June 22, 2007

Leadership meeting focuses on strategic plan, quality and safety, budget

The MGH/MGPO clinical strategic plan, quality and safety, and the FY '08 budget were featured topics at the June 20 leadership meeting. Speakers provided updates on where the hospital currently stands in these areas and where the MGH is headed.

Since the implementation of the clinical strategic plan in 2003, the hospital is now midcourse to its 2011 vision for setting a national standard for quality and patient safety, enhancing clinical growth, and delivering care and fostering an environment that encourages patients to feel their needs are the top priority.

Allison Rimm, vice president for Strategic Planning and Information Management, thanked the many people across the organization who have been integral in turning the strategic plan into action. She described the plan — created to increase the focus on quality and safety, clinical growth, and capacity in an increasingly competitive health care market — as an actionable document that guides and streamlines decision making and resource allocation. Rimm highlighted examples of the impressive progress made toward achieving our strategic goals. Next steps involve intensifying process improvement efforts, refreshing the data that guided development of the plan, developing a management dashboard and linking the educational and clinical strategic plans.

Gregg Meyer, MD, MSc, senior vice president for Quality and Safety, described the newly revamped MGH/MGPO quality and safety efforts. The initiative is centered on two goals — creating the highest quality and safest care environment for patients and staff and leading the nation in quality and patient safety.

To achieve these goals, the hospital has established the MGH/MGPO Center for Quality and Safety. Meyer explained that these efforts address all six of the Institute of Medicine's recommended aims for high-quality medicine — safety, effectiveness, patient-centeredness, timeliness, efficiency and equity. He also laid out a roadmap for reaching the MGH's goal of becoming a national leader in quality and safety and reviewed the guiding principles for the restructuring efforts at the MGH.

Meyer explained that the MGH will continue to build a strong foundation of clinical data sets to inform and enhance quality improvement efforts. Other goals include developing quality incentive programs for senior leadership and regularly focusing on quality and safety at clinical and administrative leadership meetings.

The FY '08 budget was the last topic of the meeting. Sally Mason Boemer, vice president for Finance, discussed the hospital's financial performance to date. Currently, the MGH operating margin of $55.1 million exceeds the budget by $16.8 million. This is driven by strong volume, primarily inpatient; strong payment rates; and royalty revenue. Expenses are running over budget in part because of benefit costs being over budget and all new programs and positions have not yet been ramped up.

Mason Boemer described the budget outlook going into the FY '08 budget process. Several key budget drivers — volume, expense management and revenue/payor rates — present some opportunities as well as challenges. Original requests exceeded available resources by $172 million related in part to requests for new positions and programs, a growth in supplies and services and lower-than-expected growth assumptions in outpatient areas. A balanced set of targets has been developed that focuses on revenue, baseline expenses and new programs.

To conclude, Mason Boemer explained that there is progress toward a balanced budget, and the MGH will continue to grow and add new positions next year, but not at the rates of recent years. The hospital's commitment to strategic plan objectives such as quality and safety, process improvement and clinical business development will be maintained or even increased, as will the funding of competitive compensation programs in support of the workforce.