• Offer a working definition of patient safety culture and explain why culture varies within an organization
• Recognize how HSOPS dimensions measure the four components of an informed, safe culture
• Describe key organizational practices that support the four components of an informed, safe culture
• Use HSOPS results to create an action plan that ensures your organization has in place the key practices needed to support all safety and quality activities
• Conduct the HSOPS using sound methodology to meet Joint Commission Leadership Standards that take effect in January 2009

What is the difference between governance and management? What is the appropriate role of the board? As the forces and challenges affecting health care and the entire economy become more volatile and intense, the role of the board and the distinction between governance and management is quickly changing. There is a rapidly emerging new and necessary component of board work which at first glance seems less like governance and more like micro-management. Yet, this "microgovernance" is now a key and growing component of effective board work. This presentation will synthesize the trends that are driving this significant transition in governance, and outline how boards and CEOs can effectively re-examine and refine a unique and productive governance/management balance that is increasingly essential to ongoing organizational survival and success. Jamie Orlikoff will outline the challenges facing boards that must also integrate microgovernance into their work and balance strategic governance with microgovernance to generate a robust and integrated system of effective governance in an unforgiving environment. Ample time will be reserved to answer your questions about the impact of this shift on your board and your organization.

Florence Nightingale established nursing as a profession. Less well-known is the fact that she was also the first professional hospital administrator who in many respects created the blueprint for the modern hospital. In this entertaining, informative and thought-provoking program, Joe Tye challenges audiences to re-spark the spirit of mission that galvanized Nightingale and her intrepid band of health care pioneers, and to apply her leadership principles to the task of transforming today’s hospitals to thrive in the turbulent and competitive world of tomorrow. You’ll learn why you must cultivate a top-to-bottom intolerance for toxic emotional negativity and gain a proven strategy for fostering a more positive and productive workplace. Hear about the most important, and often overlooked, determinant of patient satisfaction: the quality that Nightingale considered to be the acid test of clinical care excellence. And explore how to promote leadership in every corner, not just in the corner office.

Hear about what’s going on in Washington as legislators and policymakers come together at the start of the 111th Congress to discuss health care and health care reform. AHA staff along with AHA Board Member, Ray Hino, will preview “Health for Life”, a broad-based option for healthcare reform. Providers, payors, employers and consumers have come together to create “Health for Life”. Learn how all the pieces of the health care reform puzzle fit together. Also, learn about the makeup of the new Congress and what the legislative priorities will be. We’ll explore what hospitals expect from the new Congress and Administration and what health care reform might look like.

Door County Memorial Hospital, a 25-bed critical access hospital, began its journey to service and operational excellence in 2004 and has not looked back since. Dissatisfied with the status quo and having a desire to go from “good” to “great,” the leadership galvanized staff to support the goal to some day be recognized as the Best Rural Hospital in America. The commitment of DCMH leaders to provide high quality local health care was crucial in initiating this journey, which included recruiting great employees who are determined to provide selfless patient-centered care, growing the hospital facility, improving the financial bottom line and introducing a cultural transformation. In this session, participants will learn about the actions necessary to advance a company with solid results into a high performing one. You will gain strategies essential to building a culture of service excellence and learn tactics for communicating with staff, physicians, and the community at large. Participants also will understand the value of a journey to excellence in affording the ability to provide specialty services in the rural setting.

Both for-profit and nonprofit organization failures have simulated calls for greater governing board performance and accountability; however boards need practical guidance to help achieve this goal. HRET and the Center for Healthcare Governance, with funding from Hospira, Inc., convened a Blue Ribbon Panel on Trustee Core Competencies to examine the nature of competencies and how they can be developed and applied to improve health care governance. In this session, you will learn about the panel’s work and recommendations, including:

• What competencies really are, and how they differ from the way competencies are viewed and applied in health care governance today; and
• Sample governance core competencies and how they might be applied to the work of health care boards as well as suggestions to further strengthen the link between competencies and board and organizational performance.

There is a recognizable pattern of behavior and performance among successful critical access hospitals and larger rural hospitals. Leaders at the helms of these institutions pay strict attention to inpatient and outpatient volumes, and they understand rural hospital economics and know their market service areas. They combine effective organizational design, with proactive consideration given to medical staff issues and physician practice management, and they pursue the best and most appropriate information technologies to improve business and clinical performance. In this two-part presentation, participants will acquire a better understanding of the components of a successful rural hospital and learn how the best rural hospitals put these parts together. You will gain a detailed checklist of the actions you can take when you arrive home to jumpstart success at your organization.

Note: Part II will be presented during the second set of Concurrent Sessions.

This interactive breakout will challenge participants to think about the “invisible architecture” of their organizations as carefully as they plan for the visible design and décor. While first impressions are created by beautiful buildings and furnishings, lasting relationships are built upon the foundation of core values, corporate culture, and workplace environment. In this fast-paced workshop, Joe Tye will bring a new and fresh perspective to the importance, and the power, of right-brain “soft stuff,” and share proven strategies for moving from a culture of mere accountability toward a culture in which people think and act like partners and not just hired hands. Joe will show how this dimension of your organization is the next frontier for making quantum leaps in patient satisfaction, employee loyalty, and organizational productivity. He will also provide an important perspective on preparing for likely JCAHO standards on cultural competency.

The session continues with further discussion of how to integrate the components of a successful rural hospital.

Rockcastle Hospital and Respiratory Care Center has benefited from a unique relationship with UK HealthCare, the clinical enterprise of the University of Kentucky. The collaboration has resulted in several UK HealthCare advanced specialty physicians delivering care at the rural Rockcastle Hospital site. The outreach program’s emphasis is to provide care in the rural community so long as the treatment is appropriate and safe. The provision of outreach clinics has now resulted in affiliations with UK HealthCare’s Markey Cancer Center, Kentucky Children’s Hospital and Gill Heart Institute. Medical education and specialized training is emphasized for the Rockcastle Hospital staff and access has been created for patients to UK HealthCare’s clinical trials. UK HealthCare has also made Rockcastle an affiliate in its group purchasing network. In this example of a highly successful collaboration, leaders from both sides will:

• Recognize the concerns that rural community hospitals and physicians have with more urban based providers.
• Share strategies for establishing trust with local community providers.
• Identify the ways rural patients can best be cared for in their local facilities appropriately and safely, and explore the appropriate usage of tertiary and quaternary care providers.
• Show how a network of providers can be organized to better provide care to outlying rural locations.

NETWORKING RECEPTION

Support for the reception is generously provided by

CONTINENTAL BREAKFAST

AHA staff will provide a drill down of rural specific issues including recent Administrative and Hill activity on CAH relocation and legislative work on a PPS low-adjustment. Ms. Welsh will also discuss the upcoming legislative session and describe how rural health care priorities fit into the debate for large health care reform. This session is designed for hospital CEOs and trustees who have a strong grasp of the rural policy and advocacy process.

This session will focus on the mechanics and architecture of influential leadership, defined as the type of leadership that relies on influence as opposed to coercion. You will discover the link among the triad of self-awareness, self-management, and empathy and the art of handling other people’s emotions effectively to build authentic relationships in the organization. Behavioral competencies are not innate talents but learned abilities, each of which has a unique contribution to making leaders more influential and therefore more effective to achieve the most wildly important goals at work and in life. Michael E. Frisina is an award winning educator and former faculty member at The United States Military Academy, West Point and the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Rural hospitals face far greater recruitment and retention challenges than suburban and urban health facilities. The old medical staff model with its culture of advocacy, rotating leadership, and protectionism is no longer relevant in an economic environment where physicians are experiencing decreasing net revenues secondary to decreased reimbursement and increased overhead. Physicians are leaving rural environments to seek corporate positions in larger organizations with corporate compensation packages and benefits. With the coming physician shortages, there will be bidding wars to lure physicians to the most profitable organizations. Rural facilities will need to re-think how to organize around a more complex medical staff model in order to secure and retain top talent.  Choosing the right model depends on the specific rural health environment and the organization’s and medical staff’s strategic goals to appropriately align structures, processes, and outcomes. In this session, you will learn about the strengths and weaknesses of the new medical staff models, and understand how to assess the different models in light of strategic organizational goals when re-designing and re-configuring the medical staff towards greater long term viability and sustainability.

Communities facing challenges to finance a new hospital or replacement facility don't have to abandon local ownership. Learn how a rural municipal hospital has enhanced its access to capital by developing a community partnership model that combines state, local and commercial investments. Together, these became the foundation of a new hospital and medical campus, giving rise to a new facility plan that is the foundation of economic growth and future commercial prosperity. In this session, you will learn the steps to get strong community buy-in including how to keep outside provocateurs at bay. Additionally, the presenters will offer a process to determine if a new facility's design and scope is matched to what the market can support, and they will explore how a new hospital can spur economic growth in a community. With respect to access to capital, participants will get the straight answers regarding best practices in financing techniques and products.

A changing workforce, new technologies, plus regulatory, consumer and competitive demands are giving cause to many a scraped knuckle for hospital leaders. In this session, Judy Cordeniz will share her insights, derived from a lengthy hospital career, on using what you know, what you have and adding a few news twists to effect change at today’s accelerated pace. Having lived rural health care for over 30 years, Judy’s strategies, historical perspective and applications are all directed toward rural health care implementation. She offers a no-nonsense, lessons learned approach to achieving high performance and efficient productivity, sorting through the latest fads for creating change – and demonstrating in the process that strong rural leaders have all the tools they need to improve clinical and business performance.

Rural hospitals face a unique set of challenges for successful implementation of information technology, from limited resources to finding skilled IT staff. Yet, rural hospitals are meeting this challenge, as demonstrated by the Most Wired Small and Rural Award winners. These hospitals are carefully identifying what technologies are necessary to uphold their missions, while incorporating input from physicians and other staff to ease implementation. This town hall forum will focus on successful strategies that H&HN’s Most Wired Small and Rural hospitals are adopting to best serve their communities. Participants will hear an overview of the IT challenges faced by small and rural hospitals. They will learn to identify important and necessary areas of IT investment and gain strategies for facilitating board buy-in. The panel also will explore strategies for including clinicians in the conceptualization and implementation of IT projects.

For the first time in 25 years, the IRS has revised and significantly expanded the information tax-exempt organizations, including hospitals, must annually report to the IRS. One of the key changes is the creation of a schedule to accompany the core Form 990 that is unique and specific to hospitals, the Schedule-H. The new forms will make an unprecedented amount of information available to the public, policymakers, and the communities served by hospitals. This session will provide background on the development of Schedule H and take an in-depth look at what information is required and when. A case example will provide first-hand experience and insights into identifying and gathering the data. Participants will take away:

• Increased awareness of the most current environment for examining and reporting community benefit to the IRS.
• Timelines and responsibilities of hospitals for reporting Form 990 and Schedule H to the IRS and making the information publicly available.
• Suggestions for organizing internal efforts to prepare for and complete Schedule H.

Note: Part II will be presented during the second set of Concurrent Sessions.

As discussed in Part 1, Schedule H requests detail on facility information, charity care, certain other community benefits, community building, bad debt and collection practices, joint ventures, and supplemental information on related activities. This session will feature case examples on tracking and recording the required information and completing Schedule H. Examples will include demonstrations of software programs designed to assist hospitals in gathering and reporting these data as well as a discussion of how this information can be shared with the community. Participants will take away:

• Increased familiarity with the electronic tools available to assist in completing Schedule H.
• Suggestions for how to most effectively make use of the tools in gathering and reporting information.
• Insights on accomplishing a smooth transition to new software.

Todd Linden will discuss the importance of continually developing leadership within the hospital and define strategies to accomplish this with limited human and financial resources. He will also discuss the value of a hospital’s role in a rural community, as both a critical part of the integrated health spectrum and a vital player in civic initiatives. In this interactive presentation, participants will have the opportunity to share best practices for self renewal, organizational leadership development and community activism. Mr. Linden is president and CEO of Grinnell Regional Medical Center, a 49 bed, private acute care hospital in Grinnell, Iowa. Mr. Linden is an active leader within his hospital, in his local community, throughout the state, as well as nationally via his roles with the American Hospital Association and the U.S. Department of Health and Human Services.