ASQ Healthcare Division Newsletter
May / June 2010
Learning from the Best
As a healthcare professional, you’re probably always looking for ways to improve the quality of the care you provide. What if I told you that I know how? Steal shamelessly! As members of ASQ, you may be shocked to hear that coming from an ASQ Fellow. What if I told you that the very people you’d be stealing from want you to do it? Read on.
Healthcare has been bitten by the “Baldrige Bug” as evidenced by the 42 healthcare applicants out of a total of 70 applicants in 2009. And two of the five 2009 Award recipients were from healthcare. At the recent Quest for Excellence, I had the opportunity to listen to many of the presentations from these recipients, Heartland Health and AtlantiCare. Both provided inspiration as well as insights into their journey toward Performance Excellence.
What has been the appeal to healthcare to adopt Baldrige? The Baldrige National Quality Program is a public-private partnership whose objective is to improve the performance of U. S. organizations. The first Baldrige Awards were presented in 1988. Initially targeting manufacturing, service, and small business, the scope was expanded to include education and healthcare in 1998. The first healthcare organization, Sisters of Saint Mary (SSM), to earn the Baldrige Award occurred in 2002. Since then, a total of 11 healthcare organizations have been named Baldrige Award Recipients. And many, many more have been recognized at various levels of achievement by their Baldrige-based state programs.
What is so compelling about these recipients? Results. Results across a variety of important indicators: clinical outcomes, patient safety, physician satisfaction, employee engagement, financial and market-share performance. Let me share a few of these impressive results from the 2009 recipients.
Heartland Health is a not-for-profit, community-based integrated health system in St. Joseph, Missouri. Patient safety is driven by the vision “to be the best and safest” as a key element of the organizational culture. Senior leadership establishes and monitors patient-safety measures through the use of a patient-safety scorecard. When scorecard measures fail to reach goals, leaders make improvements as necessary. In 2009, Heartland Regional Medical Center received the HealthGrades’ Patient Safety Excellence AwardTM. An independent healthcare rating organization, HealthGrades presents this award to hospitals with overall patient safety records in the top 5 percent of the nation.
The Commonwealth Fund, a nonprofit quality rating system, ranked Heartland Regional Medical Center the 19th-best hospital in the nation in 2009, based on measures of evidenced-based care, patient experience, readmission, mortality rates, and costs. In 2008 and 2009, it ranked in the top 1 percent of hospitals.
And even in the past two years of significant economic challenges, Heartland Health consistently maintains its Moody’s and Fitch bond ratings of A and A2, respectively. In fiscal year 2009, the organization exceeded the Moody’s and Fitch current bond rating requirements for days cash on hand and achieved performance in both rating agencies’ top 10 percent for total margin and operating margin.
AtlantiCare is a not-for-profit health system in southeastern New Jersey. AtlantiCare Regional Medical Center achieved the Centers for Medicare and Medicaid Services national top 10-percent performance in 2008 for patient care measures related to congestive heart failure, acute myocardial infarction, and pneumonia. From 2007 to 2009, survey responses for multiple service lines, including those for the Surgery Center, the Spine Institute, urgent care, and clinical labs, show customer satisfaction above the Professional Research Consultants (PRC) 90th percentile national benchmarks. In customer preference, AtlantiCare was the 2008 market leader over competitors for the overall system.
AtlantiCare’s current employee-loyalty index score from an Allegiance Technologies survey indicate that it is the healthcare leader in this measure while results from the 2009 HR Solutions survey of key drivers of workforce engagement are equal to or approaching 90th percentile national performance levels. The annual turnover rate for nurses declined from 7.75 percent in 2006 to 6.02 percent in 2008, significantly outperforming the New Jersey Hospital Association average of 12.43 percent. In 2008, AtlantiCare was recognized by the American Nurses’ Credentialing Center as a Magnet nursing organization, receiving the nursing profession’s highest honor for the second time.
Similar to Heartland, AtlantiCare demonstrated strong financial performance during challenging economic times. From 2000 to 2008, its revenues grew from $280 million to $651 million, an 11 percent compound annual growth rate, compared to a state average of 5.6 percent. During the same time frame, its medical center volume increase from about 34,000 to more than 56,000 discharges—also more than twice the state average.
At this year’s Quest for Excellence, the senior leaders of all of the recipients talked about how important it was on their journey to learn from other organizations that were further along. They spoke of how those best practices, adapted for their organization and its culture, accelerated their rate of improvement. Heartland, AtlantiCare, and all of the other healthcare recipients of the Baldrige Award want you to steal their best practices. They offered them freely at the Quest for Excellence, and they will do so again at the two regional conferences: September 14 in Newport, California, and September 28 in Nashville, Tennessee. And if you can’t wait until September, go to the Baldrige website and “purloin” a few of those best practices that can be found in the application summaries, http://www.baldrige.nist.gov/Contacts_Profiles.htm.
Message from the Chair
Please Join Us in Making a Difference This Year!
Inevitably in life, there comes a time when one must move on. Regrettably for the HCD, that time has come for David Eitel, MD, who has led the HCD through a year during which his father passed away; he wrote a book, Emergency Department Throughput; taught a graduate course in process improvement, and resumed the practice of emergency medicine after a long hiatus. Dave has decided for personal reasons not to complete the second year of his two-year term as HCD Chair.
During his watch, the HCD generated the ASQ White Paper on Healthcare Reform and two ASQ comments on aspects of the Health IT legislation. The Division also got serious about a new healthcare quality certification. Dave was also the architect of our partnership with the Society for Health Systems in the Building Better Healthcare Systems conference held in February.
Individually and collectively, the Healthcare Division owes a great debt to Dave for his leadership and for the contributions he has made to strengthen and grow the HDC in troubled economic times. His formula for this was simple: by creating and delivering real value to our Division members, we can ensure the Division’s growth and effectiveness!