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Clark Regional Medical Center

  • Location: Winchester, KY
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: June 2007

In 1915, Clark Regional Medical Center, then Clark County Hospital, was granted a charter as a nonprofit organization by the Commonwealth of Kentucky, and began accepting patients on March 17, 1917. The hospital is located in Winchester, Kentucky, about 17 miles east of Lexington.

In 1967, the Board of Directors purchased 40 acres at the present site and relocated the hospital. Various improvements were made throughout the years and in 1984, the 3rd floor and west wing were added. In the process, capacity increased to 100 beds and the active medical staff expanded to more than 35 physicians.

Since the beginning, the hospital has experienced continual growth and in 1989, the hospital name was changed to Clark Regional Medical Center to better reflect the expanded service area.

Today, the grounds boast five medical office buildings, and long range plans include further developments, renovations and expansions. Off site services include Clark Regional Immediate Care Center and Powell County Clinic in an adjacent county.

Our Mission

  • To provide optimal health, safety and satisfaction for all those we serve.

Our Vision

  • To be the first choice in healthcare and employment by committing to quality, patient safety and exceeding customer expectations.

Our Values

  • Quality Patient Safety Service Compassion Integrity Teamwork Accountability Innovation

While growth continued in services provided, technology advances, and patients served, CRMC began to experience a decline in patient satisfaction and an increase in employee turnover. In 2001, turnover was at 32.17% and overall patient satisfaction was in the 8th percentile. Administration began to shift in focus to providing "very good" customer service. A patient representative was hired, patient satisfaction teams were implemented. Both patient satisfaction and employee turnover improved, but results continued to fluctuate.

In 2005, while CRMC provided good quality care, a change was needed to fulfill our mission and vision so Administration began discussion with the Studer Group to assist in a cultural transformation... "From Good to Great." The journey began with several key staff members attending "Taking You and Your Organization to the Next Level" in the Fall of 2005 thus igniting the flame to move CRMC from Good to Great. Studer Group staff held a two day introductory training on the 9 principles for our entire leadership team. In September, 2005 our Studer Group coach Cis Gruebbel, was assigned and our journey began.

Here are some of our improvements thus far:

Service

Actions Taken/"Must Haves" Implemented:

  • Standards Team—Standards of Behavior Developed—implemented 3/06 with all applicants being required to review and sign prior to being able to complete an application for employment; all new and current staff including our Volunteers signed an acknowledgement of understanding and agreement to abide by standards of behavior; "Standard of Month" is posted on CRMC intranet resource center; 2007 calendar was produced with one standard and illustration of that standard as submitted by CRMC staff members children, grandchildren, etc.
  • ED Service Line Team– List all actions implemented (e.g., standardized treatment protocols developed (i.e., extremity pain protocol); key words at key times; ED nurse call backs and scripting; dry erase boards; AIDET; caregiver cards provided at triage; ED manager business cards in lobby; renovated ED lobby; ED nursing leaders rounding on patients; hourly rounding by staff nurses; sending sympathy cards to patient families who experience a patient loss in the ED; ED physician and P.A. call backs; purchase of ED electronic patient record system which is scheduled for implementation in November, 2007
  • Patient Satisfaction and Service Recovery Team– Implemented discharge phone calls on inpatient units; patient rounding by all nurse leaders and some support leaders and staff (i.e., Environmental Services; Maintenance; Lab; Radiology; Nutritional Services); Developed a card to go on back of staff badges for quick reference regarding "key words at key times" for service recovery and how to address and keep patients informed of delays; AIDET monitoring ("secret shopper") game utilized by team members; implemented use of dry erase boards in each patient room to provide information about caregivers
  • Measurement Team—developed a consistent monthly report format (graphs) and template for reporting patient satisfaction (Press-Ganey) results (mean score and percentile) for their department/unit goals as well as the organization-wide goal; educated leaders regarding HCAHPS survey tool questions and trends; educated leaders completely to being able to fully utilize Patient Satisfaction data, tools for analysis and improvement, pulling actual surveys off the system and performing follow-up phone calls on patients rating us < 5 ("very good") when a patient name was provided. All leaders are required to meet with the Administrative Council monthly to present their patient satisfaction scores, action plans, etc.

Overall Inpatient Satisfaction Scores:

  • 1st quarter, 2006 – 72nd percentile
  • 2nd quarter, 2006—79th percentile
  • 3rd quarter, 2006 – 86th percentile
  • 4th quarter, 2006—92nd percentile
  • 1st quarter, 2007—87th percentile

QUALITY:

Pneumococcal vaccine administration:

  • 1st quarter 2006 – 63%
  • 1st quarter 2007 – 76%
  • April, 2007 – 90%

Heart Failure –complete discharge instructions provided:

  • 1st quarter 2006 – 71%
  • April, 2007 – 100%

Pneumonia, AMI, and Heart Failure—smoking cessation advice provided:

  • 1st quarter 2006 – 71%
  • April, 2007 – 83%
  • Revised Pneumonia Clinical Pathway and developed a CHF clinical pathway with standardized order sets and patient education; have increased physician utilization of Pneumonia clinical pathway from 18% in 4th quarter 2005 to 68% in 1st quarter 2007

PEOPLE:

Employee Turnover rate:

  • January, 2006 – 23.3%
  • April, 2007—19.4%
  • Number of leadership group who have attended a "Taking your Organization to the Next Level" meeting = 30 Number of staff who have been trained in peer interviewing (including leaders) to date = 66
  • Employer of Choice and Reward and Recognition Team—Developed and implemented "I Spy" program which allows leaders to recognize staff for specific, observed desired behaviors such as use of AIDET, compliance with standards of behavior, "key words at key times", etc. in order to reinforce "quick wins"; instituted an employee "Service Excellence" monthly reward program; implemented a departmental "Service Excellence" trophy based upon highest monthly achievement of patient satisfaction scores; instituted a monthly departmental "spotlight" board; organization-wide celebrations for exceeding overall patient satisfaction goal; conducting periodic educational classes for staff in "peer interviewing"; use of 30 and 90 day questions for new employees by department leaders; first time use of Press-Ganey for Employee Satisfaction survey in September, 2006 with subsequent development and implementation of action plans on a departmental basis and organization-wide basis with planned re-survey in fall 2007; leader rounding on staff with submission of monthly rounding logs (50% compliance in 2/06 to 94% compliance in 3/07); administrative leader "thank you notes" to staff mailed to home for staff who have been "managed up" for "above and beyond" service excellence behavior(s)
  • Leadership Development Institute Team (LDI)—have developed and provided six (6) quarterly LDI training sessions (2 days each) to help improve leadership skills and accountability in all of the organizational pillars; trained leaders in performance conversations ("High, Middle, Low") and have had at least two required rounds of performance conversations within the past year.
  • Leader Evaluation Team–implemented and trained all leaders on the use of the Studer Group Leader Evaluation Manager tool as a means of helping to assure aligned leadership which includes leaders developing individual, objective, measurable goals in accordance with the organization-wide pillar goals; targets; monthly measurement and quarterly action plans
  • Communications Team—implemented quarterly employee "Pep Rallies" where the CEO updates staff on the status of our organization-wide pillar goals; results of employee rounding (processes changed, tools and equipment purchased, number of staff recognized); and other important information related to our journey of transforming our organizational culture from "Good to Great"; instituted a "departmental pillar goal board" contest; monitoring of departmental pillar goal boards to assure are kept up to date; revamped Employee Newsletter

FINANCE

FY ‘2007 – goal of operating margin of at least 0.78%; YTD (7/06 – 4/07—average monthly operating margin of 1.9%)

GROWTH

FY’ 2007—goal of annualized patient days of 57,375; (YTD 7/06 – 3/07 –57,619)

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