Traverse City, a popular resort town near the northern tip of Michigans Lower Peninsula, has a population that ebbs and flows with the seasons. And Munson Medical Center, the only hospital within a two-hour drive, has to be staffed accordingly.
In the classic sense, we dont have competition, says President and Chief Executive Officer Ed Ness. But in some ways, it makes the staffing balance more important. If we were in a larger city, a patient could go down the road. But we dont have anywhere to divert them to. To make sure he has enough people, Ness has made flexibility his best friend.
Munson, a 368-bed facility that hosts a family practice internship and residency program through Michigan State University, has been a 100 Top Hospitals winner nine timeswhich ties it for a record in its category. Its the flagship hospital of Munson Healthcare, a regional not-for-profit system that owns or manages seven hospitals in northern Michigan.
Despite its seasonal census fluctuations, Munson Medical Center uses very little contract labor to fill in at peak times. Instead, it has developed staffing pools whose employees are cross-trained in different departments so that they can be plugged in where needed. While overall compensation is right at the median for both clinical and support employees, according to salary surveys, the hospital has cultivated a large part-time staff by offering full-time benefits for working as few as 16 hours per week. Part-timers are guaranteed 16 hours a week in the winter months and they can ramp up to full time in the summer.
Any remaining gaps are filled by summer-only workers, though theyre still hired directly by Munson rather than coming through an agency. Some are snowbirds who spend their winters working in Florida and want to keep their skills sharp year-round; others may be students. Since the beach calls to the summer-only workers, flexible hours are the way to keep them happy.
Munsons employee vacancy rate is only 4%, and overall turnover is in the low teens.
Throughout the hospital, Munson pursues a balanced scorecard approach to measuring quality and financial performance to ensure that its not sacrificing quality at the expense of cost, Ness says. To measure cost performance, it uses benchmarks from the Healthcare Management Council, a consultancy specializing in hospital performance measurement. On the quality side, the hospitals overall goal is to be in the top 10% on the CMS core measures. Its efforts also focus on the Joint Commissions National Patient Safety Goals, and on the Institute for Healthcare Improvements 100,000 Lives Campaign.
The most valuable business tools at Munson, Ness says, are lean management techniques adapted from the manufacturing philosophy developed by Toyota, which focuses on making processes flow smoothly and eliminating wastes of time, money and materials.
While executive pay is linked to achieving performance benchmarks, frontline workers dont have a formal financial incentive program. Nonetheless, Ness hasnt seen any difficulties getting the part-timers and seasonal workers onboard with the institutions performance improvement initiatives. Each worker gets a full briefing on the initiatives during general orientation and from his or her departmental manager.
Munson is now implementing an electronic medical-record system, and has completed nursing documentation and the bar-coding of medications. Computerized physician order entry is on the horizon, and records will be all electronic within two years if all goes well. While the system has improved quality of care and patient safety, it has probably had a net negative impact on efficiency because its not complete, Ness says.
Were finding that whenever you have two different records, a portion electronic and a portion on paper, you lose any efficiencies you gain, he says. You really need to get everything into one world.