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Strategic Plan 2011 - 2013

Jefferson Healthcare Strategic Plan 2011-2013

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About Jefferson Healthcare

Jefferson Healthcare (Jefferson County Public Hospital District No. 2) is


the primary healthcare provider for more than 20,000 residents of
Eastern Jefferson County. It is governed by a five-member elected
board.
We provide inpatient care at its 25-bed acute care facility and a
comprehensive range of outpatient services including emergency care,
diagnostic imaging, laboratory, physical therapy and rehabilitation,
surgical services and sleep medicine. In addition, we operate five
primary care clinics and a home health & hospice agency.
By employing about 500 workers, Jefferson Healthcare provides
significant economic benefit to Jefferson County as the largest
employer. It also employs about 25 physicians and midlevel
professionals and has agreements with specialists to provide care for
the residents of our county.

Jefferson Healthcare Strategic Plan 2011-2013

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Mission, Vision, Values


Mission
Jefferson Healthcare excellence with compassion and innovation.
Purpose
Assure appropriate health care services are available to support the
health of all the people of Eastern Jefferson County.
Values
Jefferson Healthcare is:
Intentionally patient centered.
Committed to the highest possible quality health care for all.
An employer that recognizes the quality of its employees and helps
them to reach their potential.
Committed to a healthy community that encourages individual
responsibility.
A prudent steward of health care resources.

Jefferson Healthcare Strategic Plan 2011-2013

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Quality and Patient Safety


Jefferson Healthcare will provide safe, quality, patient-centered care to every
patient we serve, every time we serve them.
Strategy A. Achieve accreditation.
Strategy B. Develop and implement the Jefferson Healthcare Quality Index.
Strategy C. Develop, cultivate and promote a Culture of Safety at Jefferson
Healthcare.
Measurable Goals
1.
2.
3.
4.
5.

Achieve accreditation by June 30, 2011.


Achieve 75% compliance (green) for entire index by 4th quarter 2011.
Complete Culture of Safety curriculum by 75% of staff by December 31, 2011.
Complete Culture of Safety survey by June 30, 2011.
Improvement in selected National Patient Safety goals by 4th quarter 2011.

Jefferson Healthcare Strategic Plan 2011-2013

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Quality and Patient Safety


Jefferson Healthcare will fully embrace performance improvement as the means
to achieving clinical and operational excellence.
Strategy A. Align quality and LEAN departments to facilitate quality and
operational improvement initiatives across the enterprise.
Strategy B. Fully implement evidence-based standard work for directors and
leaders.
Strategy C. Train and build the skills of directors and staff on the methods and
tools of LEAN and performance improvement to empower utilization within
departments.
Measurable Goals
1. Achieve day-to-day performance improvement in 75% of measures by
September 1, 2011.
2. Complete performance improvement training for directors by July 30, 2011.
3. Complete three performance improvement projects within each department
by December 31, 2011.

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Quality and Patient Safety


Jefferson Healthcare will organize hospital-based providers and outpatient clinic
services to promote tighter mission and goal alignment.
Strategy A. Develop and complete operational excellence plans.
Strategy B. Align incentives in quality, growth, service and financial performance.
Strategy C. Identify service leaders for hospital-based provider services to identify
and achieve higher standards of quality, service, growth and financial
performance.
Measurable Goals
1. Align all provider contracts with quality, service, growth and financial
performance incentives by December 31, 2011.
2. Show consistent and progressive improvement in related Jefferson
Healthcare QI indicators beginning 4th quarter 2011.
3. Meet or exceed budgeted patient volumes, revenues and expense targets by
all hospital-based provider services in 2011.

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Quality and Patient Safety


Jefferson Healthcare will select an Electronic Health Record (EHR) that improves
the continuity and safety of care, enhances communication, provides decision
support, improves documentation and makes patient information readily
accessible to the interdisciplinary care team throughout the Jefferson Healthcare
enterprise.
Strategy A. Identify EHR option(s) most capable of meeting Jefferson Healthcare
performance and CMS meaningful use criteria.
Strategy B. Identify plan to finance selected EHR.
Measurable Goals
1. Complete EHR selection process and identify system most capable of
meeting Jefferson Healthcare clinical and operational needs by October 31,
2011.
2. Have finance plan in place at time of selection.

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People
Jefferson Healthcare will recruit and retain a clinically exceptional staff.
Strategy A. Implement best practices for effective recruitment to assure the hiring
and development of exceptional staff.
Strategy B. Revise the current hiring, orientation and onboarding programs to
assist in the recruitment and retention of most talented candidates.
Strategy C. Revise job descriptions to clearly state qualifications, expectations and
accountability and set a high standard for performance.
Strategy D. Revise the current performance evaluation system to improve the
process of measuring employee performance improvement and engagement.
Strategy E. Develop a People & Engagement Committee to assist leadership in
policy and goal development and employee engagement programs.
Measurable Goals
1. Reduce turnover during probationary period by 50% by December 31, 2011.
2. Decrease the time from position posted to time of hire to an average of 60
days by September 31, 2011.
3. Develop a tool to determine the effectiveness of orientation of new
employees at 90 days by September 30, 2011.
4. Increase patient satisfaction and reduce number of complaints about
employees performance by December 31, 2011.
5. Complete job description revisions by December 31, 2011.
6. Complete performance evaluation revisions by December 31, 2011.

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People
Jefferson Healthcare will be the employer of choice for employees who seek
professional fulfillment and want excellence in their work and the work of the
organization.
Strategy A. Seek employee involvement; be transparent and deliberate in
communications and consistent and equitable in the application of human
resource policies and procedures.
Strategy B. Establish new intentional employee recognition programs to recognize
employee contributions that support Jefferson Healthcare initiatives.
Strategy C. Provide employees with professional opportunities for growth through
internal and external programs.
Strategy D. Develop lateral career and career ladder job enrichment opportunities
for all staff positions.
Strategy E. Balance ratio of full-time to part-time employees to assure continuity
and commitment that supports excellence and balanced workloads.
Strategy F. Develop open lines of communication between administration and
staff.
Measurable Goals
1. Improve Press Ganey scores related to engagement to 40th percentile in
2011.
2. Develop and implement two new employee recognition programs by August
31, 2011.
3. Increase number of full-time employees in relation to part-time employees
by 10% in 2011 and by an additional 10% in 2012.
4. Hold quarterly employee open forums and provide timely communications to
staff to improve communication and seek feedback by September 1, 2011.

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People
Jefferson Healthcare will promote and maintain an effectively organized, goalaligned medical group.
Strategy A. Explore the viability of creating Jefferson Providers, a tighter, more
cohesive multi-specialty medical group.
Strategy B. Hold meetings of employed and contractual providers to discuss
external and internal challenges, improved communications between providers,
and other ways to improve continuity of care by increasing intra-system referrals.
Strategy C. Explore innovative primary care delivery concepts such as medical
home and implement strategies that are financially responsible and would be
supported within the framework of our organization and community.
Measurable Goals
1. Establish baseline patient satisfaction with clinic/contractual medical service
using Press Ganey by 2nd quarter 2011.
2. Establish baseline provider satisfaction by June 1, 2011 and have response
measures in place by June 30, 2011.
3. Establish quarterly meetings with employed, contracted and other
community providers beginning 2nd quarter 2011.
4. Begin exploration of innovative primary care models in 2012.
5. Increase intra-system (Jefferson Healthcare to Jefferson Healthcare) referrals
by 10% in 2011 and 25% in 2012.
6. Complete an analysis and submit recommendation to Provider Leadership
Group on the advantages of evolving employed and contracted providers
into Jefferson Providers, a multi-specialty medical group in 2011.

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Service Excellence
Jefferson Healthcare will become a high-performing organization focused on
providing patient-centered care and services.
Strategy A. Identify and research innovative collaborative partnership models
(Planetree, IHI) with the intent of determining a model that will dramatically
improve the patient experience at Jefferson Healthcare.
Strategy B. Adopt the IHIs definition of patient-centered care to be used as a
standard in planning, facility design, program development and integration of
services across the continuum of care.
Strategy C. Adopt right patient in right place to deliver responsible and equitable
use of resources in balancing patient expectations and system needs.
Measurable Goals
1. Complete IHI self-assessment of patient-centered care by July 31, 2011.
2. Develop methodology to achieve patient-centered care by September 30, 2011.
3. Existing models of high-performing patient-centered care will be identified by
September 30, 2011.

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Service Excellence
Jefferson Healthcare will become an organization which reliably exceeds the
service expectations of our patients, guests and community.
Strategy A. Train, support and expect staff to practice service excellence in all
interactions with patients and others, including co-workers.
Strategy B. Design and implement patient advocacy program that will help lead
improvement in service excellence as well as respond to the individual concerns of
patients.
Measurable Goals
1. Develop service excellence standards by June 30, 2011.
2. Develop Jefferson Healthcare University by October 31, 2011.
3. Incrementally train all Jefferson Healthcare staff (10% in 2011, 50% in 2012,
all others in 2013) and train newly hired staff at the next available service
excellence program.
4. Train high impact departments (admitting, ED, clinics) in Jefferson Healthcare
service excellence standards by September 30, 2011.
5. Increase patient satisfaction to the 60th percentile by December 2011, 75th
percentile by December 2012 and 90th percentile by December 2013.

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Finance
Jefferson Healthcare will achieve and maintain a financially strong, locally owned
community health care system.
Strategy A. Achieve best practice operating performance by implementing
operational improvements and financial management tools/reports within all
hospital departments and clinics.
Strategy B. Achieve best practice revenue cycle management performance.
Strategy C. Maintain competitive patient charges.
Strategy D. Explore the possibility of developing a charitable foundation for
Jefferson Healthcare.
Measurable Goals
1. Jefferson Healthcare cash flow will be 60 days cash on hand by December 31,
2011, and will increase by a minimum of five days annually.
2. Reduce and maintain accounts receivable days at 45 days or less by December
31, 2011, and at 40 days or the 75th percentile, whichever is less, as measured
for critical access hospitals by December 31, 2012.

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Finance
Jefferson Healthcare will develop a robust operating budget development and
compliance system.
Strategy A. Implement a monitoring system based on management and financial
reports that requires accountability for variances.
Strategy B. Provide budget development and management training for leadership
and directors to build competence and accountability.
Strategy C. Establish user friendly management reports and consultation to those
responsible for budgets.
Measurable Goals
1. Begin budget process no later than August of each budget year.
2. Achieve budgeted operating margin target by December 31, 2011.
3. Achieve 75% compliance (green) on Jefferson Healthcare financial flash report
by December 31, 2011.
4. Achieve 95% labor productivity performance for entire organization by October
31, 2011.
5. Complete monthly financial reports for hospitals, home health & hospice, clinics
and five largest ancillary services by December 31, 2011.

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Finance
Jefferson Healthcare will maximize financial reserves for operational
contingency, capital reinvestment and routine facility improvement.
Strategy A. Develop and annually update a three-year financial projection that
forecasts revenue growth, expense management and capital needs.
Strategy B. Build reserves through revenue growth, astute financial management
and cost-effective expense management.
Strategy C. Establish capital acquisition process.
Strategy D. Develop a five-year capital budget that includes medical equipment
and facility improvement.
Measurable Goals
1. Financial reserves grow at rate of 5-10% per year.
2. Develop external benchmarking tool to compare Jefferson Healthcare
financial performance, productivity and expense management by December
31, 2011.

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Growth
Jefferson Healthcare will be the preferred health care provider for all residents
of Eastern Jefferson County.
Strategy A. Complete a market share analysis for Jefferson County inpatient
services, including a drill-down analysis for surgery, orthopedics, cardiology and
gynecology services.
Strategy B. Encourage all Jefferson Healthcare employees to utilize Jefferson
Healthcare services.
Strategy C. Organize and promote Jefferson Healthcare to better capture outmigration to services that are available locally through Jefferson Healthcare.
Strategy D. Educate the community on local care options and promote the
advantages of seeking quality care closer to home.
Strategy E. Develop primary care and/or satellite services in Eastern Jefferson
County.
Strategy F. Explore affiliation with a large metropolitan medical center to provide
continuity of care of local services to and from services not provided in Jefferson
Healthcare and additional specialists placed in the community to provide local
services.
Strategy G. Outreach to local businesses about ways to improve access to local
services, including becoming preferred providers.
Measurable Goals
1. Meet or exceed budgeted volume targets in 75% of all service areas in 2011.
2. Achieve 45% inpatient market share for residents of Eastern Jefferson County
in 2011. Achieve 50% inpatient market share for residents of Eastern
Jefferson County in 2012.

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Growth
Jefferson Healthcare will grow existing services, and identify new businesses and
service opportunities to better meet the health care needs of Eastern Jefferson
County.
Strategy A. Implement Business Development Committee to identify new business
opportunities and monitor existing services.
Strategy B. Jefferson Healthcare Clinics will grow primary care services as a
method to increase activity in all service areas.
Strategy C. Develop and grow Ancillary Services Committee comprised of
diagnostic imaging, laboratory, rehab, sleep and other designated services to
stimulate departmental growth, share best marketing practices, and monitor
growth goals and objectives.
Strategy D. Work with hospital quality department, clinics, home health and
hospice to identify patients with frequent admissions to the ED or hospital for
chronic disease management.
Strategy E. Explore aligning with orthopedic services outside the area to provide a
broader range of local orthopedic services that meet the communitys needs.
Measurable Goals
1. Identify one new business opportunity (generating $500,000) by September 30,
2011.
2. Increase primary care visits by 10% in 2011.
3. Meet or exceed budgeted volume targets by 75% of all ancillary services in
2011.
4. Increase joint replacement market share to 50% in 2011 and 60% in 2012.
5. Establish Business Development Committee by May 31, 2011.
6. Establish Grow Ancillary Services Committee by April 30, 2011.

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Mission
Jefferson Healthcare will become the full expression of its mission.
Strategy A. Develop and report to the community the index of contribution to the
well-being of the community (charity care, subsidies to medical care, employment,
people served, etc.).
Measurable Goals
1. Develop a community index of contribution by June 30, 2011.
2. Make two community group/media presentations by December 31, 2011.

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Mission
Jefferson Healthcare will manage its future by open communication, careful
analysis and comprehensive planning.
Strategy A. Develop a strong and flexible planning process that focuses resources
and provides for resiliency in an environment of health industry changes (strategic
plan, campus renewal plan, community relations plan).
Measurable Goals
1. Three-year strategic plan update finalized by March 1, 2011.
2. Master Site Plan in place by June 30, 2011.
3. EHR plan in place by June 30, 2011.

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Mission
Jefferson Healthcare will provide access to necessary care to all residents of
Eastern Jefferson County.
Strategy A. Define access parameters of necessary care by the Board and
administration.
Strategy B. Develop a community responsive and fiscally responsible policy on
meeting the non or under-reimbursed (defined focus) care needs of Jefferson
County.
Measurable Goals
1. The Board reviews and adopts a service access policy by September 30, 2011.
2. Develop and initiate access policy implementation plan within 30 days of
board direction.

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Mission
Jefferson Healthcare will be an active partner in matters that impact the health
and vitality of the community at large.
Strategy A. Assume a visible interest and role in the community by Jefferson
Healthcare leadership.
Strategy B. Reach out to community groups to provide support to their programs
for community wellness such as providing staff for health fairs or collaborating in
program development.
Strategy C. Develop planned outreach to local businesses.
Strategy D. Be an active member of the community in emergency response.
Measurable Goals
1. Establish membership/involvement in community groups by 100% of SLG in
2011.
2. Participate in five community health fairs or events in 2011.

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