Want a really successful hospital?
Then lose your hospital management traditions
USA - Employment turnover is low and morale high. The level of response to patients call buttons is high - but, if not, patients can tell the hospital CEO. This is a formula that turns an ordinary community hospital into a star-rated healthcare establishment: the patients are happy with what they receive.
Finding the frontier of Hospital Management, led by Professor John Griffith, of the University of Michigan School of Public Health and published recently in the Journal of Healthcare Management.
His opinion results from ratings given by caregivers and patients that were analysed and reported in the study. This type of philosophy and service, he reports, “delight” patients and underpin the most successful community hospitals in the USA.
For the study, Prof Griffith looked at the winning factors of 34 community hospitals in nine states that had earned the Health Care Sector Malcolm Baldrige National Quality Award, a recognized US quality benchmark for various industries. He found that the one biggest factor in patient satisfaction is that the top management in those hospitals had departed radically from traditional hospital management.
Direct communication with the top
At the Florida hospital, for example, patients receive a welcome letter, signed by the CEO and including his home phone number. Finding fault, they can simply ring. They are also visited by their unit’s nurse manager, who gives them his/her cell and office phone numbers. The professor points out that this kind of personal service is not cheap, but the hospitals kept costs low enough to prosper on standard Medicare and insurance payments, despite good rates of pay for employees – staff are rewarded monetarily, and definitely celebrated. One interesting point is that the hospitals suffer no staff shortages. ‘They have enough well-trained nurses and well-motivated nurses,’ he points out.
The 34 hospitals emphasised a broadly communicated mission, a supportive learning culture, universal measurement and benchmarking, and systematic process improvement, he says, adding that, traditionally, hospitals emphasise static domains of authority and do not formally measure performance, goal setting or continuous improvement.
Two key question for patients answering questionnaires were: Will you return? Will you refer? The professor said that the loyal patient will tick both boxes. ‘These places got that in 90% of patients. The usual answer is a little better than half.’
The study also found that, in national rankings, the 34 hospitals scored in the top 50% in almost all quality and satisfaction measures and were frequently in the top 10%. In addition, they spend considerable time on employee training. Whereas one provided more than two weeks’ full-time training of each full-time employee, nationally the average is not more than a week.
01.03.2009
