HR and the Diabetes Center

Today was my last day in the HR department.

Jennifer Acker, the manager for recruiting, gave me an overview of what she does on a daily basis. Basically, everything from the point of when an applicant fills out an application to the point at which that individual is hired is under her responsibility. I had no idea how structured the whole process is! I guess that's how it has to be when there are over 20,000 job applications, 4,000 interviews, and 1,700 offers in a given year.

David Burrack then gave me an understanding of his role as Manager of Compensation, Benefits, & HRIS. NMC most often uses the Haygroup tool in order to determine salaries for exempt (or full-time) workers rather than focusing just on salary surveys. Haygroup classifies job roles based on know-how, problem solving, and accountability measurements to systematically determine the appropriate salary level for a particular job. It’s based on a point system that identifies a pay grade. Each pay grade has a min, med, and max value that is typically based on experience. Some of the major takeaways from the meeting were that communication is key in any compensation conversation. Just because you receive a salary located in the median range does not mean you are average. NMC goes through great measures to ensure that its employees are justly compensated. In addition, maintaining thorough documentation is extremely important because it provides proof in case of a dispute. Recognizing that NMC has over 5,000 employees, the Human Resources department does a great job.

After lunch I headed over to the Patient Services Pavilion to check out the Diabetes Center. Beth Pfeffer gave Annette and me a tour of the Center, and overall I was impressed with the attractiveness of the facilities and the resources that are provided for those with endocrine/diabetic problems. They are doing great work at the facility and I am excited to work on a project that brings these things to the forefront of people's minds.

Human Resources Continues

Ann, Julie, and Mindy showed me around the employee relations side of Human Resources today.

Basically, they're responsible for improving morale among unhappy employees and keeping happy employees happy. Much of what they do is interpreting corporate and department policy for managers and employees, such as clarifying when holiday time can be taken, what qualifies as a leave of absence, and when timecards should be submitted. They are also involved in taking a mediator role when conflict arises between employees and their managers. Education and training managers can play a major part in reducing the number of these negative meetings, so they are involved in that as well. You'd think that dealing with negative issues all day would wear you down, but they also get to plan fun activities and events for employees as well, giving them a reprieve from the tougher aspects of the job.

After being in HR for the morning, I was able to sit in on a SimplyWell board meeting for lunch. SimplyWell is a wellness program/initiative that allows employees of firms that purchase a subscription to get a detailed physical and health status report, have access to online health resources, and be given a detailed list of health goals for individuals who need to manage a chronic condition.

This afternoon I went to a meeting with a number of UNMC physicians who discussed health reform issues with Joe from Senator Nelson's staff. It looks like I'll be doing a summer project with them, which will be challenging and rewarding at the same time.

Meeting with Senator Nelson

I had the privilege of meeting Senator Ben Nelson from Nebraska.

Senator Nelson held a special healthcare roundtable for various representatives from the provider side of healthcare, and since Glenn was invited, he was able to get me into the meeting as well. It was a memorable experience to be among members of a very select group that had a lot of sway in terms of healthcare policy that is developed in the Nebraska region. They had CEOs of hospitals and hospital systems, representatives from provider groups (such as physicians, nurses, pharmacists, and therapists), and healthcare policymakers. The whole point of the roundtable was to solicit feedback on proposals for healthcare reform that have been discuss in and around Washington. It was interesting to see everybody's viewpoints, especially since a number of stakeholders had opposing priorities that were difficult to reconcile. It will be interesting to see what happens with health reform as time passes.

More Great Material

I got my first taste of Operations Council this morning. One of the interesting topics discussed was a new Barcode Medication Administration Report that showed incredible results. After completing the first phase of data monitoring, results showed that 4 potential errors were averted/1000 attempts, which is stunning data. It is this type of information technology that is the future of medicine.

New Acronyms:
BSI: blood stream infections
RCA: root cause analysis
RRT: rapid response team
KIR: key indicator report

Meeting with Glenn:
A CEO's role is different than others. It requires vision, knowing where to go, having people you trust on the boat, and then having the ability to make it go there by supporting them.
One of the secrets is knowing when to intervene.
Referrals: we're doing it because we need to protect our employees' jobs
There are certain times you've got to be willing to draw a line in the sand and be serious
When Glenn was an MP, he matched force with force. However, if you go to him objectively, he will go out of his way to be helpful.
First thing he did when he became CEO: 1) Started defining priorities, 2) Showed commitments (quality)
Believe and have confidence that you can help
Find your style...watch others' styles
I want people to feel comfortable and work with me.
I get the greatest satisfaction when I hear I am doing a good job

Regional Referral Growth Summit

This morning I headed over to the Qwest Center here in Omaha to be a part of the Regional Referral Growth Summit, a conference of administrators and providers focused on increasing the number of referrals throughout the region. There are a number of reasons why the executive team would want to bring these individuals together, most importantly because NMC wants to continue its focus on "Serious Medicine" and get referrals for the big ticket items such as transplants, cancer care, neuro cases, and heart care. By building lasting relationships with employees and patients, NMC wants to continue to lead the area in these product lines.

Takeaways:
The more a customer interacts with your service, the less customer sacrifice should occur. (ex. Ritz-Carlton has a guest preference pad where every time the guests make a request, they make note of it on a database and amek sure that when you stay there again, your preferences are provided for.)
It's time to move to a new level of economic value: EXPERIENCES
ex. Coffee (commodity - $0.02/cup, good (ground, packaged) - $0.15/cup, service (cafe, etc.) - $1.50/cup, experience (Starbucks) - $5.00/cup)

Quotes of the day:
"You can accomplish a lot in life if you're willing not to take credit for it."
"We're not in the education business, we're in the transformation business." London Business School

Employee orientation and meeting with Glenn

I came away from today incredibly glad that I was at the Nebraska Medical Center for the summer. Most of my day was spent listening to the story of NMC and how it's developed over the years to be where it is today. I was also able to sit down with Glenn and talk with him about the future.

New learnings:
Red status bed = means that you don't have a med surg available
FMEA = Failure Modes and Effects Analysis (what can go wrong)

Takeaways:
Change Acceleration Process (CAP) and Workout have been two tools that NMC has used to positively promote change within the organization. Q (Quality) x A (Acceptance) = Change

Interesting Quotes:
"Can you shut the door so they don't hear me screaming?" -Glenn
"We face significant challenges...welcome to the ride." -Glenn
"Quality improvement is like religion, you can't go twice a year." -Glenn
"You know when you're really into quality when you go to the bathroom and analyze how many pieces of toilet paper you've used." -Glenn
"There's not a lot of 75 in a row of anything we do in this organization." -Glenn
"From the first day I came to the Nebraska Medical Center, I wanted two things: 1) when I finished my career as CEO I hoped people would care, 2) I wanted our competitors to curse the day I came into this office." -Glenn

Start Day

Today was my first day as an intern for the Nebraska Medical Center. It's good to finally be here and start meeting the people I will be working with for the rest of the summer. This morning I met with Jason Lebsack and Terrie Johansen, both involved with quality initiatives at NMC. They mentioned the development of the mortality committee, a new program where they review 100% of deaths to see what they can learn from what happened. What they've found is that 50% of documents show inadequate documentation of the situation and don't accurately reflect what happened. In addition, they've been able to find evidence to support the development of a palliative care program to help create a comfortable experience for patients when they pass away. It's obvious that NMC is interested in improving quality, which is one reason why I am so excited to be here for the summer.

In addition I was able to meet with Glenn to discuss plans for the summer. We talked (well, he mostly did the talking) about the healthcare situation (volume is down b/c people are holding off on elective procedures, we make most of our profits on out-of-town referrals to our main service lines, these profits subsidize other parts of the hospital such as primary care and OB/GYN) and about his style as CEO (his job is to #1: Define and develop a vision, and #2: Get people to go there). He had a number of one-liners that I thought were notable:
- Don't mess with my people. I don't like it when people pass the blame onto others who are not responsible for a particular mistake.
- This is not a democracy, this is business. When things go bad they fire the CEO, and I don't want to go home to my wife without a paycheck. Nobody in this business is more important than my family.
- We are a communication entity. Be clear and concise with numbers. Use the "gee" word. Don't do something that's not sincere. Sincerity is a hard thing to argue against (ex. lowering voice in classrooms). "Come see me if you have any problems."
- Look at others' management styles and adapt them to your own. Monitor them and find out what is right for you.

I enjoyed talking with him and have a feeling this is going to be a great internship.