b'BOARD BOOKBLUE SKY VISIONINGLeveraging the deep market, environmental, and organizational understanding from the Discovery phase of work, we conducted an engaging and collaborative virtual Blue Sky Visioning (BSV) session in May 2021. The BSV engaged an intentionally-selectedcross-sectionof ARHleadersandproviders,allowingustoexperienceaspirational,critical thinking from multiple perspectives, and diverse backgrounds. At the end of our two-day session, a bold new vision, refreshed values, and four strategic goals emerged as the future of the organization. Over the course of two days,32 LEADERS & PHYSICIANS13 HOSPITALSREPRESENTING.APPALACHIAN REGIONAL HEALTHCARE // OPPORTUNITY STATEMENT MAY 11-12, 2021 we established a clear groupVIRTUAL WORKSHOP/MAY 11 & 12, 2021EVALUATE THE ORGANIZATION HEALTHCARE PRIORITIES THROUGH OUR STAKEHOLDERS EYESTransformational Agility VALUES Maggie // Patientcfa arvea nilaavbilgea ctoomr; mEduunciatyt iroens oounr tchees ;p Proopset-rp caarrteum fo ra nhde rp cehdiiladt; ric careunderstanding of the current state transformational agility Cspir Values:The deeply ingrained principles that guide all of a companys actions WANTS Connectiond itnog a osible and flexible care erventions to positively influence her personal t; A ore ational NEEDS Uprnodveidrsetrasn; Accesadjective noun P ccident Valuey s:V Those that a compan andards required of any employee Educ ARH; Acceptance and lack of judgement from providers; Emotional supporalues: Simply reflect the minimum behay needs to succeed in the fvioral and social stutureA thorough or dramatic change in form or appearance. The ability to express nimbleness and dexterity. Aermission tal Vo Plaalues: Arise spontaneously without being cultivated by leadership and take hold over time Trust in ation and financial resources; Int of industry trends and compared and support systemWOWS Childcare assistation; Supporance; Personal ct networare nak of other tvigateen parents; Employment opporor; Follow-up appointmenttunities; Strongly 3.2 4.1 Strongly 13% 13% ion 12% 12% 12% Col 11% 10% 19% 5% 3% communic contrasted within our environment. Connection to community resources; Financial aidTrust Compas Service CommunityInnovation aborationCommitmentResilienceStewardshipInclusivity Dr. Cohen // Community Primary Care PhysicianENGAGEMENT AND EXPERIENCE eliverya;l Tisitmsely refer APPALACHIAN REGIONAL HEALTHCARE // VISION FLIGHT PLANMAY 11-12, 2021Disagree y implementi ow-through forWRH has the resiliency t AgreePress Ganey show ter patient eexperty, technicience and higher employee engagement ha 1 NEEDS E pfafiticeienntsc; yC; oTnenste rcetsiounlttdo speci als; Communication; Quality care for hisWe also identified our mostTELLING OUR STORY READERS REACTIONSAReH A hskased: a history of discnigpl icnhea anngde. fol opportunity to learn and grow.o view failure as anbusiness performance, as ws that hospitell as beals with beter records in saf al quality, length of stay, and readmission rve betatter es. 1 WANTS Case managers to navigate patient care; Clear understanding of his futureMaggie // PatientW om Line:A e Asked:Hospitals that improve over time in distinctHCAHPS survey measures of patient experience or employeerelationship with ARH; Feeling appreciated and valued from care teams; Mutual successfulHistorically, disciplined execution and focused,ARHthas a hig h level of resiliency with a greatengagement also see improvement in patients global ratings of their care. 2 WOWS agreement to put patients firstimportant current and aspirationalQualit atient Experiencal, fe orming par ARH has been successftnerships with educul in moving cational institare beyond utions, and Bot Boom Line:decisive action has not been a core attribute. opportunity to learn and grow from historical failures. Doctors put in a positive mood before making a diagnosis show almost 3x more intelligence and creativity thanOn-demand access to ARH technology; Telehealth availability for patients; Wellness doctors in a neutral state, and they make accurate diagnoses 19% faster. resources and outreach the four wy & Palls of the hospitEXPECTATIONS FOR CHANGE 2. Achor, ShawnThe Happines Advantage2010. Hugh // Nurse developing innovative technology solutions. ARH has an opporare resources. Howtunity for improvement ever, I 1. Buhlman & Lee - When Patient Experience and Employee Engagement Both Improve, Hospitals Ratings and Profits ClimbHBR2019. in addressing patients basic social needs and providing childcCHANGE EXPECTATION // Our future will require our people to: INTERNAL AND EXTERNAL RESOURCES NEEDS Work lifee-; bMaelanntocres; hInipd;i vRideluiaablilzee adn adp sptraebcliea tcioon-w aonrdk erresc aongndi tsiuopne; Drveispoerndable and flexibleorganizational values. believe that they will r ting me to schedul The Future of the Worise tkforo the challenge.ceARH has met my needs and wants through their Without infinite bandwidth (financial resources, human capital, time, and expertise), organizations should exploreWANTS unities;reputation as the provider of choice in the community. I am confident that I am receiving creative w xisting care deliv ery mechanismsConsider virtual care opportunities beyond direct-to-consumerAccessiblea wteiolnln ceshsa npnroelgsr wamith a lneda mdeernshtaipl ;h Teuailttiho nre rseoimurbcuerss; eCmareenetr;Agrnonwutahlsoaplaproyrtthe best career paths within the organization. Maximizays te eo deliver more. C possible c are when I am here. ARH has also gone above and beyond in connecinocmremasuensi;c Understand the why20 such as consults with sub-specialists or remote robotic surgeries; Maximize throughput and capacity by managingWOWS Competitive benefits; Incentives for working overtime hours; Welness incentives;The Evolution of Care DeliveryARHs virtual telehealth visits, care navigators, and 0 Adapt to the Future 11 across facilities; Closely examine where the value of investments are not fully realized such as equipment, services,Retention bonus / rewards for time of service at ARH 2 QUALTY & PATIENT EXPERIENCE 2 THE FUTURE OF THE WORKFORCE 2 THE EVOLUTION OF CARE DELIVERY 2 EXPLORING TEAMWORK & SYSTEMNESS Teamwork & Sve been eystory. I also greatly appreciat omens support groups I have found home visits ha xtremely helpful resources for me as a new mother.or human capitalRemain the SameFundamentally Change Seek opportunities to influence external factorsMeet patients where they are through formalized targetedMimi // Educator Where did we focus eforts in order to transformHow did ARH secure the talent needed to meet theWhat r stemness? ual care play in pursuing qualityWhat led t to promote my st emnessI enjoy serving as an e the wARH ambassador in the community outreach efforts to underserved communities and high-r in America? n? and syole did virt Fewer contro graceatted/er tafeamfiliatwed employeesork? through ARH.schools, and religious institutions that provide safety-net health services; Leverisk populations; Create parage financial ctnerships with locapital to bolstal non-profits, er NEEDS Convenience; Orthopedic services; Awareness of employment opportunities for herIntualLearning from each othertelling the stories ofDr. Cohen // Community Primary Care Physicianally changelocal infrastructure WANTS students; Other womens health services; Medical spa services; Dental services r urAaclh hieevaeltdh s aynstde wmenlel-sbs eaicnrgo ssstAoR aHls As o fl oAcRatHiosn rse gionalo rgdaeniztaifiteioddtloalceanl tt aw RStood up an Emergency Department that is virer others doing great things Quality & Patient ExperienceARH has done an outstanding job addressing Social Cultural education about the service area and population; R Pcrhooviodl esdy stteelemhsealth service Identifie nal visiloeitnhtin a tt hae y oorugnagneirz aatgioe n to growUtilized the TeleICU and Command Cent Peer-peer coaching, mentoring programs, manager The rapid pace of change in the healthcare industry requires us to fundamentare. QUALITY activity programs for her students; Local professional networehab services; Phk of colleagues; ysicalic ilneses, obesity, hypertension,caer-ereercsruited people who have left the region to comenot an exceptione patient monitoring as the norm and development and upskillingDeterminants of Health and comorbidities in the community. They have also succeeded how we view the patient relationship and deliver c Used remotPRIDE IN ARH teamwork Quality cannot happen in a vacuumFully leverage resources to improve quality and employee pride and satisfaction. Healthier food options; Great pediatric care for her students anddd raedsdsiecdti ocnhr wonittsh aintothuercpooimnmt oufn eitnitersy to provide aS B ive10 back (combat r ing the Eastern Kentucky drain) 10 Developed apps that inform dietary and wellness10New employee mentoring progr in provider recruitment and retention efforts and expanded access across the region Using technology to beter connecamst teamsemployee e e together orts service love my job and teamcommunity committment y t purpose ngExternal Factors: Education access and quality; Neighborhood and environment; Air and water quality; Access to E make excusesWOWS Partnership with her school on cAcknowledge when w or addressing obstacles tsThe group also clearly defined10 Int w w b Engaged patien c it ne m smhighest20 bWhat relationsehciopnso dmidie As?RH enhance or foster to R P G C R s c e p 28e f information -centered approach and mes differently?t patients19 personal connec A 12 HO tR P s I ARH should look to provide.Sruercaal mheea tlthhe p perirmspaectiveservices by both patients and providersmore mental health resources terms of areas fo their employees.or future improvement, nutr nal Facoods; Economic st ext medicine program for her needs and stareer opporudent athletunities and medictes; School nursing progral education; Sporam;consistent standarrdyoefa cralyr eadopters from a nationals upCpoolatb loorcaatel d with community partners to enticeCombated adoption and perception of telehealthWhat characteristics will embody great teamwork? through telehealth. In tdedicated to patients Interitious f tors: Psychologicaability; Social and community cont Medical care on demand; Local option for half marathons peerrsvpedectiveb pa eortpnlee rteod r wetiuthr ns ctho oEoalsst aenrndKceonl tugceksy to identifyHow did w Understanding Ation tRHs o itWHY and feeling a strong,The Future of the ing reliable cWorkforce are. I see the health syst The stable, high-quality wem as a parorkforce at tner for trARH has seaining mt them y own l safety and reporting; Standardization of care; Health equity; Patient-centered outcomesas a leadoethrfarto mthe t hseta ated vaoncda ncya tainodna lle lgeivselaltTook a patiente reach our patient Recognizing and celebrating each other for theirapart in deliveropportunity to give back CURRENT ARH ENVIRONMENT LIQUIDITY OF EXPECTATIONS at investments and partnerships did we make? local talent rn program with senior high schoolwhere they want to be met contributions more often than once per year staff and am considering working full-time for ARH. cialists throughout the region positive competition ARHs mission supportive rise to the occasion A FOCUS ON OUR PEOPLE: eams and equip managers to help their teams throughWhat is unique about D oduct, values, How can ARH apply similar lee do not meessons going ft patient orward? Whernal th trueedmwenteotxs tAe tRoH help identify career paths and introduceCreated remote locations outside the walls of How did you connect the larger vision and goalThdetEhveoilru atbioilnit yo ft oC faurret hDeerl iavdedryre s sA eaHms- bacacsee ds c taor es pheacls m mpye cnteaetdio sn asn, din wceannttisves, culturert Harness the energy and commitment of individual t and interactions with itominos prs customers? expectations Invested in our technology platforms yee compensation andthe hospitalthroughout all levels of the organization? anotential gaps and barriers that must be addressed inudee te xsupportabove and beyond community coming togetherchange and drive greater systemness. Listened to the customers needsTake feedback and use it as a catalyst to improve future state success for our keyRestructured oure snutp ptol yr ecchrauiintmanedt hreotdaoilno gthyeeHeonwe fiditdseemvopllvoea?lary adjustments for cost of livingUsed home hospital, pharmacy on-site to helpPromote ARHs WHY from the first moment anP nd cownortrk & Sact alyigstnemnementss . S T Lcollegial suppo family Explore a huitment goals and the associat Did not dispute the customers feedback orEmpower employees to be creative and makeMade a c loiinn o ployees from an education andovoenrs tidheer eyeda srs ividuals for service years explain medicationemployee joins the organizationaeam Aresiliency positivity team qualtiy cornerstone our peopled appreciate resilience leadership technology adaptablecommitment to growth Define recr Looked at the problem internally, bringing everychanges Invaelsittye d m views on health and wellness ation to change patientsBecome less task-oriented in management andTARHs teamwork efforts and strong communicechnology for on-demand access tation, upside o Provided community educadopted technology qu icmiuarExpanded access for our patients onboarding of new employees benefits from being part of the ACO, and enhanced tcommunity suppo ybrid work-from-home environment ted strato ategy, as much of the wtract and retain top toralent.kforce retires.Reward employees f Invoerest reidsk isn a innndo fvaailt ifast / priorit to the individua fits and compensationHow did we use our existing resources moreDevelop leadership academies for all levelspatient results have wowed me.culture and peoplrtclinical guidelines mission trust A FOCUS ON OUR PATIENTS: person at every level in t and criticism development perspeocnt,i uvnederstaizned oinugrhdoecwi stioo tnaskAeloowgendiz feodrtinaidlolrse nde beednseectivaged physician liaisons / ambassadors withCreate deep bonds for sharo disseminating ideas and creativitiese the vision andHugh // Nurseconnectionseconomic suppo Put effort into getting quality rightIf we do not, someone else will. Took the feedback as an opporo fix the problemtunity for m Lever ely?translate that to their unique worldcollaborativrt improvement and succeededquicker H additional IT capabilities Provide the resources tevidence based care caring value we brieCenter the impact to the patientWe have the ability to make their lives positive or negative. What is unique about Deltas product, values, andHow can ARH apply similar lessons going forward? External y beneficial partnerships with our24oTwi eddid e AvaRluHa trieownsa/rpde erfmorpmloaynecees t do icfofemrpenen tlsya?t ionLeveraged teleneurology for other medical27What does systemness mean? Quality & Patient Experorship, growth, and continual educienceARH has met mation oppory expectations as an employer of choice tunities.my hospital estrong regional employees people sense of communityInvest in operational and compensation changes that impact quality data. int ted demands c byus entomercouras?ging the feeling of Generate excitement around returning to ARH andaudiences, both internal andFormed mutual adjustmentsdisciplines Create the same eor new employees, fxperience and consistor team members, ency for through mentaccountabloutreach eff survivors serving the underservedeconomic backbone A FOCUS ON OUR COMMUNITY:erCacreations with it let the community know it is saf eedback competitorsCeewleabrrdaetedd l opnegoepvliet ya nadn dth teeinr ucroentributions toUtilized ARH Connected Care in job titles, and in performance standards The Future of the WorkforceAt ARH, I know that I am vjoy the additional woralued, mk-life balance and fley opinion counts, and xibility cellence exteam shar unitedconnection to community patients, fquality of care patients focus adaptabilitcommitmenAddress the challenges of the community including children in poverty, obesity, mental health challenges, exmciptheamseiznetd the safety of returning to travel Drive greater patient engagement and fe co H our mision 35Ho ARH develop cvelop sucareerces, fssion planning?oster employeeand expectationsI can trust the health system. I also enFooramrdesd t op abrutinled rosuhrip psi pweitlihn ee ducators and workforceExpanded and broadened our home health servicessurvivors Formmmeudn pitayr tgnreorusphsip isnwthieth r eemgiopnlo yers or otherention, and de transferring patients where they cork across the specan best be servedtrum bythat AvRHolution o provides.f Car and teen pregnancy. C Leverage areas of best practice to provide anexternal, in order to develop aIniovtrehks fatoderddci ecin td itoernveaeltompemnet,n rte fhoar btihliotastei othna et fsfotrrutsg,g alned36reotwen dtiidon A, RanH dd edveevelolopp c asurecceress,s fioosnt eprl aenmninlogy?eeU retw didateBreak down silos and w The E e DeliveryARHs ability to streamline processes and make Provide access to healthcare differently, for all generations.Kreepatt tehde a p vaisssioenn gfoerrs th bee fsutt uinrtee trehsrot uagt hh enaerwtchange exceptional experienceand ambassadors for ARH information quick syster, screm tipting to help communico exceedThink of each hospit ockys patientbut information more accessible at the bed side has allowed me to take care of my patients Enhanced the ITInvest in the workforce by starting education early and driving a cultural change. Employees serve as br expectations rather than a standalone entityal as a department of ARHin a more timely manner.HEALTHCARE 30What was the best yardstick to truly measure qualityTatirlgizeetde dt heef fboretnse ffiotrs s oufc cseyssstieomn pnleasnsn ingE Enhanced health and wellness by partnering with36 Avoid labelsnot R ss while stillTeamwork & Systemnexsstra resources and supporThe collegial support that I need tt associated with o succeed. I also ARHs eICU has RHs patient 2021 Dixon Hughes Goodman LLP. Al rights reserved. DHG is registered in the U.S. Patent and Trademark Office to Dixon Hughes Goodman LLP. specific vision for our future. a nAancahliyesviisn,g proces improvement, and standardizationU F wenrdee crstood personal goals and desired career pathscommunity organizations How did we work toward socultysurtemnees? provided me with the ed patienteoxupr e5r-isetnarc ejo?urney through root causevaluauterdre jnotbly fi itn d tuhreiinrg r orelecruitment and while theyEmphasized preventative care honoring regional micr appreciate the eductifications.ation and advancement programs at ARH that allow me to earn Invested in telemedicine infrastructure additional cer Percentage of patient return to ARH for careP Doecvuesleodpe odn m eamnpalogyere etr raeincionggn pitrioognr ams D Developed grant progrechnology solutionsams to help our patients moreMaintain the elements of local cultures that makeMimi // Educatoreasily access t those communities unique and specialEomspitliovyee ber amnodr arleec oangcneit oionnour core measures connect with them at a local-level edic chalenges.This vision ultimately informed Excelent perform 43W greovwetloh poepdp aonrt AunRiHti einsc fuobr amtoarn atog eprros/vliedaed setrrsetch and43 Celebrate local wins in their own unique wem-level and ay Quality & Patient ExperienceARHs focus on telemedicine has helped address my Engage with employees at a systpihvoatt iwnge rteh eA RfuHtusr ecr oitf itchael isru wcocreksfso fraccet?ors whenWhat economics of scale were pursued?neheed Fsu atunrde w oafn tthse r eWlaotrekdf otorc me yoArtRhHo phas gonroeg arbaomvse,amnedn btoeryionng,d a innd p sahrtandeorwinigng w. Tithhe my yaThoroughly evaluated our culture to identifyTCoemvemloipteddat ocuarlteuerre a osfp uirnadteiornsstand Policies, protactices in meeocols, and sttings and agendasandards screh osohla tpoin pgr othveid efu htuerael tohfftahiresir,ewdourckafotirocnea al npdh athveeAacRcHe scso tmom vuirntuitayl. orthopedic consults, the early structure of our strengths andwa ceaulktnurees soefs flexibilityinD R e g and support forBest pr Tpheec Eiavloisltust,i hoonm oefCviasriets D, aenlidv ecrayr enAavti AgRatHo,r sI . These resources have helped me quickly sadopted consistently across the systare stemandards Evidence based medicine and ceaecvha motpheedr ssy cstem orientation to start of on aPurchasing power and supply chain contractingget back on my feet.Staffing and resourcing for providerscollective strategic plan. positive note and educate them on the culture of ARH bargaining limitations Tamwork & Sysuct. d around jobs and fuetcukrlees- dfoorw mn ye fsfte temdenntes sissin cTrehdei bolpep. Torhteu nciotmiems AuRnHity h waisl lc grreeaatetly benefit from this triHEALTHCARE 2021 Dixon Hughes Goodman LLP. Al rights reserved. DHG is registered in the U.S. Patent and Trademark Office to Dixon Hughes Goodman LLP.STRATEGIC PLAN ARCHITECTUREMission: To improve health and promote well-being of all people in Central Appalachia in partnership with our communities.Vision: ARH will be the premier destination for quality care, a driver of advancement and development, and a leader in health for the communitieswe serve. GROW COMMUNITIES FROM WITHIN PROVIDE A DISTINGUISHED EXPERIENCE At the end of Blue Sky Visioning, Invest in the development and healthPurposefuly listen to and incorporate of our people as the key pillar of ourfeedback along with objective data to communities. improve the way we deliver on our mission. the early structure of a strategic Mission plan emerged. This plan is centered VisionValuesTRUST around our Mission, Vision, and N INO NS SERVICE O Values and expresses four key IVSAATP MIO N OCCOLLABORATION strategic goals to help us move toward this vision for our future.CURATE HIGH-VALUE SERVICES SERVE THE GREATER GOODPursue innovative solutions and targetedImprove access to routine care,growth to deliver on our commitments toresources, and education as a thought the community. leader and strategic partner.HEALTHCARE 2021 Dixon Hughes Godman LP. All rights reserved. DHG is registered in the U.S. Patent and Trademark Office to Dixon Hughes Godman LP.7'