Tenet Healthcare Corporation · NYSE:THC
Tenet Healthcare — Investor Day (2006)
23 slides from Tenet Healthcare's investor day presentation, Nov 11, 2006
Slide 1: Commitment to Quality
Commitment to Quality Jennifer Daley, MD FACP Senior Vice President Clinical Quality Chief Medical Officer 1
Slide 2: Tenet's Commitment to Quality
Tenet’s Commitment to Quality • Commitment to invest in improving clinical practice • Clinical leadership • Evidence-based medicine • Patient safety • Physician excellence • Nursing excellence • Patient flow and capacity management • Utilization review and management • Clinical resource management •
Slide 3: Investing in Improving Clinical Practice
Investing in Improving Clinical Practice • 2005 corporate level investment = $45 million annually in quality and safety programs (including related IT costs) • Implementation teams with quality and operational redesign expertise visit each hospital for 4-8 weeks on site • Followed by bi-monthly “che
Slide 4: Clinical Leadership
Clinical Leadership • Regional Chief Medical Officers • Regional Directors of Clinical Quality Improvement • Regional Transformation Teams (implementation teams) • Corporate level clinical subject matter experts as internal consultants in clinical service lines (e.g., cardiology, obstetrics, surgery
Slide 5: Evidence-Based Medicine Programs
Evidence-Based Medicine Programs • Heart attack (AMI) • Pneumonia (PN) • Congestive heart failure (CHF) • Surgical infection prophylaxis (SIP) • Coronary artery bypass graft and valve replacement (CABG and other open heart procedures) • Prevention of surgical complications (SCIP) • Bariatric surgery
Slide 6: Tenet Healthcare Performance Trend – CMS Overall
Tenet Healthcare Performance Trend – CMS Overall 100% % % % 89 89 87 % % 84 % 81 % % 80 % 78 78 80% 76 60% 40% 20% 0% Q1-04 Q2-04 Q3-04 Q4-04 Q1-05 Q2-05 Q3-05 Q4-05 Q1-06 For AMI, PN, and CHF 6
Slide 7: Quality: CMS Core Measures
Quality: CMS Core Measures National Average, Other Health Systems vs. Tenet 82.3% Current results vs. lagging 100% % % % 5% 4% 8. 9 8. 9 8. 5 . . . 4% . 3% 0% 7% % 8 8 8 87 87 85 85 . . 2. 8 1 % % 4 % 3% 84 83 8 1. 9. 9 5. . 8 7 7 75 80% 60% 40% 20% 0% es d As ser W A le o ) Un A t l n 6 rs sa ne OH
Slide 8: The Bottom Line
The Bottom Line In the first quarter of 2006, 136 more patients survived their hospitalization for a heart attack or congestive heart failure compared with the first quarter of 2005…. 8
Slide 9: Patient Safety
Patient Safety • Early members of the IHI 100K Lives Campaign • 2005 key initiatives: Pharmacy safety and prevention of adverse drug events • 2006 key initiatives: Reduction of hospital- acquired infections (HAI) and implementation of “rapid response teams” • 2007 key initiatives: Promoting a cultur
Slide 10: Informatics-enabled Infection Control Monitoring
Informatics-enabled Infection Control Monitoring Sample screen shots from the CCM and IC story boards due 9/12 will go here 10
Slide 11: Physician Excellence
Physician Excellence • Day-long educational session bi-annually for all Tenet hospital governing board members regarding their fiduciary responsibility for quality, safety, and physician credentialing (900 members) • Standardization of the business processes of physician credentialing and privilegin
Slide 12: Credentialing
Credentialing Echo and Echoapps screen shots 12
Slide 13: Credentialing
Credentialing Echo and Echoapps screen shots 13
Slide 14: Nursing Excellence
Nursing Excellence • Nursing Leadership Academy • Recruitment and retention • Nursing focus on evidence-based practice • Reduction of hospital-acquired infections • Evidence-based protocols in fall prevention • Evidence-based protocols in skin care • Nurse staffing to meet the needs of the mix and a
Slide 15: C2Q: Patient Flow and Capacity Management
C2Q: Patient Flow and Capacity Management • Delays and “blocks” in high flow areas of the hospital are not the result of lack of space or staff • Delays and “blocks” in high flow areas of the hospital are the result of a failure to “connect the dots” in tightly coupled systems and a failure of synch
Slide 16: Daily Tool Snapshot
Daily Tool Snapshot Red Text = Values underperforming target by more than 25% Yellow Text = Values within 25% of target Green Text = Values equal to or outperforming target Blue Text = Values greater than 199.99% of target 16
Slide 17: Tenet Hospital Commitment to Quality Improvements
Tenet Hospital # 34 Commitment to Quality Improvements ED ALOS D/C ED ALOS Admitted 174.0 Minutes Decrease Reduction Minutes of 14% of 30% 160.0 456.0 383.0 150.0 320.0 Baseline Q1’05 Q4’05 Baseline Q1’05 Q4’05 Left without being seen (%) ED Diversion Decrease Decrease Percent of registrations Hours
Slide 18: Utilization Management and Review
Utilization Management and Review • InterQual assessment for 100% of all adult medical/surgical, pediatric and behavioral health admissions for appropriateness of inpatient admission and continuing of stay • In invasive cardiology and cardiac surgery, use American Heart Association/American College
Slide 19: Clinical Resource Management
Clinical Resource Management • Pharmacy utilization and cost management • Blood product utilization • Evidence-based management of the utilization of high cost devices (ICDs, stents, hip and knee prostheses) • Aggressive management of case pack utilization in operating rooms and other high cost area
Slide 20: Service Excellence
Service Excellence • For patients and their families – In 2007, CMS will publish results of patient satisfaction surveys on a semi-annual basis • For our physician partners – Bi-annual physician satisfaction surveys – Operational excellence is a key factor in physician satisfaction • For our employe
Slide 21: Tenet Comparison to H-CAHPS National Test Database
Tenet Comparison to H-CAHPS National Test Database Tenet H-CAHPS Percent PSMS Categories System Test Results* Difference Willing to Recommend 72.3 70.9 2.0% Nursing Communication 78.2 75.0 4.3% Pain Control 74.6 70.0 6.6% Responsiveness of Staff 66.2 61.0 8.5% Physical Environment 66.1 61.0 8.3% Doc
Slide 22: The "Business Case" For Investing in Quality Improvement
The “Business Case” For Investing in Quality Improvement Increase volume Reduce costs • Enhance local reputation from • Lowering malpractice costs publicly reported metrics • Reduce costs of treating • Enhance consumer choice of complications (that are not high quality care facilities paid for under
Slide 23: Positive Forces At Work
Positive Forces At Work • Leadership • Resources • Standardized approach with “local customization” • Communication, communication, communication • Accountability • Public influence in dialogue about performance 23