Q&A: Vision 2014—Getting to Best in the Nation
Hardwired Results® interviews Hackensack University Medical Center president and CEO John Ferguson, FACHE
HR: Having led HUMC for more than 20 years, you are widely credited with bringing your vision to all levels of the organization. Can you share a bit about your philosophy?
JF: Our vision is to be the number one medical center in the nation by 2014. HUMC's strategic plan is organized under the five pillars—people, service, quality, finance, and growth—although it is heavily weighted on quality and safety initiatives this year.
Quality and the patient come first. But people have always been the backbone of our success. We have a work culture that is based upon trust, opportunity for advancement, and training. For instance, we have a very robust clinical and organizational education program. We give people what they need and let them do their jobs. As a result, members of our staff are very loyal. HUMC attracts physicians, nurses, and employees who have strong personal drive because they see our commitment to being the best. We have a number of senior leaders here who started out as secretaries and assistants. In fact, it's harder to get into HUMC than Harvard. (We receive more than 20,000 applications each year for about 1500 positions.)
We also recognize the importance of how service and quality must come together equally to create the patient experience. As a result, we appointed a vice president of service quality in 2004. To bring service up to the same standard as our clinical quality, we hired the head of housekeeping from Ritz Carlton and head of food service from Four Seasons. We also en- Align Your Board of Directors See how HUMC aligns Board meetings to the strategic plan with a five pillar agenda. Download a sample copy at www.studergroup.com/ board_agenda gaged with Studer Group in late 2005 to help us move from good to great. With HCAHPS a reality, it's even more important that we hardwire our success with inpatients and other populations that are important to us.
We are also still in a major growth mode. We've steadily brought on a number of "destination" physicians and programs that patients want. As a result, we've doubled volumes in the past 12 years.
HR: And yet, HUMC doesn't have a lot of goals in its annual strategic plan. Why?
JF: Having many goals is confusing. We have nine strategic directions to keep it simple and align everyone's focus. We moved these under the five pillars and created metrics and accountability to measure our progress. These goals became the framework for establishing individual leader goals for annual evaluations. (We are just now implementing Studer Group's Leader Evaluation ManagerSM). For instance, under the quality pillar, we monitor the organizational mortality rate and cascade that goal throughout the organization. We coach the department chairmen on how to understand and address the metrics that align and impact that rate (e.g. infections, decubiti).
It's not enough to talk about strategy at high level team meetings. We need goals that are simple and direct that make sense to our nearly 7,800 plus employees and what they do every day. You can never over-communicate. The pillars resonate with employees because they understand that if we take care of service and quality, finance and growth take care of themselves.
HR: Can you talk about some of the tools you are using to address service and quality as you
work towards becoming the leading medical center in the nation?
JF: Since we are constantly trying to improve how we deliver care and patient outcomes, we were quick to adopt discharge phone calls and excited to learn about Studer Group's Alliance for Healthcare Research study on hourly rounding on patients. We've included these tools—as well as nurse leader rounding, bedside shift report and individualized patient care—in our patient care model.
Once we adopted discharge phone calls, we asked ourselves how we would know if they were working. That led to measuring patient satisfaction among those who received discharge phone calls. Use of this tool almost doubled patient satisfaction.
HR: How does physician satisfaction and engagement fit into HUMC'S strategic plan?
JF: Physician satisfaction and loyalty is very high among our 1500 physicians. They work in partnership with administration to implement goals. Likewise, we challenge clinical areas to be responsible for achieving results that will move HUMC to best in the nation.
We also encourage physicians to come to us early with their ideas so we can adopt and deploy them. Bariatric surgery is one example of that. We also started an association for the office staff of physicians on the medical staff to make working with us easier. We recognize they have a choice where they refer patients so it benefits us to train their staff on how to use our information technology, provide OSHA training, and dialogue on their behalf with insurers.
HR: Sometimes employees on the front lines can feel removed from the strategic plan. How do you ensure everyone feels ownership in the process?
JF: We communicate goals in many ways. Prospective employees receive a booklet that integrates our standards of behavior and the strategic plan before they even interview. At the interview, we ask if they can commit to these. Every employee also receives a booklet small enough to fit into their ID badge holder that outlines our vision, beliefs, standards, and strategic direction. Orientation also refers back to goals and standards as does an annual discussion between each employee and his or her supervisor.
Keeping ownership alive requires active effort for continuous communication. I also lead quarterly employee forums where employees can ask me direct questions. When I answer, I try to connect back to our strategic plan, the five pillars, and our vision. As a result, employee forums have been very well-received.
HR: Any tips or lessons learned you can share with other leaders who are on this journey to service and operational excellence?
JF: Timing and sequencing is key. Looking back, I believe if we had put in the Leader Evaluation Manager first, we would have hardwired other tools and processes more quickly.
And also, don't ever give up! We've had some painful bumps along the way, but it's important to realize that in today's environment, if you aren't getting better you are getting worse. If your goal is to lead the nation in quality care, your competition is not local hospitals, but every organization.
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