PIP first quarter results indicate a positive start to the year

Performance Incentive Plan (PIP) results for the first quarter of fiscal year 2014, which ended Dec. 31, 2013, indicate a strong start for the year in several areas.

If PIP were paid today, eligible employees would receive a payout of up to 2.4 percent of their salary. If all goals are achieved at maximum, the potential PIP maximum payout is 3 percent of salary. This year, PIP results are measured in four hospital-wide areas of performance: patient safety and quality, patient experience, employee engagement and financial performance.

Patient safety and quality — This category includes four measures: Joint Commission accreditation survey, hand hygiene, bloodstream infections and high reliability organization training.

Surveyors from The Joint Commission, the regulatory agency that accredits U.S. healthcare organizations, re-accredited YNHH after a January survey. Results for the hand hygiene infection control measure, which returned to the PIP program for 2014, met the target goal, coming in at 94 percent. Bloodstream infections (BSI) measures the number of infections caused by insertion and maintenance of catheters in patients on floors and intensive care units. BSI results exceeded the maximum goal of 2.0 BSIs per 10,000 patient days by coming in at 1.7 BSIs.

A new measure to the PIP program is High Reliability Organization (HRO) training. An HRO is an organization which has fewer than normal accidents or harmful incidents. The target goal is for 98 percent of YNHH employees to be trained in fiscal year 2014. Results will be determined at the end of the fiscal year.

Patient experience — This category measures patients' experiences from ambulatory to emergency to inpatient services through post-discharge follow-up. For 2014, it includes six measures related to patient satisfaction as reported in patient surveys.

The overall rating of the hospital through HCAHPS (Hospital Consumer Assessment of Health Providers and Systems) surveys indicates a patient's likelihood to recommend YNHH to others, how they felt about their communications with doctors and nurses and staff responsiveness. Results for the overall rating of the hospital almost reached the target score of 72, coming in at 71. Press Ganey surveys report how patients rated the level of care received:

  • Adult Inpatient — at the York Street or Saint Raphael campuses. Results met the threshold of 86.6.
  • Children's Hospital — including the Pediatric Emergency Department. Results narrowly missed the threshold goal of 88.3, coming in at 88.1.
  • Inpatient Behavioral Health — at Yale-New Haven Psychiatric Hospital. At 83.6, results exceeded the target goal.
  • Ambulatory Surgery — at the YSC, SRC or Temple Outpatient Surgery. Results were 92.4, exceeding the threshold goal.
  • Emergency Department — at the YSC, SRC or Shoreline Medical Center. Results exceeded the maximum goal and came in at 86.9.

Employee engagement — For the first time, PIP includes a measure based on participation in the employee engagement survey. This was also the first year Saint Raphael Campus employees participated in the survey. Ninety-three percent of YNHH employees completed the electronic survey, exceeding the target goal of 90 percent.

Financial performance — This consists of two components. For the first quarter, the hospital's net operating margin was 3.04 percent, exceeding the maximum goal. Also included in 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 result was $15,640, exceeding the maximum goal.

"PIP results from the first quarter are very encouraging and reflect the hard work and strategic planning of employees," said Richard D'Aquila, president and chief operating officer. "Our challenge is to keep up the momentum as we continue to work at reaching and exceeding goals and providing exceptional care to our patients."

PIP third quarter goals and results

Category Measure Threshold Target Max Actual
Patient safety and quality (25%) Joint Commission accreditation Accreditation   Received Yes
Hand hygiene 91% 93% 96% 94%
Bloodstream infections 2.7 2.3 2.0 1.7
High reliability organization training 95%* 98%* 99%* TBD
Patient experience (25%) Overall rating (HCAHPS) 71 72 76 71
Adult Inpatient 86.6 87.6 87.8 86.6
Children's Hospital 88.3 89.2 89.7 88.1
Inpatient Behavioral Health 82.3 83.2 83.8 83.6
Ambulatory Surgery 92.2 92.6 92.8 92.4
Emergency Department 83.4 84.1 84.6 86.9
Employee engagement (25%)   85%** 90%** 95%** 93%**
Financial (25%) Net Operating Margin 1.49% 1.74% 1.99% 3.04%
Cost per equivalent discharge $15,790 $15,758 $15,726 $15,640

KEY: red – below threshold; yellow – met threshold; green – met target; blue – met maximum
* Percent of eligible employees trained ** Percent of employees who completed the survey