Employee Turnover Rate Formula by fcg52446

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									    Developing an
Organizational Scorecard
     Mike Trachta, CEO
    Waverly Health Center
           Outline
• Balanced Scorecard Introduction
• Performance Indicator Reports
• WHC’s Strategic Plan
• WHC’s Organizational Scorecard
• Conclusion
    Definition of Balanced
          Scorecard
A new approach to strategic management was
  developed in the early 1990's by Drs. Robert
  Kaplan (Harvard Business School) and David
  Norton. The balanced scorecard is a
  management system (not only a measurement
  system) that enables organizations to clarify
  their vision and strategy and translate them into
  action. It provides feedback around both the
  internal business processes and external
  outcomes in order to continuously improve
  strategic performance and results. When fully
  deployed, the balanced scorecard transforms
  strategic planning from an academic exercise
  into the nerve center of an enterprise.
   Definition - continued
• The balanced scorecard suggests that
  we view the organization from four
  perspectives, and to develop metrics,
  collect data and analyze it relative to
  each of these perspectives:
• The Learning and Growth Perspective
• The Business Process Perspective
• The Customer Perspective
• The Financial Perspective
Balanced Scorecard
Performance Measurement
       & Indicators
Performance Indicator Reports
 • Created to provide an in-depth
   look at the financial, operational
   and satisfaction/quality
   performance of WHC
 • Multiple ratios selected, defined,
   and results displayed graphically
   over 5 year period
 • WHC performance compared to 2
   benchmarks
Benchmark Methodology
• External Benchmark
    – Iowa hospitals classified as Rural
         • Examples: Grinnell Regional Medical Center, Unity Healthcare in Muscatine, &
           Skiff Medical Center in Newton
• Local Competitors
    – Average of three nearest hospitals: Allen Health System, Covenant
      Medical Center, & Sartori Memorial Hospital
• Financial Indicators Report
    – Income Statement & Balance Sheet data used to manually calculate each
      ratio
• Operating Indicators Report
    – Ratio’s formulas, definitions, & values taken from IHA report generated
      using income statement & utilization information
• Satisfaction and Quality IndicatorsReport
    – Measurements of Patient Satisfaction, Employee Satisfaction and Quality
      Indicators are compared to Press Ganey, Institute for Quality Healthcare,
      Iowa Hospital Association databanks and others.
Financial Performance
   Indicator Report
       Key Ratios
Profitability Ratio – Operating
             Margin
• Formula
  – Operating Margin = Operating Income /
    Operating Revenue
• Directly affected by markup ratios,
  contractual allowances, & cost
  control
• A higher ratio and increasing trend
  is preferred
Profitability Ratio – Operating
             Margin
                              Operating Margin

  12%
                                                       11.4%

  10%
                                                     9.0%
                                     8.6%
  8%                                                                   7.6%

                                                                     7.5%

  6%                                        5.9%


         4.0%
  4%              3.5%
                                            3.7%   3.6%
           2.8%
                   2.8%
  2%    2.4%
                                                                           1.5%
                      1.6%

  0%
        FY'00      FY '01              FY '02      FY '03           FY '04


            WHC             External Benchmark         Local Competitors
Liquidity Ratio – Days Cash,
           Current
• Formula
  – Days Cash = (Cash + Limited-use Assets) /
    [(Expenses – Depreciation)/365]
• Provides an estimate of the number
  of days expenses WHC has in cash
  & short-term investments
• Higher ratios imply a greater ability
  to meet liabilities
Liquidity Ratio – Days Cash,
           Current
                    Days Cash on Hand - Current

       70


       60                                                          57.5
                                                   59.4

                                                                    54.5
       50


       40    36.3
Days




       30
                     24.9
                                         23.6
                                                  20.4
       20            22.2                21.4
                                                                   20.6

       10                                         12.3


        0
            FY'00   FY '01              FY '02   FY '03           FY '04



             WHC            External Benchmark       Local Competitors
Capital Structure – Long-term
   Debt to Capitalization
• Formula
  – LT Debt to Capitalization = LT Debt /
    (LT Debt + Fund Balance)
• Indicates what level of assets is
  funded with long term debt
• A stable, lower ratio is preferred
Capital Structure – Long-term
   Debt to Capitalization
                          LT Debt to Capitalization

 0.6

                                                                               0.54
 0.5



 0.4



 0.3

        0.22           0.22
 0.2                                       0.19                            0.19
                                                       0.17

                                                        0.15                   0.14
 0.1



 0.0
       FY'00         FY '01              FY '02       FY '03             FY '04


               WHC            External Benchmark           Local Competitors
Capital Structure – Debt Service
       Coverage (DSC)
 • Formula
   – DSC = (Net Income + interest expense +
     Depreciation) / (Interest Expense + Debt
     Principle)
 • Measures ability to meet debt
   service payments from cash flow
 • A higher ratio is favorable and an
   increasing trend is desirable
Capital Structure – Debt Service
       Coverage (DSC)
                    Debt Service Coverage (DSC) Ratio

  6
                                                                 5.7
          5.5

  5                                                4.9


                                                           4.1
  4
                          3.9

                           3.4
                                             3.0                                   3.2
  3

                                                                                2.3

  2

                                                          1.3                   1.3

  1



  0
      FY'00           FY '01               FY '02        FY '03                FY '04


              WHC                External Benchmark                Local Competitors
Asset Management – Average
        Age of Plant
 • Formula
   – Ave Age of Plant = Accumulated
     Depreciation / Depreciation Expense
 • Provides a rough estimate of the
   age of WHC’s fixed assets
 • Lower values indicate new facilities
   and equipment
Asset Management – Average
        Age of Plant
                            Average Age of Plant

         15



         13                                          12.8             13.4




         11
                                                    10.0              10.1
 Years




                                           10.0
                      9.4

         9

                        7.5
                                                     7.1
         7     7.4                         7.5                        7.4




         5
              FY'00   FY '01             FY '02    FY '03            FY '04

               WHC          External Benchmark        Local Competitors
Revenue Cycle – Days in AR
 • Formula
   – Days in AR = Net Patient AR / [Net
     Patient Revenue/365]
 • Measures liquidity, as well as how
   efficient WHC is throughout the
   revenue cycle
 • A lower value and decreasing
   trend is desirable
Revenue Cycle – Days in AR
                    Days in Patient Accounts Receivables

 110

                          101.1
 100


  90
             83.4
  80                                                                          76.5

                           71.3                        70.6
  70
                        70.0                    66.6      66.4
             68.0
                                                                             61.7
                                           59.7
  60                                                     62.0
                                                                             59.6
                                            56.0
  50


  40
        FY'00            FY '01            FY '02      FY '03                FY '04

       WHC                 External Benchmark            Local Competitors
Operating Performance
  Indicators Report
       Key Ratios
Outpatient Revenue Percentage
  • Formula
    – Outpatient Rev % = Total Outpatient
      Charges / Total Charges
  • Revenue indicator that tells what
    percentage of WHC business is
    generated in outpatient care
Outpatient Revenue Percentage
                  Outpatient Revenue Percentage

  75%
                                                               72.2%
         70.1%                      70.3%     70.9%
  70%


  65%                64.4%

                                      60.8%
  60%    59.3%                                               58.2%
                       60.3%
                                              56.8%

  55%
                                   52.1%      52.2%           53.5%
        49.8%
  50%               48.5%


  45%


  40%
        FY ' 00      FY '01         FY ' 02   FY ' 03         FY ' 04

         WHC            External Benchmark       Local Competitors
  Contractual Allowance
       Percentage
• Formula
  – Contractual Allowance % = Total
    Contractual Allowances / Total Charges
• Revenue indicator that provides an
  estimate of the average discount
  level third-party payors receive
• Lower ratios are preferred
      Contractual Allowance
           Percentage
                    Contractual Allowance Percentage

55%


50%                                                                49.4%

                                                 45.2%
45%
                                     42.0%

40%
                        36.6%
      37.7%                                                         37.6%
35%                                               34.6%
                                       31.9%

30%
                        27.8%
       26.5%
                         27.3%         27.6%
25%
          23.6%                                  24.3%
                                                                        21.0%
20%


15%
       FY ' 00          FY '01         FY ' 02     FY ' 03        FY ' 04

              WHC          External Benchmark       Local Competitors
Bremer County Market Share
                          Inpatient Market Share - Bremer County

   50%
          39.8%               4 1. 8 %            40.7%
                                                                       38.2%                   42.7%
   40%
   30%                        22.0%              22.9%                 2 1. 8 %
         2 1. 4 %                                                                       19 . 6 %
   20%                                                                 2 1. 3 %
              2 0 . 1%          16 . 0 %         17 . 6 %                                   19 . 4 %
   10%
             1. 6 %              1. 6 %            1. 3 %               2 . 1%
                                                                                               2.3%
    0%
         2000                  2001               2002                  2003             2004

         WHC                             Allen              Covenant                  Sartori



                         Outpatient Market Share - Bremer County

   50%
                                                                                        38.4%
   40%                                                                 35.9%


   30%                                                                     26.8%
                                                                                                   25.9%
   20%                                                                     12 . 2 %
                                                                                                   11. 6 %
   10%                                                                     4.0%
                                                                                                   4.5%
   0%
         2000                  2001               2002                  2003             2004

          WHC                            Allen              Covenant                  Sartori
Butler County Market Share
                          Inpatient Market Share - Butler County

   40%
                                                 33.3%                 33.3%                          35.8%
          36.9%               37.2%
   30%
                                19 . 0 %           18 . 3 %                   19 . 9 %
   20%      16 . 4 %                                                                                  17 . 7 %
                                      13 . 6 %       16 . 0 %                 16 . 0 %
              14 . 2 %                                                                           14 . 8 %
   10%                                7.3%
                  5.5%                                   6.2%                       6.9%              6.5%

    0%
           2000                2001                2002                    2003               2004

             WHC                       Allen                    Covenant                   Sartori




                         Outpatient Market Share - Butler County

   30%
                                                                            27. 1%                    27. 3%
   2 5%
                                                                                                      23. 1%
                                                                             21. 4%
   20%
                                                                           14. 0%            13. 4%
   15%

   10 %                                                                                       11. 7%
                                                                            10. 6%

    5%

    0%
          2000                2001                2002                     2003               2004


              WHC                      Allen                    Covenant                   Sartori
 Average Length of Stay
• Formula
  – Ave LOS = Total Patient Days / Total
    Discharges
• Utilization measure that estimates
  the average length of stay a
  patient remains at WHC
• Decreasing trend or lower LOS is
  generally preferred
Average Length of Stay
                   Average Length of Stay - Overall

 8
                                                  7.7
 7
                                                                   5.9
 6
 5   4.6             4.3               4.5         4.7             4.6
 4
                      3.1                           3.1            3.3
                                         3.0
 3    3.5
 2
 FY ' 00            FY '01             FY ' 02    FY ' 03              FY ' 04

            WHC              External Benchmark    Local Competitors




                  Average Length of Stay - Acute Care

 5

                     4.3                 4.2
 4
     3.7                                                           3.6
                      3.5              3.5          3.5
     3.6
                                                  3.3                    3.4
 3
     3.1               2.6
                                                   2.7                 2.8
                                         2.5
 2
 FY ' 00            FY '01             FY ' 02    FY ' 03              FY ' 04

            WHC              External Benchmark    Local Competitors
Inpatient & Ambulatory Surgery
             Trends
Births & Outpatient Visits Trends
                                         Births

     1,000
                 782                                                     840
       800
                            748                720        759
       600
       400
       200                                                186            180
                86           88                114                             100
       -                                                     107
               FY ' 00      FY '01           FY ' 02    FY ' 03         FY ' 04

                 WHC           External Benchmark           Local Competitors




                                  Outpatient Visits

     400,000
     300,000      296,085
                            217,677           224,478   222,376          224,695
     200,000
                            110,224           121,684       131,656       134,044
     100,000    95,778
                                                          76,179         77,050
         -
                FY ' 00      FY '01           FY ' 02    FY ' 03        FY ' 04

                 WHC              External Benchmark         Local Competitors
Operating Expense per Adjusted
     Patient Day - Overall
  • Formula
    – Op Exp per Day = (Total Operating
      Expense x IP %) / Total Patient Days
  • Cost indicator that estimates the
    level of resources used to treat a
    patient during an inpatient day
  • A decreasing trend or lower rate is
    preferred
Operating Expense per Adjusted
     Patient Day - Overall
             Operating Expense per Adjusted Patient Day

  $1,400
                                                   $1,348             $1,325
  $1,300                             $1,249
                                                                        $1,196
  $1,200
                     $1,155

                                        $1,086       $1,088
  $1,100                 $1,115
           $1,028
  $1,000
           $989
   $900

   $800
                                                                         $789
   $700

   $600
                                                       $588
   $500
           FY ' 00       FY '01          FY ' 02    FY ' 03           FY ' 04

              WHC             External Benchmark            Local Competitors
FTEs per Adjusted Occupied Bed
  • Formula
    – FTEs per Bed = (FTE x IP%) / Ave Daily
      Census
  • Cost indicator that estimates the
    number of employees assignable to
    inpatient beds
FTE per Adjusted Occupied Bed
                    FTEs per Adjusted Occupied Bed

  5.5
                                                                                5.2
  5.0
                                           4.8            5.0
        4.6            4.9

  4.5                                      4.6
                      4.0                             4.3                 4.3
  4.0
        3.6
  3.5

                                                                              3.0
  3.0

                                                    2.6
  2.5


  2.0
        FY ' 00       FY '01              FY ' 02    FY ' 03              FY ' 04


              WHC            External Benchmark           Local Competitors
   Satisfaction and Quality
Performance Indicators Report
          Key Ratios
 Outpatient Satisfaction
• Outpatient Satisfaction Score
  – This is the overall score for WHC during the quarter out of
    a possible 100. It is the result of a Press Ganey Survey that
    is sent to select outpatients during the period. The overall
    score displayed takes the following categories into
    consideration: registration, facility, test or treatment,
    personal issues, and overall assessment. An increasing
    trend and higher score is preferred.

  – Outpatient Percentile Rank: This is an indication of how
    WHC's satisfaction score compares to other institutions
    included in the groups or databases.
Outpatient Satisfaction
                         Outpatient Overall Satisfaction Score

 100

  95

  90       91                                90                90

  85

  80
       Aug-04           Nov-04           Feb-05          May-05      Aug-05          Nov-05

                                           Quarter End Date


                              Outpatient - Percentile Ranking

100%
80%
        62%
60%                                                        48%
            61%                           42%                43%
         58%
40%                                37%
                                                               41%
20%                                        35%

 0%
       Aug-04           Nov-04           Feb-05          May-05      Aug-05         Nov-05
                                            Quarter End Date

                  All Facilities            51K - 150K Procedures         Iowa Hospitals
   Inpatient Satisfaction
• Inpatient Satisfaction Score
  – This is the overall score for WHC during the quarter out of
    a possible 100. It is the result of a Press Ganey Survey that
    is sent to select inpatients on a monthly basis. The overall
    score displayed takes the following things into
    consideration: admitting, rooms, meals, nurses, tests &
    treatment, family & friends, physicians, discharge, and
    personal issues. An increasing trend and a higher score is
    preferred.

  – Inpatient Percentile Rank: This is an indication of how
    WHC's satisfaction score compares to other institutions
    included in the groups or databases.
                      Inpatient Satisfaction
                                                  Inpatient Satisfaction Score

             100

                      95
Score




                      90
                                             86                                          88
                                                                 88
                      85          85

                      80
                           Aug-04            Nov-04            Feb-05            May-05            Aug-05    Nov-05

                                                                        Quarter End Date



                                        Inpatient Satisfaction Score - Percentile Rank

                      100%
                                                                        91%               94%
    Percentile Rank




                       80%                                                                84%
                                                      77%               75%
                       60%             60%            59%
                       40%             39%
                       20%
                           0%
                                Aug-04         Nov-04           Feb-05            May-05            Aug-05   Nov-05
                                                                      Quarter End Date


                                              Small Facility                             All Press-Ganey
Emergency Department Patient
        Satisfaction
 • Emergency Department Satisfaction Score
   – This is the overall score for WHC during the quarter out of
     a possible 100. It is the result of a Press Ganey Survey that
     is sent to every emergency department patient that was not
     admitted during the period. The overall score displayed
     takes the following categories into consideration: arrival,
     nurses, doctors, tests, family & friends, personal &
     insurance information, personal issues, and overall
     assessment. An increasing trend and higher score is
     preferred.

   – Emergency Department Percentile Rank: This is an
     indication of how WHC's satisfaction score compares to
     other institutions included in the groups or databases.
              ED Patient Satisfaction
                                   Emergency Department Satisfaction Score

100

95

90                                                   91
                     89           89                                     90

85

80
              Aug-04             Nov-04          Feb-05             May-05          Aug-05     Nov-05

                                                          Quarter End Date



                                       Emergency Department - Percentile Rank

              100%
                      86%                86%         89%                      94%
              80%                                   69%                       77%
                       60%
 Percentile




                                        57%
              60%                                                             60%
                                                          56%
              40%         44%             53%

              20%

               0%
                     Aug-04             Nov-04      Feb-05             May-05         Aug-05    Nov-05
                                                          Quarter End Date

                                All Facilities              Small ED                Iowa ED
Ambulatory Surgery Patient
      Satisfaction
• Ambulatory Surgery Satisfaction Score
  – This is the overall score for WHC during the quarter out of
    a possible 100. It is the result of a Press Ganey Survey that
    is sent to select ambulatory surgery patients during the
    period. The overall score displayed takes the following
    categories into consideration: registration, facility, nursing,
    physician, personal issues, and overall assessment. An
    increasing trend and higher score is preferred.

  – Ambulatory Surgery Percentile Rank: This is an indication
    of how WHC's satisfaction score compares to other
    institutions included in the groups or databases.
Ambulatory Surgery Satisfaction
                                    Ambulatory Surgery Satisfaction Score

                100

                95
   Score




                                                     91
                90                       89                                    90
                        89
                85

                80
                      Aug-04          Nov-04         Feb-05             May-05       Aug-05              Nov-05

                                                          Quarter End Date


                                Ambulatory Surgery Satisfaction Score - Percentile Rank

                100%
                 80%
   Percentile




                 60%
                                                     45%
                 40%                                        40%
                         22%
                                                            38%                22%
                 20%                    12%
                     19%                       10%                             12%
                  0% 9%                   8%
                       Aug-04           Nov-04        Feb-05             May-05      Aug-05              Nov-05
                                                            Quarter End Date

                                   All Facilities             < 3,000 Procedures              All Iowa
  Employee Satisfaction
• Employee Satisfaction Score
  – Employee satisfaction is measured using an Press
    Ganey Associates Employee Perspective Survey.
    The results graphically displayed on the
    following page are from a survey conducted in
    June, 2004.
  – Employee satisfaction is measured in two ways.
    First, there is a Satisfaction Score, which is out of
    a possible 100. The second metric is percentile
    rank, which is how WHC employee satisfaction
    compares to other satisfaction levels included in
    the group or database.
Employee Satisfaction
                                     Employee Satisfaction Survey - Part I

              100                                                                                                                                    100%
               90                                                                                                                         82         90%
                                                            76
               80                                                                                                                                    80%
                                                                                                                                             69%
               70             63                                                                                                                     70%




                                                                                                                                                                 Percentile
                                              56                           53                              53               54
               60                                                                                                                                    60%
Score

                                                             51%                           50
               50                                                                                                                                    50%
               40                                                                           45%                                                      40%
               30             25%                                                                                                                    30%
                                                                                                           15%
               20                                                                                                                                    20%
                                              4%
               10                                                          16%                                              2%                       10%
                -                                                                                                                                    0%




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                                                                                                               Scores                              Percentile
                                         M




                                     Employee Satisfaction Survey - Part II

        100                                                                                                                                         100%
         90                                                                                                                                         90%
                                                                                                                    79%
         80                                                                                      73                                     77%         80%
         70                               68                 67                                                                         73          70%
                                                                                                                     65




                                                                                                                                                           Percentile
                                                                               62
         60                                                                                                                                         60%
Score




         50             46                                                                       56%                                                50%
                                                            49%                51%
         40                                                                                                                                         40%
                                          41%
         30                                                                                                                                         30%
         20             14%                                                                                                                         20%
         10                                                                                                                                         10%
          -                                                                                                                                         0%
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                                                                                                                             Score                  Percentile
                                                                  T
     Employee Turnover
• Formula
  – Employee Turnover = Number of Separations /
    Total Employees
• Definition
  – This is the ratio of the number of employee
    separations to the total sum of employees. It is
    an indicator of employee satisfaction, where a
    lower employee turnover rate indicates higher
    employee satisfaction because there were fewer
    voluntary separations.
      Employee Turnover
                         Employee Turnover Rate

6%


                             5.0%                 4.8%
5%
                                                                            4.5%
            3.9%      4.0%
4%                                                          4.1%
     3.5%                                                                           3.5%
                      3.8%          3.1%                        3.2%
                                                  3.5%   3.7%
3%                                                                           3.2%
     3.2%                    3.0%          2.7%                    3.1%
               2.3%                                                               2.5%
2%


1%


0%
     Q1 -   Q2 -      Q3 -   Q4 -    Q1 -         Q2 -   Q3 -      Q4 -    Q1 -     Q2 -
     2003   2003      2003   2003    2004         2004   2004      2004    2005     2005

                      WHC Turnover Rate                  Comparison Rate
  Medication Error Rate
• Formula
  – Medication Errors Rate = (Total Number
    of Medication Errors / Total number of
    Doses administered) * 10,000
• Definition
  – This is the rate of total medication errors
    that occurred per 10,000 doses
    administered. It is a quality indicator and
    a lower rate or decreasing trend is
    preferred.
                                 Medication Error Rate
                                                               Medication Errors Rate

                                14



                                12
                                                                                                11.6
Error Rate (per 10,000 doses)




                                                                    10.6
                                        10.1                                                                             10.1
                                10
                                      9.7            9.2          10.1         9.5
                                        9.5                                                  9.4
                                                      9.0                       8.2
                                8
                                                                                 7.9                                      7.8
                                                                                                              6.8
                                                                      6.9
                                6
                                                      4.7
                                                                                                          4.2
                                4
                                                                                                        3.5               3.9

                                2
                                     3rd Q 2003   4th Q 2003    1st Q 2004   2nd Q 2004   3rd Q 2004   4th Q 2004     1st Q 2005

                                                      WHC                    CAH Combined                 All Units
       Patient Fall Rate
• Formula
  – Patient Fall Rate = (Total number of falls /
    Total Patient Days) * 1,000
• Definition
  – This is the ratio of number of patient falls
    per 1,000 patient days. It is a quality
    indicator and a lower rate or decreasing
    trend is desirable.
                                         Patient Fall Rate
                                                            Patient Fall Rate

                           6
                                                                                         5.5

                           5
                                   4.6
                                                4.4
                                                             4.3
                                                                                                      4.1
Fall Rate per 1,000 Days




                                   4.3                                                                               3.9
                           4
                                               4.0          4.1
                                     3.5
                                                                          3.6                        3.5             3.5
                                                                                        3.4
                           3

                                                             2.0
                           2

                                                                             1.3                     1.3
                                                                                                                      1.0
                           1

                                               0.0                                      0.0
                           0
                               3rd Q 2003   4th Q 2003   1st Q 2004    2nd Q 2004    3rd Q 2004   4th Q 2004      1st Q 2005

                                             WHC                      CAH Combined                    All Units
Hospital Acquired Infections -
         Pneumonia
• Formula
  – HAI Pneumonia Rate = Number of HAI
    Pneumonia Occurrences / Total Patient
    Days in Period
• Definition
  – This is the ratio of total healthcare acquired pneumonia
    cases in a period to the total number of patient days in the
    period. It provides an indication of the quality of care
    patient's receive and a decreasing trend or lower rate is
    desirable.
               HAI - Pneumonia
                                         HAI - Pneumonia

0.0009

                              0.0008
0.0008

0.0007
                                                                                                       0.0007

0.0006

0.0005

0.0004

0.0003         0.0003                                                                   0.0003
                                             0.0003                      0.0003
0.0002
                                                       0.0002
0.0001

    0           0.00           0.00           0.00          0.00          0.00           0.00           0.00
         3rd Q 2003     4th Q 2003     1st Q 2004     2nd Q 2004   3rd Q 2004     4th Q 2004     1st Q 2005

                                           WHC                           All Units
Strategic Plan Background
• Select group put together to examine
  WHC mission statement and strategic
  plan
• Internal and External Environment
  examined
• Four broad focus areas identified
  –   Pursuing Excellence
  –   Improving Efficiencies
  –   Fostering Growth
  –   Increasing Community Involvement
   Pursuing Excellence
• Goals:
  – Develop a workforce of employees
    committed to pursuing excellence
  – Increase Patient Satisfaction
  – Improve employee communication
    processes
  Improving Efficiencies
• Goals
  – Improve medical technology available
  – Increase educational opportunities
    available to patients and staff
  – Maintain supplies inventory in the most
    efficient manner possible
  – Monitor and utilize patient feedback to
    improve efficiencies and delivery of care
      Fostering Growth
• Goals
  – Ensure physical facilities are constructed
    to meet current and future patient/staff
    needs
  – Foster partner relationships to benefit
    WHC
  – Increase marketing efforts to community
    members
   Increasing Community
        Involvement
• Goals
  – Increase hospital and community
    involvement by staff
  – Centralize community health education
  – Improve public relations/marketing effort
    as related to community involvement and
    education
Balanced Scorecard
 As of July 25, 2005
   Balanced Scorecard
• Actual
  – Most recent quarterly data for WHC
• Target
  – External benchmark or internal goal
• Status
  – Favorable  more than 3% difference from
    target in a positive direction
  – Meets target  within plus or minus 3% of target
  – Unfavorable  more than 3% difference from
    target in a negative direction
Pursuing Excellence - Quality
 • Medication Errors Rate
   – Actual = 10.1
   – Target = 7.77
 • Patient Fall Rate
   – Actual = .97
   – Target = 3.49
 • HAI – Pneumonia
   – Actual = 0
   – Target = 0
     Pursuing Excellence –
      Patient Satisfaction
• Inpatient Satisfaction
   – Actual = 88.0
   – Target = 88.0
• Outpatient Satisfaction
   – Actual = 90.1
   – Target = 88.0
• Ambulatory Satisfaction
   – Actual = 89.6
   – Target = 88.0
• Emergency Department Satisfaction
   – Actual = 89.1
   – Target = 88.0
   Pursuing Excellence –
   Committed Workforce
• Employee Satisfaction
  – Actual = 25th percentile
  – Target = 50th percentile
• Employee Turnover
  – Actual = 2.5%
  – Target = 3.5%
   Pursuing Excellence –
   Committed Workforce
• Salary per FTE
  – Actual = $40,027
  – Target = $40,910
• Benefits per FTE
  – Actual = $10,806
  – Target = $10,077
• FTEs per Occupied Bed
  – Actual = 5.28
  – Target = 3.02
   Improving Efficiencies -
        Operational
• Acute Care Length of Stay
  – Actual = 3.1
  – Target = 3.3
• Operating Expenses per Patient Day
  – Actual = $1,487
  – Target = $822
• Supply Expense Ratio
  – Actual = 16.5%
  – Target = 16.5%
   Improving Efficiencies –
         Financial
• Operating Margin
  – Actual = 8.5%
  – Target = 3.2%
• Days Cash – Current
  – Actual = 39.7
  – Target = 49.0
• Debt Service Coverage
  – Actual = 3.2
  – Target = 5.1
• Days in AR
  – Actual = 82.3
  – Target = 60.0
      Fostering Growth
• Inpatient Market Share
  – Actual = 17.4%
  – Target = 20.9%
• Outpatient Market Share
  – Actual = 34.0%
  – Target = 32.4%
• Births
  – Actual = 137
  – Target = 100
      Fostering Growth
• Ambulatory Surgeries
  – Actual = 1,929
  – Target = 1,828
• Average Age of Plant
  – Actual = 4.0
  – Target = 10.1
                                              Balanced Scorecard
                                              As of July 25, 2005

                                              Mission Statement:
            Waverly Health Center strives to provide the highest quality, patient-focused health care.

                                                             Actual                 Target               Status
            Pursuing Excellences
                   Quality

Medication Errors Rate                                          10.10                    7.77
Patient Fall Rate                                                0.97                    3.49
HAI - Pneumonia                                                   -                       -
             Patient Satisfaction

Inpatient Satisfaction Score                                     88.0                    88.0
Outpatient Satisfaction Score                                    90.1                    88.0
Ambulatory Satisfaction Score                                    89.6                    88.0
Emergency Department Satisfaction Scores                         89.1                    88.0
           Committed Workforce

Employee Satisfaction                                         25%                    50%
Employee Turnover                                              3%                     4%
Salary per FTE                                           $      40,027          $      40,910
Benefits per FTE                                         $      10,806          $      10,077
FTEs per Occupied Bed                                         5.28                   3.02
Status:
Favorable =                          Meets Target =                      Unfavorable =
                                                        Actual               Target      Status
           Improving Efficiencies
                Operational

Acute Care Length of Stay                                     3.1                  3.3
Operating Expenses per Patient Day                    $    1,487           $      822
Supply Expense Ratio                                    16.5%                16.5%

                  Financial

Operating Margin                                         8.5%                 3.2%
Days Cash - Current                                          39.7                 49.0
Debt Service Coverage                                         2.0                  5.1
Days in AR                                                   82.3                 60.0
              Fostering Growth

Inpatient Market Share                                  17.4%                20.9%
Outpatient Market Share                                 34.0%                32.4%
Births                                                       137                  100
Ambulatory Surgeries                                       1,929                1,828
Average Age of Plant                                          4.0                10.1


Status:
Favorable =                          Meets Target =                 Unfavorable =
             Limitations
• Use of historical data
  – Reflects past decisions, not predictive of future
    results
• Variations in service mix among
  benchmark hospitals
• No consensus on good performance
  – Outperforming benchmarks good enough?
• Potential data quality concerns
  – Hospitals reporting accurate information to
    I.H.A.?
Questions???
              Sources:
• Arveson, Paul. “What is the Balanced
  Scorecard?”
  www.balancedscorecard.org/basics. 1998
• Flex Monitoring Team Briefing Paper. Financial
  Indicators for Critical Access Hospitals. May,
  2005.
• Iowa Hospital Association. “Databank Program
  Manual.” October 2004.
• Gapenski, Louis. Understanding Healthcare
  Financial Management. 2003.

								
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