4:35 ← 20181 HSA3661_CaseSt... 5 of 20 Strategies for Leadership CASE STUDY: SSM HEALTH CARE "Your doctor and the nurses and other professionals at our hospital are committed to working with you and your family to meet your health care needs." -The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities BACKGROUND Improving Communications with Patients and Families BLUEPRINT FOR ACTION SSM Health Care, based in St. Louis, is one of the largest Catholic health systems in the country. It owns, manages and is affiliated with 21 acute care hospitals and three nursing homes in Missouri, Illinois, Wisconsin and Oklahoma. In November 2002, SSM Health Care became the first health care organization in the country to be named a Malcolm Baldrige National Quality Award winner. The Baldrige Award, given by the U.S. Department of Commerce, is the highest honor a U.S. company can receive for quality management and performance improvement. SSM Health Care has used the Baldrige model for the past seven years as a foundation to help achieve their mission of providing exceptional health care services. Their numerous quality and performance achievements are summarized on www.nist.gov/public_affairs/releases/ssmhealth.htm. Highlighted below are some of the key patient-focused initiatives at SSM Health Care. enhance the communication between the patient and his or her family and the treatment team, so everyone involved in the patient's care is working toward a unified goal. The conferences include the patient, family, physicians, nursing personnel, pastoral care, case manager, social worker and other disciplines as appropriate, such as physical, respiratory or speech therapy. The family also picks one or two spokespersons to represent their interests. Anyone involved in the patient's care can initiate these conferences if they feel that more in-depth communica- tion is needed to raise concerns or issues with the family and/or the care team. The family and the patient are encouraged to articulate their questions and concerns. The increased communication and unified approach can reduce the patient's and family's anxiety in what is often a highly charged environment during which life-and-death decisions are made. INITIATIVES SSM Health Care has worked diligently to build a culture of continuous quality improvement. This deeply embedded culture, integrated with leadership's unwavering commitment and a continual focus on mission, are key success factors for the organization. Alignment of system, network, entity, department, and employee goals helps everyone to focus on the five defined characteristics of exceptional health care: exceptional clinical and financial performances, and exceptional patient, physician, and employee satisfaction. All the initiatives support one or more of these essential elements. Bringing Patients and Their Families into the Care Team At SSM St. Mary's Health Center in St. Louis, patient/family care team conferences are designed to Involving Parents in Their Children's Care At SSM Cardinal Glennon Children's Hospital, part of the SSM Health Care system, parents are asked for infor- mation about their child when the child is hospitalized. Parents offer insight into how their child responds to pain, what he or she likes to eat, and behaviors the hospital staff should be aware of. When the child is a newborn who has been in the neonatal ICU, this kind of information flows the other way from nurses to parents - since in most cases, at this early point in an infant's life, the hospital staff knows more about the baby than the parents. Also in the neonatal ICU, parents are very involved in the care of their children. The physician or nurse practitioner meets with the parents during every visit to keep them informed about the plan for the child's care. Nurses check on the kinds of training the family may need, such as CPR, feeding instruction, information on medications CASE STUDY: SSM HEALTH CARE or dealing with a monitor at home. Parents can find additional information about their child's illness through the library in the neonatal ICU, which contains books written especially for lay readers. For neonatal patients suffering from complicated conditions that involve several different illnesses, parents attend care conferences with all the specialists involved in the infant's care, as well as the rest of the care team. Improving Clinical Outcomes SSM Health Care has several systems in place that facilitate rapid improvements in patients' clinical outcomes. Teams of physicians, clinicians and administrators from across the system choose collaboratives in specific clinical areas (e.g.. congestive heart failure) and set in motion a process to exceed national benchmarks in that area. Collaboratives improve the quality and value of patient care, while creating a network of clinical experts. In ad clinical guidelines and protocols and standing orders are groups physician contacts, telephone surveys, and focus p are also studied to ensure that the system responds to customer requirements. Formal and informal listening and learning tools are used to learn from former and current patients and their families. Surveys are customized for key segments: inpatient, outpatient, emergency department, long-term care, and home care. Other tools such as comment cards, patient follow-up phone calls, focus groups, and a system-wide complaint system also are used to ensure that customer needs are met and exceeded. Finally, employee job descriptions and performance evaluations include required service standard competencies. OUTCOMES The following are among the successful results of these tives: 4:35 20181_HSA3661_CaseSt... initiatives at SSM Health Care. INITIATIVES SSM Health Care has worked diligently to build a culture of continuous quality improvement. This deeply embedded culture, integrated with leadership's unwavering commitment and a continual focus on mission, are key success factors for the organization. Alignment of system, network, entity, department, and employee goals helps everyone to focus on the five defined characteristics of exceptional health care: exceptional clinical and financial performances, and exceptional patient, physician, and employee satisfaction. All the initiatives support one or more of these essential elements. Bringing Patients and Their Families into the Care Team At SSM St. Mary's Health Center in St. Louis, patient/family care team conferences are designed to Involving Parents in Their Children's Care At SSM Cardinal Glennon Children's Hospital, part of the SSM Health Care system, parents are asked for infor- mation about their child when the child is hospitalized. Parents offer insight into how their child responds to pain, what he or she likes to eat, and behaviors the hospital staff should be aware of. When the child is a newborn who has been in the neonatal ICU, this kind of information flows the other way from nurses to parents - since in most cases, at this early point in an infant's life, the hospital staff knows more about the baby than the parents. Also in the neonatal ICU, parents are very involved in the care of their children. The physician or nurse practitioner meets with the parents during every visit to keep them informed about the plan for the child's care. Nurses check on the kinds of training the family may need, such as CPR, feeding instruction, information on medications CASE STUDY: SSM HEALTH CARE or dealing with a monitor at home. Parents can find additional information about their child's illness through the library in the neonatal ICU, which contains books written especially for lay readers. For neonatal patients suffering from complicated conditions that involve several different illnesses, parents attend care conferences with all the specialists involved in the infant's care, as well as the rest of the care team. Improving Clinical Outcomes SSM Health Care has several systems in place that facilitate rapid improvements in patients' clinical outcomes. Teams of physicians, clinicians and administrators from across the system choose collaboratives in specific clinical areas (e.g.. congestive heart failure) and set in motion a process to exceed national benchmarks in that area. Collaboratives improve the quality and value of patient care, while creating a network of clinical experts. In addition, care pathways, clinical guidelines and protocols and standing orders are used to outline a standardized plan of care for patients with certain diagnoses. These tools are designed with patient input, creating partnerships with physicians to improve patient care. SSM Health Care uses an automated system to make clinical, financial, operational and customer information available to all of its sites. Data is made available to many physician partners by using personal computers, personal digital assistants, pagers and fax machines. Listening to and Understanding Customers High patient satisfaction and loyalty are major contributors to SSM Health Care's success. Key patient requirements have been identified using impact analyses: responsiveness, accuracy, good communication and good health outcomes. Loyalty is measured by considering overall satisfaction, willingness to recommend the organization to others, and the patient's experience compared to his or her expectations. Every three years, SSM Health Care identifies potential customers and future markets during its strategic planning process. The assumptions are validated annually. A sophis- ticated analysis of market research, market share by product line, and population trends helps define the current and projected environment for customers. Data from annual medical staff surveys, patient satisfaction surveys, physician contacts, telephone surveys, and focus groups are also studied to ensure that the system responds to customer requirements. Formal and informal listening and learning tools are used to learn from former and current patients and their families. Surveys are customized for key segments: inpatient, outpatient, emergency department, long-term care, and home care. Other tools such as comment cards, patient follow-up phone calls, focus groups, and a system-wide complaint system also are used to ensure that customer needs are met and exceeded. Finally, employee job descriptions and performance evaluations include required service standard competencies. OUTCOMES The following are among the successful results of these SSM Health Care initiatives: In 1999, SSMHC started a clinical collaborative program with four teams to improve patient outcomes. By 2002, 85 teams have been involved in six clinical collaboratives. Physicians connected to an automated information system have increased steadily from 3.200 in 1999 to 7,288 in 2002. CONTACT INFORMATION For more about SSM Health Care's patient-focused initiatives, please contact Eunice Halverson, corporate vice president, Quality Resource Center, at Eunice Halverson@ssmhc.com or (314) 994-7747- For more information about SSM Health Care, please visit www.ssmhc.com. Strategies for Leadership АНА Advancing Health in America CASE STUDY: NORTHWESTERN MEMORIAL HOSPITAL "Your comfort and confidence in your care are very important to us.'