At the University of Kentucky Chandler Hospital, Lexington, improving quality, patient safety and efficiency along with strengthening relationships with faculty physicians and outlying rural hospitals helped the 436-bed facility boost admissions by 47% and increase operating profits 295%, says Michael Karpf, a physician who's the university's executive vice president of health affairs.
"One of the things that made us successful the past few years is that we have moved to more of an integrated system with the hospital and doctors more aligned," Karpf says.
Meanwhile at 64-bed Mecosta County Medical Center, in Big Rapids, Mich., an $11 million bond issue to build a new surgery department and emergency room and a variety of quality-improvement projects helped the organization turn financial losses to operating gains, says Sam Daugherty, the hospital's chief executive officer.
"It all becomes a synergistic effect where the OR-ER project improved our perception in the community, we were then able to recruit more physicians, and our employees and staff wanted to provide the best care," Daugherty says.
At 338-bed Meriter Hospital, in Madison, Wis., focusing on Malcolm Baldrige National Quality Award criteria improved organization performance by leading to safer clinical services, providing top-rated customer service, offering a best-practice environment for physicians, and supporting employee and community needs, says Robert Coats, the hospital's chief operating officer.
UK Chandler, Mecosta County and Meriter are three of 100 hospitals listed on Thomson Healthcare's annual 100 Top Hospitals: Performance Improvement Leaders list. Thomson, formerly Solucient, a healthcare information company based in Evanston, Ill., also publishes the 100 Top Hospitals list, which annually ranks the nation's best-performing hospitals.
Performance-improvement leader hospitals are selected based on their performance over a five-year period in four categories: quality, financial, operations and growth. Thomson analyzed 2,897 acute-care hospitals from 2001 through 2005 using Medicare Provider Analysis and Review data, as well as information from Medicare cost reports.
Thomson scored facilities on eight measures: risk-adjusted mortality; risk-adjusted complications; risk-adjusted patient safety; severity-adjusted average length of stay; expense per adjusted discharge; operating profit margin; cash to total debt; and growth in patient volume.
"These hospitals are ones that have management teams driving higher clinical, financial and efficiency performance," says Jean Chenoweth, Thomson's senior vice president of performance improvement and the 100 Top Hospitals programs.