The Possible Scot Lecture

International Futures Forum
Royal Society of Edinburgh
Michael Shea Memorial Lecture

Edinburgh, 17 February 2014
Copyright © 2011 Southcentral Foundation. All Rights Reserved.
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Katherine Gottlieb, MBA, DPS (h.c.), President/CEO
Steve Tierney, MD, Medical Director – Quality
Improvement
Michelle Tierney, MPA, MA, Vice President
Organizational Development and Innovation
Kevin Gottlieb, DDS, Vice President Resource and
Development and Chief of Staff

NOTICE: Unless otherwise indicated, this work represents copyrighted material protected by United States and international law.
This work may not be used, reproduced, downloaded, disseminated, published, transferred or transmitted, in whole or in part, in any form or by
any means, electronic or mechanical, including photocopying, recording or information storage and retrieval, except with the express written permission of
the publisher. This work may not be edited, altered, or otherwise modified, in whole or in part, except with the express written permission of the publisher.

SCF Programs and Services




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

Compliance
Data Services
Organizational Development
Development Center
Human Resources
Quality Assurance
Research
Nuka Institute

 Tribal Relations and Village
Initiatives
 Traditional Healing Clinic
 Planning Grants
 Communications & Public
Relations
 RAISE Programs
 Elder Program
 Seattle Office
 Board Support
 Corporate Office Support


 Behavioral Health
• Fireweed
• PCC








BURT
Denaa Yeets’
TRAILS and FASD
The Pathway Home
Quyana Clubhouse
Dena A Coy
• Residential
• Outpatient
• Willa’s Way

 Behavioral Health Service
McGrath Behavioral Health Clinics

 Therapeutic Family Group Homes
• Cottonwood
• Rendezvous
• Cleveland

 Alaska Womens Recovery Project
(AWRP)
 Access To Recovery (ATR)














Dental (ANMC and Fireweed)
Facilities
General Counsel
Information Technology
Special Assistant Program
Budget Planning and
Management
Contracts
Financial Operations
Patient Accounts
Payroll
Reimbursement


From 1982 to 2013…
Operating Budget
$227m

 64,000 Customerowners
• 54,000 Anchorage and Valley
• 10,000 55 villages

 Employees
• 1982: Fewer than 100
• 2013: About 1,600

 Operating Budget

$3m
1982

FY
2013

• 1982: $3 million
• FY 2013: $227 million


Vision

A Native Community
that enjoys physical,
mental, emotional
and spiritual wellness

Mission

Working together with
the Native Community
to achieve wellness
through health and
related services


Corporate Objectives
Shared Responsibility


Health care provider changes
 No longer a hero but a partner
•
•
•
•
•

Control does not equal compliance
Replace blaming with understanding
Give customer options, not orders
Provide customer with resources
Make it simple


Commitment to Quality


Customer-owner changes






Be active, not passive
Take responsibility for your health
Get information about your health
Ask questions about advice
Ask for options


Customer Connections
 Governing board
 Advisory committees
 Elders Council
 Focus Groups
 Annual Gathering
 24- hour hotline
 Community gatherings
 Personal interaction with
employees

 Satisfaction surveys
 Comment cards


Customer feedback
The number one source
for change
Raising the Bar
Become interested
owners in their journey of
health
Begin to attend functions

 Begin to give advice
about enhancing
programs and services
 Become involved in
changing behaviors

Workforce Focus
Key Improvements
 Interview /Hiring
 Onboarding (ASTP, etc)
 Leadership development
 Development Center
 Career Ladders
 Job Progressions
 Mentoring
 Employee Wellness


Family Wellness


It’s All About Customer-ownership
and Relationships


Core Concepts Training
 Three-day training, ALL
employees
 Led by SCF President/CEO
 Build and sustain healthy
relationships
 How we impact others
 How to articulate story from
your heart
 Partnered with Society for
Organizational Learning to
develop


Core Concepts
Work together in relationship to learn and grow
E ncourage understanding
L isten with an open mind
L augh and enjoy humor throughout the day
Notice the dignity and value of ourselves and others
E ngage others with compassion
S hare our stories and our hearts
S trive to honor and respect ourselves and others


Operational Principles
Relationships between customer-owner, family and provider must be fostered and supported
Emphasis on wellness of the whole person, family and community
Locations convenient for customer-owners with minimal stops to get all their needs addressed
Access optimized and waiting times limited
Together with the customer-owner as an active partner
I ntentional whole-system design to maximize coordination and minimize duplication
Outcome and process measures continuously evaluated and improved
Not complicated but simple and easy to use
Services financially sustainable and viable
Hub of the system is the family
I nterests of customer-owners drive the system to determine what we do and how we do it
Population-based systems and services
Services and systems build on the strengths of Alaska Native cultures


Information to Knowledge
50%

% SCF Central Pharmacy customer-owners requesting other
medications at dispensing

40%

Change
Tested

Better

Change
Implemented

30%
20%

Percent
Average

10%
0%
8/5/10

8/12/10 8/19/10

8/26/10

9/2/10

9/9/10

9/16/10 9/23/10

9/30/10

Source: Cent ral Pharmacy-Pharmacy t ic-sheet 9.27.10


Measures of Success
 Utilization
• 75% decrease in hospital admissions since 1999
• 71% decrease in hospital days per 1000 since 1999
• 36% decrease in outpatient visits per 1000 customerowners

 Clinical quality
• Level 3 NCQA Patient Centered Medical Home
• 75 or 90 percentile for HEDIS outcome measures
o Diabetes
o Cancer
o Cardiovascular disease


Measures of Success
 Customer-owner satisfaction
• Overall 93%

 Employee satisfaction
• Overall 94%
• Response rate 95%

 Employee Turnover
• 10.8%

 Baldrige National Quality Award - 2011


Linkages
EVERYTHING TIES TOGETHER!


Leadership
 Governance joins in
celebration of success
 Leadership encourage
recognitions and rewards
 Innovation and creativity
are endorsed as a high
motivators


Thank You!
Qaĝaasakung

Aleut

Mahsi'

Gwich’in Athabascan

Quyana
Yup’ik

Tsin'aen

Ahtna Athabascan

Quyanaq

‘Awa'ahdah

Inupiaq

Eyak

Igamsiqanaghhalek

Siberian Yupik

T’oyaxsm
Tsimshian

Quyanaa
Alutiiq

Háw'aa

Haida

Gunalchéesh
Tlingit

Chin’an

Dena’ina Athabascan


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