There's nothing like an award contest to get everybody psyched up and rowing in the same direction. SSM Health Care System, a 21-hospital consortium that operates in four Midwestern states, is using the first Malcolm Baldrige National Quality Award in healthcare to do just that.
The Baldrige award, administered by the Department of Commerce, is well-established as the nation's quality benchmark in manufacturing, services and small business. But this year, Congress also has funded awards in healthcare and education for the first time.
Mary Bostwick, award administrator, says many organizations enter the contest to benefit from the self-assessment and the feedback from the judges. "It can help them prioritize their next round of improvements," she says. "Organizing to apply for this can be a catalytic event for the organization."
Sister Mary Jean Ryan, president and chief executive officer of St. Louis-based SSM, concurs. "I do believe the Baldrige award is the best way to get better faster," she says. Ryan adds that she wants her hospital chain to become one of those organizations "that dare to do things differently because they have a commitment to continuous improvement and their customers."
Ryan isn't just sitting in her office mouthing slogans; she proclaimed them with conviction to an audience of 180 employees at 240-bed Saint Francis Hospital and Health Center in Blue Island, Ill., during a recent visit.
And staff members were eating it up. As Ryan pointed out clinical improvement teams, rounds of applause greeted each group. "Emergency department fast-track team, stand and be recognized. Patient safety protection team, you're an example to everybody in our system. Please don't forget how good you are. You are an inspiration to me. Your commitment to quality improvement is a gift to our entire system and, most of all, to our patients."
This was the 13th of Ryan's 25 visits to the system's hospitals and nursing homes to push the notion that quality improvement matters.
For the hospital, Ryan's appearance also functioned as a dress rehearsal. If SSM makes the first two cuts, Baldrige award officials will visit the chain's facilities in October. They'll interview everyone from the CEO to cafeteria employees to verify that what's written on the 50-page application is true. Then the officials will deliver a report to the system with suggestions for improvements.
The point, Ryan says, is not to win but to learn. Organizations that enter the contest are known to be more successful. "Keep on asking those hard questions that will help you achieve true quality improvement," she says. "It's not like (entering this contest) costs 10 cents. But we get great value out of it."
Ryan supports the systems approach to quality improvement. Every system is designed to produce the result it generates, she says. Therefore, to improve the result, improve the system.
Quality improvement is a key element in SSM's integration strategy. The system started working on quality in 1990, and the training is paying off. "There's a lot more collaboration now," says Curtis May, director of materials management and pharmacy at Saint Francis. "No one thinks in a vacuum any more. No one is so presumptuous as to assume they can solve this without the assistance of others."
Continuous quality improvement has helped managers perform their jobs better. Before CQI, Elena Pedela, director of medical records at the hospital, says people managed according to their gut. "Now when you collect the data, it's a totally different problem than you thought you had," she says.
At Saint Francis Hospital, Ryan visits four departments to hear how rank-and-file employees are handling the quality mission. "This is not an inspection," she told them. "I'm not from the Joint Commission (on Accreditation of Healthcare Organizations)."
Ryan had a repertoire of questions to get people talking: "What changes have you seen?" "What's the best part of your job?" "If you thought something could be improved by changing it, would you feel free to do that?" "What kind of messages are you getting from your hospital CEO, Jay Kreuzer?" "Do you think you have been recognized for the contributions you make?"
She asked the medical transcriptionists, "If you had my job for a day, what would you change?"
She was met with blank stares. Finally one woman braved a response. "Sister, what do you really do?"
After the laughter subsided, Ryan answered: "I'm responsible and accountable for everything that happens within the system."