Ascension Health’s Approach to Transformational Development

1. Ascension Health’s Approach to Transformational Development Ascension Health Board of Trustees September 13, 2007

2. Healthcare That Works: Consistent, Exceptional Ascension Health Experience Through Holistic, Sustainable Models for Life Healthcare That Leaves No One Behind: 100% Access Through National Advocacy, New Models for Care and Transformed Access Leaders We have embraced a Strategic Directionto realize our 2020 Vision Total Satisfaction Healthcare That Is Safe: Clinically Excellent Services Across the Care Continuum and the Community Total Excellence Total Access Presence as Needed at Full Potential Vital Presence Knowledge on Demand as a Connected Ministry Empowering Knowledge Integrated Alliance Network of Values-Compatible Partners Trusted Partnerships Model Community of Mission-Centered, Healthy Associates Inspired People 2

3. Healthcare That Works: Consistent, Exceptional Ascension Health Experience Through Holistic, Sustainable Models for Life Healthcare That Leaves No One Behind: 100% Access Through National Advocacy, New Models for Care and Transformed Access Leaders FOR LIFE! Total Satisfaction Healthcare That Is Safe: Clinically Excellent Services Across the Care Continuum and the Community Total Excellence Total Access Presence as Needed at Full Potential Vital Presence Knowledge on Demand as a Connected Ministry Empowering Knowledge Integrated Alliance Network of Values-Compatible Partners Trusted Partnerships Model Community of Mission-Centered, Healthy Associates Inspired People 3

4. RISK: Transforming innovations come from other healthcare sectors We have recognized that our current approach represents good strategy, with risk Operations Performance Strategy Time

5. …our evolved approach requiresfocused resources to Optimize Operationsand dedicated resources for Transformation Optimization Strategy Transformational Strategy Performance Time

6. ES

7. If Not Us, Who?If Not Now, When? • Compelling need to transform healthcare to achieve Strategic Direction • Ascension Health positioned to lead this work • Mission and Vision • Role within healthcare • Call To Action results • Evolved structure provides focus and urgency • Will benefit from the gifts of all

8. Two Tracks of Transformational Development Work • Sharpen our Focus on “What’s Next” • Nurturing seeds planted today to ensure Ascension Health is positioned to deliver what is “next” toward accomplishing our Strategic Direction • Extend our Line of Sight to “Beyond Next” • Developing and planting new seeds through the identification and exploration of complementary models and/or disruptive innovations with the potential to transform Healthcare and achieve our Vision

9. Ascension Health’s Approach to Transformation Societal Health Transformational Development Scope of Transformation Track #2 Beyond Next Healthcare Delivery System Track #1 What’s Next Operations Optimization Deliver the 5-year ISFP Healthcare Operations Short-term 2020 Vision Realized Medium-term Long-term Time Horizon

10. 7 5 4 3 2 1 6 Strategic Direction serves as a construct for Operations Optimization & Transformational Development Operations Optimization Transformational Development + = Vision Realized 5 Year ISFP Period 6-15 Year Window 2005 2010 2020 Examples Examples • AH Experience for those we serve (patients) • AH Experience for those who serve with us (associates, MDs) • Optimizing patient flow and caregiver effectiveness • AH role in navigating healthcare options & resources • Financially sustainable models (new revenue streams, more sensible delivery & payment systems) Consistent, Exceptional Experience Through Holistic, Sustainable Models for Life Total Satisfaction • Priorities for Action to eliminate preventable injuries and deaths • Standardized meds administration technologies to minimize ADEs • Integrative palliative care models • Redesign physician relationships • Chronic disease management • Evidence-based predictive models and practices • Clinical research capabilities • Preventative care management • Community wellness Clinically Excellent Services Across the Care Continuum and the Community Total Excellence 10

11. 8 9 10 11 Map Strategic Direction serves as a construct for Operations Optimization & Transformational Development Operations Optimization Transformational Development + = Vision Realized 5 Year ISFP Period 6-15 Year Window 2005 2010 2020 Examples Examples • Develop core leadership capability for 100% access • National public policy partner towards sustainable national funding model for 100% access • Advocate for legislation that expands access for patients served by the public safety net • Support HMs to develop Access Leadership Plans to implement the 5-step model to 100% access 100% Access Through National Advocacy, New Models for Care & Transformed Access Leaders Total Access • Implementing Ministry Configuration recommendations • Ambulatory development • Strengthening the Catholic health ministry – Catholic consolidation • Strengthening the Catholic health ministry – innovative collaborations and Broader Context exploration Presence as Needed at Full Potential Be Where We Are Needed, How We Are Needed to be There 11

12. 14 12 13 Strategic Direction serves as a construct for Operations Optimization & Transformational Development Operations Optimization Transformational Development + = Vision Realized 5 Year ISFP Period 6-15 Year Window 2005 2010 2020 Examples Examples • AH knowledge architecture • Community, regional and national connectivity • Clinical information systems • Digital imaging systems • Event reporting system • ERP systems (Fin, HR, SC) • IT infrastructure management • IT application imp./support Knowledge on Demand as a Fully Connected Ministry Bring All That Is Known to Someone Known to Us at the Point of Service • Continuum partnerships to optimize current model • Support partnerships to optimize current model • Continuum and support partnerships that catalyze transformation Alliance Network of Values-Compatible Partners Provide Access to a Full Continuum of Care for Life 12

13. 17 15 16 Strategic Direction serves as a construct for Operations Optimization & Transformational Development Operations Optimization Transformational Development + = Vision Realized 5 Year ISFP Period 6-15 Year Window 2005 2010 2020 Examples Examples • Developing a pipeline of inspired, qualified caregivers • Leadership formation & development • Workplace spirituality • Associate satisfaction/ engagement improvement • Leadership formation & development • Workplace spirituality • Associate assessment/selection • Socially just rewards • Associate health promotion Model Community of Values-Inspired Healthy Associates A Model Community that Fosters Spirituality in the Workplace and Is Intentionally Committed to the Health and Well-being of our Associates 13

14. 2 1 5 6 7 8 9 3 4 11 16 10 12 14 13 15 17 Map Ascension Health’s Approach to Transformation: Strategic Direction as Organizing Construct Societal Health Transformational Development Scope of Transformation Track #2 Beyond Next Healthcare Delivery System Track #1 What’s Next Operations Optimization Deliver the 5-year ISFP Healthcare Operations Short-term 2020 Vision Realized Medium-term Long-term Time Horizon

15. Ex Constructing and filling a virtual pipeline of input, partnerships and projects with traditional and non-traditional sources # of ideas in each stage decreases Virtual scanning/ networking Informal affiliations Formal engagements Seeding/ incubating Integrating components Test & validate Development Scanning/Discovery Intensity of AH resources increases

16. Health Ministries President’s Council Serves as Supporting Cast to Operations Optimization and Transformational Development “…the President’s Council will serve as the “supporting cast” to both Operations Optimization and Transformational Development, offering advice and counsel to ensure value creation for our Health Ministries, and, ultimately, those we serve as we work together to accomplish our Strategic Direction.“ Those We Serve Testing & Validation Adhocracies Transformational Development Operations Optimization President’s Council CEO

17. Wco Health Ministries The Core Group of Transformational Development will add selected resources and rely on President’s Council members “…the President’s Council serves both as the “supporting cast” and as content contributors/leaders of components of the Transformational Development agenda, offering not only advice and counsel, but actually leading the work within their areas of expertise or pioneering work in non-traditional areas.“ Those We Serve Testing & Validation Adhocracies J Doyle S LeResche H Kim E Engler Transformational Development Operations Optimization J Impicciche Sr. Maureen Sr Bernice S Levy D Pryor B Henkel T Speranzo T Tersigni

18. Health Ministries President’s Council Also Serves as Supporting Cast to Operations Optimization “…the President’s Council serves as the “supporting cast” to Operations Optimization offering advice and counsel to ensure value creation for our Health Ministries, and contributing to operations programs upon request.” Those We Serve Testing & Validation Adhocracies B Henkel S Jeffcoat L Kaiser 9 Ministry Market Leaders Transformational Development Operations Optimization J Impicciche Sr. Maureen Sr Bernice J Doyle T Speranzo S Levy D Pryor T Tersigni

19. Screen 2** Strategy & Development Operationalize R&D Testing & Validation Knowledge Management Effective Rapid Cycle Decision-making Process to Achieve Nurturing, Nimble, High-Performance Transformational Agenda Screen 3*** Discovery Theoretical Collaborative Prototyping Validation of Value Prop Replicability Operationalize Screen 1* Degree of Involvement Spread/ Migration Design Development Full Operations Pure Research Preparation Piloting Low Time *Screen 1 = Transformational Development Leadership **Screen 2 = Collaboration between Transformational Development & Operations Optimization ***Screen 3 = President’s Council Agenda Management Pro

20. Focused Inquiry • What areas need greater clarity? • What guidance would the Board provide regarding the components that will be essential to ensure a successful launch of Transformational Development? • What meaningful symbols, resources and other commitments would the Board suggest to demonstrate our commitment to transformation? • How do we ensure that we stay the course for this work when the culture is primarily operations and shorter-term performance driven?

21. Transformational Development Elevator Speech Our Mission compels us, our strength enables us, and our experience empowers us to lead the transformation of healthcare.  The time is now.  We have the purpose, the passion and the people. Back

22. Why These Things Fail Not establishing a sense of urgency and compelling vision – recognition by the organization of why transformation is required (making the status quo more dangerous than launching into the unknown)Not creating a powerful enough guiding coalition – titles, expertise, reputations, relationships, influenceNot establishing credible communication that captures the hearts and minds of the organizationNot removing obstacles – organizational structure, compensation/performance appraisals, etc.Not anchoring changes to the corporation’s culture – including ensuring that the next generation of management personifies the new approach Background Info Excerpts from “Why Transformation Efforts Fail” Harvard Business Review

23. Ascension Health’s Approach to Transformational Development Ascension Health Board of Trustees September 13, 2007