Successful practices benchmarked at CHA

Members encouraged to learn from each other

[Editor’s note: This is the third in a three-part series on the Catholic Health Association of the United States’ (CHA) performance improvement program, "Living Our Promises, Acting on Faith." The previous article described how the baseline data derived from a comparative date process informed the selection of a specific area targeted for performance improvement. In this final installment, we see how CHA empowered its members to benchmark successful practices implemented at other member facilities and systems.]

Using its 12 collaborative partners as the focal point, the CHA wanted to ensure that these partners would share what they learned with the members, the Catholic Health Ministry, explains Julie Jones, MA, director of resource development.

"At the national level, our goal was to empower members with information so they could move to successful practices," she notes.

In June 2001, at the CHA’s annual assembly of members, the Performance Improvement Collaborative Report "Employee Satisfaction with Involvement in Decision Making," was released. "We promoted it there through story boards and at a session during the assembly for all members interested in learning," says Jones, who facilitated the session.

The speakers included Robert G. Gift, MS, president of Omaha, NE-based Systems Management Associates Inc., and a consultant to the CHA on the initiative; one of the CHA’s ethicists; and CEOs from the two facilities profiled in the report — St. Joseph Regional Medical Center in Ponca City, OK, and Providence Hospital in Washington, DC.

Outlining successful practices

The session outlined successful practices through interviews with high performers (external to the CHA) and through sharing what the collaborative benchmarking initiative had learned, as well as through the profiles of the facilities.

The program at Providence Hospital entailed the initiation of Employee Planning Days, which had begun in 1991. Each year, at the beginning of the hospital’s planning cycle, four sessions are conducted to generate employee input that will shape the strategic plan. The four-hour sessions involve about 400 nonmanagement employees, from all levels and all departments.

The planning days, which also involve dividing into smaller discussion groups, are organized around three themes:

1. Mission.

2. Organizational performance.

3. Quality, defined at Providence as "meeting or exceeding expectations that represent value to patients/customers."

According to Providence president and CEO Sr. Carol Keehan, DC, "Approximately 80% of the facility’s innovations — from the need for a new nursing home to ways to reward employees who don’t use up their sick time — come from the planning days."

St. Joseph was recognized for a number of different practices that resulted in a high level of satisfaction among its 550 employees. It was rated a "high performer" on the measure "percent of employees indicating satisfaction with their involvement in decision making."

This was attributed to a number of integrated strategies, including:

• A strong emphasis on performance improvement.

This cultural expectation is impressed on all new employees, and performance appraisal includes involvement in organizational improvement activities.

• Manager and supervisor training.

In their first year on the job, manager/supervisors will received about 50 hours of management training.

• The Quality of Work Life initiative.

A 12-member employee task force initiated a work/life survey and then recommended further development in six areas:

1. education;

2. staffing;

3. benefits/compensation/performance evaluation;

4. management/supervision;

5. employee/physician relations;

6. communication.

To date, the following results have been achieved:

1. increased nurse education resources;

2. improved hospital security staffing;

3. improved employee communication methods;

4. nursing wage adjustment;

5. enhanced benefit plan with paid time off;

6. more consistent supervisory practices.

Spreading the message

After the assembly, the CHA released the report to the entire ministry, to both individual facilities and systems. "Our goal was to leverage our information and turn it into performance improvement for the ministry," Jones says. "We know that some facilities have followed up on the report."

For example, she observes, Providence Portland (OR) Medical Center, one of the members of the original collaborative group, implemented employee planning days in February 2002.

"They took the information they learned, and they applied it; it went very well," Jones says.

"They are in the process of implementing the recommendations that came out of those sessions, which focus around employee retention, employee safety, and patient safety," she explains. They are publishing a newsletter to close the loop of communication with employees and have a site on their intranet.

As the CHA initiative continued, a report was released in spring 2002 on data and trends from acute care facilities. It provides follow-up data collected in 2001 and, where possible, includes comparisons to baseline data collected in 1999 and 2000. It is divided into these major sections:

  • organizational culture;
  • holistic care;
  • care for poor and vulnerable people;
  • care for the dying;
  • relationship to the church.

"Each section offers examples and provides resources," Jones explains. For example, an Iowa-based team of several CHA-member organizations is cited for developing a manual, Recognizing Pain as the 5th Vital Sign: A Guide to Developing and Implementing an Effective Pain Management Program.

Jones says she is "absolutely pleased with the results to date. We have had success on a number of fronts, some of them planned and some not."

The CHA expected that when it started measuring performance and giving members comparative data, it would begin performance improvement, "and that has been achieved," Jones asserts.

"We also wanted the process to be educational from the beginning — and it has been," she continues. "We met recently with several executives who noted a major breakthrough in addition to the data; we have helped employees understand in a much deeper way our mission and their role in it."

Need More Information?

For more information, contact:

  • The Catholic Health Association of the United States, 4455 Woodson Road, St. Louis, MO 63134-3797. Telephone: (314) 427-2500. Fax: (314) 427-0029.