Quality Improvement Initiatives Communication

OPENNESS AND COMMUNICATION INITIATIVES

Employee Communication

Employee Town Meetings
Fletcher Allen President and Chief Executive Officer Melinda Estes, M.D., holds Employee Town Meetings to share information and encourage feedback from employees. The meetings have helped improve communication between Fletcher Allen senior leadership and front-line employees. In addition, Fletcher Allen holds quarterly meetings for all of leadership – from supervisors through senior vice presidents – and quarterly meetings with all director-level employees.

"Just Ask" Program
In late 2003, Fletcher Allen implemented a "Just Ask" program. Through this program, employees can ask questions or offer comments to senior leaders at Fletcher Allen and receive responses in a "Just Ask" newsletter published by the Human Resources Department. Employees submit their questions through email, or in drop-boxes at different locations throughout the organization.

Employee Pulse Survey
In November 2007 – following employee opinion surveys in 2004 and 2006 -- Fletcher Allen employees participated in a brief employee opinion "pulse" survey to measure overall general employee satisfaction and employees' perceptions of specific aspects of the organization's culture. A total of 3,151 employees responded to the survey, for a 55 percent response rate. Results of the survey were shared with all departments. An additional employee survey is planned for the fall of 2008.

Employee Advisory Committee
Fletcher Allen's 20-member Employee Advisory Committee encourages employee input on workplace issues. This committee discusses issues that directly impact employee satisfaction, with the goal of enhancing communication between senior leadership and employees.


Other Openness Initiatives

Plan for Improving Institutional Communication and Openness
Fletcher Allen adopted a plan for improving institutional communication and openness in 2004, in response to one of the conditions of the Renaissance Project Certificate of Need (CON) approval, which was issued in November 2003. The goal of this plan is to improve Fletcher Allen's communication process, and to ensure increased transparency and inclusiveness in our operations and decision-making. To view a full copy of the plan click here. For more information, call the Office of the General Counsel at (802) 847-3968.

Public Reporting of Quality Data
In February 2006, as part of its commitment to service excellence, Fletcher Allen launched a new Quality of Care section on its public Web site, providing detailed information about how it performs on quality of care measures. The new Web site includes measures that are publicly available in Fletcher Allen's Act 53 Quality Report, as well as additional quality measures for birthing, cardiology, general surgery, heart surgery, obstetrics and gynecology, orthopedics, neurology, pneumonia care, pediatrics at Vermont Children's Hospital and nursing. Each section includes data on clinical information, length of stay, patient satisfaction, and numbers of cases seen (volume). To visit the site, go to: http://www.FletcherAllen.org/Quality/index.html

"Speak Up" Campaign
In 2007, Fletcher Allen announced its participation in a nationwide campaign called "Speak Up" that encourages patients to be active participants in their health care and help improve the safety of their care. The campaign urges patients to take a role in preventing health care errors by becoming active, involved and informed participants in their care. For more information, call Marketing & Communications at (802) 847-2886.


STRATEGIC PLANNING AND DECISION-MAKING

Fletcher Allen's Strategic Plan
In late 2006, building on the many strides the organization made over the previous several years, Fletcher Allen initiated a new strategic planning process looking out to the year 2010 and beyond. This process was based on a vision articulated by Melinda L. Estes, M.D, President and Chief Executive Officer: to become a national model for the delivery of high-quality academic health care for a rural region.  The process included input from all levels of Fletcher Allen's leadership, as well as the focused attention of the senior executive team and the organization's Board of Trustees. It was based on the principles of the Balanced Scorecard, an approach to strategic management developed by professors at the Harvard Business School designed to help organizations clarify their vision and strategy and translate them into action. Using the scorecard as a guide, Fletcher Allen's administrative and clinical leaders developed a strategy management system and strategy map that serves to inform all staff and employees about the organization's strategic objectives. This system allows the organization to clearly articulate its vision and strategy, measure progress towards reaching its goals, allocate resources to critical projects and initiatives, and ensure that all areas of the organization are aligned and working together in support of the strategy. For more information, contact Diana Scalise, vice president of Planning, at (802) 847-3964.


Regional Planning Efforts
Fletcher Allen, in partnership with the Champlain Initiative, the Regional Planning Commission, and the Greater Burlington Industrial Corporation (GBIC), is participating in an interdisciplinary planning effort designed to build connections among planning efforts at organizations in different fields throughout the region. For more information about this effort, contact Diana Scalise, vice president of Planning, at (802) 847-3964.

The Mental Health Program Quality Committee
This committee, originally established as a subcommittee of the Mental Health Task Force, meets monthly and is open to the public. It includes representatives of a broad range of mental health advocacy groups, representatives of the Vermont Division of Mental Health Services, members of the public, health care providers, and consumer and family members. For more information, contact Mary LaCasse at (802) 847-2124.

Understanding Community Health Care Needs

In 2007, as part of its strategic plan, Fletcher Allen convened an internal group to look at how it allocates Community Benefits with the goal of better aligning community support with strategic goals and unmet needs in the community. To inform this effort, Fletcher Allen conducted comprehensive interviews with 22 members of Chittenden County-based community organizations. Participants assessed Fletcher Allen's performance in meeting community needs and collaborating with community partners -- and its ability to provide for future needs. Participants also were interviewed about their relationship with Fletcher Allen and how it could be improved. Information gathered from this work will inform Fletcher Allen's strategic plan and its efforts to understand community health care needs and work in partnership with community organizations to address them. Future plans call for creating a Community Needs Collaborative and expanding Fletcher Allen's communication and outreach efforts.

Ward 1 Parking and Traffic Task Force
In 1999, as part of a Memorandum of Understanding and Agreement between the City of Burlington and Fletcher Allen, Fletcher Allen established a task force to address parking and traffic related to the construction of Fletcher Allen's Ambulatory Care Center. The task force continues today and has remained active. It consists of representatives from the Ward 1 Neighborhood Planning Assembly and Fletcher Allen. The work of the task force guides Fletcher Allen's strategic planning and decision-making concerning parking and traffic, as well as planning, zoning and permitting issues on the Medical Center Campus.


Vermont Children's Hospital Community Advisory Council
The Vermont Children's Hospital Community Advisory Council is a group of representatives from non-profits, businesses, the education sector, social services, children's services, state agencies and the Vermont Legislature, along with parents in the community and physicians, nurses and staff from the Vermont Children's Hospital at Fletcher Allen. The group began meeting in January 2004 and meets on a quarterly basis. Council members are asked to serve as consultants in the strategic planning of new initiatives for Vermont Children's Hospital; to provide input from the community so the Vermont Children's Hospital is meeting the needs of those it serves; to review the progress of ongoing clinical, educational, research and financial developments that are designed to improve care to children in the community; and to be ambassadors on an ongoing basis for the work of Vermont Children's Hospital by helping to define our goals and objectives for each fiscal/academic year.

Elder Care Council
In September 2003, Fletcher Allen formed a Community Elder Care Council composed of 15 representatives from local non-profit agencies, the state of Vermont Agency on Disability, Aging and Independent Living, researchers from the University of Vermont, a primary care physician, and the community at large, in addition to four staff members from Fletcher Allen's Elder Care Services. The council works with Elder Care Services to help prioritize elder care issues in the community and state, and develop strategies to address them. The council meets quarterly.

Collaboration with Other Hospitals, Health Systems and Agencies
Fletcher Allen is actively engaged with hospitals, health systems and agencies in Vermont, as well as in areas of New York and New Hampshire, to ensure that its strategic plan responds to the needs of people in outlying communities as appropriately as possible. It is also engaged in collaborative efforts to improve health care services and technology throughout the state. Examples of these efforts include:

• Establishment of outreach clinics throughout Vermont and northern New York to ensure access to specialty services in local communities as appropriate and requested. Fletcher Allen's health care professionals are currently involved in more than 100 outreach programs, clinics or services. Examples of such services include clinics in cardiology, neurosurgery, pediatric surgery, rheumatology, otolaryngology, dermatology, endocrinology, perinatal outreach and teletrauma and radiology services. In addition, Fletcher Allen specialists work with local community hospitals and physicians to help them start up and provide programs that benefit the people of their community.

• Laboratory Outreach Services. Fletcher Allen's laboratory has had an extensive outreach program for more than 25 years and currently serves as the reference laboratory for all of the hospitals in Vermont. In addition, Fletcher Allen is a founding member and serves as the reference laboratory for the Northeast Clinical Laboratory Alliance – a group of hospitals in Vermont. NECLA was formed in 1996.

• Ensuring appropriate access to critical care transport services through Fletcher Allen Coordinated Transport (FACT), a wholly-owned subsidiary that owns and operates ambulances in Vermont and northern New York. FACT is based in Burlington, and also has an ambulance stationed in Malone, N.Y. to ensure appropriate access to this service for people in that region.

• Participation in the Governor's Chronic Care Initiative. Fletcher Allen and the University of Vermont College of Medicine work closely with the Vermont Department of Health on the Vermont Blueprint for Health, a public-private partnership charged with designing and implementing the chronic care model for health care in order to improve health outcomes and reduce costs.  As part of this work, teams have been formed at several Fletcher Allen Primary Care Internal Medicine and Family Medicine practice sites to bring together physicians, nurses and staff in a collaborative effort to achieve the goals of the Blueprint.  The focus of the work has been on Clinical Microsystems -- including improved message handling, prescription refills, scheduling and patient flow -- and on diabetes care, with a focus on self-management, goal setting, management of lipids and diabetic renal disease. Fletcher Allen recently received a Blueprint grant for Phase 2 of the Blueprint project. In July 2008, Fletcher Allen's Primary Care Internal Medicine Aesculapius practice in South Burlington and the community practice of Dr. Gene Moore in Burlington will initiate a pilot project to develop "advanced medical homes" for patients with chronic medical conditions.

• Participation in the Vermont Program for Quality in Health Care. VPQHC is a private, non-profit corporation focused on statewide health care quality initiatives. Fletcher Allen's vice president for Quality serves on its board of directors, and approximately 12.5 percent of VPQHC's total annual budget comes from our institution. Numerous Fletcher Allen physicians and nurses actively participate on VPQHC projects.

• Collaborating with the state of Vermont on the creation of a new approach to psychiatric care to replace the Vermont State Hospital. Fletcher Allen, as the state's academic health center, has been a key participant in this ongoing dialogue. Robert Pierattini, M.D., physician leader of Psychiatry at Fletcher Allen, represented Fletcher Allen's Psychiatry Service in these discussions, and served on The Futures Advisory Committee, a group of Vermont citizens and mental health professionals that studied redesigning the state's mental health system.

• Partnering with Vermont HITEC to provide education and training to address the shortage of qualified medical personnel in Vermont. In 2007, Fletcher Allen and Vermont HITEC teamed up to train practice support specialists and registration representatives. In February 2008, the organizations launched a training program for medical coders. Fletcher Allen and Vermont HITEC developed their partnership in 2004 with funding assistance from both the state of Vermont and the U.S. Department of Labor. A total of 48 Vermonters have been trained and offered positions at Fletcher Allen as a result of these programs.

• Collaborating with the state of Vermont and Vermont hospitals and health care organizations to promote the use of health information technology and develop a statewide information technology plan. In November, 2004, a 501(c) (3) organization, Vermont Information Technology Leaders, or VITL, was formed to oversee this effort. Fletcher Allen Chief Operating Officer Angie Marano serves on the VITL board, and employees from Fletcher Allen's Information Services are actively involved with the project.

• Active participation in the Vermont Association of Hospitals and Health Systems (VAHHS), a statewide network of health systems that promotes collaboration among health care organizations, and works to influence political, economic, social and regulatory issues facing health care providers in the state – with the goal of improving the delivery of health care to Vermonters.