One of the top presentations at the 2012 National Center for Healthcare Leadership meeting in Chicago. Defines HFM's care system Core Beliefs, describes its organizational transformation to a Second Curve leader, and identifies key success factors in culture shaping and maximizing human capital

1. “ROADMAP TO RESULTS”
HOLY FAMILY MEMORIAL
Mark Herzog, FACHE Laura Fielding
President & CEO Administrative Director –
Organizational Development

2. Holy Family Memorial
Manitowoc, WI
City of Manitowoc
33,545 residents (level since 1990)
Manitowoc County
80,976 residents (level since 1990)
80 miles north of Milwaukee
35 miles southeast of Green Bay

3. Overview of Holy Family Memorial
single-market, tightly integrated healthcare delivery system including:
▪ Medical Center
▪ Faith based, full range of services
▪ Employed Physician Network
▪ Multi-specialty practice
▪ Regional Orthopaedic Program
▪ Wellness & Prevention
▪ Wellness Center, ACO
▪ Work Health Options/Bus. Connections
▪ Our people
▪ 1,220 Employees including 90 Providers
▪ 300+ Volunteers

4. First-Curve to Second-Curve Markets
How will hospitals successfully navigate the shift from first-curve to second-
curve economics?

5. Between the Curves
Second Curve
Population Health
First Curve FFS
Infrastructure
Culture
Collaboration
Payment Model

6. Core Beliefs Driving HFM’s Care
System Design
I. Provide the RIGHT CARE – the most effective
evidence based approach possible
II. In the RIGHT SETTING – the most cost effective,
safest, highest quality and greatest value
III. To achieve the RIGHT OUTCOME – achieve the
greatest long term benefit to the patient and
society while minimizing physical and financial risk
IV. Cultural and Organizational transformation
between the Curves must Maximize Human Capital
& Leadership
The results……..

7. HFM Inpatients, Outpatients, and
Charges: 2001 to TODAY
25% Decrease
Since 2001
5K
Inpatient
EOC $65M
Total Charges 18% Decrease $55M
4K
(less price increases)
Since 2001 8% Increase
Since 2001
$45M
3K
Outpatient
EOC 43% Decrease $35M
Since 2001
*EOC-Episodes of Care 2001 2003 2005 2007 2009 2011
10/11/12

8. 2001
2012 HFM Care System Design
HOSPITAL PHYSICIANS SENIOR MISSION RECOGNITION
& NP/PA LEADERS FOCUS
90 bed 90 10 Senior Focus on Nationally
hospital Employed Leaders Wellness recognized
Providers & for Safety,
Prevention Innovation
& Thought
Leadership
5 Senior Focus on
35 bed 35 Leaders the Sick
hospital Employed Population Locally
Physicians Recognized

9. Major Disease Mortality Rates in
Manitowoc County
HEART
200
DISEASE
CANCER
150
15.6% Decline in
100 Mortality Rates of
Major Diseases
STROKE
50
LUNG
0
2002 2004 2006 2008 2010

10. Population Health
▪ Robert Wood Johnson Foundation and the University of
Wisconsin Population Health Institute have documented
a 42% improvement from 2009 to 2011 in Manitowoc
County’s overall Clinical Care Rank in Wisconsin moving
from 31st to 18th out of the 72 counties.
▪ Led by HFM’s focus on the right care/setting/outcome
our community is moving the needle on population
health. Other factors include Health Behaviors, Social &
Economic and Physical Environment. The challenge in
these areas is much greater……..

11. This very moment on 21st &
Franklin……..

12. Reform Roadmap
Improvement Innovation Strategic Transformation
(Incremental/Process) (Service/Operations) (Fundamental Model Change)
OPEN
INNOVATION
SPUR
Strategic Program
Unit Review
LEAN
Six Sigma

13. Reform Roadmap’s Compass
N Hardwire ―the HFM way‖ (I & I)
into HFM culture
S Sharpen leadership processes to focus more on strategy and
achievement, broader engagement and integrate physician
leadership
E Raise the bar for success as a leader, provider and employee –
―We are what we tolerate…we become what we reward.‖
W Accelerate transformation by leveraging the Change Support Team

14. ▪ Redesigning Care –Be a
Strategies recognized role model for
redesigning the healthcare
delivery model to achieve
excellent quality, cost and
population health outcomes
Redesigning Care
around an ▪ Exceptional Experience – We will
create patient and customer
Exceptional experiences so exceptional that
Experience we drive market share to Holy
by way of Family Memorial
Ideal Culture ▪ Ideal Culture – We will have the
most innovative, engaged and
high achieving culture

16. Shaping HFM’s Culture
2009 Ideal
HFM Culture HFM Culture
Conventional Humanistic/Encouraging
Dependent Self Actualizing
Approval-Oriented Achievement
Source: Human Synergistics, Michigan

17. ▪ Leadership Institute
▪ Leadership Assessment /
Ranking
▪ Continuity & Development of
Self, Staff & Providers
▪ Administrative Fellowship
/Internship
Leadership ▪ Learning Partnerships
Development

18. Performance Accountability Review
“Rearview Mirror”
Source: NCHL

19. Leadership Team Assessment
“Headlights ”
50% Weighting
 COURAGE TO: internal fortitude to lead
 CULTURE SHAPING CONGRUITY: ability to fit in current
culture & transform to ideal culture
30% Weighting 20% Weighting
 ABLE TO: competent to lead  PROMOTABILITY:
 WILLING TO: desire to lead Advancement potential
Every leader
ranked 1-5
annually

20. Assessment vs. PAR
Sample of Individual Leadership Scores
High Middle Low
92 90 93
76 80
68
Ldrship Assessment Score PAR Score-
"Headlights" "Rearview Mirror"

21. SPUR - Making a
Difference
Reposition,
21%
Maintain,
Since 2009…
39%
66 of 91 SPURS
conducted
Grow/Improve,
40%
SPUR OUTCOMES
Grow/Improve Maintain Reposition
# of Projects 26 26 14
$$$ Impact $447,014 ($259,831) $2,137,852

22. The Green Dollar Difference
Improvement
Savings
2009 – 2011
$4.3M Total
Improvement
2009 – 2011
$6.9M
Innovation
Impact
2009 – 2011
$2.6M

23. The Culture Difference
% strongly % strongly %
EMPLOYEE PRIDE SURVEY
agree 2008 agree 2011 Change
I am proud to work for HFM
71.1% 87.2% 23%
I would recommend HFM’s care and service to
76.3% 86.7% 14%
friends & family
I feel a part of HFM and am excited about its
48.4% 73.1% 51%
future
HFM’s leadership team welcomes my ideas
and suggestions for process improvement 42.0% 64.6% 54%
▪ 70% survey participation rate
▪ All categories show significant growth!

24. The Culture Difference
% strongly % strongly %
PHYSICIAN PRIDE SURVEY
agree 2008 agree 2011 Change
I have confidence, trust in HFM’s leadership
40% 87% 118%
I am proud to be part of HFM
n/a 90%
I would recommend HFM to family & friends
n/a 81%
I feel a part of and am excited for HFM’s
future n/a 88%
▪ 47% survey participation rate

25. Recent Recognition
REGIONAL RECOGNITION
 2010 New North Excellence in the Workplace
 2009 Manitowoc Chamber Business of the Year
TOP 2% NATIONALLY
 Solucient 100 Top Performance Improvement Leaders
 Top 25 Most Wired—Small and Rural Hospitals
 Healthcare Information & Management Systems
Society Stage 6
 4x Recipient of HealthGrades Excellence in
Patient Safety

26. Success Barriers
SUCCESS FACTORS & BARRIERS Factors
Reform Roadmap – Aligns transformation process
 Ideal transitions between Curves is impossible given
& engages all stakeholders; Governance & Sponsor
the uncertain change timetable
“on board”
 Organizational planning & execution risk is increasingly
Leadership Development – Maximizing the human
 high at the same time detached critical thought is
capital of aspiring and established
most needed
administrative, clinical and physician leaders
 A highly competent first curve work force will not be
Culture shaping – creating an increasingly
 the “A” team in the second curve leadership paradigm
adaptable & achievement oriented organization
 Maintaining full engagement of the organization’s
 Human Capital to connect with the all levels – most
Engaged, empowered leaders at “why” behind our
(not all) can develop second curve competences
service will be challenging

27. Thank you!
QUESTIONS?