SUSI HOSHI: STAFF PARTICIPATION IN PERFORMANCE IMPROVEMENT

Using HMC Benchmark Data

	Susi firmly believes that the key to achieving real improvement is tied to involving the staff in all initiatives. She shares the annual HMC benchmarking results for Rehab Services with supervisors and associates. "I like the fact that HMC shows where the areas of improvement are-staffing costs or supply costs. The graphs are easy to interpret and extremely informative."
	Susi also used the benchmark to protect the work she has already done. When a hospital-wide 3% reduction in expenses was announced, Susi used the benchmark data to demonstrate the already superior performance in her department. This allowed the department to focus on more immediate operational and process issues.

HMC Benchmarks Revealed the Situation

In 1996: All Rehab Services: $13.34 per total rehabilitation procedure Physical Therapy: $9.31 per PT procedure Occupational Therapy: $14.88 per OT procedure Speech Therapy: $45.09 per ST procedure Cited Savings Potential: $131 K

Action Steps

Susi offers some insight as to how she was able to build a culture to facilitate performance improvement:

	Provide the opportunities for associates to participate in the decision-making process. Set the parameters for the solution and then allow them to generate the ideas to make it work.
	Hire the right people. Susi believes that "It's all about how you talk to the staff and present the issues to them. I want to hire people who understand that they need to be flexible to get the job done". "The key is to listen to your staff. They are my customers, and I need to take care of them." Susi Hoshi Director of Physical Medicine & Rehab Services Mary Washington Hospital
	Identify personal and professional goals for each associate at the beginning of each year. Susi mentors and role plays with individuals to develop supervisory skills, to build financial and analytical acumen, and to develop new programs. "They're not just clinicians any longer", Susi adds. "They're financial reps, analysts, and problems solvers."
	Develop a morale and reward system for staff and management. The Rehab Survivor Challenge, an annual team building retreat, and recognition of the associate of the quarter are a few of the programs currently in place.
	Cross-train staff. As demand and workload requirements shift between inpatient, outpatient and the skilled nursing facility, associates now understand they are expected to adapt their schedules according to the treatment plans that are developed.
	Every associate monitors his/her own productivity. We use these reports to identify internal processes which need improved.
	Encourage associates to participate in performance improvement committees and activities. Every staff member must serve on at least one PI initiative.

Management That Means Results

In 1999, Mary Washington Hospital's Rehabilitation Services department shows only a small savings opportunity when compared to their respective targets. All Rehab Services: $10.04 per total rehabilitation procedure Physical Therapy: $7.28 per PT procedure Occupational Therapy: $10.70 per OT procedure Speech Therapy: $15.23 per ST procedure