Much like the previous quarter, third quarter PIP results for fiscal year 2012, which ended June 30, reveal a mixture of results — employees exceeded maximum goals in some categories, met goals in others and fell short of reaching goals in a few areas. If PIP were paid today, eligible employees would receive a payout of up to 2.07 percent of their salary. If all goals are achieved at maximum, the potential PIP maximum payout is 3 percent for FY12. For fiscal year 2012, PIP results are measured in four areas of performance: financial, patient safety and quality, patient satisfaction and throughput.
Financial results The financial measure is the net operating margin, which accounts for 30 percent of PIP. Through the third quarter, the net operating margin exceeded the maximum goal of 3.4 percent, coming in at 6 percent.
"The hospital's operating gain has never been higher," said James Staten, senior vice president, and chief financial officer, YNHH. "We're seeing more patients than ever before at the hospital and our outpatient areas. "This performance is important given the headwinds YNHH will face next year in responding to healthcare reform reimbursement reductions and other market forces," Staten continued.
Patient safety and quality The patient safety and quality category includes four measures: blood stream infections (BSIs); value-based purchasing (VBP); readmissions; and environment-of-care mock surveys. Together, these measures account for 30 percent of PIP.
BSIs, the number of infections caused by patient line insertions and line maintenance, were 24.56 BSIs per 10,000 patient discharges for the third quarter, narrowly missing the threshold goal of no more than 24 BSIs per 10,000 patient discharges.
Value-based purchasing (VBP), now part of the PIP program — as Medicare will soon reimburse, or purchase, from hospitals only those services that it defines as quality and safe patient care — is based on a combination of patient satisfaction, as measured by HCAHPS, and core measures. For the second consecutive quarter, the score of 96 percent exceeded the target goal. Readmissions — or the number of heart attack, heart failure and pneumonia patients re-admitted to the hospital within 30 days of their discharge — came in at 19.8 percent and did not meet the threshold goal of no more than 18 percent readmissions for these conditions.
The environment-of-care or regulatory mock survey measure came in at 95 percent and also missed its threshold goal of 96 percent.
Patient satisfaction The patient satisfaction category includes HCAHPS percentage ratings for overall patient satisfaction, staff responsiveness, environment and Press Ganey inpatient satisfaction scores. The patient satisfaction category also accounts for 30 percent of PIP.
The HCAHPS component is based on the percentage of patients who gave the highest possible response — "always" — on the HCAHPS survey. For the second quarter in a row, HCAHPS overall patient satisfaction ratings reached the maximum goal of 74 percent. With a rating of 65 percent, staff responsiveness exceeded its target goal of 62 percent. Results for the hospital environment came in at 60 percent exceeding its threshold goal of 57 percent.
At 89.1 percent, results from Press Ganey patient satisfaction surveys almost reached the target goal of 89.3 percent.
Throughput The throughput category accounts for 10 percent of PIP and includes 11 a.m. discharge and length of stay. Discharging clinically ready patients by 11 a.m. exceeded the maximum goal with a result of 23.96 percent. Length of stay nearly met the maximum goal of 5.1 days coming at 5.12 days for the average length of a patient stay.
"While our net operating margin, patient satisfaction and 11 a.m. discharges remain strong, we still have work to do in the important areas of patient safety and quality," said Richard D'Aquila, president and COO.
"Considering our consistently high census and housewide efforts to prepare for the integration of the Hospital of Saint Raphael, our employees have been remarkable in their attention to the performance metrics that make up PIP," said D'Aquila.