 1882

•• Charity care was an Charity care was an

important aspect of the important aspect of the

agreementagreement

•• New hospital was New hospital was

designated a teaching designated a teaching

institutioninstitution

Saint Luke’s HospitalSaint Luke’s Hospital


2 June 2005 14th Annual MIDAS+ SymposiumTucson, Arizona

Who We Are Today…Who We Are Today…

•• 590 beds590 beds

•• 3200 employees3200 employees

•• 500 physicians500 physicians

•• Not for profitNot for profit

•• Tertiary care referralTertiary care referral

•• Episcopal ChurchEpiscopal Church

•• Primary teaching hospital Primary teaching hospital –– UMKCUMKC

•• InstitutesInstitutes–– Mid America Heart InstituteMid America Heart Institute

–– Mid America Brain InstituteMid America Brain Institute

•• Centers of ExcellenceCenters of Excellence–– Level III Neonatal careLevel III Neonatal care

–– Level I Trauma CenterLevel I Trauma Center


Part Of A Health SystemPart Of A Health System

•• 10 Hospitals10 Hospitals–– Six metropolitanSix metropolitan

–– Four ruralFour rural

•• 7000 FTE7000 FTE

•• Double ring and Hub Double ring and Hub

DesignDesign


MissionMissionCommitted to the highest levels of Committed to the highest levels of

excellence in providing health services excellence in providing health services

to all patients in a caring to all patients in a caring

environment…dedicated to medical environment…dedicated to medical

research and education.research and education.




VisionVisionThe Best Place to The Best Place to GetGet Care,Care,

The Best Place to The Best Place to GiveGive CareCare


The Best Place to The Best Place to GetGet CareCareMost Preferred in Kansas CityMost Preferred in Kansas City

*NRC 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004*NRC 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004


The Best Place to The Best Place to GiveGive CareCare

That is why:That is why:

•• High retentionHigh retention

•• High employee High employee

satisfactionsatisfaction

•• HighlyHighly

dedicated and dedicated and

engagedengaged

workforceworkforce

Our People Make the DifferenceOur People Make the Difference




What We Stand For…What We Stand For…

Our Core ValuesOur Core Values

•• Quality/ExcellenceQuality/Excellence

•• Customer FocusCustomer Focus

•• Resource ManagementResource Management

•• Team WorkTeam Work

Be the BestBe the Best

Identify/Analyze ProblemsIdentify/Analyze Problems

High QualityHigh Quality

Corporate ComplianceCorporate Compliance

Courtesy/RespectCourtesy/Respect

Customer SatisfactionCustomer Satisfaction

Ethics/ConfidentialityEthics/Confidentiality

Celebrate DiversityCelebrate Diversity

Cost EffectiveCost Effective

FlexibilityFlexibility

CooperationCooperation

Honest CommunicationHonest Communication

Team CultureTeam Culture

Recognize AchievementRecognize Achievement

OORRGGAANNIIZZAATTIIOONNAALL

EEXXCCEELLLLEENNCCEE

122 YearsServing Kansas City

and the Region


Why Pursue Baldrige?Why Pursue Baldrige?Why Pursue Baldrige?

“…“…Because it’s Logical”Because it’s Logical”

•• LeadershipLeadership

•• Strategic PlanningStrategic Planning

•• Focus on Patients, Other Customers, and MarketsFocus on Patients, Other Customers, and Markets

•• Measurement, Analysis, and Knowledge Measurement, Analysis, and Knowledge

ManagementManagement

•• Staff FocusStaff Focus

•• Process ManagementProcess Management

Organizational Performance ResultsOrganizational Performance Results

•• Provides a systematic approachProvides a systematic approach

•• Aligns organizational componentsAligns organizational components

•• Requires deployment of best practicesRequires deployment of best practices

•• Requires benchmarking against the bestRequires benchmarking against the best

•• Must achieve high performanceMust achieve high performance

•• Desires sustained improvementsDesires sustained improvements

Why Did Saint Luke’s Hospital Why Did Saint Luke’s Hospital

Embrace the Baldrige Embrace the Baldrige

Management Model?Management Model?



PrePre--Baldrige Management ModelBaldrige Management Model•• Hierarchal governance structureHierarchal governance structure

•• NonNon-- empowered workforceempowered workforce

•• NonNon-- aligned strategic planning processaligned strategic planning process

•• Silo drivenSilo driven

•• Quality Assurance orientedQuality Assurance oriented

•• Focus on “bad apples” (audit mentality)Focus on “bad apples” (audit mentality)

•• TQM would solve everythingTQM would solve everything

•• ReRe-- engineering failureengineering failure

•• Lack of a focused metrics architecture Lack of a focused metrics architecture aligned to strategyaligned to strategy


QuestionQuestion


How Did Saint Luke’sHow Did Saint Luke’s

Hospital Implement the Hospital Implement the

Baldrige Management Model?Baldrige Management Model?

Begins With Leadership!Begins With Leadership!

Leadership ApproachLeadership Approach

Medical Staff/Medical Staff/AdministrativeAdministrative

PartnershipPartnership

InformationInformationSharing &Sharing &InnovationInnovation

EmpoweredEmpoweredWorkforceWorkforce

OrganizationalOrganizational

AlignmentAlignment

BaldrigeBaldrigeManagementManagementPhilosophyPhilosophy

FactFact--BasedBased

AgilityAgility

MISSIONMISSION




• Manage People

• Manage Clinical

and Administrative

Quality

• Manage Customers

• Manage Growth

and Development

• Manage Financial

Performance

• Leadership• Strategic Planning• Patient/Customer

Focus• Measurement and

KnowledgeManagement

• Staff Focus• Process Management• Results Focus

Strategic Focus Areas

Level 1 ProcessesCommitment to Excellence

Assessment Model

Balanced Scorecard PerspectivesClinical &

AdministrativeQuality

People Customer FinanceGrowth &Development

SSCC

OO

RREE

CC

AARR

DD

BB

AA

LLAA

NN

CCEE

DD

PP

MM

PP

PROCESSPROCESS SCORECARDSSCORECARDS

Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans

90-Day Action PlansIndividual

DevelopmentPlans Performance

Improvement& Innovation

KnowledgeSharing


SLH Leadership forSLH Leadership forPerformance Excellence ModelPerformance Excellence Model

Examples of Leadership Approach…Examples of Leadership Approach…


•• CollaborationCollaboration

–– Medical staff and administration coMedical staff and administration co--leaders of leaders of

Balanced Scorecard (BSC)Balanced Scorecard (BSC)

•• EmpowermentEmpowerment

–– Nursing shared governanceNursing shared governance

•• Information SharingInformation Sharing

–– Focused retreatsFocused retreats

•• Organizational AlignmentOrganizational Alignment

–– Strategy, Balanced Scorecard, 90Strategy, Balanced Scorecard, 90--day action plans, day action plans,

Performance Management Process (PMP)Performance Management Process (PMP)

MBNQAMBNQAMalcolm Baldrige National Quality Award RecipientMalcolm Baldrige National Quality Award Recipient

Governor of MissouriGovernor of MissouriMissouri Team Quality Award Missouri Team Quality Award –– Extreme Neuro TeamExtreme Neuro Team

Missouri Quality AwardMissouri Quality AwardBand 6 Band 6 ––Baldrige AssessmentBaldrige Assessment

Kansas City Business JournalKansas City Business JournalBest Place to Work for DiversityBest Place to Work for Diversity

Moody’sMoody’sA+ Bond RatingA+ Bond Rating

Standard and Poor’sStandard and Poor’sAA--1 Bond Rating1 Bond Rating

Ingram’s MagazineIngram’s MagazineBest Hospital in Kansas City Best Hospital in Kansas City –– Gold AwardGold Award

Am Soc of Health System PharmacistsAm Soc of Health System PharmacistsASHP Best Practices Award in Health System PharmacyASHP Best Practices Award in Health System Pharmacy

HRMAHRMAParagon Award for Best HR Practices in KC Metro AreaParagon Award for Best HR Practices in KC Metro Area

Hospitals and Health NetworksHospitals and Health Networks100 Most Wired in Nation100 Most Wired in Nation

NRCNRC2003 Consumer Preference Award2003 Consumer Preference Award

SponsorSponsor2003 Awards/Recognitions2003 Awards/Recognitions

Dept of Health and Human ServicesDept of Health and Human ServicesOrgan Donation Breakthrough Collaborative Organ Donation Breakthrough Collaborative –– 75% conversion75% conversion

Women’s Day MagazineWomen’s Day MagazineRed Dress AwardRed Dress Award

IDG’sIDG’s ComputerworldComputerworldBest Places to Work in Information TechnologyBest Places to Work in Information Technology

American Nurses Credentialing CenterAmerican Nurses Credentialing CenterMagnet Recognition Award for Excellence in Nursing ServiceMagnet Recognition Award for Excellence in Nursing Service

ASHPASHPBest Practices AwardBest Practices Award

NRCNRC2004 Consumer Preference Award2004 Consumer Preference Award

VHAVHAClinical Excellence in Cardiac CareClinical Excellence in Cardiac Care

Hospitals and Health NetworksHospitals and Health Networks100 Most Wired in Nation100 Most Wired in Nation

JCAHOJCAHODiseaseDisease--Specific Gold Seal of Approval, Stroke CareSpecific Gold Seal of Approval, Stroke Care

SponsorSponsor2004 Awards/Recognitions2004 Awards/Recognitions



SLH Leadership for Performance Excellence ModelSLH Leadership for Performance Excellence Model


Strategy Development ProcessStrategy Development Process

• Manage People

• Manage Clinical

and Administrative

Quality


• Manage Growth

and Development


Performance



KnowledgeManagement



Assessment Model




SSCC

OO

RREE

CC

AARR

DD

BB

AA

LLAA

NN

CCEE

DD

PP

MM

PP


STRATEGIC PLANNING

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans




KnowledgeSharing

STRATEGIC FOCUS AREAS

DEVELOP

DEPLOY

MANAGE

Develop the PlanDevelop the Plan

••Clinical & Administrative Clinical & Administrative Quality RetreatQuality Retreat

••Customer Focus GroupsCustomer Focus Groups

••Product Line ConferenceProduct Line Conference

••Growth & Financial RetreatGrowth & Financial Retreat

••Capital Budget ProcessCapital Budget Process

••Operating Budget ProcessOperating Budget Process

••HR Planning ProcessHR Planning Process

••System PlanSystem Plan

••Med Staff Development PlanMed Staff Development Plan

••Risk AssessmentRisk Assessment

••SFA ValidationSFA Validation

••Customer RetreatCustomer Retreat

••People RetreatPeople Retreat

••Environmental AssessmentEnvironmental Assessment

••Mission, Vision, ValuesMission, Vision, Values

STEP 4 STEP 4 –– BALANCE BALANCE CUSTOMER NEEDSCUSTOMER NEEDS

STEP 3 STEP 3 –– ALLOCATEALLOCATERESOURCESRESOURCES

STEP 2 STEP 2 –– DEVELOP DEVELOP SAS’sSAS’s && SAP’sSAP’s

STEP 1 STEP 1 –– DEVELOP DEVELOP SIGNIFICANT ISSUESSIGNIFICANT ISSUES

•• 9090--Day Action Planning Process Day Action Planning Process

•• Performance Management ProcessPerformance Management Process

•• Finalize BudgetsFinalize Budgets

•• Board ApprovalBoard Approval

•• Reset BSCReset BSC

•• Deployment RetreatDeployment Retreat

STEP 6 STEP 6 –– CREATE ALIGNMENTCREATE ALIGNMENTSTEP 5 STEP 5 –– FINALIZE AND APPROVEFINALIZE AND APPROVE

•• BSC ReviewsBSC Reviews

•• 9090--Day Process ReviewsDay Process Reviews

•• BSC Department Report FormBSC Department Report Form

STEP 7 STEP 7 –– REVIEW PROCESSREVIEW PROCESS


Strategy Development ProcessStrategy Development Process

Example of SFA, SAS, SAP and Related MeasuresExample of SFA, SAS, SAP and Related Measures


Strategy DeploymentStrategy Deployment

• Profitable eligible

IP market share

• Facilitate increased

surgical volume

• Increase profitable

market share

Growth and

Development

• Total Margin• Improve processes related

to payment denials

• Assure financial

stabilityFinancial

•• Infection Control Infection Control

IndexIndex

•• Refine and implement Refine and implement

critical care best practicescritical care best practices

•• Improve patient Improve patient

safetysafety

Clinical and Clinical and

Administrative Administrative

QualityQuality

• Employee

Retention Rate

• Employ systematic

approach to employee

education

• Assure workforce

availabilityPeople

•• Admitting Wait Admitting Wait

TimeTime

•• Deploy targeted IP & OR Deploy targeted IP & OR

capacity enhancement capacity enhancement

strategiesstrategies

•• Improve customer Improve customer

satisfactionsatisfactionCustomerCustomer

SAPSAP MeasuresMeasuresSASSASSFASFA



BETTER


SLH RetentionSLH Retention

75

80

85

90

1998 1999 2000 2001 2002 2003 2004

%

SLH Saratoga Institute





IP market share

• Facilitate increased surgical

volume

• Increase

profitable market

share

Growth and

Development

• Total Margin• Improve processes related to

payment denials


stabilityFinancial

• Infection Control

Index

• Refine and implement

critical care best practices

• Improve patient

safety

Clinical and

Administrative

Quality

•• Employee Employee

Retention RateRetention Rate

•• Employ systematic approach Employ systematic approach

to employee educationto employee education

•• Assure Assure

workforce workforce

availabilityavailability

PeoplePeople


TimeTime




•• Improve Improve

customer customer


CustomerCustomer


0

1

2

3

4

1998 1999 2000 2001 2002 2003 2004

Perc

en

t

SLH NNISBETTERBETTER

††Index modified for 2 of the 10 measures 01Index modified for 2 of the 10 measures 01--0303

†


Infection Rate IndexInfection Rate Index

10 Measures of Infection







IP market share


volume

• Increase

profitable market

share

Growth and

Development


payment denials


stabilityFinancial


IndexIndex




safetysafety



QualityQuality






workforce workforce


PeoplePeople

• Admitting Wait

Time

• Deploy targeted IP & OR

capacity enhancement

strategies

• Improve

customer

satisfaction

Customer


0

1

2

3

4

5

6

IP OP

Patient Type

Min

ute

s

2001 2002

2003 2004BETTERBETTER


Admitting Wait TimeAdmitting Wait Time





IP market share


volume

• Increase

profitable market

share

Growth and

Development


payment denials


stabilityFinancial


IndexIndex




safetysafety



QualityQuality






workforce workforce


PeoplePeople


TimeTime





customer customer


CustomerCustomer




BETTER


Profitable Market ShareProfitable Market Share

6.00%

6.50%

7.00%

7.50%

8.00%

8.50%

9.00%

1Q

02

2Q

02

3Q

02

4Q

02

1Q

03

2Q

03

3Q

03

4Q

03

1Q

04

2Q

04

3Q

04

4Q

04





IP market share


volume

• Increase

profitable market

share

Growth and

Development


payment denials


stabilityFinancial


IndexIndex




safetysafety



QualityQuality






workforce workforce


PeoplePeople


TimeTime





customer customer


CustomerCustomer


0

2

4

6

8

10

12

14

16

18

1999 2000 2001 2002 2003 2004

%

SLH

COTH Top Quartile

A BondBETTER

*SLH data represents best 5% of comparative group

*


Total MarginTotal Margin




• Manage People

• Manage Clinical

and Administrative

Quality

•• Manage CustomersManage Customers

• Manage Growth

and Development


Performance

• Leadership• Strategic Planning

•• Patient/CustomerPatient/CustomerFocusFocus

• Measurement andKnowledgeManagement




Assessment Model



People CustomerCustomer FinanceGrowth &Development

SSCC

OO

RREE

CC

AARR

DD

BB

AA

LLAA

NN

CCEE

DD

PP

MM

PP


Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans




KnowledgeSharing


Focus on Patients and Other MarketsFocus on Patients and Other Markets

•• Patients and familiesPatients and families

•• Residents and studentsResidents and students

•• Physicians viewed as partnersPhysicians viewed as partners

CustomersCustomers


Key Patient RequirementsKey Patient Requirements


•• ReliabilityReliability

•• AccessAccess

•• ResponsivenessResponsiveness

•• EmpathyEmpathy

•• CompetencyCompetency



Key Patient SatisfiersKey Patient Satisfiers


•• Wait time Wait time

•• Outcome of careOutcome of care

•• Responsiveness to complaintsResponsiveness to complaints

•• Significant indicatorsSignificant indicators

Relationship BuildingRelationship Building


•• Employee use of Very Employee use of Very

Important PrinciplesImportant Principles

•• Produce patient loyalty Produce patient loyalty

through personalizing the through personalizing the

delivery of caredelivery of care

•• Centers of excellenceCenters of excellence


Very Important PrinciplesVery Important Principles



Market Segmentation ProcessMarket Segmentation Process


SurveysSurveys

PAPA

AOCAOC

Focus Focus

GroupsGroups

ExternalExternal

DatabaseDatabase

InternalInternal

DatabaseDatabase

NurseLineNurseLine

Complaint Complaint

ManagementManagement

OtherOther

D

A

T

A

S

O

U

R

C

E

RESEARCH

PROCESS

Research and Analysis DepartmentResearch and Analysis Department

External DataExternal Data Internal DataInternal Data

Listening / Learning StrategiesListening / Learning Strategies

FormalFormal InformalInformal

Qualitative & Quantitative Research ToolsQualitative & Quantitative Research Tools

ENVIRONMENTAL ANALYSIS DOCUMENT

Market Segmentation ProcessMarket Segmentation Process


Different Different

Needs Needs

Emerging?Emerging?

Different Different

Key Satisfiers Key Satisfiers

Emerging?Emerging?

Different Different

Segmentation Segmentation

and Value?and Value?

QUESTIONS

ASKED

PLANNING

PROCESS

Environmental AnalysisEnvironmental Analysis

SLH LeadershipSLH Leadership SLHS LeadershipSLHS Leadership

Leadership RetreatsLeadership Retreats

Segmentation of CustomersSegmentation of Customers

Determination is MadeDetermination is Made

TOOLSTOOLS METHODSMETHODS CORECOREQUESTIONSQUESTIONS RESULTSRESULTSGUIDINGGUIDING

PRINCIPLESPRINCIPLES TOOLSTOOLS METHODSMETHODS CORECOREQUESTIONSQUESTIONS RESULTSRESULTSGUIDINGGUIDING

PRINCIPLESPRINCIPLES

Achieve survey consistency among research Achieve survey consistency among research

toolstools

Identify satisfaction benchmarks for Identify satisfaction benchmarks for

comparisonscomparisons

Report satisfaction trends over timeReport satisfaction trends over time

Recommend viable alternatives to improve Recommend viable alternatives to improve

service personnel or operationsservice personnel or operations


Customer SatisfactionCustomer SatisfactionResearch ProgramResearch Program





PressPress GaneyGaney survey tool (weekly, quarterly)survey tool (weekly, quarterly)

Admitting/referring physician survey (annual)Admitting/referring physician survey (annual)

Resident/Student survey (annual)Resident/Student survey (annual)

BaldrigeBaldrige-- based employee survey (annual)based employee survey (annual)

Focus groups (semiFocus groups (semi-- annual)annual)

PostPost-- discharge phone callsdischarge phone calls





Measure overall satisfaction, outcome and perceptionMeasure overall satisfaction, outcome and perception

Strict statistical samplingStrict statistical sampling

55--point point LikertLikert scalescale

Segmented by key customer requirementsSegmented by key customer requirements

Statistical trending and regression analysisStatistical trending and regression analysis

Tabulated and distributed weekly (patients)Tabulated and distributed weekly (patients)

Formally trended and reported quarterly (patients)Formally trended and reported quarterly (patients)





What is your overall satisfaction?What is your overall satisfaction?

Would you recommend SLH to your friends Would you recommend SLH to your friends

and family?and family?

Do you have any suggestions for Do you have any suggestions for

improvement?improvement?







NRC Perception Rankings vs. Top CompetitorsNRC Perception Rankings vs. Top Competitors

11

33

22

88

66

1010

1515

20042004

11

33

44

77

22

1010

1717

20042004

11

22

33

55

44

1515

1414

20042004

11

22

33

66

55

88

1616

20022002

11

44

33

55

22

66

1515

20022002

11

22

44

77

55

88

1616

20022002

Best NursesBest NursesBest DoctorsBest DoctorsOverall QualityOverall Quality

11

22

33

55

66

1313

1515

11

33

22

88

66

1010

1515

11

33

55

66

22

1212

1515

11

33

44

77

22

1010

1717

11

22

33

55

44

1313

1212

11

22

33

66

55

1515

1414

SLHSLH

BB

CC

DD

EE

FF

GG

200120012003200320012001200320032001200120032003HospitalHospital

TOOLSTOOLS METHODSMETHODS CORECOREQUESTIONSQUESTIONS RESULTSRESULTS

GUIDINGGUIDINGPRINCIPLESPRINCIPLES



75

80

85

90

95

100

1999 2000 2001 2002 2003 2004

%

IP OP ED

Patient SatisfactionPatient Satisfaction

TOOLSTOOLS METHODSMETHODS CORECOREQUESTIONSQUESTIONS RESULTSRESULTS

GUIDINGGUIDINGPRINCIPLESPRINCIPLES

BETTERBETTER



FiveFive--ByBy--FiveFive



RESULTSRESULTSCORE CORE

QUESTIONSQUESTIONSMETHODSMETHODSTOOLSTOOLS

GUIDING GUIDING


30

35

40

45

50

55

60

65

70

75

1Q

02

2Q

02

3Q

02

4Q

02

1Q

03

2Q

03

3Q

03

4Q

03

1Q

04

2Q

04

3Q

04

4Q

04

IP

OP

ED

BETTERBETTER




Educational Benchmark DataEducational Benchmark Data

College of NursingCollege of Nursing

6.1

6.5

6.3

6.6

6.5

6.7

6.0

5.6

6.2

6.1

5.7

2002

5.35.35.45.4Overall SatisfactionOverall Satisfaction

6.26.2Role DevelopmentRole Development

6.05.85.8Core KnowledgeCore Knowledge

6.36.3Technical SkillsTechnical Skills

6.36.2Core CompetenciesCore Competencies

6.36.4Professional ValuesProfessional Values

5.95.75.7ClassmatesClassmates

5.45.05.0Facilities and AdministrationFacilities and Administration

5.85.45.4Course Lecture and InteractionCourse Lecture and Interaction

5.75.45.4Work and Class SizeWork and Class Size

5.25.24.94.9Quality of InstructionQuality of Instruction

2004200420032003Mean SLH ScoreMean SLH Score

Yellow highlighted boxes are for categories in the upper quartile nationally.


• Manage People

• Manage Clinical

and Administrative

Quality


• Manage Growth

and Development


Performance



KnowledgeManagement




Assessment Model



PeoplePeople Customer FinanceGrowth &Development

SSCC

OO

RREE

CC

AARR

DD

BB

AA

LLAA

NN

CCEE

DD

PP

MM

PP

PROCESS SCORECARDS

Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans




KnowledgeSharing


Measurement AnalysisMeasurement Analysis

•• ee-- PortalsPortals

•• Executive Information Systems and Executive Information Systems and

Decision Support SystemsDecision Support Systems

•• Administrative and Financial SystemsAdministrative and Financial Systems

• Clinical Information Systems

Information Technology’s Systems ArchitectureInformation Technology’s Systems Architecture

Data and Information AvailabilityData and Information Availability




Information Technology’s Systems Architecture

Data and Information Availability

Saint Luke’s Hospital

• Security policies

• Signed confidentiality agreements

• Strong computer passwords

• State of the art firewalls

• Daily tape backup

• Mission-critical hourly backup

• Off-site underground storage

• Data access maintained 24x7

for employees, physicians, partners, suppliers

Data Security and Access

Data and Information Availability


Growth

& Development

How do we continue to

improve and create value?

Customer

Satisfaction

Financial

Clinical &Administrative

Quality

People

Plan Design Measure Assess Improve

SLHS Service Design, Management & Improvement Model

How do customers

see us?

How do we look to

financial stakeholders?

In what must

we excel?

How do we ensure a committed

and prepared workforce?

Mission

Vision

Values

Strategy




Comparative/Benchmark Data SourcesComparative/Benchmark Data Sources


•• Process OutcomesProcess OutcomesCEO Workgroup CEO Workgroup –– VHAVHA

•• Consumer PerceptionConsumer PerceptionNational Research CorporationNational Research Corporation

•• Patient SatisfactionPatient SatisfactionPressPress GaneyGaney

•• HR PerformanceHR PerformanceSaratoga InstituteSaratoga Institute

•• FinancialFinancialMoody, Standard & Poor, FitchMoody, Standard & Poor, Fitch

•• FinancialFinancialCHIPSCHIPS

•• Operations and FinancialOperations and FinancialSolucientSolucient--ACTIONACTION

•• Clinical, Operational, Financial & Clinical, Operational, Financial & MiscMiscNational/State Quality Award RecipientNational/State Quality Award Recipient

•• ClinicalClinicalHEDISHEDIS

•• ClinicalClinicalVHA VHA GreenlightGreenlight ProjectProject

•• ClinicalClinicalMaryland Quality Indicator ProjectMaryland Quality Indicator Project

Data TypeData TypeSourceSource

Performance MeasurementPerformance Measurement

InternalInternal

CustomerCustomer

FinancialFinancial

Learning &Learning &

InnovationInnovationVision & StrategyVision & Strategy

Kaplan & Norton Model

Saint Luke's Health System

Model

Clinical & Clinical &

Administrative QualityAdministrative Quality

Customer Customer

SatisfactionSatisfaction

FinancialFinancial

GrowthGrowth

& Development& Development

PeoplePeopleVision & StrategyVision & Strategy


Performance MeasurementPerformance Measurement


•• Primary measurement toolPrimary measurement tool

Balanced ScorecardBalanced Scorecard

•• 5 perspectives5 perspectives

•• Key measures linked to Key measures linked to strategystrategy

•• Scoring criteria set by Scoring criteria set by statistical methods and statistical methods and benchmarksbenchmarks

•• Tracks overall organization Tracks overall organization performanceperformance

•• Provides organizational Provides organizational alignmentalignment



Building Trend ChartsScoring Zones, Benchmarks, Stretch Targets, Trend Analysis

Net Days in Accounts Receivables

(IP; OP)

30405060708090

100110120

199

8

99Q

1

99Q

2

99Q

3

99Q

4

00Q

1

00Q

2

00Q

3

00Q

4

Ave

rag

e D

ays Annual Goal

Risk

Immediate

Action

Required

Moderate Risk

Needs

Improvement

Stretch

Target

Current

Performance

Current

Performance


Balanced Scorecard Trend ChartsBalanced Scorecard Trend ChartsPerformance MeasurementPerformance Measurement


Days Cash on Hand

125

175

225

275

325

375

425

19

98

99

Q2

99

Q4

00

Q2

00

Q4

01

Q2

01

Q4

02

Q2

02

Q4

03

Q2

03

Q4

04

Q2

04

Q4

Avera

ge D

ays

Longer than Expected

Wait Time (IP; OP; ED)0%

5%

10%

15%

20%

25%

19

98

99Q

2

99Q

4

00Q

2

00Q

4

01Q

2

01Q

4

02Q

2

02Q

4

03Q

2

03Q

4

04Q

2

04Q

4

% N

ot

Me

eti

ng

Exp

ecta

tio

n

Eligible IP Market Share

7%

8%

9%

10%

02

Q1

02

Q2

02

Q3

02

Q4

03

Q1

03

Q2

03

Q3

03

Q4

04

Q1

04

Q2

04

Q3

04

Q4P

erc

en

t E

lig

ible

Mark

et

Sh

are

Maryland Quality Indicator

Index

0

2

4

6

8

10

19

98

99Q

2

99Q

4

00Q

2

00Q

4

01Q

2

01Q

4

02Q

2

02Q

4

03Q

2

03Q

4

04Q

2

04Q

4

Av

era

ge S

co

re

Human Capital Value

Added

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

$100,000

19

98

99

Q2

99

Q4

00

Q2

00

Q4

01

Q2

01

Q4

02

Q2

02

Q4

03

Q2

03

Q4

04

Q2

04

Q4

Ne

t R

even

ue A

dd

ed

/

FT

E

Clinical & Administrative Clinical & Administrative Quality PerspectiveQuality Perspective

•• Inpatient Clinical Care IndexInpatient Clinical Care Index

•• Outpatient Clinical Care IndexOutpatient Clinical Care Index

•• Patient Safety IndexPatient Safety Index

•• Operational IndexOperational Index

•• Maryland Quality Indicator IndexMaryland Quality Indicator Index

•• Infection Control IndexInfection Control Index

•• Medical Staff Clinical Indicator IndexMedical Staff Clinical Indicator Index

•• Net Days in Accounts ReceivableNet Days in Accounts Receivable




Medical Staff Clinical Indicator IndexMedical Staff Clinical Indicator Index


Knowledge SharingKnowledge Sharing

•• ReportsReports

•• RetreatsRetreats

•• Story BoardsStory Boards

•• CMECME

•• PublicationsPublications

•• EE--mailmail

•• CommitteesCommittees

•• Best PracticesBest Practices

Sharing DaySharing Day


Organizational KnowledgeOrganizational Knowledge


• Manage People

• Manage Clinical

and Administrative

Quality


• Manage Growth

and Development


Performance



KnowledgeManagement




Assessment Model




SSCCOO

RR

EECC

AARR

DD

BB

AALL

AA

NNCCEE

DD

PP

MM

PP


Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans




KnowledgeSharing

• Manage People

• Manage Clinical

and Administrative

Quality


• Manage Growth

and Development


Performance



KnowledgeManagement




Assessment Model




SSCCOO

RR

EECC

AARR

DD

BB

AALL

AA

NNCCEE

DD

PP

MM

PP


Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans




KnowledgeSharing


•• Manage PeopleManage People• Manage Clinical

and Administrative

Quality


• Manage Growth

and Development


Performance



KnowledgeManagement

•• Staff FocusStaff Focus• Process Management• Results Focus



Assessment Model




SSCC

OO

RREE

CC

AARR

DD

BB

AA

LLAA

NN

CCEE

DD

PP

MM

PP


Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans




KnowledgeSharing


Staff FocusStaff Focus



•• Quality/Excellence:Quality/Excellence:“Tell me about a creative idea or change you’ve “Tell me about a creative idea or change you’ve

successfully put to work in a recent assignment.”successfully put to work in a recent assignment.”

•• Resource Management:Resource Management:“Tell me about a time you were assigned several “Tell me about a time you were assigned several

important projects at the same time. How did you important projects at the same time. How did you

go about setting priorities?”go about setting priorities?”

BehaviorBehavior--Based InterviewsBased Interviews

by Core Valueby Core Value


•• Customer Focus:Customer Focus:“Tell me about a time you had to deal with an “Tell me about a time you had to deal with an

upset patient.”upset patient.”

•• Teamwork:Teamwork:“Tell me about a time when you had to get “Tell me about a time when you had to get

cooperation from other departments to cooperation from other departments to

accomplish a certain task.”accomplish a certain task.”

BehaviorBehavior--Based InterviewsBased Interviews

by Core Valueby Core Value


•• Shared BehaviorsShared Behaviors::“What is expected of me as an “What is expected of me as an

employee of Saint Luke’s Health employee of Saint Luke’s Health

System?”System?”

•• Job Specific AccountabilitiesJob Specific Accountabilities::“What am I accountable for because “What am I accountable for because

of the job I hold?”of the job I hold?”

•• Personal CommitmentsPersonal Commitments::”What goals will I commit to for the ”What goals will I commit to for the

coming year based on my own coming year based on my own

individual talents?”individual talents?”

Performance ManagementPerformance Management

Process by Core ValueProcess by Core Value




•• Assure financial stability by SLH departments and Assure financial stability by SLH departments and

services collectively achieving operating margin goal.services collectively achieving operating margin goal.

Department Director Personal Commitment:Department Director Personal Commitment:

Assure financial stability of East 3 by meeting budgeted Assure financial stability of East 3 by meeting budgeted

gross revenue and maintaining supplies, salaries and other gross revenue and maintaining supplies, salaries and other

expenses within 2003 budget. Measured with the monthly expenses within 2003 budget. Measured with the monthly

flex budget report.flex budget report.

Registered Nurse I Personal CommitmentRegistered Nurse I Personal Commitment::

Achieve 100% accuracy on charge entry and documentation Achieve 100% accuracy on charge entry and documentation

measured by quarterly unit auditsmeasured by quarterly unit audits

Alignment of Strategy with the Alignment of Strategy with the Performance Management Process (PMP)Performance Management Process (PMP)


Employee SatisfactionEmployee Satisfaction

Segmented according to the life cycleSegmented according to the life cycle

of an SLH employeeof an SLH employee


SLHAlumni

AlumniSurveyDesign

in Process

Recruitment

Process

Survey

Hire

Intro

Period

Celebration

9090--DayDayIntro PeriodIntro PeriodCompleteComplete

Employee

Opinion

Survey

RandomRandomSelectionSelection

Renew

Interviews

1 to 41 to 4Years ofYears ofServiceService

Stay

Interviews

5 to 155 to 15Years ofYears ofServiceService

Separation

Exit

Interview

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

20000

Apps HR Interviews Filled

2002

2003

2004

Selection Process ResultsSelection Process Results




Human Capital Value AddedHuman Capital Value Added

40

50

60

70

80

90

1998 1999 2000 2001 2002 2003 2004

$K

SLH

Saratoga Institute

BETTERBETTER

†2004 comparative data not available

†


DiversityDiversity

5

6

7

8

9

10

1998 1999 2000 2001 2002 2003 2004

%

SLH KC BETTERBETTER



• Manage People

• Manage Clinical

and Administrative

Quality


• Manage Growth

and Development


Performance



KnowledgeManagement

• Staff Focus

•• Process ManagementProcess Management• Results Focus



Assessment Model




SSCC

OO

RREE

CC

AARR

DD

BB

AA

LLAA

NN

CCEE

DD

PP

MM

PP

PROCESS SCORECARDS

Strategic Planning

VISION

MISSION

CORE VALUES

STRATEGY

VERY

IMPORTANT

PRINCIPLES

Level II,

III, IV

Process

Improvement

Plans




KnowledgeSharing


Process ManagementProcess Management



ProcessProcess ScorecardsScorecards

Achieving Strategic Alignment Achieving Strategic Alignment

Throughout the SLHSThroughout the SLHS



Saint Luke’s Health SystemSaint Luke’s Health System

Department UnitsDepartment Units

Individual EmployeesIndividual Employees

•• Avoid departmental or unit silosAvoid departmental or unit silos

•• Recognition that all work is a process Recognition that all work is a process

designed to meet customers’ needsdesigned to meet customers’ needs

•• Do we really understand how well our Do we really understand how well our

processes are working?processes are working?

•• Serves to link daily operations, inServes to link daily operations, in-- process process

measures and BSC outcomes measuresmeasures and BSC outcomes measures

•• Used by process owners to monitor overall Used by process owners to monitor overall

process performanceprocess performance

Why Process Level Scorecards?Why Process Level Scorecards?


Level 1 ProcessesLevel 1 Processes

•• Perform Financial ManagementPerform Financial Management

•• Satisfy CustomersSatisfy Customers

•• Enhance Growth and DevelopmentEnhance Growth and Development

•• Provide Clinical and Administrative Provide Clinical and Administrative

ServicesServices

•• Manage Human ResourcesManage Human Resources




Level 2 Processes :Level 2 Processes :

Manage Human ResourcesManage Human Resources

•• Hire staffHire staff

•• Orient new employeesOrient new employees

•• Train staffTrain staff

•• Develop staffDevelop staff

•• Motivate staffMotivate staff


Level 3 Processes:Level 3 Processes:

Motivate StaffMotivate Staff

•• Segment employeesSegment employees

•• Determine employee satisfactionDetermine employee satisfaction

•• Recognize employeesRecognize employees

•• Provide and administer benefits and Provide and administer benefits and

compensationcompensation

•• Provide a safe work environmentProvide a safe work environment


•• InIn-- process measuresprocess measures::–– RetentionRetention

–– Stay Interview ResultsStay Interview Results

–– Employee Recognition Program SurveysEmployee Recognition Program Surveys

•• Angel for an AngelAngel for an Angel

•• Quality TeamworkQuality Teamwork

•• Employee of the MonthEmployee of the Month

•• Clinical Excellence in NursingClinical Excellence in Nursing

•• Manager’s Tool KitManager’s Tool Kit

–– Participation:Participation:

•• Wall of FameWall of Fame

•• Outcome MeasureOutcome Measure:: “I am recognized for my work.”“I am recognized for my work.”

Recognition Process ScorecardRecognition Process Scorecard




Recognition Process ScorecardRecognition Process Scorecard


DEEP BLUE Stretch Target

10 Outstanding

LIGHT BLUE Stretch

9,8 Exceeds

Expectation

GREEN Goal

7Meets

Expectation

YELLOW Moderate

6,5,4 Needs

Improvement

RED Risk 3,2,1

Immediate Action

Performance Level

August, 2004

Measure Monthly Performance

Scoring Criteria (2003)

BSC Retention 90.0 > or = 86.9% 85.1 - 86.8% 83.3 - 85.0% 79.7 - 83.2% 76.0 - 79.6%

Job: 70.2 > or = 67.3 61.7 - 67.2 56.5 - 61.6 51.7 - 56.6 < or = 51.6

Supervisor: 65.1 > or = 70.6 59.9 - 70.5 49.2 - 59.8 38.4 - 49.1 < or = 38.3

Commun: 64.0 > or = 55.3 54.6 - 55.2 53.3 - 53.9 58.5 - 53.2 < or = 53.1

Stay Interview Results

Benefits: 56.3 > or = 72.5 60.8 - 66.6 54.9 - 60.7 49.0 - 54.8 < or = 48.9

Angel: 4.6Teamwork: 4.0EOM: 4.5Nursing: 4.7

Employee Recognition Programs survey results

Tool Kit: 3.6

4.6- 5.0 4.1 - 4.5 3.6 - 4.0 3.1 - 3.5 < or = 3.0

Employee participation in Recognition programs

377> or = 310 302 - 309 296 - 301 275 -295 < or = 274

Employee sat :”I am recognized for my work.”

68.2% Historical Data Not Available

Employee Opinion Survey ResultsEmployee Opinion Survey Results

0

10

20

30

40

50

60

70

80

90

100

Diversity Mission Pride Accomplishment Overall

Satisfaction

%

2000 2001 2002 2003 2004BETTERBETTER


RESULTSRESULTS

Saint Luke’s HospitalSaint Luke’s HospitalKansas City, MissouriKansas City, Missouri



•• Improved Financial PerformanceImproved Financial Performance

Organizational RewardsOrganizational Rewards

Baldrige Management ModelBaldrige Management Model

100

150

200

250

300

350

400

450

1999 2000 2001 2002 2003 2004

Days

SLH A Bond BETTERBETTER

Days Cash on HandDays Cash on Hand

•• Improved Clinical OutcomesImproved Clinical Outcomes



0

5

10

15

20

25

30

35

2000 2001 2002 2003 2004

% o

f P

ati

en

ts

SLH

National Average

Next Best

BETTERBETTER

Patients Receiving Patients Receiving tPAtPA Following Ischemic StrokeFollowing Ischemic Stroke

20

25

30

35

40

45

1998 1999 2000 2001 2002 2003 2004

Tests

/Dis

charg

e

SLH

COTH Top QuartileBETTERBETTER

Inpatient Tests/Discharge Inpatient Tests/Discharge –– High CMI HospitalsHigh CMI Hospitals






Obstetrical/Obstetrical/PerinatalPerinatalIndicator RatesIndicator Rates

3.23.2

0.050.05

0.060.06

0.490.49

0.030.03

15.715.7

21.821.8

30.230.2

0404

0.00

0.02

0.03

0.23

0.00

20.1

16.8

24.5

0404

3.63.63.13.13.73.74.24.25.35.36.36.34.24.20.0MeconiumMeconium Aspiration Aspiration –– Other Other

(Good(Good ↓↓))

0.50.50.600.600.50.50.60.60.300.40.20.4MeconiumMeconium Aspiration InbornAspiration Inborn

(Good(Good ↓↓))

0.60.60.700.700.80.80.80.80.600.600.70.70.80.80.3Birth Trauma Inborn (Good Birth Trauma Inborn (Good ↓↓))

0.530.530.540.540.500.500.440.440.310.400.390.420.42Wound Disruption or Wound Disruption or

Infection (Good Infection (Good ↓↓))

17.317.321.021.025.925.929.229.221.125.332.435.6VBAC (Good VBAC (Good ↑↑))

21.321.319.719.718.518.517.817.819.219.919.916.914.8Primary CPrimary C--Section (Good Section (Good ↓↓))

0.030.03

29.629.6

0303

0.030.03

27.227.2

0202

0.040.04

25.425.4

0101

0.040.04

24.324.3

0000

0.00

26.8

0303

0.00

26.126.1

0202

0.080.08

23.3

0101

0.00

20.8

0000IndicatorIndicator

Anesthesia Complications Anesthesia Complications

(Good(Good ↓↓))

CC--Section (Good Section (Good ↓↓))

NTHNTHSLHSLH


Mid America Heart InstituteMid America Heart Institute

Physician Recredentialing Report: Dr No.Physician Recredentialing Report: Dr No.

2003 2003 –– 1Q041Q04

89.5%89.5%38383434100.0%100.0%3333Quarter 1 2004Quarter 1 2004

85.4%85.4%41413535100.0%100.0%4444Quarter 4 2003Quarter 4 2003

94.6%94.6%56565353100.0%100.0%1111Quarter 3 2003Quarter 3 200378%78%93%93%

95.1%95.1%41413939100.0%100.0%7777Quarter 2 2003Quarter 2 2003

Top 50% Top 50%

ScoredScored

higherhigher

thanthan

Top 10%Top 10%

ScoredScored

higherhigher

thanthan

%%DenDenNumNum%%DenDenNumNumAMIAMI--3:3:

ACEI at discharge for ACEI at discharge for

LVSDLVSD

98.8%98.8%168168166166100.0%100.0%7777Quarter 1 2004Quarter 1 2004

99.4%99.4%176176175175100.0%100.0%6666Quarter 4 2003Quarter 4 2003

98.4%98.4%187187184184100.0%100.0%5555Quarter 3 2003Quarter 3 200394%94%99 %99 %

99.4%99.4%162162161161100.0%100.0%15151515Quarter 2 2003Quarter 2 2003

Top 50%Top 50%

ScoredScored

higherhigher

thanthan

Top 10% Top 10%

ScoredScored

higherhigher

thanthan

%%DenDenNumNum%%DenDenNumNumAMIAMI--22

Aspirin at dischargeAspirin at discharge

CMS CMS -- MissouriMissouriMAHIMAHIPhysicianPhysician

How We Achieved ItHow We Achieved It

COMMITMENT OF

SENIOR LEADERS

ASSIGNEDASSIGNED

SENIORSENIOR

LEADERSLEADERS

AS CAT LEADERSAS CAT LEADERS

EMBRACEDTHE CRITERIA

WROTEWROTE

APPLICATIONSAPPLICATIONS

TO GAINTO GAIN

KNOWLEDGEKNOWLEDGE

USEDUSED

FEEDBACKFEEDBACK

TO IMPROVETO IMPROVE

BENCHMARKED

AGGRESSIVELY

PERSEVEREDPERSEVERED

THROUGHTHROUGH

MULTIPLEMULTIPLE

REFINEMENTSREFINEMENTS

RESTRUCTUREDRESTRUCTURED

METRICSMETRICS

ARCHITECTUREARCHITECTURE

ALIGNED

THE

ORGANIZATION

MAINTAINEDMAINTAINED

OUROUR

FOCUSFOCUS

PROUDLYTOLD

OUR STORY

PREPARED FORPREPARED FOR

SITE VISITSITE VISIT

Baldrige Business ModelBaldrige Business Model

Assessment ProcessAssessment Process




Sustaining Performance Excellence


Sustaining Performance ExcellenceSustaining Performance Excellence

•• Leadership drives and sustains the Leadership drives and sustains the

processprocess

•• Leadership at all levels is importantLeadership at all levels is important

•• More difficult to change the culture than More difficult to change the culture than

to learn the toolsto learn the tools

•• Valuable team building experienceValuable team building experience

•• Trust is extremely important Trust is extremely important

Lessons LearnedLessons Learned

•• There are no “quick fixes”There are no “quick fixes”

•• Must always focus on the customerMust always focus on the customer

•• Should never be satisfied with the Should never be satisfied with the

present level of qualitypresent level of quality

•• Decisions must be driven by data and Decisions must be driven by data and

compared to “best”compared to “best”

•• Employees make it happen!Employees make it happen!

Lessons LearnedLessons Learned


Sustaining Performance Excellence


Sustaining Performance ExcellenceSustaining Performance Excellence

Our People Make the DifferenceOur People Make the Difference

They Are Our Competitive Advantage!They Are Our Competitive Advantage!




THANK YOUTHANK YOUFor Your AttentionFor Your Attention

Are There Any Questions?Are There Any Questions?

Documents

Our Journey to Performance Excellence€¦ · · 2005-06-21Our Journey to Performance Excellence 14th Annual MIDAS+ Symposium June 2005 1 Tucson, Arizona Integrating the Baldrige