Good morning. I’m honored to be with you today, and delighted to have this opportunity to share SSM Health Care’s story with you. First, the single most important learning of our entire Baldrige experience: Learn the name of the secretary of commerce. Because when he called early on the morning of November 19 th , all I was told was that Don Evans was on the line. Had I not done my homework, I might have said, “Take a message. I’m expecting the secretary of commerce.” (pause) It is a privilege -- as well as an awesome responsibility -- to be the first health care organization to receive the Baldrige Award. On behalf of the 33,000 people who ARE SSM Health Care, I want you to know that we will do our best to live up to this great honor. (pause) What we do is sacred work. (short pause) We care for people at a very difficult time in their lives. The patients we serve are very often not at their best. They are sick, they are vulnerable, and they are afraid. The fact that we have been honored with the Baldrige is a testimony to our ability to make our care the best that it can possibly be under those very challenging circumstances. In the next 15 minutes, I’d like to give you a glimpse of how we’ve done that.
Let me start at the beginning, which for us, was 1872. That was the year our organization was founded by Mother Odilia Berger, a German nun, who came to St. Louis with four other sisters to avoid religious persecution. Those sisters had $5 among them and spoke no English. This is the earliest photo we have of some of those sisters. Please remember that our early sisters had no strategic plan – except to go where there was a need. They opened hospitals. They scraped by with very little money. And they relied on their faith to get them through difficult times. Throughout our history, we’ve followed the sisters’ example of meeting community needs. At times, we’ve also had very little money. And we’ve weathered difficult times through prayer, strength of will, and a good business sense. (pause) I am proud that SSM Health Care is still sponsored by that same congregation -- my congregation -- now known as the Franciscan Sisters of Mary. (pause)
Today, SSM Health Care owns, manages and is affiliated with 21 acute care hospitals and three nursing homes in four states: Wisconsin, Illinois, Oklahoma and Missouri. We also own physician practices, home care, an award-winning information center and other health businesses. So we’re not only geographically diverse, we’re also diverse in the services we provide. We have 23,000+ employees, 5,000 physicians and 5,000 volunteers. And our workforce is 82% female and 18% ethnic minorities. Within SSM Health Care, we balance the need for standardization with the benefits of local autonomy. Local networks and hospitals have the authority to address their market’s unique challenges. We reap the benefits of this flexibility in rapid decision-making. At the same time, there are certain requirements for all entities, which I’ll talk about shortly. (pause) Just like any other organization, we have groups of executive leaders who are responsible for overall decision making. --- --- ---
To encourage breakthrough performance among these executive leaders, we recognized the need to develop a cohesive leadership system. In 1997, as part of an internal self-assessment modeled on the Baldrige Award Criteria, we developed a leadership philosophy and seven performance expectations based on work that had been done at our hospital in Madison, Wisconsin. These expectations flow from our five system values: compassion, respect, excellence, stewardship and community. The seven expectations are: superior results in clinical, operational, and financial performance; fact-based decision making; shared accountability; continuous quality improvement; customer focus; information sharing; and a commitment to develop people.
However, one of the factors that characterizes our organization is that every employee is viewed as a leader. Every employee is expected to contribute to his or her fullest potential. (pause) Why is this so important? Because the leadership that builds an exceptional organization is not the CEO making one pivotal decision. It’s the minute-by-minute, day-by-day actions of every employee wanting to learn more, wanting to teach more, wanting to improve everything they do. A leader is someone who takes the initiative to do a job in a more efficient way or a better way. A leader is someone who sees an unfair situation and speaks up without hesitation to correct it. A leader is someone who extends herself or himself to others with compassion and thinks of ways to be helpful. A leader is someone who is confident of her or his abilities and freely expresses that confidence, not with arrogance. . . but with humility.
I am very proud of the fact that everyone in our organization is united behind a common mission. Our mission statement is only 13 words. And I think you will agree that it is truly exceptional. Here it is: &quot;Through our exceptional health care services, we reveal the healing presence of God.“ (PAUSE) Let me explain how it came to be. . . The power of our mission statement is that it was discovered from within, that is, it came from a year-long process that involved nearly 3,000 employees at every one of our entities and at every level . (pause) However, if there's anything we've learned over the years from the Baldrige assessment process, it is this: It doesn't matter if we have the greatest mission statement ever written. If everyone in our organization is not focused on that mission and engaged in its pursuit -- then it's not worth the paper it's printed on. (pause)
And I am pleased to tell you that everyone in SSM Health Care is focused on our mission – not only because it’s such a great mission, but because we’ve defined exceptional health care services in a very specific way. (pause) With help from previous Baldrige feedback, we’ve identified five characteristics of exceptional health care. They are: exceptional patient, employee, and physician satisfaction; exceptional clinical outcomes; and exceptional financial performance. Remember that balance between autonomy and standardization that I mentioned earlier? Well, this is an example of standardization. You’ll find that every one of our entities has goals for the characteristics of exceptional health care. And at each entity, every department has goals designed to achieve the entity’s goals. In addition, each year every employee fills out a passport and writes down personal goals, which support the department goals – and ultimately, our mission.
You may be asking, “How do you deploy a consistent message over such a vast organization?” (short pause) I assure you, it’s not easy, but it would have been far more difficult had we not had a culture of continuous improvement already in place. Our culture is characterized by consensus building and decision-making at the level of greatest impact. Employees and physicians work together in teams. And sharing information among entities is part of who we are. Has it been easy to create this culture? Sure! And I have some swampland for sale in Florida! Suffice it to say that the commitment of our system’s executive leadership has been absolutely essential to staying the course. Nevertheless, when you don’t see a quick fix or fast results, it’s easy to move on to the next management “flavor of the month.” So if you take away only one message from my remarks today, let it be this: Hang onto your vision even in the darkest days.
I’ve spoken about our mission, and I mentioned earlier that our Board of Directors sets our vision. Our vision is : “Through our participation in the healing ministry of Jesus Christ, communities, especially those that are economically, physically and socially marginalized, will experience improved health in body, mind, spirit and environment within the financial limits of the system.” To achieve our vision, we have requirements for our entities in three specific areas. Again, here’s that balance between autonomy and standardization. We require that each of our entities have: A Preservation of the Earth Committee; a Healthy Communities Initiative, and a commitment to provide Charity Care Yet each entity determines what that healthy communities initiative will be and what the focus of the Preservation of the Earth Committee will be. And the amount of charity care we provide is based on the needs of the community where each entity is located.
To give you an idea of how our CQI culture helps us address every day challenges, I want to explain how we’re addressing the nursing shortage. It’s a huge issue in health care. By the year 2010, it‘s estimated that there will be a shortage of 1 million nurses in our nation. At SSM Health Care, we chose to involve our clinicians in creating a solution to the challenge. This approach is consistent with the CQI principle of involving employees in decision-making and our view that all employees are leaders. One of their recommendations was that we take a best practice at our Madison, Wisconsin hospital and implement it system wide. The best practice is shared accountability, a model in which nurses have greater decision-making authority and overall accountability for the nursing practice. In other words, it places responsibility for the professional practice of nursing with those most knowledgeable – the nurses.
First, Preservation of the Earth. One of the core philosophies of our sponsoring congregation, the Franciscan Sisters of Mary, is non-violence in all forms. One aspect of that is reducing the violence that is being done to our planet. So at every one of our entities, Preservation of the Earth Committees undertake activities to minimize the harm to our environment. Recycling is one of a host of activities championed by these creative committees. And last year, our system recycled more than 1.5 million pounds of material. You can see how in an organization as large as ours, this commitment can truly make a difference to our planet. (pause)
Likewise, we can improve the health of our communities by leveraging our resources to address unmet needs. Our Healthy Communities initiative requires every entity to engage in one or more community projects designed to address a specific health need. One program begun by our two Southern Illinois hospitals screens low-income and uninsured women for breast and cervical cancer. Programs at other facilities focus on preventing alcohol abuse among teens, early detection of osteoporosis, ensuring prenatal care for uninsured women, and providing dental care for the uninsured. These initiatives take us outside the walls of our hospitals and often involve partnerships with other community organizations. The result: better health for the people of our communities.
A third area that helps us achieve our vision is charity care. From our earliest days, we’ve provided care regardless of our patients’ ability to pay. Account books from the 1800s identify almost 60 percent of patients as “ODL”--Our Dear Lord’s. These were patients who could not pay for their care. It’s no different today. No one is ever refused admission to our hospitals because they cannot pay. In 2002, as a system, we provided more than $35 million in charity care, that is, free services to people who could not pay. We provided an additional $44 plus million in unreimbursed cost of services under Medicaid. (pause) But at the same time, we are still able to maintain a double A credit rating.
SSM Healthcare: A Baldrige Perspective on Leadership
Leadership Category Jim Hyde, President Bone & Joint Hospital SSM Health Care
<ul><li>21 hospitals, three nursing homes, physician practices, home care, award-winning information center </li></ul><ul><li>23,000+ employees, 5,000 physicians, 5,000 volunteers </li></ul><ul><li>82% women, 18% minorities </li></ul>SSM Health Care
In Oklahoma . . . <ul><li>Bone & Joint Hospital </li></ul><ul><ul><li>Founded in 1926 </li></ul></ul><ul><ul><li>330 Employees </li></ul></ul><ul><ul><li>140 Physicians </li></ul></ul><ul><li>St. Anthony Hospital </li></ul><ul><ul><li>Founded in 1898 </li></ul></ul><ul><ul><li>2000 Employees </li></ul></ul><ul><ul><li>650 Physicians </li></ul></ul>
Leadership System <ul><li>Recognized need to encourage breakthrough performance among executive leaders </li></ul><ul><li>Developed a cohesive leadership system in 1997 as a part of an internal self-assessment model based on the Baldrige Award </li></ul>
Executive Leadership <ul><li>Seven expectations for executive leaders ... </li></ul>Based on five system values: Compassion, Respect, Excellence Stewardship, Community
Expectations <ul><li>Superior Results in clinical, operational, and financial performance </li></ul><ul><li>Fact-based decision making </li></ul><ul><li>Shared accountability </li></ul><ul><li>Continuous quality improvement </li></ul><ul><li>Customer focus </li></ul><ul><li>Information sharing </li></ul><ul><li>Commitment to develop people </li></ul>
Our Vision Statement <ul><ul><li>“ ... Communities, especially those that </li></ul></ul><ul><ul><li>are economically , physically and </li></ul></ul><ul><ul><li>socially marginalized , will experience </li></ul></ul><ul><ul><li>improved health in body, mind, </li></ul></ul><ul><ul><li>spirit and environment ... ” </li></ul></ul>
Strategic, Financial and HR Planning Process <ul><li>Goals set by Innsbrook Group </li></ul><ul><li>Support Vision and Mission </li></ul><ul><li>Processes occur within each entity and network to translate goals into entity SFPs </li></ul><ul><li>Ensure the goals reflect each stakeholder’s requirements </li></ul>
Deploying Our Mission <ul><li>Established goals as a part of the strategic, financial and human resources planning process </li></ul><ul><li>Developed department posters and employee passports to ensure alignment of goals across the organization </li></ul>
Culture of Improvement Addressing the nursing shortage
Assessing the Organization’s Performance <ul><li>Performance Management Process </li></ul><ul><ul><li>Defines the roles and responsibilities of leadership groups </li></ul></ul><ul><ul><li>Defines a consistent set of reporting tools </li></ul></ul><ul><ul><li>Establishes standardized definitions and indicators to ensure consistency in measurement </li></ul></ul>
Assessing the Organization’s Performance <ul><li>Three General Areas of Reporting </li></ul><ul><ul><li>Financial </li></ul></ul><ul><ul><li>Customer Satisfaction </li></ul></ul><ul><ul><li>Clinical Quality Performance </li></ul></ul><ul><li>16 System Level Indicators </li></ul><ul><ul><li>Monthly entity performance indicator reports </li></ul></ul><ul><ul><li>Examination of variances </li></ul></ul><ul><ul><li>Action on variances </li></ul></ul>
Assessing the Organization’s Performance <ul><li>Leadership Development Process </li></ul><ul><ul><li>360-degree evaluations </li></ul></ul><ul><ul><li>Based on the 7 management practices adopted </li></ul></ul><ul><li>Stakeholder surveys </li></ul><ul><li>Utilized annual Baldrige feedback to develop action plans for improvement </li></ul>
Criteria Public Responsibility & Citizenship - Responsibilities to the Public - Support of Key Communities and Community Health
Responsibility to the Public <ul><li>Corporate Responsibility Process (CRP) </li></ul><ul><li>Safe environment for patients, employees and visitors </li></ul><ul><li>Regulatory/licensure </li></ul><ul><li>Accreditation </li></ul><ul><li>Community Health </li></ul><ul><li>Bioterrorism Task Force </li></ul><ul><li>Contract Review Process </li></ul>
Preservation of the Earth 1,557,481 pounds recycled
Mission Awareness <ul><li>Spirit Days </li></ul><ul><li>Reinforces the Mission throughout the year </li></ul><ul><li>Community Activities </li></ul><ul><ul><li>Adopt a Family </li></ul></ul><ul><ul><li>Mark Twain Elementary </li></ul></ul>
Charity Care <ul><li>$35.5 million in charity care </li></ul><ul><li>$44.4 million in unreimbursed cost of services under Medicaid </li></ul>