The process creates a scorecard
that measures the extent to
which a Catholic health care
organization has integrated these
six principles into its structures
- Solidarity with those who live in poverty
- Holistic care
- Respect for human life
- Participatory community of work and mutual respect
- Act in communion with the church
Avera facilities are striving
to move past anecdotal examples
to specific measures to ensure
these principles are hardwired
into policies, procedures and
The CIM has been carried out at Avera McKennan, Avera St. Luke’s, Avera Queen of Peace and Avera Sacred Heart hospitals. In 2012, Avera was the first health care organization to pilot CIM with clinics and physicians through Avera Medical Group. Next, Avera has asked the Veritas Institute to develop a version for central services.
When the Sisters came to South Dakota over a century ago, they were guided by a set of concrete values as a ministry of the Catholic church. Today, CIM helps us ensure that despite the pressures of a changing society, we uphold those same values as we serve people most in need.J. Michael Stebbins, PhD
Executive Vice President of Mission
In 2014-15, Avera leaders
studied Food for the Journey:
of the Catholic Healthcare
Ministry, by Sister
Juliana Casey, IHM.
Topics for reflection included:
- Our experience of God
- The mission and ministry of Jesus
- Caring for the sick
- The meaning of suffering and death
- Serving the poor
- Environmental stewardship
In 2015, 1,250 Avera
leaders participated in
Leaders in Ministry
Leaders in Ministry, a nine-month theological and spiritual formation program for Avera leaders, has completed its 10th year. Monthly sessions are held at the Broom Tree Retreat Center near Irene, S.D.
Since its inception, 151 Avera leaders have participated in Leaders in Ministry
In the past year, 19 leaders completed the program.
91-94%* of employees report satisfaction in three main categories: job engagement, organization engagement, overall satisfaction
98%* understand how their job supports the organization’s mission
93%* are proud to be a part of Avera
*Percentage of employees who answered “agree or strongly agree” or “satisfied or strongly satisfied”
Five key drivers of overall employee satisfaction
- Administrative trust
- Management of the facility
- Employee recognition
- Understanding needs
Out-of-pocket medical assistance for unique or catastrophic financial situations that employees may face
25% premium discount for employees meeting income guidelines
Case management services to assist employees or their family members experiencing complex illness or injuries in navigating the health care system and their benefits
Avera Medical Group mission activities
- Mission formation sessions are held at the beginning of every meeting of the service lines
- Mission Advisory Council continues to send out quarterly “mission reminders” to all clinic staff
- Mission formation sessions are planned for each clinic.
Avera Medical Group LIGHT Program
LIGHT (Live, Improve, Grow, Heal, Treat),
is a well-being program for physicians,
physician assistants, and nurse
practitioners. Avera’s LIGHT program
represents a new level of care and action
to optimize personal development and
What LIGHT offers providers
- Strategies for sustaining a fulfilling career from onboarding to retirement
- Resources to help providers renew their enthusiasm for their practice or overcome burnout
- A continuum of care to help providers care for themselves, so they can reach out and serve others
- Proactive ideas to help prevent compassion fatigue and burnout
- Training program for providers and leaders to become Peer Strategy Coaches
Avera’s mission also involves making a positive impact upon the communities we serve, often accomplished through providing community benefits.
Examples of community benefits
- Community health services and screenings
- Health professions education
- Subsidized services, including Careflight, emergency services, hospice care, behavioral health services, and more
- Financial and in-kind contributions
- Community-building activities
By the numbers...
- Charity care/financial assistance
- Unpaid costs of government programs
- Additional community benefits
Through 140 partners, Avera allocates a total of $1.1 million in donations and sponsorships that qualify as community benefits – those programs or activities that provide treatment or promote health and healing as a response to identified community needs.
- Feeding South Dakota ($35,000) – Every week, this hunger relief organization provides temporary food assistance to approximately 21,000 individuals and families. The BackPack Program gives food every weekend to more than 5,000 school children who otherwise might go hungry. This sponsorship helped in the construction of new food banks in Sioux Falls and Pierre.
- Charis Ministries ($7,000) – With vehicles marked “Project Car,” volunteers help individuals with transportation needs get to medical appointments.
- Holy Innocence Ministry ($5,000) – This program operated through the St. Vincent de Paul Society of Sioux Falls assists needy families with diapers for their children, promoting better health and hygiene.
Number of clinic visits: 1,722,046
- Gross patient and resident revenue in 2015
- Net profit margin for investment in future services, technology and capital projects
A1 by Moody’s
AA- by Standard and Poor’s.
700 community partners
$5.3 million in donations and sponsorships
Avera is proud to partner with the
Washington Pavilion to sponsor the Kirby
Science Discovery Center’s Stage Science.
Opening in May 2015, Stage Science serves
as a permanent location to offer daily
The first exhibit focused
on Avera’s work in genetics,
and included a video on Genetics 101,
and hands-on genetic experiments,
like extracting DNA from wheat germ.
“Since the first sequencing
of the human genome in 2000, genetics
has become the future of medicine.
The Avera Institute for Human Genetics
is truly on the ground floor of the exciting
advancements happening today in genetic
science,” said Gareth Davies, PhD,
Chief Scientific Officer with Avera
Institute for Human Genetics.
“Through Stage Science, we hope to give young people a glimpse of what’s possible, and possibly inspire some to enter the STEM fields of science, technology, engineering and mathematics,” said Gareth Davies, PhD, Chief Scientific Officer with Avera Institute for Human Genetics.
Departments that have become centralized
- Risk Management and General Counsel
- Information Technology
- Human Resources
- Construction Management Services
- Centralized Business Office
their best strengths
and abilities, where they
are already located. While
jobs might change,
no jobs are lost in
Human Resources Centralization
Avera began bringing HR departments from all entities under one department two years ago. HR staff specialize in three key areas, serving the entire Avera system to solidify Avera’s standing as an employer of choice:
- Talent Management: Hiring, recruiting, onboarding, performance management, employee health
- Total Rewards: Compensation, benefits, awards and recognition
- Leadership and Organizational Development: Leadership and staff development and educational events
Also part of this team are HR officers – the “go-to” people at individual Avera locations who operationalize these three areas.
Over the past year, Avera Human Resources:
- Received and processed 41,400 job applications
- Hired 5,400 people
- Continued to serve 16,122 Avera employees and 2,687 volunteers
One year ago, Marketing at Avera centralized, bringing together 56 staff under one team—Avera Marketing. First year accomplishments include:
- Avera KnowledgeNet: Avera’s first system-wide intranet—more than 1,466,000 visits
- We magazine: Avera’s new quarterly magazine for employees and their families
- Community Partnership Program: Coordinates all donations and sponsorships across Avera. More than 700 community partners.
- AMG Newsletter: Avera’s physician and provider newsletter—1,365 subscribers
- SHE magazine: Avera produces an extra issue of SHE magazine for Mother’s Day
Avera Cancer Institute:
- “The Girls Will Thank You” breast cancer campaign—12 percent increase in mammogram appointments
- “Cancer Care Done Differently,” emphasizing Avera’s interconnectedness, cutting-edge science and holistic care for the body and soul
- “Butt Seriously,” raising awareness of colorectal cancer and the importance of regular screenings—15 percent more colonoscopies than predicted in April 2015.
- Avera Cancer Institute magazine.
“Live Better. Live Balanced:” Avera is starting a conversation in our communities to inspire a grassroots movement to position good health as leading to greater joy through a new narrative that’s simple, positive and emotional.
- Balance community newsletter – Provided to 250,000 households
- Live Better. Live Balanced. advertising campaign
Avera has developed the largest and most robust telehealth service in the United States and world that serves a rural area:
- eICU® CARE™
- eCorrectional Health
Avera eCARE is continually
innovating through pilot projects
to reach new populations through
e-services, including schools,
worksites and more.
A NATO team visited
Avera eCARE in June to gain
insights in developing an
network to extend specialty
care to disaster sites.
Patients touched:178,000 Past Year805,000 Since inception
Total sites served:235 Since inception
Health care dollars saved:30 million Past Year171 million Since inception
Square miles covered:545,000 Since inception across eight states
Advantages of AveraNow
- Available 24/7 for patients as young as age 2 into adulthood
- A real-time, two-way video visit with an Avera provider
- Evidence-based protocols ensure high quality care
AveraNow is one more option as part of Avera’s growing direct-to-consumer, easy access points of care.
- Home health technologies like AveraNow are predicted to increase from 14.3 million worldwide in 2014 to 78.5 million by 2020 (Tractica)
- Telemedicine delivers quality outcomes comparable to in-person visits
- Patients report a 96 percent satisfaction with this mode of health care delivery
- Telehealth is one of the most cost-effective ways to see a doctor. While an emergency room visit costs, on average, $1,500 to $3,000, an AveraNow visit is $49.
During open enrollment for
the Health Insurance Marketplace,
66% renewed members and 34 percent were new
individual policy holders.
We continue to cover the majority of policyholders who are enrolled through the Marketplace.
As of the end of FY 2015 88,204 carry the Avera Health Plans member ID card.
Also starting July 1, Avera Home Medical Equipment locations became part of Avera@Home, aligning equipment resources to holistically serve patients in their home.
- 16 home health and hospice locations
- 15 home medical equipment locations
- 370 employees
- 1,234 patients served in 2015
To support Avera’s clinical applications of personalized medicine using genetic science, the Avera Research Institute conducts research on the benefits of pharmacogenomic testing.
100 active studies
over the past year in
oncology, diabetes, pain
management and mental health Benefiting more
than 800 patients
The Avera Institute for Human Genetics is a CLIA-certified molecular genetics laboratory capable of performing high throughput genetics analysis for both research efforts and clinical application of personalized medicine. Current areas of focus include the following:
- Genetic sequencing to match the right drugs to patients for pain management, behavioral health and other conditions
- DNA analysis as part of the world’s largest twin study, shedding new light on the influence of heredity and a wide range of illnesses, including cardiovascular disease, pediatric bipolar disorder, ADHD and depression
Projects at Avera-owned facilities that were underway or completed in 2015:
- Avera Prince of Peace Retirement Community construction and remodel, Sioux Falls: $25 million
- Grasslands Campus and new Avera Medical Group Mitchell clinic: $19.4 million
- Coach Don & Carmen Meyer Center of Excellence, home to Avera Cancer Institute Aberdeen: $13.7 million
- Avera Medical Group 69th and Cliff new clinic, Sioux Falls: $11.75 million
- Neonatal Intensive Care Unit at Avera McKennan Hospital & University Health Center: $7 million
- Avera De Smet Memorial Hospital, new hospital addition and renovation: $3.2 million
- Avera Sacred Heart Hospital, Yankton, fourth floor remodel and update: $3.15 million
- Avera St. Mary’s Hospital, Pierre, OB remodel and new surgical clinic: $1.6 million
Avera’s response plan
- Travel screening questions of all patients at clinics and emergency rooms
- All-staff training and education
- Specialized training for direct caregivers
- Personal Protective Equipment (PPE) in place for personnel that might face potential threats, with preparations made to dispatch PPE as needed to any clinic, site or facility
- Plans to assess and isolate suspected Ebola patients in concert with South Dakota Department of Health and Centers for Disease Control and Prevention policy
- Plans to transfer confirmed Ebola patients to a government-designated Ebola Treatment Facility
Fortunately, Avera was not presented with an actual case during this time of heightened awareness. Because disease outbreaks can occur unexpectedly at any time, Avera remains ready with our plan for Ebola or other infectious diseases.
Avera Medical Group is an active member of the HCPLAN as well as a strong supporter of the national quality strategy.
Avera Medical Group quality achievements
- Successfully submitted Physician Quality Reporting System data for more than 850 providers. Overall, Avera was above national averages for quality while remaining less expensive than expected.
- Achieved 98 percent Stage 1 or Stage 2 Meaningful Use compliance compared to a national average of only 42 percent successful compliance with Stage 2.
Coordinated Care is specifically designed to help people who have significant barriers to improved health, such as multiple diagnoses, catastrophic illness, health literacy issues, or psychosocial issues such as lack of finances, depression, or lack of health insurance. There is no charge to patients for these services, but rather, Avera recoups the expenses through quality incentives earned through improved outcomes.
- Eight teams across the Avera footprint, each comprised of an RN as team coordinator, a clinic care specialist, and a social worker
- 1,010 patients active in the program
In 2015, Avera’s Coordinated Care program was recognized as among the top five of health organizations that participated in a Centers for Medicare & Medicaid Innovation (CMMI) Health Care Innovation Challenge Grant.
This is Teresa’s journey – we’re simply walking side by side with her. Anything she has accomplished she has done. We’re just there next to her to give her the support she needs and the inspiration that she truly gives back to us.Kelli Rockafellow, Clinical Care Social Worker
This higher and more consistent level of quality is achieved in part through evidence-based, best-practice protocols. By taking a system-wide approach, these transitions happen more smoothly, improve outcomes and create a better care experience.
Best Practice Success Stories
The Emergency Medicine Service Line continues to strive to improve the patient experience, quality of care delivered, and working environment for staff.
- Standardization initiatives include carts, equipment, medications and patient flow processes so patients receive the same quality service, no matter where they present throughout the Avera system.
- Careflight is developing a centralized communication/dispatch center and, ultimately, a unified aero medical program.
- Implementing these changes is projected to increase revenue by $160,000 and produce savings of more than $380,000.
Avera collaborates with Elekta to equip its locations with advanced cancer treatment technology. This includes linear accelerators, gamma knife and brachytherapy, as well as advanced software for treatment planning, cancer registry and electronic patient records, tying the entire system together.
In addition to providing consistent, high quality care across all Avera Cancer Institute locations, this initiative will save Avera approximately $10 million over the next five years.
Providing customers with the highest quality care is a top priority for Avera. In addition to positive patient outcomes, quality outcomes are tied directly to the financial performance of the health system.
Each year, 7.75 percent of Medicare payments are at risk based on performance in the Centers for Medicare & Medicaid Services (CMS) reimbursement programs. These programs drive system quality strategy and include preventing patient harm and unnecessary readmissions.
Avera advances quality beyond the required Medicare programs by voluntarily participating in the QUEST program through Premier, Inc. This program applies more stringent measurement than that of CMS, and allows Avera to compare our performance to top performers in the nation.
Quality initiatives fall into the following domains: Patient safety, evidence-based care, patient and family engagement, appropriate hospital use, mortality, cost and efficiency, and community health.
This past year the quality strategy has emphasized using a system approach to opportunities that impact not only quality of patient care but also coding, documentation, and cost of care.
Advanced analytics are being incorporated to validate the scope of the problem followed by performance improvement efforts at a system level. These projects have included transfusion reduction, pneumonia, sepsis, discharge disposition, inpatient colon surgery, surgical site infection, and the relationship of OB inductions to C-section rates.
For a complete report on Quality Measures, go to www.Avera.org/quality