AGENDA 1. Vision, Mission, Values 2. System Goals Updates – 2010 and 2011 People*, Service, Quality, Growth, Finance, and Academics *Enhancements to Security Services – Shawn Reilly 3. Other Updates 2011 Employee Incentive, US News, Senior-Level Searches, March of Dimes 4. Campus President Update 5. Wrap-Up, Questions, and Surveys
Who We Are Our VisionTransform health care for the benefit of the people and communities we serve. Our MissionHeal compassionately. Teach innovatively. Improve constantly.
What We Stand For GHS Values Our core values are compassion, respect, caring, honesty, integrity, and trust. We live our values through open communication, forward thinking, creativity, continually striving to improve, responsiveness, a willingness to change, education, research, and clinical quality.
Pillar Frameworkfor FY 2011 GHS Total Health Philosophy The GHS Total Health philosophy is central to ourapproach to health care delivery, work force development and medical education. We value interdisciplinary collaboration throughout a highly integrated delivery structure using patient-centered, standardized, and evidence-based practices with reportable quality and financial outcomes. GHS Pillars of Excellence People Service Quality Growth Finance Academics
We work to transform health care.Measured by: 2011 Employee Opinion Survey – Commitment Index ScoreTarget: 4.29 (85th Percentile)Result: Not yet available. Surveyscheduled for March 2011.
People: Town Hall Surveys Offer a Snapshot Between Annual Surveys Town Hall Survey Results Compared to Selected Questions from the Annual Employee Opinion Survey 2010 Annual Feb May Aug Nov Survey Question Emp Survey 2010 2010 2010 2010 Confidence in Senior Management’s leadership 4.03 4.16 402 4.20 4.12 GroupDiscussion Different levels communicate effectively 3.44 3.66 3.55 3.54 3.36 Proud to tell people I work for this organization 4.43 4.41 4.39 4.47 4.39 Recommend GHS to family and friends 4.44 4.45 4.41 4.56 4.45 Would work at GHS three years from now 4.47 4.47 4.44 4.61 4.44 Stay if offered job elsewhere for slightly higher pay 3.87 4.12 4.08 4.29 4.05 Healthcare employer of choice in this area 4.32 4.41 4.38 4.56 4.40 Recommend GHS as a good place to work 4.29 4.38 4.35 4.46 4.34 Overall, I am a satisfied employee 4.20 4.27 4.26 4.37 4.22 Quarterly Town Hall Survey results generally track consistently with 2010 Employee 9 Opinion Survey results on key questions.
2011 Employee Opinion Survey• March 7-21, 2011• Similar confidential process and survey as in previous years. – All surveys will be completed on line – Employees will use individual passwords – Our survey vendor holds and compiles all the data. No GHS employee ever sees individual employee responses to survey questions. – Employed physicians will participate again this year. 10
2010 Highlights:• Employee Development – Continued focused leadership development training for all Management Staff – Introduced Emerging Leaders Program – Solidified Young Professionals Program in first full year – Action planning and formal coaching program for targeted work units – More than 1,000 employees received education assistance (>$750,000) 11
2010 Highlights:• Employee Compensation and Benefits – Despite financial pressures, preserved jobs and paid 2010 employee incentive – Maintained competitive benefits offerings for employees (over $150 Million budgeted in FY 2011 for benefits) – 2011 health and dental premium adjustments were well below the national average – Added an out-of-area plan for employees who live and work more than a 30 minute drive from GMMC – Health and dental coverage for dependent children up to age 26; removed lifetime maximums for health plans – Approved 215 PTO Donation requests – Expanded seasonal flu shots and biometric screenings 12 to family members
2010 Highlights:• Work Environment – Upgraded and expanded security systems in selected areas – Replaced nearly 500 computer workstations since March 2010 Your managers received a detailed list of program enhancements resulting from employee feedback. If you haven’t yet seen it, ask your supervisor. 13
GHS Law Security Services Enforcement ServicesOur Purpose: to provide a safe and secure environment for our employees, patients, and visitors .
Overview• Why change to GHS police?• What will we get?• Where will they work?• Are they the same as regular police?• When will this happen?• Where can I get more information?
Why Change to GHS Law Enforcement Services• We are committed to our employee’s safety and security through aggressive crime prevention and emergency response programs• We have invested greatly in the safety and security of patients, visitors, and employees in improved security manpower, and physical security systems.• Establishment of our own police force is part of the path we are taking to continue to bring increase peace of mind to our patients, visitors, and employees
What will we get?• This is the time to make the change – We can use the same dollars and have the our own police officers on a regular schedule – Outside emergencies will not call them away from their duties here at GMH – We will have a presence that is consistent and predicable
Where will they work?• With fulltime police we are able to staff the ER 24/7 with little or no break in coverage• Provide a dedicated police patrol on campus--a resource lacking till now• Staff the front reception desk from 9 PM to 5 AM every day
Are they the same as regular police?• GHS officers are South Carolina class one certified – No difference between the training of a GPD officer and a GHS officer – Officers will carry the same weapons and equipment as a city officer – Are required to maintain the same training levels as any law enforcement officer in SC
When will this happen?• Late January 2011 we will beginning the hiring process for a senior police supervisor• We will put all the needed policies and procedures in place and then begin hiring officers.• We hope to have all officers on board by the end of 2011.
Where will this happen?Established at GMMC first to get a understanding of the issues anddevelop a smooth operation before deciding to go out to the other campuses.
Where can I get more information?You may contact:Shawn Reilly Sreilly@GHS.orgTammy Mikels TMikels@GHS.orgOrReda Reilly RReilly@GHS.orgOr by phone through security dispatch at 455-7931
Small Group Discussion andInvitation for Feedback“Different levels in the organization communicate effectively.” Group Discussion What are specific examples of ways that different levels in the organization could communicate more effectively?Please record your ideas in the “Additional Comments” box 24(#4.3) on the Town Hall Survey.
Two Great QuestionsTo Help Improve Communications What do I know that someoneelse may benefit from knowing? What don’t I know that I think someone else can tell me? 25
Patients and families are the focus of everything we do.Measured by: HCAHPS Overall Rating* (Percent 9’s and 10’s) Press Ganey Overall Mean Scores** FY 2011 YTD Targets Results*Inpatient 74.0% 74.0% 2 78th %-tile**Ambulatory 93.7 83.8 Surgery 83rd %-tile**Emergency 86.4 93.2 1 Services. 65th %-tile
Studer Organization of the Month• GHS received Studer Group’s Fire Starter award for January 2011.• We were recognized for: – System-wide approach to integrating key elements of Commitment to Excellence – Improved and sustained results in key service measures – High levels of physician engagement in culture change within the System 27
We provide right care at the right time and in the right place.Measured By Targets YTD ResultsCMS All Care 93.0% 93.2%Measures 75th %-tilePatient Safety 67% Not yetCulture 75th %-tile available.SurveyHand 80% 87.2%Hygiene (Year Two) 2
Spotlight on “Owner”Behavior• Regan Howard, Circulating Scrub Technician, Greer Memorial Hospital• Noticed a broken instrument in a surgical tray• Investigated cases from the previous day (including reviewing x-rays) and identified the object on the x-ray• Notified the Charge Nurse, Clinical Director, Nurse Manager and the physician• No clinical issues for patient• A great example of personal commitment to our culture of patient safety. 29
Hand Hygiene Update • First Quarter results are tracking above FY 2011 goal – using direct observation methods. • Electronic monitoring will be implemented in 2011 on nursing units – using monitoring devices imbedded in dispensers.Bracelets to be handed out at Town HallMeetings as a reminder of theimportance of hand hygiene.
We develop our System to meet the needs of our communities.Measured Annual YTD YTD By Target Target ResultsNet $1,363 M $330.2 M $340.5 MRevenue 1New 146,195 36,244 34,204PatientVisits Through December 2010 1
Growth…inpatient andoutpatient• It just feels busier lately, doesn’t it?• Inpatient – Steady increase in “surge” activity (medical surgical beds, critical care beds) at GMMC and other campuses – Volumes are up compared to budget and FY 2010• Outpatient – MD 360 (first 12 month’s experience) as just one example • Budgeted Visits: 8,700 • Actual Visits: 15, 794 32
Financial Performance UpdateKey Results December 2010 Current Month Year To Date Actual Budget Variance Actual Budget VarianceUtilization StatisticsDischarges 3,677 3,587 90 10,932 10,702 230Acute ALOS 4.77 4.76 0.01 4.77 4.77 -Patient Days 24,374 24,214 160 72,285 72,055 230Outpatient Visits 200,137 195,577 4,560 585,341 588,246 (2,905)ProfitabilityOperating Margin 3,471 (1,156) 4,627 6,085 (3,035) 9,120Non-Operating Margin (2,539) 972 (3,511) (1,751) 2,917 (4,668)% Operating Margin 2.9% (1.0%) 3.9% 1.7% (0.9%) 2.6%% Excess Margin 0.8% (0.2%) 1.0% 1.2% 0.0% 1.2%$ In Thousands
Cautions• Increased activity is one important element in the revenue equation; but it’s more complex.• Payor mix is the other critical element. – Private medical insurance – Private pay – Medicare and Medicaid – Charity and Bad Debt• We’re paying special attention to payor mix. – Continuing weak economic conditions keep us cautiously optimistic about how FY2011 will evolve. 34
We responsibly direct our resources to support our mission.Measured by: Operating Margin Annual YTD YTD Target Target Results 1.5% (0.9%) 1.7% ($21.0 M) Through December 2010
SC Economy While showing some signs of recovery, our state and national economies are continued sources of caution. 36
South Carolina’sEconomy Budget Year SC State Date BudgetFY2008/2009 Budget $7.1 Billion July 2008FY 2008/2009 Revised $6.2 Billion June 2009FY 2009/2010 Budget $6.0 Billion June 2009FY 2009/2010 Revised $5.6 Billion April 2010FY 2010/2011 Projected $5.5 Billion April 2010FY 2010/2011 Revised $5.8 Billion Nov 2010FY 2011/2012 Projected $5.9 Billion Nov 2010 Tentative signs of improvement…but still well below 2008 levels. Source:South Carolina Board of 38 Economic Advisors
Medicaid FundingChallenges• $227 million deficit in the current year (SC fiscal year, ending June 30th)• $353 million shortfall next year (beginning July 1st)• Options – Reduced services – Increase provider taxes – Significant funds shifted away from other state functions• GHS remains focused on managing costs to be prepared if needed. – Operations Council leads this effort 39
We educate to transform health care.Measured by:Implementation of strategic initiatives thatadvance our Academic Health System model.Target:Achieve preliminary accreditation of USCSOM-Greenville by June 30, 2011.YTD RESULT: On track.
People keep asking… Why is GHS starting a medical School? 41
Here are the Facts• GHS is not starting a medical school.• USC is expanding its program in Greenville.• The USC School of Medicine – Greenville will be part of USC and operated independently of the USC School of Medicine in Columbia. 42
People keep asking… Can GHS really afford to support the expansion of the USC School of Medicine – Greenville? 43
Here are the Facts• Expansion is projected to cost $186 million over ten years.• $105 million will be paid for by tuition and fees.• GHS will cover the remaining $81 million over ten years. – $45 million from current/existing medical education expenditures; – $35-45 million from new incremental support… over ten years. • This is less than one half of one percent (<0.5%) of our annual operating budget. 44
Some Other ImportantFacts about this Initiative• No state funds will be used to support the medical school.• It will be funded by GHS, future student tuition and community philanthropists.• Despite the current economic conditions, GHS remains financially strong – Our credit analysis shows that our support of the school will not impair our credit or bond ratings, which are among the highest in the nation for health care institutions 45
Why is this such a good idea?• Good for Our Patients and Families – Enhanced quality, access to clinical innovations, etc. – Helps address looming physician shortage• Good for GHS – Consistent with our mission to teach innovatively – Access to highly trained physicians and other practitioners who are taught to practice as members of quality-driven, cost-effective teams• Good for our Community – Supports our knowledge-based economy – Will translate to more jobs in the Upstate – Actively supported by the Greenville Chamber of Commerce
So, how will it operate?• Strategic and operational direction from USCSOM- Greenville will be set jointly by USC and GHS.• It will have its own curriculum and budget.• It will be led by a Dean located in Greenville who will be jointly selected by USC and GHS.• It will be a school which is integrated with the delivery system.• Basic science courses will be provided by USC.• UMG physicians will be the clinical faculty.
OTHER UPDATES-- FY 2011 Employee Incentive-- US News Rankings – Gastroenterology-- Senior Level Searches-- 2011 March of Dimes Campaign 48
FY 2011 EmployeeIncentive Reminder 15%* 30%* 30%* --- 25%* --- *WeightingLinked to GHS Organizational Goals Potential Employee Incentive:• All employees share these goals • Up to 1% of FY 2010 earnings;• Same calculation for all levels in the maximum of $1,000 organization FY 2011 Financial Trigger – No payout if payment would result in an operating margin of less than 1.5%.
US News & World ReportBest Hospitals Greenville Memorial Hospital #25 #39 #45 Drill-Down
How We Did It• Commitment to being a highly integrated delivery system: – Specialty hospitals – Regional referral center – Physician practices (employed/affiliated) – Clinical staff• Ranking Criteria – reputation, mortality, patient safety, and other (technology, patient services, presence of intensivists, palliative care…)
Updates on Active Senior Searches• Chief Financial Officer Named – Terri Newsom, currently at Duke, will begin March 14th – Thanks to Search Committee, chaired by Chip Wiper, MD – Skip Morris is serving as interim CFO• Chair, Department of Surgery Appointed – Gene Langan, MD has begun in his new role as department chair – Thanks to the Search Committee, chaired by Pat Marshall, MD – Thanks also to David Cull, MD for service as interim chair 54
Updates on ActiveSenior Searches• GMMC Campus President – Search Committee has been formed, chaired by David Williams, MD – Currently identifying potential candidates• Chief Nursing Officer – Will focus on GMMC an the system – Expanded levels of system-collaboration among senior nursing positions across the system – Search Committee has been formed, chaired by Skip Morris 55 – Currently identifying potential candidates
2010 March for Babies• Sat., April 24 • 9 a.m. -- at CU-ICAR• March for Babies is close to the hearts of many at GHS and consistent with our role as a leading health resource for women and children in the Upstate.• Join Team GHS and fight to save babies from premature birth. – Help us continue our record as number one fundraiser in Greenville County – 2008 and 2009! – More information at GHSNet 56