Want to become a quality award winner? Here's how
Want to become a quality award winner? Here’s how
Mississippi hospital wins state quality award
St. Dominic Hospital in Jackson, MS, rarely has a problem with poor customer service. In fact, the 571-bed, not-for-profit hospital of the Dominican Sisters of Springfield, IL, has always set its standards quite high for the sake of quality patient care and a hard-earned reputation as a "modern health care provider with 1950s values."
So what does a customer service-driven facility have to do to win a state quality award? Set those goals even higher, says Karen Countiss, MED, performance improvement coordinator at St. Dominic. The hospital did just that and walked away with two Mississippi state awards based on the same criteria as the national Malcolm Baldrige quality award. (See framework and feedback form, pp. 142-143.)
"The Mississippi State quality award is like a mini-Malcolm. There are four levels, with level four ranking the highest," she notes. "We met the criteria requirements and won a level three award of excellence in both 1995 and 1997. St. Dominic has been doing quality improvement here for a long time, but there’s always room for improvement, no matter how many [awards you win]. We showed them the results of our efforts, especially where patient satisfaction was concerned."
When Countiss came to the hospital in 1994, she noticed that total quality management revolved around five core values established by hospital employees:
r an ethical and moral spirit;
r a spirit of service and community;
r a positive spirit;
r a high work standard;
r professionalism.
And while most facilities would also place a great deal of importance on those values, Countiss said employment and advancement depends on it.
"We want to make sure that an employee has more than just clinical competence. That person must also exhibit strong values and show us that he or she knows how to treat others beyond [clinical parameters]," she explains. "Before anyone becomes part of St. Dominic’s [staff], he or she has to go through a behavioral interviewing process. We ask questions to see how the applicant would react to certain situations and determine if this person would fit in with St. Dominic’s value standards."
Being a customer service-oriented facility requires more than entrance interviews, however. St. Dominic achieves employee excellence in a number of other ways, namely a values feedback instrument called "Sharing the Mission." This tool allows hospital personnel to monitor another employee’s work ethics by either offering suggestions for improvement or praising a job well done.
"If you are a nurse, for example, your supervisor will give your co-workers a confidential feedback form to monitor you and make sure you are exhibiting St. Dominic’s values," Countiss explains. "They see whether you are taking an active initiative to assist [in certain situations], respect diversity, communicate clearly, and make patients and their families feel welcome and comfortable in a [clinical environment]. Everyone knows what is expected from them, or they wouldn’t be a part of St. Dominic in the first place."
Like every business, this hospital is never completely free from unpleasant customer service situations. In a less than satisfactory situation, supervisors and co-workers work with the individual closely to educate them about acceptable and expected behavior.
"You have to expect that there will occasionally be an unpleasant situation. Sometimes, [employees] may have other things on their minds or are having a bad day that could make them take it out on someone else," she says. "But they should not be screaming at the lab or slamming the phone down in anger. If it’s a rare thing, we tend to [overlook it] a bit more. But if employees are not offering good service on a regular basis, they just may not fit in and might feel more comfortable working somewhere else."
Although demonstrating positive work ethics is a leg up for internal work relationships, those qualities are doubly important when seen through the patients’ eyes, Countiss says. To maintain St. Dominic’s values and improve patient satisfaction, hospital personnel strive to make patients feel comfortable and welcome from the moment they walk through the doors until the time they are discharged.
"We look at every way we can make improvements for the patient. That means everything from available parking to support for the patients and their families," she explains. "We also want to give them the best care for the best price."
Patients are always the priority
Ensuring that patient needs remain a priority, multidisciplinary teams meet frequently to discuss necessary changes and problem-solving strategies. For example, if a patient or family member seems dissatisfied with parking arrangements, all employees closest to the problem work to improve that area.
"We have TQM training for all hospital employees. The teams have about eight to 12 people most closely associated with the process being improved," she adds. "They meet for about six weeks to redesign an area. Sometimes, the teams are more aggressive and meet every other day for the first month or so. Other times, they may meet only as necessary, depending on the severity of the problem." Throughout the course of the meetings, employees once again use the Values Feedback Instrument to monitor their peers on their attitudes to continuous improvement.
Their pledge for ongoing improvement efforts are often reflected in patient satisfaction surveys. Each quarter, approximately 570 patients are randomly selected to participate in a detailed phone survey. Results are tallied and analyzed, and task groups decide which areas require the most improvements.
Focus on patients’ concerns
"We have an average of 315 inpatients per day. We randomly pick patients each quarter, look at their responses, and then decide where to go from there," she adds. "If a survey shows that patients aren’t happy with a certain aspect of care, we have task groups work to change that. It’s a continual process, though. We use the surveys to look at how we’ve improved over the last quarter. Overall, I think the surveys show we’re working hard, and that’s good for St. Dominic and the patient."
According to the hospital’s 1997 second quarter survey results, all of its service areas received a score between 4.0 (good) and 5.0 (excellent). First quarter results for courteous treatment of patients, family, friends, and visitors climbed to 4.74, up from 4.69 in fourth quarter 1996. Friendliness of admissions staff scored an average of 4.68 for the second quarter in 1997, compared to 4.63 in fourth quarter 1996. Also on the rise was the score for St. Dominic’s overall treatment costs. Patients ranked the costs favorably, with an average of 4.34 in the second quarter of 1997.
Although St. Dominic is proud of its accomplishments, Countiss says the key to an award-winning hospital and outstanding quality care does not rest with top patient satisfaction scores.
"Quality improvements have to be an ongoing process in order to succeed in the future," she notes. "Even if all patient satisfaction scores [reach the top], we know we can always find ways to better our care. if you look inside yourself, you’ll probably find there’s still some room to move in an upward scale."
[For more information, contact: Karen Countiss, MED, Performance Improvement Coordinator, St. Dominic Hospital. Telephone: (601) 364-6865.]
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