The Possible Scot Lecture

Copyright © 2011 Southcentral Foundation. All Rights Reserved.NOTICE: Unless otherwise indicated, this work represents copyrighted material protected by United States and international law. This work may not be used, reproduced, downloaded, disseminated, published, transferred or transmitted, in whole or in part, in any form or by any means, electronic or mechanical, including photocopying, recording or information storage and retrieval, except with the express written permission of the publisher. This work may not be edited, altered, or otherwise modified, in whole or in part, except with the express written permission of the publisher.

International Futures ForumRoyal Society of Edinburgh Michael Shea Memorial Lecture

Edinburgh, 17 February 2014

Katherine Gottlieb, MBA, DPS (h.c.), President/CEO

Steve Tierney, MD, Medical Director – Quality Improvement

Michelle Tierney, MPA, MA, Vice President Organizational Development and Innovation

Kevin Gottlieb, DDS, Vice President Resource and Development and Chief of Staff

Copyright © 2011 Southcentral Foundation. All Rights Reserved.NOTICE: Unless otherwise indicated, this work represents copyrighted material protected by United States and international law. This work may not be used, reproduced, downloaded, disseminated, published, transferred or transmitted, in whole or in part, in any form or by any means, electronic or mechanical, including photocopying, recording or information storage and retrieval, except with the express written permission of the publisher. This work may not be edited, altered, or otherwise modified, in whole or in part, except with the express written permission of the publisher.

Copyright © 2011 Southcentral Foundation. All Rights Reserved.

Compliance Data Services Organizational Development Development Center Human Resources Quality Assurance Research Nuka Institute

SCF Programs and Services

Tribal Relations and Village Initiatives

Traditional Healing Clinic

Planning Grants Communications &

Public Relations RAISE Programs Elder Program Seattle Office Board Support Corporate Office

Support


Behavioral Health• Fireweed• PCC

BURT Denaa Yeets’ TRAILS and FASD The Pathway Home Quyana Clubhouse Dena A Coy

• Residential• Outpatient• Willa’s Way

Behavioral Health Service McGrath Behavioral Health Clinics

Therapeutic Family Group Homes• Cottonwood• Rendezvous• Cleveland

Alaska Womens Recovery Project (AWRP)

Access To Recovery (ATR)



Dental (ANMC and Fireweed) Facilities General Counsel Information Technology Special Assistant Program Budget Planning and

Management Contracts Financial Operations Patient Accounts Payroll Reimbursement



64,000 Customer-owners

• 54,000 Anchorage and Valley

• 10,000 55 villages

Employees• 1982: Fewer than 100• 2013: About 1,600

Operating Budget• 1982: $3 million• FY 2013: $227 million

From 1982 to 2013…Operating Budget

1982 FY 2013

$3m

$227m


Vision A Native Community that enjoys physical, mental, emotional and spiritual wellness Mission Working together with the Native Community to achieve wellness through health and related services Copyright © 2011 Southcentral Foundation. All Rights Reserved.

Corporate Objectives

Shared Responsibility


No longer a hero but a partner• Control does not equal compliance• Replace blaming with

understanding• Give customer options, not orders• Provide customer with resources• Make it simple

Health care provider changes



Commitment to Quality



Be active, not passive Take responsibility for your health Get information about your health Ask questions about advice Ask for options

Customer-owner changes


Governing board Advisory committees Elders Council Focus Groups Annual Gathering 24- hour hotline Community gatherings Personal interaction

with employees

Satisfaction surveys Comment cards

Customer Connections


The number one source for changeRaising the BarBecome interested owners in their journey of healthBegin to attend functions

Begin to give advice about enhancing programs and services

Become involved in changing behaviors

Customer feedback

Interview /Hiring Onboarding (ASTP, etc) Leadership

development Development Center Career Ladders Job Progressions Mentoring Employee Wellness

Workforce FocusKey Improvements




Family Wellness


It’s All About Customer-ownership and Relationships


Core Concepts Training Three-day training, ALL

employees Led by SCF

President/CEO Build and sustain

healthy relationships How we impact others How to articulate story

from your heart Partnered with Society

for Organizational Learning to develop


Core Concepts

Work together in relationship to learn and grow

Encourage understanding

L isten with an open mind

L augh and enjoy humor throughout the day

Notice the dignity and value of ourselves and others

Engage others with compassion

Share our stories and our hearts

Strive to honor and respect ourselves and others


Relationships between customer-owner, family and provider must be fostered and supportedEmphasis on wellness of the whole person, family and community Locations convenient for customer-owners with minimal stops to get all their needs addressedAccess optimized and waiting times limitedTogether with the customer-owner as an active partnerIntentional whole-system design to maximize coordination and minimize duplicationOutcome and process measures continuously evaluated and improvedNot complicated but simple and easy to useServices financially sustainable and viable Hub of the system is the familyInterests of customer-owners drive the system to determine what we do and how we do itPopulation-based systems and servicesServices and systems build on the strengths of Alaska Native cultures

Operational Principles


24

Information to Knowledge% SCF Central Pharmacy customer-owners requesting other

medications at dispensing

0%

10%

20%

30%

40%

50%

8/5/10 8/12/10 8/19/10 8/26/10 9/2/10 9/9/10 9/16/10 9/23/10 9/30/10

Percent

Average

Better

Source: Central Pharmacy-Pharmacy tic-sheet 9.27.10

Change Tested

Change Implemented

% Employees with Current Annual Disaster Tng

53

74

94 98 100

0

50

100

2005 2006 2007 2008 2009

%

SCF Industry Best (100%)


Utilization• 75% decrease in hospital admissions since 1999• 71% decrease in hospital days per 1000 since

1999 • 36% decrease in outpatient visits per 1000

customer-owners Clinical quality

• Level 3 NCQA Patient Centered Medical Home • 75 or 90 percentile for HEDIS outcome measures

o Diabetes o Cancer o Cardiovascular disease

Measures of Success


Customer-owner satisfaction• Overall 93%

Employee satisfaction• Overall 94% • Response rate 95%

Employee Turnover • 10.8%

Baldrige National Quality Award - 2011

Measures of Success


Planning Linkages The Corporate Strategic Plan is linked and communicated all the way through the organization through division , committee, and department

annual plans and the employee evaluation system

Corporate Strategic Plan

(Rolling 3+ yrs)

Includes strategic challenges/

advantages, corporate goals & corporate

objectives.

Corporate Annual Plan

(1-3 yrs) and Budget Plan (1 yr)

Includes priority 1 initiatives – initiatives that

will begin in the next 12 months.

Annual Plans(1 qtr – 1 yr)

Includes division,

committee & department

annual plans.

Quarter Reports

(1 qtr)

Includes division,

committee & department

annual plans.

Employee Evaluation System

(1 yr)

Includes employee evaluation

& employee action plans.

LinkagesEVERYTHING TIES

TOGETHER!


Governance joins in celebration of success

Leadership encourage recognitions and rewards

Innovation and creativity are endorsed as a high motivators

Leadership


Thank You!

Qaĝaasakung

Aleut

QuyanaqInupiaq

Háw'aa Haida

‘Awa'ahdahEyak

Mahsi'Gwich’in

Athabascan

Igamsiqanaghhalek

Siberian Yupik

Tsin'aenAhtna Athabascan

T’oyaxsmTsimshian

Gunalchéesh Tlingit

QuyanaYup’ik

Chin’anDena’ina Athabascan

QuyanaaAlutiiq


Health & Medicine

The Possible Scot Lecture