Working together spring 2014

Working Together for

SPRING 2014

UMMC

P UB L I SHED I N C ON JUN C T I ON WI TH TH E S P R I N G E MP L O Y E E C O MM U N I C A TI O N F O R U M S

Dea r Col l ea g u e s,

U

MMC is continually planning ahead to meet the

challenges that we can predict – and to be ready for those we can’t.

I am excited to share with you a bold, five-year strategic plan for 2014-18 developed by UMMC leaders, including staff and physicians from both campuses – University and Midtown – that positions us well for the future.

This ambitious plan depends on our providing excellent and compassionate care in the most cost-effective way. All Maryland hospitals face a challenging and bold, new reimbursement environment. Each of us will be required to approach our jobs in new ways.

By understanding all the factors that go into how our hospital is paid for the care you deliver, you can have a direct impact on our ability to deliver the best care and the best patient experience. We must also always be aware of ways to be more efficient and reduce our expenses.

And by doing that, you have a direct impact on making sure UMMC remains financially able to continue to fulfill our mission of teaching, discovery and patient care.

Every role in our hospital is important and every staff member is critical to our mission. Thank you again for your patience and willingness to adapt to the changing health care environment, and for what you do every day for our patients.

Sincerely,

JEFFREY A. RIVEST President and Chief Executive Officer

Inside: ALSO SEE

w All Hands On Deck for a Smooth Patient Experience w Crews Transform 4 North Into New NICU w Strategic Plan Insert

201 4 – 2 018 UMM C STR ATE GIC PLA N

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5 Key Goals

2018 VISION: UMM C will be known improving healt for providing high h in Maryland and -value and com passionate care, beyond, educating discovering innov ative ways to adva futur nce medicine world e health care leaders and wide.

PAT IEN T SAF ETY & QUA LIT UMMC will Y

provide safe, high-q uality care, mainta become a recogn in a safe and secure ized leader in achiev environment for ing optimal clinica patients and staff, l outcomes. and

HIG HLY ENG AGE D PEO

PEO PLE UMMC will be an “employer of choice leadership develo ” and a leader in pment. staff recruitment, retention, satisfa ction

and ongoing

EXC EPT ION AL SER VIC

VIC E UMMC will provid e compassiona te care and outsta and families, exceed nding service in ing expectation a culturally s.

sensitive manne r to all

patients

STR ATE ATE GIC STR GIC INN INN OVA

TIO N OVATIO N UMMC will develo p innovative progra residents of comm ms unities served while and services to improve the health status and fulfilling our acade quality mic mission to educate and advan of life for ce knowledge.

STE WA RDS HIP

& COM

MUN ITY ENG UMMC will achiev AGE MEN T e revenue growt h and manage investment in our operating expen strategic priorit ses to achieve ies, while meetin financial results g our mission to allowing provide services to all.

OUR MISSI ON: WE HE AL • WE T EACH • W E DISCOVE R • WE CA RE

RIDING THE WAVE – AND THE WAIVER – TO RAISE QUALITY AND LOWER COSTS

M

aryland has always had a waiver from the federal government that gives the state permission to set hospital rates. A state agency – the Health Services Cost Review Commission (HSCRC) – is responsible for setting the rates.

Maryland is the only state with such a system. What is being tried in Maryland has never been done before on such a large scale.

Maryland’s new waiver, as of Jan. 1, 2014, is complex, but the impact it has on patients and health care workers boils down to two basic principles: 1. The amount of money to pay hospitals in Maryland is being capped on an annual basis, based on population in the state, not based on how many patients are treated in each hospital.

2. The amount of money hospitals get paid will be directly affected by how good a job they do taking care of patients – including readmission and infection rates and what patients report in satisfaction surveys after they go home.

The new rules tie hospital finances more directly to quality of care. Even patient satisfaction scores will have an impact on how much money hospitals receive for caring for patients. (See story, page 2) The waiver requires more emphasis on ambulatory care, discharge planning and coordination across both campuses of the University of Maryland Medical Center to ensure care is delivered at the most appropriate location for the type of care needed – the right care, in the right place, at the right time, for the most effective cost.

UMMC University Campus and UMMC Midtown Campus are also looking at ways to reduce duplication where it makes sense to do so.

“In addition to sustaining and even improving the quality of our patient care, we need to treat people nicely – the way we would want someone to take care of us or a loved one,” said Lisa Rowen, DNSc, RN, senior vice president and chief nursing officer.

“Not only will this help our patients heal, it will position UMMC as a top performer in patient satisfaction.”

FOCUS ON SUCCESS AFTER DISCHARGE

Hospitals now have a financial incentive to make sure patients have a successful transition home. Both UMMC campuses started a program called Transitional Care Coordination (TCC), to have a nurse case manager meet with certain patients long before they are discharged.

It’s an innovative collaboration between the inpatient and outpatient staff: Nurses and other unit staff let the TCC team know of patients who, after discharge, might have trouble keeping up with their health needs, such as obtaining prescription drugs and having access to primary care or follow-up doctor appointments.

As of Jan. 1, 2014, hospitals in Maryland are under a new payment structure. Hospitals’ rates will be lowered – meaning less money for salaries, staffing and to provide patient care – if they don’t do the following:

1.

Reduce by 30 percent their rates of infections and injuries that occur in the hospital.

2. Do a better job of keeping patients healthier and out of the hospital once they are discharged.

3. Keep total hospital revenue

growth down, regardless of the number of patients treated.

2

ALL HANDS ON DECK NEEDED

FOR A SMOOTH PATIENT EXPERIENCE TOP 10 WAYS

Individual staff members in a hospital have a direct impact

WE CAN INFLUENCE THE PATIENT EXPERIENCE

on how patients rate their hospital experience.

P

From the Patient Experience Team

1

atient satisfaction scores matter more than ever, and the state formula for setting the reimbursement that UMMC receives to care for patients will depend partly on how patients rate their hospital experience.

“All of us who work in the Medical Center are used to hearing about forces that affect health care that we have little control over,” said Kerry Sobol, MBA, RN, director of C2X and the patient experience. “But every single one of us can make a big difference in a patient’s stay with us -- whether you’re a member of the clinical staff or you’re an office worker who happens to be walking through the atrium when a patient or family member needs help or has a complaint.”

usually, or never. The only answer that matters is always – anything below that puts the hospital at risk for lowering its rates the next year.

If the survey results were letter grades, it would be as if a hospital could earn an A, B, C, D or F, but anything lower than an A is a failing grade.

PATIENT SURVEYS

A sample of UMMC patients gets a survey phone call after going home, with the results reported at www.hospitalcompare.hhs.gov. Patients are asked questions such as whether the staff treated them with dignity and respect, or whether the hospital was quiet at night or clean. The answer choices are: always, sometimes,

Introduce yourself!

2

Reassure them that they are in the right place, and that you will take good care of them.

3

QUALITY-BASED REIMBURSEMENT

In deciding what hospitals are paid, starting this year the state will factor in each hospital’s performance in three areas: 1.

Core measures 2.

Patient outcomes 3.

Patient satisfaction This new system of deciding how hospitals are paid is called “quality-based reimbursement.” By being mindful of every interaction with patients and making sure patients feel cared for so they can get well, a staff member can directly improve how much money the hospital has to operate and to deliver the best care for patients.

For example, if UMMC were to do poorly in the above measures, it could result in a $23 million drop in revenue next year.

with a smile and genuine concern.

HOW TO GIVE PATIENTS A BETTER EXPERIENCE

The overriding principle is to be kind and helpful, even if a patient is complaining about something that is not your fault, Sobol said.

“The important thing is to share any complaint with someone who can help,” Sobol said. “We want to know what people aren’t happy about, so we can try to make it better.”

Sobol said the hospital has been trying for years to improve patient satisfaction scores. It isn’t easy, because so many factors, so many departments and so many staff contribute to the patient’s experience. Any one of them falling short can color the patient’s whole experience.

“The most important way to improve scores is to have consistency,” Sobol said. “It’s very hard, but at some point the blocks will all line up, and we will move those scores up.”

Greet your patients and families

Use empathy when communicating – share in your patients’ and families’ experience; stay connected to them.

4

Educate your patients and families as needed. Know what resources exist for them – and offer them with compassion.

5

Follow through on issues and

*

concerns, use Act with HEART

strategies and report up the chain of command if needed.

6

Work as a team! Do not use blaming language; accept accountability for everything the patients and families experience – even if you are not directly responsible.

7

Keep our environment safe, neat and inviting.

*

8

Act with HEART stands for: Hear what they are saying.

Empathize with them.

Acknowledge and apologize without being defensive.

Respond appropriately and get help if needed.

Thank them for sharing the issue so we can improve. >>> To find out more, or to get a badge tag with the program information, ask your manager or email Kerry Sobol at ksobol@umm.edu

Watch your non-verbal communication. Body language speaks volumes.

9

Stay positive – use positive phrases such as “We can help you” or “I am here for you.” Resist the urge to burden patients with personal frustrations, such as by saying, “This problem happens all the time.”

10

Take pride in your work and in our organization! Your confidence drives our patients’ and families’ trust in us as their health care provider.

quality-based

reimbursement

UMMC DEVELOPS STRATEGY

FOR A STRONG FUTURE

The next few years require a great deal of strategic planning as the delivery of health care reinvents itself.

A

year’s worth of study and work went into the 2014-2018 Strategic Plan: “Medicine on a Mission: Delivering High-Value Health Care.”

The title is purposeful – “high-value health care” refers directly to increased attention to spending every dollar wisely, in a way that makes patients and the community healthier.

The new strategic plan looks at state and regional demographic numbers – where the population is growing, what the age distribution is, what the greatest health care needs will be in 5 years – and how to most effectively utilize both

campuses of UMMC – the University Campus and Midtown Campus. The two locations will focus on coordinating services to maximize the strengths of each and provide the right care at the right time, in the right setting.

For example, the most critically ill patients will be cared for at the University Campus, which has many specialized intensive care units. Other services, such as ambulatory (outpatient) care and same-day surgery, will grow at the Midtown Campus. More faculty physicians from the University of Maryland School of Medicine will

practice at the Midtown Campus in addition to veteran community-based physicians.

“I encourage you to learn more about our fiveyear strategic plan, and what you can do to help us reach our goals,” said Jeffrey A. Rivest, president and chief executive officer of UMMC. “To that end, we have created a special strategic plan website that features a fun and informative video, key plan goals and strategies, our new mission and vision statements, and more.”

See the video at umm.edu/stratplan Also, see the strategic plan insert in this issue of Working Together for specific goals and strategies.

2 01 4 – 2018 UMMC STRAT E GIC PLA N

DELIVERING HIGH-VALUE HEALTH CARE 2018 VISION: UMMC will be known for providing high-value and compassionate care, improving health in Maryland and beyond, educating future health care leaders and discovering innovative ways to advance medicine worldwide.

201 4 – 2 018 UMM C STR ATE GIC PLA N

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2018 VISION: UMM C will be known improving healt for providing high h in Maryland and -value and com passionate care, beyond, educating discovering innov ative ways to adva futur nce medicine world e health care leaders and wide.

5 Key Goals

THE STRATEGIC PLAN MATTERS TO EVERY STAFF MEMBER: • Everyone’s input and dedication will be needed to put the plan into practice.

• Understanding the goals of the plan will help all staff do their jobs in a way that maximizes the financial health and reputation of the Medical Center.

• If the Medical Center has a strong plan that will keep it financially sound, the mission of the hospital will continue to flourish.

• Staff will find more satisfaction in their work when the Medical Center is financially sound, and

PAT IEN T SAF ETY &

QUA LIT Y UMMC will provid e safe, high-quality become a recogn care, maintain a ized leader in achiev safe and secure environment for ing optimal clinica patients and staff, l outcomes. and HIG HLY ENG AGE D PEO

PEO PLE UMMC will be an “employer of choice leadership develo ” and a leader in pment. staff recruitment, retention, satisfa ction

and ongoing

EXC EPT ION AL SER VIC

VIC E UMMC will provid e compassiona te care and outsta and families, exceed nding service in ing expectation a culturally sensiti s. ve

manner to all patien ts

STR ATE ATE GIC STR GIC INN INN OVA OVATIO TIO N N UMMC

will develop innova tive programs residents of comm unities served while and services to improve the health status and fulfilling our acade quality mic mission to educate and advan of life for ce knowledge.

able to provide staffing, salaries and resources to ensure great patient care and customer service.

STE WA RDS HIP

& COM

MUN ITY ENG UMMC will achiev AGE MEN T e revenue growt h and manage investment in our operating expen strategic priorit ses to achieve ies, while meetin financial results g our mission to allowing provide services to all.

• Understanding the strategic plan will help ensure staff and resources are used wisely and with a view to the future.

OUR MISSI ON: WE HE AL • WE T EACH • W E DISCOVE R

• WE CARE

CREWS TRANSFORM 4 NORTH INTO A NEW NICU

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onstruction crews started May 1 on a yearlong project to transform the fourth floor of the North Hospital (4 North) into an expanded Neonatal Intensive Care Unit (NICU). The target completion date is May 1, 2015.

Staff and faculty in Women’s and Children’s Services have been advocating for a new NICU for years to better serve the families of newborns who need intensive care immediately after birth.

A new NICU and labor and delivery area are both part of the Women’s and Children’s Services Master Plan. The labor and delivery unit construction could start as early as next summer.

HERE’S WHAT HAD TO HAPPEN:

The new NICU will feature 52 private rooms that will include a family area so parents can stay with their newborn overnight. Full bathroom facilities for parents will be available on the unit.

The current NICU on 5 South has 40 bassinets, arranged in four large rooms that each have 10 infants. The unit is nearly always at capacity, meaning that sometimes a high-risk pregnancy patient must be directed to another hospital in the area with NICU space. The new unit will allow UMMC to serve more of these patients.

More than 11 departments have helped create space for the new NICU. Much like an intricate domino arrangement, a series of more than 11 moves had to occur – starting more than two years ago – to relocate several patient units and faculty offices so that 4 North could be free and clear for the new construction.

The Division of

The Finance move

Vascular Surgery

freed up space

moved out of 4

for the divisions

Anesthesiology faculty offices

The General

10 South space

Neurology faculty

The Finance

Cardiac Surgery

Outpatient

Orthopaedics

moved from 8

Surgery faculty

vacated by

offices moved out

Department

to move faculty

Rehabilitation

faculty offices

South into the

moved from

Clinical Practice

of 4 North and

moved from

offices from 3

offices then moved

The Vascular Lab

moved from

11 South space

4 South to the

and Professional

into the Paca-Pratt

Paca-Pratt to

South and 4 South

from 4 North

moved from

11 South to

vacated by

Greene Street

Development.

Building.

250 W. Pratt St.

to Paca-Pratt.

to 4 South.

4 North to 3 South.

Paca-Pratt.

Orthopaedics.

Building.

of Cardiology and

North and into the

Construction crews begin turning 4 North into a 38,000-square-foot NICU.

[

RIDING THE WAVE TO RAISE QUALITY AND LOWER COSTS

]

4

STAFF HONORED

FOR SERVICE MILESTONES Staff members who celebrated a milestone year in their service to UMMC/UMMS were honored this spring at two events. The employees who have given 5 or 10 years of service enjoyed a luncheon at the Baltimore Hilton on March 28. More than 360 employees were honored for their 5-year anniversary and more than 260 were recognized for 10 years.

A gala March 29 honored those with 15, 20, 25, 30, 35, 40 or 45 years of dedication to UMMC/UMMS. An impressive number – 12 employees – celebrated their 40th or 45th years of service during the gala.

“It is truly the privilege and pleasure of UMMC senior leadership to honor our staff who are celebrating significant service milestones. We’re grateful to the hundreds of annual service awards recipients for their commitment to UMMC, collaboration with their colleagues, and contributions to our patients and their families,” said Jeffrey A. Rivest, president and chief executive officer.

HUMAN RESOURCES REMINDERS

HRConnections is… the new online portal for staff to manage their benefits – during open enrollment and all year long – to update personal information, obtain information on accrued vacation, and view or print paystubs and W2 forms.

Get there via the bright red box on the Intranet home page, or from your home computer, smartphone or tablet via www.umms.org/ hrconnections Need to ask a live person for help?

The HRConnections Service Call Center professionals are available at 1-855-486-6747.

benefits OPEN ENROLLMENT

MAY 5–23 EVERYBODY MUST ENROLL to have benefits coverage after June 30

HRConnections

» From the intranet

or at www.umms.org/ hrconnections

» Questions?

HRConnections Service Call Center 1-855-486-6747

@

umms.org/ hrconnections

Support ices and ared Serv ources Sh es R an Hum ith UMMS ing you w Connect

net the intra s icon on n o ti c e n s Con ONLINE nnection t the HR org/hrco rk: selec w.umms. w From wo w to o me: g From ho 747) 55-486-6 CENTER :00 pm SERVICE MSHR (1-8 riday, 7:30 am - 5 M U -4 5 5 8 F 1– t: y c a d ta n Con n: Mo Operatio Hours of

» Enroll via

Your HR Leaders Paula Henderson, MBA, vice president for human resources, UMMC (University and Midtown Campuses) and UM Rehabilitation & Orthopaedic Institute

The University of Maryland Medical Center is an equal opportunity employer and proud supporter of an environment of diversity.

Amy Fulmer, director of employee and labor relations, UMMC

This publication is printed on recycled paper.