pullman regional hospital june 30, 2010 culture trumps strategy the impact of leadership on patient...
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Pullman Regional HospitalJune 30, 2010
Culture Trumps Strategy
The Impact of Leadership on Patient Safety
A Learning Organization
““A place where people are continually discovering A place where people are continually discovering how they create their reality. And how they can how they create their reality. And how they can change it.”change it.”– Personal Mastery– Shared Vision– Mental Models– Team Learning– Systems Thinking
Developing a Culture - A Strong Foundation
Values:• personal integrity and commitment to provide compassionate, responsible, quality
services to our community• an environment that allows individuality, team work, and communication to flourish• the enriching nature of diversity, creativity, and innovation• honesty and leadership in an atmosphere of mutual respect and trust.Vision:Pullman Regional Hospital is a community leader of integrated health and healing activitieswhere our values guide and inspire, and science and technology quietly enable people to comfort, encourage, and heal.Mission: Pullman regional Hospital exists to nurture and facilitate a healthier quality of life for ourcommunity
Supporting Structures
• Patient Care Philosophy (1995)• Customer Service Philosophy (1996)• Leadership Philosophy (1997)• Strategic Focus Areas (2005)• Commitment to Accountability (2007)• Commitment to Philanthropy (2008)• Employment Commitment (2009)• Cultural Traits (2009)
Patient Care Philosophy
• It is our belief that all individuals are active partners in their own health and healing. We support this belief with flexible care environments where information is shared while participation and personal choice are encouraged.
Customer Service Philosophy
• Each of us at Pullman Regional Hospital is sincerely interested in exceeding the expectations of others in a courteous, respectful and friendly manner. We accept personal responsibility to understand each person’s needs and provide individualized service.
Cultural TraitsLeaders, Staff and Combined Culture Opinions
0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00 9.00 10.00
Truth-seeking
Consistency
Personal Accountability
Inclusive
Personal Growth
Transparent
Tolerant
Flexibility
Progressive
Choice
Serving Others
Combined
Staff
Leaders
LeadershipGroup
OrganizationalLearningForum
StrategicCoordinating
Council
Patient Family
Employee Physician
CEO
Medical StaffBoard
Values
VisionM
ission
Employee Employee Work Work GroupsGroups
Quality Quality OutcomeOutcome
PartnershipsPartnerships
Financial Financial EffectivenessEffectiveness
Employee Employee SatisfactionSatisfaction
Customer Customer SatisfactionSatisfaction
Superior Superior Clinical Clinical
OutcomesOutcomes
New/Improved New/Improved ServicesServices
Organizational Organizational OverviewOverview
All Staff All Staff MeetingsMeetings
Infrastructure
• Reorientation• Budgeting process• Performance appraisal
system• Compensation• Staffing• No mandatory “low census”
• Leadership norms• Hiring process• Orientation• New hospital• Overhead paging• Personal appearance• Mandatory is a “four letter
word”
Learning from Others
• Culturally consistent
• Customization
• Adaptable
• Willing to abandon
External Supporting Structures
• Six Sigma• Magnet Status• Relationship Based Care• Washington State Quality Award (WSQA)• Healthy Work Environment• Press Ganey Surveys (patients, staff, physicians)• Culture of Safety
External Infrastructure Efforts• Hand Hygiene• VAP• Heart Failure• Pneumonia• AMI• TCAB• Surgical Checklist
• SCOAP• Flu Vaccination• TICC• Rapid Response Teams• 100,000 lives• CUSP• 5,000,000 lives
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)HCAHPS is a standardized survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience. The “State of WA Ranking’s” are obtained from the Washington State Hospital Association (WSHA) website. At the time of this report, the WSHA website lists data from patients who were discharged from July 2008-June 2009.
TABLE 4 – HCAHPS Scores
CategoryCurrent Period
Mean Score
State of WA Mean Score
State of WA Ranking
National Average
Percent of patients who gave their hospital a rating of 9 or 10 87.0 65.0 #1 65.0
Percent of patients who reported YES, they would definitely recommend the hospital
89.0 71.0 #1 68.0
Percent of patients who reported that their nurses ALWAYS communicated well
84.0 72.0 #1 75.0
Percent of patients who reported that their doctors ALWAYS communicated well
86.0 78.0 #1 80.0
Percent of patients who reported that they ALWAYS received help as soon as they wanted
79.0 61.0 #1 63.0
Percent of patients who reported that their pain was ALWAYS well controlled
77.0 68.0 #1 68.0
Percent of patients who reported that staff ALWAYS explained about medicines before giving it to them
75.0 59.0 #1 59.0
Percent of patients who reported that their room and bathroom were ALWAYS clean
84.0 69.0 #1 70.0
Percent of patients who reported that the area around their room was ALWAYS quiet at night
71.0 50.0 #1 57.0
Percent of patients at each hospital who reported that YES, they were given information about what to do during their recovery at home
86.0 83.0 #12 81.0
Inpatient Satisfaction ScoresThe mean score is calculated on a 1 – 100 scoring average. The scores from each survey are totaled and then divided by the sample size of the survey. A small sample size can significantly alter the mean scores from one period to the next. If the sample size is <7, Press Ganey does not calculate a score.
TABLE 1 – Pullman Regional Hospital’s Customer Satisfaction Scores - Inpatient
Category1/10 – 3/10Mean Score
1/10 – 3/10Ranking
10/09-12/09Mean Score
10//09-12/09Ranking
Overall Customer Satisfaction (n = 161) 92.2 98th percentile 91.6 97th percentile
Overall Customer Satisfaction for Med/Surg Unit (n = 74) 92.8 99th percentile 91.2 96th percentile
Overall Customer Satisfaction for BirthPlace (n = 39) 91.3 97th percentile 92.6 99th percentile
Overall Satisfaction With Physicians (n = 124) 93.6 98th percentile 92.3 96th percentile
Overall Satisfaction With Nursing (n = 121) 94.5 98th percentile 92.9 94th percentile
Likelihood of Recommending Hospital (n = 160) 95.9 99th percentile 95.1 97th percentile
(n = sample size of most recent reporting period (1/1/10 – 3/31/10)
PRESS GANEY “TOP BOX” SATISFACTION RESULTSFOR PULLMAN REGIONAL HOSPITAL(For Period January 1 – March 31 2010)
Patient Loyalty (Percent Indicating "5" on a 1 - 5 Scale)
646668707274767880
1st 07
2nd 073rd
074th 07
1st 08
2nd083rd
084th 08
1st 09
2nd 093rd
094th 09
Quarter
Perc
ent
Percentage Linear (Percentage)
Likelihood of Recommending Hospital
85
87
89
91
93
95
97
99
3rd 06 4th 06 1st 07 2nd 07 3rd 07 4th 07 1st 08 2nd 08 3rd 08 4th 08 1st 09 2nd 09 3rd 09 4th 09
Quarter
Mea
n
Likelihood of Recommending Hospital Linear (Likelihood of Recommending Hospital)
Percentile Rankings
85
87
89
91
93
95
97
99
101
3rd 06 4th 06 1st 07 2nd 07 3rd 07 4th 07 1st 08 2nd 08 3rd 08 4th 08 1st 09 2nd 09 3rd 09 4th 09
Quarter
Percentile
Employee Turnover
0.05.0
10.015.020.025.030.035.0
Y02 Y03 Y04 Y05 Y06 Y07 Y08 Y09Year
Per
cen
t
Actual % Community Average Linear (Actual %)
