PIP 2014 goals include some new, some familiar goals


The hospital rolls out the Performance Incentive Plan (PIP) for fiscal year 2014 with a combination of new measures and goals, as well as some that employees have tackled in the past.

Now in its 16th year, the basic structure of YNHH's PIP program remains the same — employees are asked to collectively meet tiered goals and will receive a financial incentive based on achieving them. How employees perform against expectations determines the size of the incentive shared by eligible employees at year-end. PIP performance is measured by the degree to which employees achieve goals — maximum exceeds expectations, target reaches goal, and threshold is acceptable, but falls short of target.

PiIP goals 2014

The hospital rolls out the Performance Incentive Plan (PIP) for fiscal year 2014 with a combination of new measures and goals, as well as some that employees have tackled in the past.

Now in its 16th year, the basic structure of YNHH's PIP program remains the same — employees are asked to collectively meet tiered goals and will receive a financial incentive based on achieving them. How employees perform against expectations determines the size of the incentive shared by eligible employees at year-end. PIP performance is measured by the degree to which employees achieve goals — maximum exceeds expectations, target reaches goal, and threshold is acceptable, but falls short of target.

In 2014, employees who meet hospital goals can potentially earn up to a 3 percent PIP payout at year-end. The 2014 PIP program began on Oct. 1, 2013 and runs through Sept. 30, 2014.

"When planning the PIP program each year, we work to adapt the PIP goals and measures to the priorities of the hospital," said Richard D'Aquila, president and COO. "This year's goals reflect our ongoing commitment to exemplary patient safety and quality, our continuing keen focus on the patient experience, the vital importance of employee input and our continued cost containment efforts."

This year, PIP results will be measured in four hospital- wide areas of performance: patient safety and quality, patient experience, employee engagement and financial performance. This is the first year that all four dimensions will be given equal weight — 25 percent — to reflect their importance to the hospital's continued success.

Patient safety and quality

The patient safety and quality category includes four measures:

  • Joint Commission accreditation
  • Hand hygiene
  • Blood stream infections
  • High Reliability Organization training

Surveyors from The Joint Commission, the regulatory agency that accredits healthcare organizations throughout the United States, will visit YNHH this fall for a tri-annual survey on all YNHH campuses. This PIP goal will be measured as achieved or not achieved rather than by threshold, target and maximum levels.

Making its return to the PIP program for 2014 is hand hygiene, an infection control measure monitored through recorded observations. The target goal for hand hygiene is 93 percent.

Blood stream infections (BSI) measures the number of BSIs caused by insertion and maintenance of catheters in patients on patient care units. The target goal is no more than 2.3 BSIs per 10,000 patient days.

A new measure to the PIP programs is High Reliability Organization (HRO) training. An HRO is an organization which has fewer than average accidents or harmful incidents. Currently a level II, YNHH is working to move to be distinguished as a level III by Healthcare Performance Improvement (HPI), a national company that helps healthcare organizations improve their safety cultures. HRO training for senior leadership begins this fall and concludes next year with all employees. The target goal is that 98 percent of YNHH employees are trained in fiscal year 2014.

Patient experience

The patient experience category measures all patients' experiences — from ambulatory to emergency to inpatient services through post-discharge followup. For 2014, it includes six measures related to patient satisfaction as reported in HCAHPS (Hospital Consumer Assessment of Health Providers and Systems) and Press Ganey surveys.

The overall rating of the hospital through HCAHPS surveys indicates a patient's likelihood to recommend YNHH to others, how they felt about their communications with doctors and nurses and staff responsiveness. The target score is 72.

Press Ganey surveys report how patients rated the level of care received:

  • Adult Inpatient — both campuses; the target score is 87.
  • Children's Hospital, including the Pediatric Emergency Department; the target score is 89.2.
  • Inpatient Behavioral Health — at Yale-New Haven Psychiatric Hospital;the target score is 83.2.
  • Ambulatory Surgery — at York Street, Saint Raphael Campus and Temple Outpatient Surgery; the target score is 92.6.
  • Emergency Department — at York Street, Saint Raphael Campus and Shoreline Medical Center; the target score is 84.1.

Employee engagement

This is the first year PIP includes an employee engagement measure, which is based on employee participation in the current engagement survey. This is also the first year that employees on the Saint Raphael Campus will participate in the survey. The target is that 90 percent of YNHH employees complete the online survey which runs through Sunday, Nov. 24.

Financial performance

The financial performance dimension consists of two components. For 2014, the hospital's net operating margin target goal is 1.75 percent, a drop from the projected margins in recent years due to the state budget cuts and the uncertainty of government reimbursements.

Introduced to PIP this year is the cost-per-equivalent-discharge measure. Related to Cost and Value Positioning initiatives designed to reduce costs while improving services and enhancing quality, the cost per equivalent discharge measures the average total cost of care of a patient. The target goal is $16,094.

"We are pleased to be able to continue to offer PIP to employees," added D'Aquila. "Since all employees have a vested interest in the success of our hospital, they should also reap the extra benefits of achieving hospital goals."

Year-end results from FY13 will be announced shortly.