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Baldrige-winning hospitals a 'revolution' in management
ANN ARBOR, Mich.—Hospital management expert John Griffith boldly declares that a revolution in hospital management is under way. In an article in today's Journal of Healthcare Management, Griffith and coauthor Kenneth White evaluate excellent hospitals and conclude that these institutions' achievements "set a new standard for performance accountability and excellence that we believe is a revolution in hospital management. Simply put, they have shown how to run health care organizations substantially better than is typical." Griffith, professor of health management and policy at the University of Michigan School of Public Health, is critical of hospital evaluations that examine only processes while ignoring financial or quality of care outcomes. He and White, director of the Graduate Program in Health Administration at Virginia Commonwealth University, examined winners of the Baldrige National Quality Award in Healthcare to look both at their practices and at the effects on their organizations. Their article in the May/June journal details many results at Baldridge-winning hospitals, including: • Improvement of admitting physician satisfaction by one quarter, and a patient satisfaction increase to 99th percentile. • A boost in cash collections by one third, and improved net income per full time equivalent employee by half. • A 40 percent decline in Occupational Safety and Health Administration (OSHA) incidents. The Baldrige Criteria for Performance Excellence, administered by the National Institute of Standards and Technology in the U.S. Department of Commerce, aims to improve productivity, effectiveness and communication. The criteria have been used by thousands of companies in many industries to improve performance, and Baldrige winners have historically outperformed their sectors. "Their approach has now been tested in over 100 diverse American communities, suggesting it is an appropriate model for most American hospitals and health care systems," the authors wrote. Griffith and White chose the first three Baldrige-winning hospitals and health systems to study: Baptist Health Care in Pensacola, Fla; SSM Health Care, located in seven markets of Missouri, Illinois, Wisconsin and Oklahoma; and St. Luke’s Health Care in Kansas City, Mo.; plus two other systems that document their results, Catholic Health Initiatives, in 64 communities in 19 states; and Intermountain Health Care, with facilities in 27 communities in Utah and Idaho. Griffith said the organizations serve different kinds of communities and are of varying sizes, but they all improved by using a similar approach to management. Griffith said spelling out strategies and stringently testing them against results is superior to operating purely by gut instinct or individuals' opinions. "For most of America and its 5,000 hospitals, the major points of how to run a hospital are no longer in question," Griffith said. Exceptions include inner city hospitals trying to escape financial crisis and academic hospitals that place a high priority on teaching in addition to other health care goals. Griffith and White examined practices in leadership, strategy, patient relations, worker relations, information management, operations and results. Among the highlights of what they saw at the five organizations: • Establishing measures and benchmarks of performance—dozens of them. Baptist Hospital, for example, records more than 75 measures. • Reporting results promptly and publicly. Important performance measures were reported daily, biweekly and monthly so managers and employees knew where they stood in relation to goals and objectives. • Using various tools to get feedback, and expecting management to act on that information. Focus groups, surveys and customer complaints all feed the system. • Identifying and keeping good employees as the core of human resource strategy. This includes boosting morale, setting up systems to foster high performance and offering significant amounts of training. • Building achievement targets into managers' goals and incentives, supplementing recognition and celebration to reward the desired performance. Griffith said he knows of no other documented work that looks at corporate-level health care management like this research project.
Griffith has been at Michigan since 1960. His text, The Well-Managed Health Care Organization, is currently in its fifth edition. The first edition won the ACHE Hamilton Prize for book of the year in 1987, and the fourth was named Book of the Year by Healthcare Information and Management Systems Society. He directs the Griffith Leadership Center, which fosters understanding of excellent leadership in health care finance and delivery by increasing communication between department faculty, students and outstanding practitioners. Journal of Healthcare Management Baldrige National Quality Program
Contact: Colleen Newvine |
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