Three years ago, 566-bed Conemaugh Memorial Medical Center in Johnstown, Pa., was losing $2 million per month from operations and losing market share. Although a homemade survey tool had shown that 98% of its patients were at least somewhat satisfied with their care, when the hospital turned to Press Ganey Associates for its national benchmarking services, patient-satisfaction scores thudded to the 22nd percentile.
Having already worked with a nationally recognized consulting firm to redesign every work process they could think of, administrators decided to rethink their bottom-line goals, giving clinical excellence and service excellence equal weight alongside cost-effectiveness. They also tapped two new sources of comment: patients and employees.
In the time since, Conemaugh has experienced a dramatic turnaround. The $2 million-per-month operations loss has turned into a $370,000-per-month gain, inpatient-satisfaction scores have reached as high as the 92nd percentile and the facility earned the 100 Top Hospitals designation in orthopedics (2000) and cardiology (1999 and 2002) from Solucient, an Evanston, Ill.-based healthcare information company. These results have earned the hospital the Spirit of Excellence Award for Service.
"The patients told us to be nice; to include them in decisionmaking; to make some facility changes; to talk to their families; to not let them wait too long; to explain things," writes President Steven Tucker in the hospital's award application. "We've got a long way to go, but we're making those changes. . . . We've finally listened to the real experts."
Conemaugh achieved its turnaround by forming nine teams to examine different areas related to patient care and to spearhead changes with help from the data from Press Ganey, a healthcare patient satisfaction-measurement company based in South Bend, Ind. For example, the inpatient-satisfaction team spurred initiatives to make post-discharge courtesy calls systematically and send patients thank you cards, as well as to enhance the infant bereavement process.
The hospital also has made efforts to break down the walls between departments, pulling together a monthly performance-improvement council that includes managers and other key employees. "We talk about what we're working on, what we're monitoring, our successes, our failures," said Mike DaShiell, director of food and nutrition services.
The Press Ganey licensing agreement costs Conemaugh $5,000 per year and the hospital has added two service-excellence coordinator positions at an annual cost of about $70,000, said Suzanne Ross, director of performance improvement. Conemaugh consistently has operated in the black on a monthly basis for two years, she said, posting a loss of $15 million, or 9% of net patient revenue, in 1999; a loss of $10 million, or 6%, in 2000; an operating gain of $3.9 million, or 2.1%, in 2001; and a gain of $5.7 million, or 2.6%, this year. The overall turnaround: roughly 12%.
Awards judge Joseph Swedish, president and chief executive officer of Centura Health in Englewood, Colo., praises the efforts of both Conemaugh and honorable mention North Broward Medical Center, Pompano Beach, Fla. (See sidebar, this page.) Swedish singles them out for putting teeth in their customer service initiatives, constructing balanced methodologies and identifying clear metrics, having "a sense of urgency and a readiness to do whatever it takes," gaining buy-in from top leaders that spread to the whole organization and creating sustainable outcomes.