RWJ Hamilton’s 15/30 program, which guarantees that patients will see a nurse within 15 minutes and a doctor within 30 minutes of entering the emergency room, has improved patient satisfaction from 85 percent in 2001 to 90 percent in 2004. From 1999 to 2003, emergency room patient volume doubled.
Inpatient satisfaction with nursing and nursing courtesy improved from 70 percent in 1999 to more than 90 percent in 2004.
Employee satisfaction with benefits rose from nearly 30 percent in 1999 to slightly above 90 percent in 2003, satisfaction with leadership increased from 90 percent in 1999 to 100 percent in 2003 and satisfaction with employee participation in decisions increased from 40 percent in 1999 to 90 percent in 2003.
Robert Wood Johnson University Hospital, of Hamilton, New Jersey, provides health care to 350,000 people annually. It’s New Jersey’s fastest-growing hospital and has steadily improved its market share, led by the cardiology, surgery and oncology units. The hospital has implemented an excellence program that all employees are required to uphold, maintains a customer survey database that monitors customer feedback, and uses an organizational performance measurement system to track daily performance and key indicators, which are reviewed weekly by senior leaders, monthly by department managers and quarterly by all employees. Deborah Baehser, vice president for patient care services, discusses the hospital’s 2004 Baldrige win.
How did you make the decision to pursue a Baldrige Award?
Baehser: We don’t look at it as pursuing an award. This is a continual pursuit for quality improvement and performance excellence. RWJ Hamilton adopted the Baldrige criteria for performance excellence, recognizing the business value of the Baldrige framework and application process.
: What kind of process and/or quality management philosophy does the hospital follow? How well does it mesh with the Baldrige criteria?
Baehser: Our quality management philosophy is based on continuous quality improvement utilizing the plan-do-check-act methodology. It’s aligned with the Baldrige criterions of leadership commitment to performance excellence; having a systematic strategic planning process; deployment and integration throughout the organization; aligning with our mission, vision and values; and measuring effectiveness.
How did the Baldrige evaluation change your processes?
Baehser: In the continuous cycle of evaluating our effectiveness, we review our existing key processes to see if they fit with our mission, vision and values; support critical success factors; and meet the needs of all our customers, whether they are patients, employees or our community.
You guarantee that emergency room patients will be seen by a nurse within 15 minutes, and by a doctor within 30 minutes. This implies that the hospital has linked good quality with prompt patient care. How did this philosophy evolve?
Baehser: In order to meet patients’ requirements of receiving timely, effective, efficient and evidenced-based care, RWJ Hamilton implemented the 15/30 service guarantee. An interdisciplinary team, which included representatives from ancillary departments, nursing leadership, staff, physicians and senior leaders, was created to develop and implement the program. During the planning stages, the team identified technology needs, and recommended process redesigns and facility renovations to successfully implement 15/30 throughout the organization. In collaboration with physicians, evidence-based guidelines were developed, implemented and monitored to ensure the same optimum level of quality care to all patients.
Have the hospital’s goals changed because of its Baldrige win?
Baehser: Our goals have changed, not necessarily from receiving the award, but because of our adoption of the Baldrige framework. We’ve been able to successfully balance our short- and long-term objectives and develop human resource, finance and technology plans to support these objectives.
How important were your feedback reports?
Baehser: The feedback reports we received provided a platform for moving us to a higher standard. They offer an in-depth, objective perspective into opportunities for improvement and the strengths of the organization. We look at our opportunities for improvement as gifts, and from them we are able to develop actionable plans to strengthen our organization as a whole.
What advice would you give to a company just starting the Baldrige process?
Baehser: Begin the process by doing an internal self-assessment. Start at the state level and stay the course. The business value of the Baldrige framework has been proven across industries as a balanced approach that leads to exceptional results in finance, customer satisfaction and quality outcomes.
Was it difficult to get your management team and/or rank-and-file employees excited about the Baldrige process?
Baehser: Leadership commitment is the key to successful cultural transformation. It’s a continuous process of improvement by reinforcement through role-model behavior, and open and active communication and participation organizationwide.
As it relates to health care, where do you think the quality movement is headed?
Baehser: There’s a cultural shift of the quality movement within health care toward a more standardized, systematic approach to provide evidence-based, error-free care that exceeds customer requirements.
Laura Smith is Quality Digest’s assistant editor.