Bobby Frist Keynote Summit 2008

Creating Excellence in Healthcare

Robert A. Frist, Jr.

Chief Executive Officer

99 HealthStream Customers Achieved Magnet Status

2008 100 Most Improved Hospitals

2008 100 Most Improved Hospitals

58% HealthStream Customers

Thompson-Rueters Top 100 Hospitals 2008

33% HealthStream Customers

Global Launch of Exclusive New Product

1pm Tomorrow!

To improve the quality of healthcareby developing the people that deliver care.

VISIONHealthStream’s

To advance healthcare organizations through continuous measurement and adaptive learning solutions, resulting in

improved patient care, increased productivity, rapid assimilation of new practices, enhanced compliance, and better outcomes.

MISSIONHealthStream’s

Specialty Healthcare Resources

• Clinical Experts• Research Consultants• Client Executive Consultants• Medical Librarian• Accreditation Experts

18 Themes

Case Studies of

The CHI Value Chain

Achieve Business & Clinical Outcomes

1. Reduction in nursing turnover2. Employee, patient, physician satisfaction 3. Aligned management4. Engaged employees5. Effective leadership

Goal

• Established Measurement Program – Employee, Leadership, Physician, Patient

• 27 measures used to assess chevrons in Value Chain• Targeted areas for improvement• Expanded education services to accelerate learning & change

Action

• Organizational Alignment• Ability to target efforts for high impact• Improved satisfaction among employees, patients, physicians• Less staff turnover• Engaged employees

Results

CHI Presentations at Summit 2008

Susan Almond

Colleen Elliott

Achieve Magnet Recognition

Goal

Action

• 18-month application process• Used HLC to assign & deliver courses in support of

Magnet requirements• Used Authoring Center to create custom courses• Produced numerous reports via the HLC

Results

• Achieved Magnet Status in June 2007 • Nursing staff completed over 100,000 education courses• Produced hundreds of required reports

To decrease unexpected events in the med-surg units, recognize signs of patient decline, and initiate calls to their

Rapid Response Team.

Goal

45 RNs completed an online scenario-based course, “Rapid Response in Medical-Surgical Units.”

Action

Compared outcomes 3 months prior and after staff completed the course

• 30% increase in calls to the Rapid Response Team• 2 fewer unexpected codes• No episodes of failure to recognize signs of patients’

declining condition

Results

U.S. Demographics & Trends

PopulationU.S. Population Trends and Projections by Age, 1980-2050

85+ Years

65-84 Years

20-64 Years

0-19 Years50

100

150

200

250

300

350

400

450

500

1980 1990 2000 2010 2020 2030 2040 2050

Mill

ions

Source: American Hospital Association 2008

U.S. Life ExpectancyBy 2030, the over-65 population will nearly double

Source: CDC 2008

Percent of People with Chronic Conditions by Type

8.8%

10.7%

11.1%

12.3%

15.8%

20.0%

20.9%

33.9%

12.5%

0% 10% 20% 30% 40%

Chronic Respiratory Infections

Asthma

Eye Disorders

Diabetes

Heart Disease

Arthritis

Respiratory Diseases

High Cholesterol

Hypertension

Percent of Noninstitutionalized Individuals


Healthcare Industry Trends

National Expenditures on Health Services and Supplies as a Percentage of GDP

U.S. GDP 2006

Health Services

and Supplies,

14.9%

Other Sectors,

85.1%

$1.97 Trillion

Hospital Care, 33%

Physician Services, 23%

Prescription Drugs, 11%Nursing Home Care, 6%

Other, 27%


Number of Full-time and Part-time Hospital Employees,1993 – 2006

4.04.14.24.34.44.54.64.74.84.95.05.15.2

93 94 95 96 97 98 99 00 01 02 03 04 05 06

Mill

ions


Allied Healthcare Workforce is in Demand

The following growth rates are projected through 2010, according to the BLS.

Medical Assistants 59.8%Physician Assistants 57.0%Medical Records/Health Information Technicians 54.1%Physical Therapists 36.7%Radiologic Technologists/Technicians 23.5%Clinical Laboratory Technicians 18.0%

National Supply and Demand Projections for FTE RNs, 2000 – 2020

RN FTE Supply

RN FTE Demand

1,500

1,700

1,900

2,100

2,300

2,500

2,700

2,900

2000 2005 2010 2015 2020

FTE

s (T

hous

ands

)


Percent of Hospitals Reporting Impacts of Workforce Shortage

6%

8%

9%

13%

13%

17%

17%

21%

35%

36%

49%

ED Overcrowding

Diverted ED Patients

Reduced Number of Staffed Beds

Increased Wait Times to Surgery

Discontinued Programs/ Reduced Service Hours

Delayed Discharge/ Increased Length of Stay

Cancelled Surgeries

Curtailed Acquisition of New Technology

Curtailed Plans for Facility Expansion

Source: 2007 AHA Survey of Hospital Leaders

Decreased Patient Satisfaction

Decreased Staff Satisfaction

Type

of I

mpa

ct

Pivotal Healthcare Movements

Quality Movement in Healthcare






Consumer-Driven Healthcare

Public Reporting

Source: Improving America’s Hospitals: The Joint Commission's Annual Report on Quality and Safety, 2007

Research and Learning Challenges

Patient Safety Continues to Be a Top Priority

81% of healthcare organizations are actively taking steps to improve patient safety

70% of healthcare organizations consider learning to be key in developing a patient safety culture

Competence to perform job responsibilities is assessed, demonstrated, and maintained.The Joint Commission Standard HR.3.10

Quality Challenge

2008 Agency for Healthcare Research and Quality (AHRQ)

Training Supports Strategic Goals —Including Patient Safety

Status of training in hospitals is increasing—as workforce development is linked to improved patient care.Nursing Research, Jan-Feb 2008

Online education program improved cardiac examination skills better than clinical training alone.Journal of Hospital Medicine, April 2008

Response

2008 Bersin & Associates

Budget Challenge

Healthcare Organizations’ 2008 Learning Staff and Budgets Remain Relatively Same as 2007

77% Same # of Staff as Last Year 1% Increase in Budget over Last YearAHRQ 2008

Technology Offers Efficiency and Quality

Among Healthcare Organizations, Self-study e-Learning + Online Instructor-led Training Accounts for 40% of training!

e-Learning 26%Online Instructor-led Training 14%Total 40%

Response


Training Challenge

Increased Need for Leadership Development

• Only 31% of nurse managers possess a graduate degree—which is the minimum recommended by AACN & AONE The Journal of Continuing Education in Nursing, 2007

• Only 12% of learning content in hospitals is focused on managerial/supervisory skillsASTD, 2007

• Only 19% of hospitals provide external professional development for physician leaders Spectrum, 2005


Mandatory Compliance TrainingSqueezes Courseware Budget

Top 2 Priorities Compliance Training 18%Management Training/IT/Systems Training 12%

Response

Among Healthcare Organizations, Compliance Training Receives the Greatest Amount of Funding Relative to Other Courseware


Measurement Challenge

Need for Continuous Data Collection

“… Healthcare organizations are being challenged to meet the data demands of a growing number of mandatory and voluntary measurement projects. For healthcare organizations, the “measurement monster” may seem impossible to tame.”Frontiers in Health Services Management, 2007

Response

Surge in Technology Utilization

“Full implementation of networked e-health records (EHR) in U.S. doctors’offices and hospitals could cost around $150 billion over eight years”Robert Miller, PhDUniversity of California, San FranciscoJuly, 2008

“52% of respondents to the HIMSS Annual Leadership Survey cited error reduction and safety as key drivers in technology adoption”HIMSS, 2007

Operating Margin By Employee Satisfaction

0.2%1.4%

4.8%6.0%

0%

2%

4%

6%

8%

1st Quarter(3.44)

2nd Quarter(3.61)

3rd Quarter(3.71)

4th Quarter(3.82)

Employee Satisfaction

Ope

ratin

g M

argi

n

Employee Satisfaction and Retention

Workforce Challenge

As Employee Satisfaction Increases, Profit Margins Tend to Increase

Response

Sharing Research Results Increases Employee Satisfaction & Retention

“Reviewing Survey Results: How the Best Managers Succeed” HealthStream Research, 2007

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Date post:	22-Oct-2014
Category:	Health & Medicine
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Bobby Frist Keynote Summit 2008

Health & Medicine