Wright Pinson, MBA, M.D., Deputy Chief Executive Officer, VUMC and CEO of the Vanderbilt Health System. 1
Today s theme is about empowerment. To me the word empower means making people stronger and more confident and giving control to maximize their potential impact. Within an organization like ours, that means for the people closest to the work having the information they need so they can make decisions which strengthens our organization. In my time with you today, I will give you an update of our Pillar Goal performance, Provide a sneak peek into priorities for next Fiscal Year, and Discuss The Vanderbilt Health Affiliated Network. 2
First, let s celebrate some wins. We were named among the top 100 Best Places to Work by Forbes magazine. Becker s Hospital Review We are featured in their 2016 list of 100 Great Hospitals in America LeapFrog awarded VUMC our 9th consecutive A rating in Hospital Safety. We are one of only 173 hospitals out of nearly 6,000 in the U.S. to obtain an A rating three years in a row. 3
Our strategic growth continues with: A new pre transplant evaluation clinic for kidney patients in Huntsville, Alabama, Expansion of our Vanderbilt Bone and Joint facilities in Franklin and Brentwood, and We will open our 7th LifeFlight helicopter base in Cookeville this summer, close to one of our affiliates, Cookeville Regional Medical Center. 4
Some important announcements about our People. Jennifer Pietenpol was named Executive Vice President for Research. She will oversee our clinical and basic science research in VUMC, and she will continue serving as the Vanderbilt Ingram Cancer Center s Director. Nancy Evans, Chief Information Officer for our Hospitals, was named one of the most powerful women in health care information technology for 2016 by Health Data Management magazine. She has worked in information technology at Vanderbilt since 1976. After 40 years here, I would say she has earned this! Ronald David Alvarez is the incoming Chair of the Department of Obstetrics and Gynecology. He is a leading expert in the field of clinical gene therapy for ovarian and cervical cancers and comes to us from the University of Alabama Birmingham. Ronald will start September 1. J. David Sweatt is the incoming chair of the Department of Pharmacology. He is known for his research on the mechanisms of learning and memory and also comes to us from the University of 5
Alabama. He will start in mid August. Please join me in congratulating all of these people. 5
Now for our Pillar Goal update. Please make a point to read all the details posted on our Elevate Web site so you can articulate and share these results with your teams. 6
Overall, we are in good shape thanks to the aligned hard work and commitment of everyone in this room as well as your teams. Considering the added duties associated with our transition from the University and a rigorous budget season, this performance is pretty remarkable. So, thank you. Now, going down the list People In People, our time to fill fell just below threshold for this past quarter, and our retention remains below the goals that we set. More on People one of our focus areas for Fiscal Year 16 in a few minutes In Service We have a lot of momentum. We are hitting our 2 day and 5 day Access measures and we are within a tenth of threshold for hitting our 15 day goal. It is so important to make access to our outpatient services easy and convenient. This year, our house wide and local team strategies have shown consistent upward movement in our rankings across all HCAHPs domains, and all entities in our overall facility rating. For patient satisfaction, we have both localized improvement and house wide improvement initiatives such as 1)Nurse Leader Rounding and 2)Discharge Phone calls are making a very 7
significant impact on our patient satisfaction. In Quality We are at or above threshold in all metrics. We have seen a 15% reduction this year in health care associated infections. For the first time ever, our performance for Colorectal SSI rates will exceed the national benchmark Our Children s Hospital is approaching 1 year without a Cath Associated UTI We are down 25% in hospital acquired conditions. At VUH, we have seen a 45% reduction in the number of patient falls with harm this year. We have seen over a 50% reduction in the number of Postoperative Respiratory Failures events. Our VUMC Observed to Expected Mortality performance has improved by over 10%. At this moment on readmissions, we are at threshold for 6 of our 9 metrics. In Growth & Finance Four of the six metrics are above threshold. Hospital patient days dipped in the first part of the year, but have exceeded threshold for February and March. Key Outpatient Procedures are below threshold, by.8 of a percent. These pillar results reflect in part our successful Documentation and Coding work a second of our focus areas for this year and, our procedure pipeline initiative, our 3 rd focus area for this year. 7
In Innovation Our CMI adjusted length of stay the fourth focus area this year is at reach Our value based episodes of care bundle development is also at reach, and Our employee health plan numbers are very close to threshold. This is a good time to address a question that several people have raised recently. Do we need to focus on growth or on cutting expenses? The answer is we need to do both. We need to grow strategically where it makes the most sense like: Areas such as Transplant, Surgery, Cardiovascular Services Cancer, and GI, Recognizing more alternative touches of care delivery through walk in clinics, home visits, apps, coaching and telemedicine. Please recall we expect to open about 50 new beds in the next year But We also do need to work smarter and be more efficiently, especially in outpatient areas. 7
Now, I want to take moment to share more about our people. As a part of empowerment, it s important you have a voice. Two years ago, we conducted the employee engagement survey. In response to the results, we have worked to increase our communication to everyone. Some of our responses have included Improving our Leadership Assemblies so you can communicate with your teams the findings reported here, and Offering more Town Halls to share information with all employees. To listen more, we launched our Conversations with Leaders Conversations with Physician Leaders, and Started widespread Executive Leader Rounding. We continue to offer by email MyVUMC twice a week, and the Reporter each week. We have over 700 ambassadors, and hundreds of subject matter experts that are engaged to help us with communications for EpicLeap. This year, our survey is called the VUMC Culture Survey and it launches on May 16. We ve combined three surveys for engagement, safety, and Magnet work into one and this one survey is for all VUMC faculty and staff. Please make sure to take the survey and encourage your 8
teams to do so as well. The input provided will give us all valuable information going forward. 8
For People, we have a better idea about both the successes and challenges in our retention. I want to share with you some new market intelligence. Each of us knows the real life impact in terms of time when we have to replace a team member. We know that collectively the cost of replacing team members is in the tens of millions of dollars each year. Over the past 3 years, our retention has improved as the national benchmark has declined. Our retention is at 84 percent compared to the national health care benchmark of 81 percent. This past year the targeted strategies in areas with the greatest opportunity for improvement have produced upward movement. We are making a measureable difference for our people and ultimately our patients. 9
As promised, I want to give you a sneak peek at where we are heading for Fiscal Year 17. These are focused areas where we can make the greatest impact. Workforce Engagement Continuing to focus on what energizes our workforce, and specifically building up our middle managers as the backbone of our organization EpicLeap making sure we are a success story of transforming our clinical enterprise through workflow improvements, enhanced governance, and better IT tools on time and on budget. Academic Integration our clinical, academic and education arms working yet more closely than ever before. Creating more value together than any one portion can by itself. Creating more value for VUMC. Strategic growth a thoughtful approach to where we do and do not choose to grow our organization. A great example of that strategic growth is The Vanderbilt Health Affiliated Network. 10
We believe in our power to drive change and to envision innovative approaches to health care. Value Based healthcare is here. This is where we get paid by results of the care we provide and our ability to provide that care at the best cost. We are already implementing new bundled payments. We get paid a set rate for a specific condition over time, with a specific set of required outcomes. Rather than fee for service where we get paid for each specific piece of work. At risk today is $100 million over the next four years as we demonstrate ability to perform on various pay for performance programs and the coming MACRA law requirements. This is part of the reason for creating the Office for Population Health Management. The challenge is that we at VUMC are often only one part of the healthcare system that is supporting our patients. It s not just about the care our own teams provide. In order for our patients to get the best outcomes from the best care at the best cost, we need to look at the entire system of care. This is part of what is driving health care system consolidations across the country. 11
So, we ve teamed up with others. At the same time, we improve the control over our own destiny. That s a big reason why we put the Medical Center into its own legal entity, and That s why we have joined with other health systems to form The Vanderbilt Health Affiliated Network, a physician led organization that is harnessing the power the region s top health care providers to improve health, one person at a time. We want to provide higher quality, lower cost care to more patients, and in this new world, it takes a community of committed health care partners to do that. The Vanderbilt Health Affiliated Network is truly leading the transformation of health care delivery across the Mid South by bringing together a high performing alliance of like minded health care providers to create innovative solutions that improve health and increase value to patients, providers, and purchasers. And, being part of the Network expands our ability to live our mission as a academic medical center an organization that translates discovery and education into service for our community and society. 12
The network has been steadily growing since the initial idea was presented in a clinical enterprise retreat in July, 2011 and its official founding in December 2012. What started as four founding hospitals in Middle Tennessee is now the largest provider organized network of doctors, regional health systems and other health care providers in Tennessee and surrounding states. The Vanderbilt Health Affiliated Network today is 11 health systems 48 hospitals Nearly 3,500 clinicians 235+ practices serving more than 100,000 patients across 4 states. That s our network, so far. We are also in active discussions to expand into other states to cover one million lives by 2020. And the network is constantly growing as more and more providers hear about the impact we re having. Earlier this week, Jennie Stuart Medical Center in Hopkinsville, Kentucky, signed the papers to join. This Network is how we will live our mission, and let me explain. 13
Clinically, as we build and optimize the network, we can eliminate gaps across patients care, including those we do not control. The network expands our ability to manage a patient s entire set of conditions, and manage risks to new conditions through data sharing, and enhanced care coordination. For us, this also means more referrals to our highly specialized programs. Academically, our patients have always been our best candidates to participate and benefit from discovery and education and that pool of candidates just increased significantly. Imagine research that demonstrates impact and outcomes across a regional population Education that develops team members across our affiliated peers Our schools of medicine and nursing are attractive to our affiliates who want the benefit of our world class education and discovery. This has begun already in the Transforming Clinical Practice Initiative. A $28 million CMS grant that will enable us to equip clinicians with tools and support to improve quality, patient access to information, and control costs over the next 4 years. 14
Before that it was the $18 million CMS Innovation grant. 14
World class discovery and innovative education.translates into service for patients across the Southeast. That s the power of The Vanderbilt Health Affiliated Network for our Vanderbilt University Medical Center. The Vanderbilt Health Affiliated Network is no longer our best kept secret. We have been asked to help other organizations implement similar networks in their geographical areas via our Advisory Services team. We will be formally introducing the network to the public in mid May, with an awareness campaign to help others understand exactly what the network has to offer. We know that the network s products and services will be especially appealing to businesses because we are improving the health of patients while demonstrating significant, proven and sustainable cost advantages. As leaders, you can help spread the word about the important work we re doing as part of the Vanderbilt Health Affiliated Network. Please familiarize yourself with this important part of our organization. Pay attention to the information that we share about the network so that you can knowledgably and comfortably communicate about it with others. We are charting an exciting new course. I hope that this vision resonates 15
with you and personally gives you confidence. 15
Now, from all that s been shared this morning, I d like to close with some action items. One, share the Pillar updates with your staff and co workers and stay focused on them so we can finish this fiscal year strong. Make sure to visit the Elevate web site for details. 16
Two, focus on further improving People and Service. Participate in the upcoming VUMC Culture Survey and take advantage of our regularly scheduled Town Halls, Conversations with Leaders, and work closely with your HR consultants to address any challenges. Know your HCAHPs scores and share them with your teams. Focus on Access. It is so important to patients and referring doctors so we can further improve in that area. 17
Three, share our vision and strategy with your teams. We know change is exhilarating for some people but scary for others. We will have challenges along the way, but we have a very bright future ahead. 18
Finally, let s work together to build a culture of empowerment. We are the new VUMC. We have many challenges and many opportunities. Our future is in our own hands. Thank you. 19