PIP mid-year results show there's work to be done

Performance Incentive Plan (PIP) results through the second quarter of fiscal year 2015, which ended March 31, show progress in some areas, but also a need for improvement in others to meet goals as the hospital moves toward the end of the year. If PIP were paid today, eligible employees would receive up to 1.51 percent of salary.

PIP results are measured in four hospital-wide performance areas: patient safety and quality, patient experience, employee engagement and financial performance. Each category receives equal weight of 25 percent.

Patient safety and quality includes four measures: hand hygiene, catheter-associated urinary tract infection (CAUTI) cases, RL Solutions adverse event reporting and readmissions.

Hand hygiene, an infection control measure monitored through recorded observations, reached the target goal. CAUTI cases, incidents where patients contract urinary tract infections from a catheter placed during treatment at YNHH, exceeded its maximum goal.

RL Solutions is the online system employees use to report near misses or potential problems related to patient safety. Results for this measure also exceeded the maximum goal. Readmissions measures the percentage of patients readmitted to YNHH within 30 days after discharge.

PIP YTD Q2 results FY15

Patient Safety and Quality (25%)
Measure Threshold Target Max Actual
Hand Hygiene 94% 96% 98% 96%
CAUTI cases 72 68 64 57
RL Solutions event reporting 8,000 8,500 9,000 11,564
Readmission 14% 13% 12% 14.4%

Patient Experience (25%)
Measure Threshold Target Max Actual
Overall Inpatient 86.8 87.0 87.2 86.4
Emergency Department 86.9 87.5 88.0 86.4
Ambulatory Services 92.4 92.6 92.7 92.3
Teamwork 92.0 92.3 92.6 91.9
HCAHPS quiet 14% 13% 12% 14.4%
Employee engagement (25%)
Measure Threshold Target Max Actual
Engagement participation 93% 93.5% 94% 95.7%
Financial (25%)
Measure Threshold Target Max Actual
Net operating margin 86.8 87.0 87.2 86.4
Cost per equivalent discharge 86.9 87.5 88.0 86.4
Cost per outpatient encounter 92.4 92.6 92.7 92.3

Key - red - below threshold; yellow - met threshold; green - met target; blue - met maximum

Results fell short of the threshold goal.

The patient experience category measures patients' experiences as expressed in Press Ganey surveys and HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) reporting. For 2015, it includes overall inpatient satisfaction, as well as the satisfaction of patients who visited the emergency departments and ambulatory sites. Patient experience results in each of these areas are narrowly missing threshold goals.

Also included in the patient experience category is a teamwork measure which includes patients' impressions of how well staff worked together to care for them, as well as quiet scores, which relate to how quiet patients perceived the hospital to be during their stay. Results fell short of threshold goals for these measures, also.

Employee engagement measured participation in the 2015 employee engagement survey. Results exceeded maximum goals in this category.

Financial performance consists of three components. The hospital's net operating margin reached the threshold goal. The results for cost per inpatient discharge and the cost per outpatient encounter both fell short of threshold goals.

"This year has been especially challenging for Yale New Haven, from unexpected financial hits, including unplanned reductions in payments from the state, to increasing challenges and demands in the healthcare industry in general," said Richard D'Aquila, YNHH president. "While we have made progress in some areas, there is still lots of work to be done.

"Although the results at the halfway mark of our fiscal year may be somewhat disappointing, it is important that we stay focused on our goals, continue to advocate for fairness from our state's policy makers and work together to provide the best care possible to our patients and an outstanding experience each and every time. Every employee, regardless of role, should be consistently practicing the CHAMP safety behaviors and creating a welcoming and healing environment for our patients," added D'Aquila.