It is tremendously exciting to transform a struggling hospital to one that can boast high quality, national respect and financial stability. But a dramatic turnaround in hospital operations is not a sprint to a finish line. It is an ongoing marathon that tests the commitment of any organization.
On Oct. 1, 1998, with enough cash to cover approximately 10 to 15 days of operating expenses, no endowment and no tax appropriations, the University of Kansas Hospital became an independently governed state authority. The state would continue to own the hospital but provide no funding and accept no revenue. And the hospital, which had been undercapitalized for many years, was faced with problem facilities and equipment, high employee turnover and a devastating slide in patient volume and revenue.
A decade later, the hospital is now considered a premier quality-healthcare provider and has been ranked two straight years for excellence in cardiac care by U.S. News & World Report. Our risk-adjusted mortality rate ranked in the top 10% among academic centers in the University HealthSystem Consortium.
Inpatient discharges were up 71% in 10 years. Outpatient volume was up 117%, and our revenue climbed 253% during this same period.
So, how does a hospital continue to motivate staff to improve performance when there is already such a dramatic success?
Actionable, timely and credible measures that are meaningful to the staff are essential to improvement. Thats why the University of Kansas Hospital, in collaboration with its medical staff, defined its key measures as patient satisfaction and mortality.
We set high expectations for each hospital unit, and initial improvement was slow, inconsistent and often discouraging. As a result, we matched high-performing units and underperforming ones so they could work together to achieve consistent results. We regularly reported back to our managers and directors with real-time performance updates and encouraged them to share results with the staff. Since nursing was the key to patient satisfaction, ownership of that metric was given to nurses.
They took the challenge.
In 10 years, we went from single-digit percentile ranking on the Press Ganey patient-satisfaction survey to a consistent score in the 90th percentile when compared with all hospitalsand the high 90s when compared with teaching hospitals.
When we had breakthrough years and saw numbers in the 70th and 80th percentiles in patient satisfaction, we were elated. But we also realized we could not stop there. In medicine, close enough is not good enough. We keep raising the bar. Our goal is to be the best, and we are still working on it.
A final, but vital, attribute is humility. It is not about individuals, as we all own the transformation, and we honor everyone who helped achieve it. When everyone owns your success, everyone is continually energized by each accomplishment.