Memorandum

To: Frank Sardone, CEO of Bronson Methodist Hospital

From: Kiel Reidenbach, RN
Date: 4/4/2016
Subject: Financial, Customer, Internal Business Process Metrics, and Learning and
Growth Perspectives
The purpose of this memo is to discuss Bronson Methodists Hospitals financial,
customer, and internal business process metrics. The organizations past
performance, as well as future progress, is interpreted and recommendations to
ensure positive future performance will be illustrated. Performance tracking over the
past year has shown that Bronson does have the ability to meet targets but is not
doing so on a consistent basis.
Bronson Methodist Hospital is currently tracking two financial metrics, three
customer metrics, three internal business process metrics, and three learning and
growth metrics: (1) Total cost savings from Medicares bundled payment program,
(2) Total dollars lost to non-reimbursable events (financial), (3) Percentage of
patients that would recommend Bronson to a friend or family member, (4) Total
number of patients that develop a hospital acquired pressure ulcer, (5) Total number
of unplanned readmissions (Customer), (6) Percentage of patients and families that
state they were included in their plan of care, (7) Total number of patients admitted
to off service units of care, and (8) Percentage of all discharged patients who
received a follow-up phone call within 2 weeks of discharge (Internal Business
Process), (9) Percentage of nurses holding a bachelors degree or higher, (10)
Percentage of employees trained on new technology within the EMR, and (11)
Number of employee suggestions for improvement that are implemented (Learning
and Growth) . Monthly data has been tracked for all eight metrics from April 2015 to
March 2016. Performance in all metrics has shown Bronsons ability to meet these
metrics, but not on a consistent basis. This is demonstrated in our ability to meet
our target of $2 million for metric 1 only four times in the past 12 months, as well as
going over our goal of a maximum of $2 million for metric 2 six times in the past
year. Inconsistent performance in metrics 3-11 has contributed to falling short on
these metrics, and better performance on these 9 metrics will improve financial
outcomes for Bronson.
One strategic challenge that Bronson faces is working with decreased
reimbursement from insurance companies. All 11 of the metrics discussed above
will have an impact on reimbursement from insurance companies as the Affordable
Care Act continues to change how we are paid for services. Bronson is penalized for
non-reimbursable events such as readmissions, HAPUs, and poor patient
experiences. Data so far has shown that although Bronson can meet these strategic
targets, we are meeting them less than 50% of the time. Bronson needs to increase
the overall implementation of, and participation in multidisciplinary rounds to
ensure patients are receiving the right care, in the right place, at the right time. This
will require an adjustment in daily workflow but will not require any additional
budgeted expenses. Although there will be an addition of 2 hours of non-productive
time for unit based Rns, physicians, pharmacists, case managers, social workers,

Memorandum
respiratory therapists, and dieticians, this will be part of daily workflow and, as a
result, part of existing salaries. This 2 hour meeting will result in each patients plan
of care being reviewed daily. By doing so patients will be treated as partners in care
and gaps and issues in care can be sought out and addressed. This initiative will
create the patient centered atmosphere that Bronson strives for, and will improve
outcomes as well as metric performance as a result.