Healthcare
Societal Responsibility
Without socially responsible leaders, organizations striving towards performance excellence in today’s market will get left behind. Ethical behavior and considerations for societal well-being are crucial elements to running a quality business. Leaders need to be role models for their organization by focusing on ethics and the protection of public health, safety, and the environment. The protection of these three elements includes the organization’s operations, as well as the life cycles of products. Effective planning will help to anticipate adverse impacts from production, distribution, transportation, use, and disposal of products.
Effective planning will help to prevent problems, provide a response if problems occur, and make available information and support needed to maintain public awareness, safety, and confidence. Henry Ford Health System, one of the winners of the 2011 Malcolm Baldrige Quality Award for Health Care, know how to think about these big-picture issues; HFHS community benefit initiatives have increased by almost 78 percent since 2006. HFHS’s commitment to patient safety is further emphasized through its evidence-based global harm campaign (evidence-based medicine integrates an individual doctor’s examining and diagnostic skills for a specific patient with the best available evidence from medical research) to reduce or eliminate some 23 sources of harm. According to the Institute for Healthcare Improvement, this program is a national best practice. HFHS’s performance in relation to overall global harm has improved from approximately 60 harm events per 1,000 patients in the first quarter of 2008 to 40 harm events per 1,000 patients in the second quarter of 2011. A prime example…
26Jan2012 | Joseph A. De Feo | 0 comments | ContinuedHelp Bootstrap My Baldrige Project
What do world-class hospitals and medical centers do differently? What can the hospitals and medical centers we use learn from them?
To answer these questions, I’ve launched a new project on Kickstarter to research and write a book called The Road to World-Class Healthcare. You can watch a video introducing the project and read a complete description of it here. The key to the book is the research: road trips to 20 to 25 world-class hospitals and medical centers across the country to interview leaders and learn about best practices.
To fund the research, I’ve posted the project on Kickstarter. A Kickstarter project succeeds by gaining backers who pledge financial support in exchange for rewards. Your reward for becoming a backer of The Road to World-Class Healthcare includes exclusive access to audio excerpts of key interviews, photos, and video of best practices. Invest more and the rewards increase. You can find the complete list of rewards here.
One of the reasons for posting this project on Kickstarter, other than to help fund the research, is to see if it can generate interest. If it meets the goal, the book will be written, and that book will appeal to mainstream publishers who expect authors to have a “platform” from which to market and sell their work. Kickstarter will help me build a platform.
Please take a couple minutes to check out the video and project description at Kickstarter here. I hope you will take a personal interest in supporting it. And, since this is a grassroots…
27Dec2011 | Steve George | 0 comments | ContinuedA Patient First Culture
It’s likely that every medical center claims to put patients first. Those that actually put patients first can back up their claims with tangible results.
Schneck Medical Center, a 2011 Baldrige Award winner, is a 93-bed nonprofit hospital in southern Indiana. “At the forefront of Schneck’s commitment to excellence,” it states on its website, “is the Patient First Culture.” That culture has enabled Schneck to score 100% on 17 of 22 core measures reported for the Centers for Medicare and Medicaid Services (CMS). Its patient satisfaction scores meet or exceed the top 10% or top 25% levels on nine of ten Press Ganey measures. Its hospital-acquired infection rate has been at or below 1% since 2008. It ranks second among 94 hospitals in its geographic region in value-based purchasing, which holds healthcare providers accountable for the quality and cost of their services.
An organization’s culture shapes its decisions. Schneck had limited treatment options for patients suffering myocardial infarctions, taking 120 minutes from the time a heart attack was diagnosed to the first intervention. To put these patients first, it collaborated with its largest competitor, located 25 miles away, to coordinate handing off patients who needed emergency cardiac catheterizations. The initiative has reduced the time between diagnosis and intervention to as low as 60 minutes.
A patient first culture does not mean that nothing else matters. Schneck also values workforce satisfaction: It has consistently been named one of Indiana’s Best Places to Work and recognized nationally as a “Best Place to Work” by Modern…
5Dec2011 | Steve George | 0 comments | ContinuedA Unique Healthcare Delivery System
For the 55,000 Alaska Native and American Indian people it serves, Southcentral Foundation (SCF) has cut costly emergency room and urgent care visits by 50% and reduced specialty care by 65%, primary care visits by 36%, and hospital admissions by 53%. Such impressive results helped SCF win the 2011 Baldrige Award.
Of those SCF serves, 45,000 live in the Anchorage, Alaska, area and 10,000 live in 55 remote villages accessible only by plane. SCF serves them through a unique health care delivery system, the Nuka System of Care, that focuses strategies and processes on wellness. The system is owned, managed, directed, designed, and driven by Alaska Native people, which SCF calls “customer-owners.”
These unique ownership and health care delivery systems are producing impressive results:
- Customer-owners can see their primary care providers on the same day if they call by 4 p.m. and arrive by 4:30. Seventy to 80% of appointment slots are open at the start of each day.
- Alaska Natives and American Indian people experience diabetes at twice the national rate. Since 2009, SCF’s performance levels for diabetes care have exceeded the 90th percentile of the Healthcare Effectiveness Data and Information set.
- SFC manages key performance data through DataMall where it is collected, aggregated, trended, segmented, and available to managers, clinicians, customer-owners, and employees.
- SCF’s overall customer satisfaction rating in 2010 was 91%. Its overall satisfaction rating on Consumer Assessment of Healthcare Providers and Systems (CAHPS) was 73.3%, significantly higher than the CAHPS TopBox benchmark of 46%.
- Staff turnover decreased from 37% in 2008 to 17% in…
Huge Health System Wins 2011 Baldrige Award
Kudos to the leaders at Henry Ford Health System, one of four Baldrige Award winners in 2011. It is very challenging for an organization to make the necessary systemic changes to produce repeatable world-class results. It is especially challenging when that organization has 140 sites: seven hospitals, 33 multispecialty ambulatory care centers, affiliated physician practices, a research and education component, the Health Alliance Plan (health insurance coverage for more than 467,000 members), and 91 community care operations.
Henry Ford Health System serves a three-county region encompassing Detroit and its suburbs with a workforce just shy of 30,000 employees, physicians, and volunteers. Its revenue in 2010 was $4.08 billion.
It’s hard to imagine the effort it has taken to keep this massive organization moving along the Baldrige path, but its results are a testament to its leaders’ tenacity:
- Rated #1 for member satisfaction among all health insurance plans in Michigan by J.D. Powers and Associates
- Satisfaction exceeding 90th percentile level for HFHS’s medical centers, with 80% likely to recommend
- Performance on CMS core measures at the 90th percentile for 75% of reporting areas across the system’s seven inpatient hospitals
- Evidence-based global harm campaign to improve patient safety recognized as a national best practice by the Institute for Healthcare Improvement
- Market leader in the area it serves, increasing inpatient market share by an average of 3% a year since 2004
- Maintained a positive net operating income despite significant increases in uncompensated care—approximately $200 million in 2010
- HFHS’s leaders model and support entrepreneurism throughout the healthcare delivery system
- Best-in-class innovations including the Perfect Depression Program,…
My Baldrige Experience in Iowa
Two days ago I took my 88-year-old mother to Wright Medical Center in Clarion, Iowa, for a hip replacement. We arrived at 6 a.m. and were greeted warmly by a woman in Admissions. Mom signed a few forms and was whisked away for lab work. I saw her again for a few minutes before they prepared her for surgery. An hour-and-a-half later, her surgery was done. I was talking to her in her room by 10 a.m.
She was expertly pampered for the rest of the day, able to get out of bed for a light dinner in the evening, walking the hallways yesterday, likely to be released today. None of it felt rushed. The attention was timely, focused, and compassionate. As a son, I felt relieved at the quality and efficiency I witnessed and at the high level of care my Mom received.
Wright Medical Center is a quality leader. It has integrated Baldrige by applying for the Iowa Recognition for Performance Excellence award. Two years ago, the quality processes it was implementing were described in Quality Progress, the magazine of the American Society for Quality.
I found all of this out when I was wandering the halls waiting for my Mom to get out of surgery. It relaxed me. I’ve worked with dozens of organizations that were integrating Baldrige and all of them aspire to be the best they can be. Wright Medical Center fit that mold. It is patient and family focused. Supplies—medicine, cold packs, food, etc.—arrived when they were…
6Oct2011 | Steve George | 2 comments | ContinuedBaldrige and Lean in Healthcare
For the last few years, nearly half of the Baldrige Award’s customers have come from healthcare, which is not surprising: Healthcare costs continue to rise without a related improvement in healthcare results.
Hospitals and medical centers embrace the Baldrige model for the systems perspective it provides. Senior leaders who have integrated Baldrige attest to the new knowledge it gives them about how their organizations operate, which means they gain greater control over the levers of success. In healthcare, where so many factors conspire to increase costs and decrease performance, understanding and controlling those factors is priceless.
One example is described here. Advocate Condell Medical Center, a 350-bed Level 1 trauma center in north Chicago, turned to Baldrige and Lean to tackle serious challenges at the hospital and its imaging business including:
- Ranking in the bottom quartile of patient satisfaction
- High percentage of denials and bad debt
- Negative growth
- 30% of calls abandoned or lost
- Report turnaround time of 16 hours
- A 6% no-show rate
- Cumbersome registration process
- Long patient wait times
- Low staff and physician morale
Baldrige provided the management framework for aligning and integrating strategies, plans, and activities. Lean improved process flow and eliminated waste by involving staff in identifying and eliminating wasteful steps and streamlining processes.
One year after launching the project, the hospital reported:
- Greater than top quartile in customer satisfaction
- Greater than 8% year-over-year profitable growth
- Reduced no shows to less than 2%
- Reduced report turnaround time to less than 4 hours
- Reduced abandoned/lost calls to less than 8%
- Reduced patient wait times from more than 30 minutes to less than 10 minutes
- Improved staff and…
