This presentation outlines the 10.5 critical roles for healthcare CEOs in creating high-performing healthcare organizations - hospitals, medical groups, and integrated systems.

1. Leading Quality & Safety
10 1/2 Critical Roles for the CEO

2. 10.5 Ways You Can Personally
Improve Quality & Safety for Your Patients

3. My Favorite Workshop of All Time …
The C-Suite’s Role in Q & S
Every EXECUTIVE Must PLAY an ACTIVE ROLE

4. Quality and Safety Programs Can …
Create Multimillion
Dollar Returns
John Byrnes, MD!
!
Clinical Associate Professor
MSU, College of Human Medicine !
!
Founder & Sr. Partner!
Byrnes Healthcare Group

5. 01
What’s Going
on in Our
Institutions?

6. 440,000 Deaths per Year
“PAEs account for “roughly one-sixth of all deaths that occur in the U.S. each year.”
Findings supported by Classen and Leape. PAE: Preventable Adverse Events
Sources:))James,)J,)“New,)Evidence6Based)Estimate)
of)Patient)Harms)Associated)with)Hospital)Care,”)
Journal(of(Patient(Safety,)September)2013.H
H

7. “Medical Errors May Be the Country’s Third-Leading Cause
of Death”
–The Advisory Board Company, Sept. 24, 2013

8. 01
You Hold
the Key
“The culture of a company, is the
behavior of its leaders … You change
the culture of a company by
changing the behavior of its leaders.”!
Dick Brown

9. 01
Decision Point
#10
What will I do
differently when I
go back to work ?

10. The CEO IS THE Leading Role
CEO Role #1

11. The #1 STRATEGIC Priority

12. Disclaimer, AKA The Fine Print
All calculations performed by the Director of Decision Support, assorted financial analysts, and
verified by a Chief Financial Officer.!
!
No calculations performed by this doctor person.

13. IMPACT at One Hospital
Revenue!
$32 Million
Savings!
$36 Million
Total = $68 Million
Hospital Margin
$74 Million
Study on select conditions through November, 2008; Pediatrics, ICUs, Trauma not included.
Source: Spectrum Health Finance, multiple publications.

14. 01
Make
SAFETY
a CORE
Value

15. 01
4: The CEO
Conducts a Monthly,
Systematic Review of
Quality & Safety
Performance

16. “Quality and Safety (and their related process
improvements) is the next frontier of cost
management.”
–Joseph J. Fifer, FHFMA, CPA
President & CEO, HFMA

17. 01
Eliminating
Complications
Saved $36 M
Study on select conditions through November, 2008; Pediatrics, ICUs, Trauma not included.
Source: Spectrum Health Finance

18. Average Costs of Common Complications
❖ Decubitus Ulcer!! ! ! $28,272!
❖ Post-op Deep Wound Infection! $27,814!
❖ Clostridium Difficile Colitis! ! $25,401!
❖ Sepsis! ! ! ! ! $23,451!
❖ Reopen Surgical Site! ! ! $19,442!
❖ Venous Thrombosis!! ! $15,976!
❖ Pulmonary Embolism! ! ! $16,331!
❖ UTI! ! ! ! ! ! $9,637
Richard Fuller, Elizabeth McCullough, Mona Bao, Richard Averill, Estimating the Costs of
Potentially Preventable Hospital Acquired Complications, Health Care Finance Review,
Summer, 2009, 30:17-­‐‑32

19. The C-Suite’s Role in Q & S
Every EXECUTIVE Must PLAY an ACTIVE ROLE!
THE CEO Enforces ACCOUNTABILITY within the C-Suite

20. #5 INTOLERANCE of Holdouts
After all, what’s at stake?

21. Performance Improvement Project
Cardiac Cath Lab
Savings = $6.7 million!
!
! On time starts!
! Throughput & room turnover!
! Open and unused supplies ($3M)!
! Preference card variation!
! Non indicated add-on procedures!
! Number of stents!
! Appropriateness

22. Medication Administration Process
125 Process Steps Before < 25 Steps After

23. #6: Ensure “Appropriate” Resources
Staff, Expertise, Tools, and Data

24. You’ll Need Dashboards
Manage What You
Measure
There is enough data already
in your finance or cost
accounting system to create
unlimited Quality reports

25. 7: The CEO Establishes a Game Changing
Board Quality Committee

26. My Favorite Composition
✤ Content Expertise in:!
✤ Clinical Improvement & Safety Science!
✤ Operational Improvement (Lean) and Satisfaction!
✤ Internal AND External Experts!
✤ Different Industries

27. 01
#8
The CEO
Chairs or Co-
Chairs the Quality
Committee

28. #9: Walk the Halls

29. One of the more powerful
interventions to improve
safety
Daily Safety Check-In

30. “Now listen up ladies, it’s time for our daily safety check-­‐‑in”

31. #10.5 Becomes Well Versed in Q&S

32. 65 Bed Hospital
NO HARM > 835
DAYS
No harm events in over 835 days!
!
Top 100 Hospital last three years in a row!
!
Before – mired in controversy and almost
closed by the community

33. 01
Back to
Decision Point
#10
What will I do
differently when I
go back to work ?

34. Everyday, Remember Why You’re There …
They Entrust Us With Their Lives, Let’s Not Let Them Down !

35. Your CEO Checklist
✤ The CEO plays THE Leading Role!
✤ The CEO makes Q&S THE #1 Strategic Priority!
✤ The CEO makes EXCELLENCE a Core Value!
✤ The CEO establishes a Board Quality Committee!
✤ The CEO conducts a systematic, monthly review of performance !
✤ The CEO enforces ACCOUNTABILITY in the C-suite !
✤ The CEO is INTOLERANT of HOLDOUTS!
✤ The CEO becomes well versed in Q&S!
✤ The CEO ensures there are adequate resources!
✤ The CEO CHAIRS or co-chairs the Quality Committee