PIP presents a mixed bag of results; employees earn 2.14 percent payout
Throughout fiscal year 2013, which ended on September 30, employees prepared for accreditation surveys, implemented a new electronic medical record system, provided exceptional patient care to a record number of patients, and successfully completed the first year of the integration of two hospitals into one. While tackling these immense challenges, Yale-New Haven Hospital employees also managed to earn a 2.14 percent Performance Incentive Plan (PIP) payout — out of a possible maximum 3 percent of salary.
To be eligible for the PIP award, employees must have worked at least 1,000 hours between September 23, 2012 and September 21, 2013 and be active as of December 12, when PIP awards are paid to employees. PIP results were measured in four hospital-wide areas of performance: patient safety and quality, patient experience, Epic implementation and financial.
Patient safety and quality
The patient safety and quality category included three measures: Joint Commission extension survey;Department of Public Health licensure survey; and 30-day readmissions. Positive results from The Joint Commission extension accreditation survey during the second quarter determined that the PIP results for this measure were achieved.
The Connecticut Department of Public Health also surveyed YNHH for license renewal this past summer. This PIP measure was successfully met as the hospital's license was renewed with the effective date of October 1, 2013.
Thirty-day readmissions measured the percentage of patients who were readmitted to the hospital within 30 days of their discharge for the same, or a related, condition. At 17 percent, the year-end results missed the threshold goal of no more than 16.9 percent.
The patient experience category measured a patient's complete experience from pre-admission through discharge. It included seven measures related to patient satisfaction as reported in HCAHPS (Hospital Consumer Assessment of Health Providers and Systems) and Press Ganey surveys. HCAHPS surveys revealed:
- Overall rating of the hospital missed the threshold goal of 74, coming in at 71;
- Medication communications achieved threshold goal coming in at 62.5;
- Environment of care, which includes cleanliness and quiet, with a score of 58.3 fell short of the threshold goal of 60. Press Ganey surveys revealed:
- Inpatient Pediatrics exceeded its maximum goal at 89.1;
- Inpatient Behavioral Health also exceeded maximum at 82.2;
- Ambulatory Surgery came in at 92.2, narrowly missing the threshold goal of 92.5;
- Emergency Department results also fell short coming in at 84.1, very narrowly missing the threshold of 84.2.
The Epic implementation goal required the successful integration of the electronic medical record system on the York Street Campus in February and the Saint Raphael Campus in June. The results exceeded the maximum goal of 95 percent with two successful implementations and 97 percent of staff trained on each campus at least one week prior to go-live.
The PIP financial measure was the hospital's net operating margin. At yearend, the net operating margin was 4.5 percent, exceeding the maximum goal. "It was an extraordinary year at Yale-New Haven and as we move into 2014, I expect the challenges to keep coming," said Richard D'Aquila, YNHH president and COO. "But along with those challenges come opportunities to address those areas that need extra focus and attention, including managing our expenses, making patient safety and quality our very highest priority and providing an exceptional patient experience for every patient, every time."
Red - below threshold | yellow - met threshold | green - met target | blue - met maximum