The hospital rolls out the Performance Incentive Plan (PIP) for fiscal year 2013 with several new and important measures and goals.
"When designing the PIP program for 2013, we took special care to develop goals and metrics that include major priorities on both campuses and in our ambulatory sites," said Richard D'Aquila, president and COO, YNHH. "The goals focus us on the major challenges we will face as a hospital this year. Every employee has a stake in achieving these goals."
Now in its 15th 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 the goals. 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.
Fiscal 2013 will be the first year that Saint Raphael Campus (SRC) employees will participate in PIP.
In 2013, eligible employees who meet hospital goals can potentially earn up to a 3 percent PIP payout at year-end.
This year, PIP results will be 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 includes three measures which, together, account for 30 percent of PIP:
- Joint Commission extension survey
- Department of Public Health licensure survey
- 30-day readmissions
Surveyors from The Joint Commission, the regulatory agency that accredits healthcare organizations throughout the United States, will visit the SRC by March 2013 for an accreditation survey. This "extension survey" will also include the Smilow Cancer Care Centers and the durable medical equipment section of The Boutique at Smilow. In a new form of measurement for the PIP program, this goal will be measured as achieved or not achieved rather than by threshold, target and maximum levels.
Similarly, the Connecticut Department of Public Health (DPH) will also survey YNHH in its entirety for license renewal in late spring or summer of 2013. In light of the importance of the DPH survey, this metric has been deemed to be a "circuit breaker," meaning that failure to obtain DPH license will automatically result in zero points for the patient safety and quality category.
The 30-day readmissions metric measures the percentage of patients who are readmitted to the hospital within 30 days of their discharge for the same — or a related — condition. The target goal for readmissions is no more than 16.2 percent.
The Patient Experience category measures a patient's complete experience from pre-admission through post-discharge follow-up. It includes seven measures related to patient satisfaction as reported in HCAHPS (Hospital Consumer Assessment of Health Providers and Systems) and Press Ganey surveys. Together, patient experience measures account for 30 percent of PIP.
HCAHPS surveys report how patients rated:
- Overall rating of hospital — their likelihood to recommend YNHH to others, communications with doctors and nurses and responsiveness of staff;
- Medication communications — patients were told the purpose of their medication and possible side effects;
- Environment of care — the cleanliness and quietness of the hospital
Press Ganey surveys report how patients rated:
- Inpatient Pediatrics — the level of care received while at YNHCH;
- Inpatient Behavioral Health — level of care received at Yale-New Haven Psychiatric Hospital;
- Ambulatory Surgery — level of care received in Ambulatory Surgery at the York Street or Chapel Street campus or Temple Outpatient Surgery;
- Emergency Department — level of care received in all YNHH emergency departments.
A measure new to the PIP program, Epic implementation is based on the successful integration of the electronic medical records system. The target goal is the successful go-live of Epic on the York Street Campus on February 1, followed by the Saint Raphael Campus on June 1. The goal is that 90 percent of appropriate staff are trained three weeks prior to each go-live date.
Epic implementation accounts for 10 percent of PIP.
The sole financial measure is the hospital's net operating margin, which accounts for 30 percent of PIP. For FY13, the target net operating margin is 3.2 percent.
"We continue to be very pleased to be able to offer this program 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."