Ascension Health Vision Plan

Ascension Health Vision Plan

IMAGINE TOUCHPOINT | ASCENSION VISION PLAN

of cost factors that we'll be happy to cost out appropriately based on the scope of your interest. You will also see a few opportunities for a higher level of team collaboration that we think would help the partnership immensely. And finally, we are making a few high level recommendations, aimed at improving patient satisfaction that we hope to discuss in greater detail around: • Allowing Ministries to choose the patient service program that best meets their needs • Return restorative cleaning to an established schedule at all Ministries • Increasing staffing in select facilities to more appropriate levels • Increasing wages to more competitive levels to help us attract and retain qualified talent • Making a reasonable level of capital investment in technology, facility renovation and flooring Thank you for imagining what's possible to attain greater efficiencies, offer new levels of service and in the end, meet your budget, satisfaction and brand goals.

Since the start of our relationship, TouchPoint has worked to establish hospitality as a signature experience for the patients, caregivers and providers, visitors and associates of Ascension Health. Throughout the journey we’ve responded to the evolving expectations of your mission and, at this intersection, appreciate the opportunity to revisit the premises underlying today’s service offerings. Over the course of our relationship, we have successfully met your budget requirements, which given your mission, set a higher bar each year. In 2012, our first transitions were operating well in excess of the 25th percentile in cost. By 2018, we were targeting the 20th percentile or better at all hospitals with many markets operating below the 10th percentile. With our most recent phase of savings initiatives we now target an operating level below the 20th percentile and in many cases below the 10th percentile. This level of cost cutting has caused the team to make serious choices in balancing cost and service levels. Today, we present options that are meant to fuel our collective thinking about the next chapter in Ascension hospitality. Our intention is to begin a new discussion. You'll see some indicators

INTRODUCTION

Reimagining Ascension Dining. ....................................................................... 07

The Caf é Experience. ....................................................................................... 15

TABLE OF CONTENTS

Environmental Services..................................................................................... 27

Hospitality Staffing............................................................................................ 35

Wellness............................................................................................................. 39

Supporting Clinical Caregivers........................................................................ 51

Team Member Engagement............................................................................ 57

REIMAGINING ASCENSION DINING

PATIENT DINING SERVICE MODELS NON-SELECT RESTAURANT-STYLE ROOM SERVICE-STYLE BLUE SKY PATIENT DINING ENHANCEMENTS MOBILE ORDERING AND PAYMENT SPECIAL PROGRAMMING

WE ALSO RECOMMEND ALLOWING INDIVIDUAL MINISTRIES THE ABILITY TO CHOOSE THEIR SERVICE MODEL.

reimagining ASCENSION DINING — Over the years, we’ve offered Ascension a variety dining services, and menus customized to meet local expectations. Each Ministry chose their preferred style of service and menus were modified to address local needs, including budget, food philosophy of the Ministry, and local taste preferences. In many cases, the Ministry also prescribed a unique look and feel.

Dining experience – one that is built on the mission and philosophy of your leadership team and garners the support of Ministries nationwide. Reinvention of the dining program cannot be accomplished by any one team in isolation. It can only be effective with a sound change management strategy and a technology roadmap that strategically aligns our respective technology initiatives and is mutually supported.

For the first six years of our relationship, we offered broad menus and two service models: restaurant-style ordering and hotel-style room service options. The most recent round of cost containment initiatives gave rise to the new, non-select service and limited menu.

We believe that it’s time we collaborate on a design for the future of the Ascension

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NON-SELECT MENUS AT MEALTIME Pre-determined, diet-compliant meals are offered to each patient by the catering associate (CA); alternatives available on request when a patient calls the call center; trays built collectively for delivery at mealtime.

$ STAFFING RATIO 1:60

RESTAURANT-STYLE ORDERING AT MEALTIME

$$ STAFFING RATIO 1:30

CA BUILDS RAPPORT WITH MULTIPLE VISITS EACH DAY; SPECIAL REQUESTS SUPPORTED THROUGHOUT THE DAY; DIET CHANGES HANDLED QUICKLY

Nursing communicates diet orders to catering associates; diet-compliant menus are spoken or presented on paper; CA visits nurse for special instructions then visits patients one hour before service; CA delivers trays at mealtimes. Best for patients who need assistance ordering; especially popular with older patients and in rural communities.

ROOM SERVICE-STYLE DINING, WHEN DESIRED

$$$ STAFFING RATIO 1:30 HIGH SATISFACTION WITH PATIENT CHOICE OF TIME AND MENU

Patient calls to order from printed, in-room menu; call center aligns with EMR and diet orders; delivery within 45 min; reminder calls if patient doesn’t order. Drives satisfaction scores for patients who are more ambulatory, those who like to make selections independently and choose their own time to dine. BLUE SKY Hybrid program allowing for select units to be offered higher levels of menu choice and on-demand, restaurant- style ordering.

DINING SERVICE POSSIBILITIES

$$$$$ STAFFING RATIO VARIES WITH PROGRAM DESIGN

NOTE: Service ratios are averages and may vary based on local dynamics.

MOST COST EFFECTIVE OPTION MODERATE COST WITH ADDED SERVICES HIGHER COST REFLECTED IN HIGHER LEVEL OF PERSONAL SERVICE PREMIUM OPTION $ $$ $$$ $$$$$

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MOBILE ORDERING & PAYMENT TECHNOLOGIES A variety of mobile solutions could be deployed to enhance the patient dining experience. Some of these options are modules of comprehensive patient engagement platforms like the GetWell Network; others are independent solutions for bedside ordering. Due to the resources needed to deploy these solutions, we’d need to partner with AH technology team to build a dining technology roadmap, aligned with patient experience priorities; starting with the reintroduction of My Dining. SPECIAL PROGRAMMING Specialized menus and programming for pediatrics, mother/baby units, oncology and others can be introduced to meet the needs of special audiences.

patient dining ENHANCEMENT OPT IONS — As we reimagine Ascension Dining, we should consider ways to enhance the dining experience that go beyond the service style and menus. Local sourcing of produce, technology and special programs can be deployed to improve efficiencies and the experience – and to respond to the unique needs of select patients.

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THE CAFÉ EXPERIENCE

RETAIL RENOVATIONS

SMART MARKETS

KIOSK ORDERING

MOBILE CHECKOUT

NATIONWIDE CAFE BRANDING

café ENHANCEMENTS —

The café experience can be a defining element in the Ascension brand and is central to the overall image of hospitality in your hospitals. We have a substantial opportunity to modernize your cafés through renovation, equipment upgrades and the introduction of technologies that will benefit the customer experience.

Renovation Sparks Overall DINING ENHANCEMENTS

This is the story of the power of retail renovation.

In September of 2014, the café at Ascension St. Vincent’s Jacksonville closed for a major retail renovation that would be completed in April 2015. The $2 million capital infusion has triggered a 25% increase in pre-renovation sales and improved retail satisfaction.

SISTER MARGARET MARY DILLON RESTAURANT Visitors to the Sister Margaret Mary Dillon Restaurant are now enjoying six action stations that offer chef-crafted features, like bread baked in house, fresh pasta and wood-fired pizza. Sauces and dressings, beef lasagna, chicken marsala and crab cakes are chef-prepared. Meats are roasted and carved in house. Entrée salads feature local produce, ancient grains and proteins-on-request, like tofu, grilled shrimp and chicken.

THE RENOVATION REJUVENATED TEAM MORALE AND CAUGHT THE ATTENTION OF SOCIAL MEDIA

The radiating impact of the renovation has benefited nearly all areas of the hospital.

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RECOMMENDED RETAI L RENOVATIONS BY MARKET

ALABAMA St. Vincent’s Birmingham St. Vincent’s East Birmingham

INDIANA Ascension St. Vincent Anderson Ascension St. Vincent Kokomo

OKLAHOMA Ascension Jane Phillips Medical Center Ascension St. John Medical Center Ascension St. John Sapulpa

CHICAGO Amita Health Adventist Medical Center La Grange

KANSAS Via Christi St. Francis Via Christi St. Joseph

TENNESSEE Saint Thomas Midtown Hospital Saint Thomas West Hospital

Amita Health Adventist Medical Center Hinsdale Amita Health Adventist Medical Center Glen Oaks Amita Health Mercy Medical Center Aurora Amita Health St. Mary’s & Elizabeth Medical Center Chicago Amita Health Holy Family Medical Center Des Plaines Amita Health St. Mary’s Hospital Kankakee

MARYLAND Saint Agnes Hospital

TEXAS Dell Children’s Medical Center of Central Texas

Seton Medical Center Hays Seton Northwest Hospital

MICHIGAN Ascension St. John Hospital

Ascension Providence Southfield Campus Ascension Macomb-Oakland Hospital Ascension Michigan Corporate Services Building Café Ascension Borgess Hospital Ascension Genesys Hospital Ascension St. Mary’s Hospital Saginaw

WISCONSIN Ascension Columbia St. Mary’s Milwaukee Ascension St. Francis Ascension NE Wisconsin Mercy Campus

FLORIDA Ascension St. Vincent Southside Ascension Sacred Heart Pensacola

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For people in a hurry to get back to their day, ordering and paying fast is a priority. Self-service kiosks streamline the guest experience while offering greater staff flexibility. Self-service kiosks streamline the guest experience and improve staff flexibility by offering guests the ability to browse menu options and make quick work of short lunch breaks. This added efficiency allows the café to serve more guests in less time. With self-checkout, order-and-pay, or order- only options, cafes can choose which solution integrates best with their workflow. KIOSK ORDERING

When the café is busy, line-busting tablets can be the answer to long wait times and kitchen tablets. In this service model, cashiers take orders on mobile tablets faster than the counter staff can work the stationary terminal. Handheld tablets are efficient and get staff from behind the counter allowing them to better engage with guests. Mobile checkout tablets enable the kitchen to start working on orders faster, which improves throughput and the guest experience. MOBILE CHECKOUT

Smart MARKETS

As seen in The Market retail concept described on page 24, Smart Market is a completely secure, unattended self-checkout market. Each market is composed of a central kiosk and a bank of refrigerated coolers and ambient cases that display fresh food, snacks and beverages. Premium bean-to-cup coffee service is also available. Users pick their items and pay at a self-service checkout.

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INCREMENTAL REVENUES HAVE INCREASED $500,000 ACROSS BOTH LOCATIONS. 50% OF REVENUES AT THE NOVI LOCATION ARE GENERATED AFTER-HOURS.

Nationwide CAFÉ BRANDING

A winning retail concept will offer a respite that caregivers and guests deserve and need with inviting and relaxing environments outstanding menus, on-trend station graphics and decors, and year-round marketing. The Market is a fully customizable retail space for 24-hour service. This concept successfully launched at Ascension Providence Novi and

Ascension St. John this year. At both locations, we invested capital to complete renovations designed to drive check averages. These operations serve breakfast and lunch, then convert to self-service after hours. Self-checkout technology has allowed for an efficient, low labor solution that satisfy the needs of third shift nurses and hospital staff.

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ENVIRONMENTAL SERVICES

STAFF CONSIDERATIONS

RESTORATIVE FLOOR CARE

RESTROOM FLOOR REFINISHING

ATP TESTING

VIRTUAL MANAGER

UV TECHNOLOGY

RESTROOM MONITORS

WE RECOMMEND THAT YOU CONSIDER RESTORING STAFFING LEVELS TO THE 25TH PERCENTILE AT THE TOP 25 “DETRACTOR” ACCOUNTS.

Environmental Services S TAFF CONS I DER AT IONS —

Maintaining both the perception and reality of cleanliness requires a multidisciplinary approach that includes our own performance management, as well as proper facilities maintenance and when needed, renovation. We have numerous examples of scores naturally rising following renovations. When we introduced TouchPoint services to Ascension Health, we were staffing well above the 25th percentile in productivity in Environmental Services. Since that time, several rounds of substantial reductions have set staffing levels below the 10th percentile in select ministries. Additional staff will help reduce the number of patient rooms managed by each housekeeper. Moving back to the 25th percentile selectively provides a greater opportunity to apply resources in areas that support the increasing of scores.

• Higher productivity/satisfaction for allied teams, such as PCTs and nursing • More frequent cleaning in offices, nursing stations, clinical break rooms and doctor’s lounges

• More frequent touches in patient rooms, public spaces, offices and elevators

• Systematic decluttering

RESTORATIVE FLOOR CARE

Flooring is one of the first visual “cues of clean” in the patient experience. We provide two services to maintain in top shape: routine and restorative cleaning. Routine cleaning ensures that everyday surface dirt is removed and that floors are sanitized on a frequent schedule. Restorative cleaning revitalizes the appearance of dingey flooring and is done less frequently. As we’ve reduced staffing levels, many of our floor care programs have moved to routine cleaning only. RESTROOM FLOOR REFINISHING In older facilities, wear on restroom flooring, such as hard water stains in showers and discolored grout, can lead patients to perceive that our facilities aren’t clean. We recommend an easy, inexpensive epoxy solution to improve the perception of restroom floor cleanliness. These coatings can be quickly applied to floor surfaces and instantly improve the facility’s visual appearance.

BEFORE

WE RECOMMEND THAT YOU RETURN RESTORATIVE CLEANING TO AN ESTABLISHED SCHEDULE, AS A PART OF YOUR COMPREHENSIVE FLOOR CARE PROGRAM TO IMPROVE THE OVERALL IMPRESSION OF YOUR FACILITIES.

AFTER

TECHNOLOGY DRIVES RESULTS IN EVS The use of the right EVS technology is a powerful way to drive clinical outcomes, productivity and efficiency. Technological advancements have provided us with easy methods of objectively measuring cleaning success. A great example is the use of ATP testing to fight the spread of C.diff infections. The implementation of ATP cleaning verification within our Ministries has helped reduce Ascension's C.diff infections by 16% year-over-year.

UV TECHNOLOGY Automated UV disinfection systems use ultra- violet (UV-C) light energy to eradicate multi-drug resistant organisms including C.diff, MRSA, VRE, CRE and Acinetobacter. UV-C is a direct line-of- sight technology that accomplishes what single emitter systems, (including pulsed xenon gas systems) simply cannot. This system has been proven to disinfect all areas of the healthcare environment in a single cycle including the bathroom.

RESTROOM MONITORS

VIRTUAL MANAGER Virtual Manager is a complete software solution that enables management to measure staff performance and efficiencies with advanced reporting and make key decisions to improve their operations. Supervisors can focus less on administration and more on efficiently managing their team and daily workflow. Skills training is simple with the built-in eLearning component and job aids.

Restroom monitors give hospital guests a voice to let the EVS team know if anything in the restroom needs servicing by tracking traffic and inviting customers to flag issues with the touch of a button. Customer alerts are then delivered via email, smartphone or pager to the appropriate individual to dispatch an attendant. Associate response times, number of notifications and amount of traffic are just a few >Page 1 Page 2-3 Page 4-5 Page 6-7 Page 8-9 Page 10-11 Page 12-13 Page 14-15 Page 16-17 Page 18-19 Page 20-21 Page 22-23 Page 24-25 Page 26-27 Page 28-29 Page 30-31 Page 32-33 Page 34-35 Page 36-37 Page 38-39 Page 40-41 Page 42-43 Page 44-45 Page 46-47 Page 48-49 Page 50-51 Page 52-53 Page 54-55 Page 56-57 Page 58-59 Page 60-61 Page 62

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