Hospital CEOs: What "Top Performance" Looks Like to Me

Becker's Hospital Review—February 15, 2012

What does it mean to be a top-performer, exactly? The phrase is often spoken with implicit meaning, but ask any two people and you'll likely hear different definitions. To help clarify what "top performance" looks like in healthcare right now, five hospital and health system CEOs from around the country deconstructed the term into five realms: clinical quality, finance, patient satisfaction, employee and physician morale, and leadership. Here is how Lou Shapiro, president and CEO of Hospital for Special Surgery, describes top performance within his organization.

Clinical quality

"First, as the people in an organization are a major determinant in the care hospitals provide, it's important to focus on the recruitment and retention of staff. You want people who are skilled at the highest level, regardless of their role, and who are committed to working together as a team to contribute to the growth of the institution. Second, care is generally not delivered by an individual but by teams, so systems need to seamlessly come together to achieve needed outcomes. It's important to pay attention to patient flow and processes that enable care delivery. Appropriate use of information technology can enable systems and processes to work efficiently with the goal of improved outcomes." — Louis Shapiro, president and CEO of Hospital for Special Surgery in New York

Finance

"Clinical quality at the highest possible level is needed for financial health. Does your hospital deliver the highest possible quality of care and create an exceptional experience for patients? What makes a hospital a top performer in clinical quality — staff and efficient processes — are also key ingredients in maintaining strong financial growth. In today's environment with constrained resources, hospitals are looking at lessons from other industries, such as lean production. Growth is also an important factor contributing to the bottom line." — Louis Shapiro

Patient satisfaction

"First, hospitals need to place a high value on patient satisfaction as a strategic priority. Hospital for Special Surgery has been at the 99th percentile for 'likelihood to recommend' for 14 consecutive quarters when benchmarked against other facilities in the Press Ganey Magnet Peer Group. It's a number one strategic priority for everyone in our institution. Second, patient satisfaction is directly linked to employee morale. Employees are 100-percent committed to what we're trying to accomplish as an organization, and they view themselves as owners [of that mission]. Patient satisfaction needs to be hardwired into your organization. For example, we implemented hourly rounding for our nurses to reduce the need for patients to use their call bell. By anticipating our patients' needs, we improved their satisfaction and made nurse workflow more efficient. Now that is part of how our nurses work every day." — Louis Shapiro

Employee and physician morale

"The most important factors are involvement, communication and environment. People are what enable the organization to perform at the highest possible level, and people want to be involved in decision-making and improvement efforts. Communication goes hand-in-hand with involvement, feedback and follow-up. People need to feel that their opinions count. This means paying attention to and following up on their suggestions for improvement. It's important to communicate what is happening at the hospital so that employees don't feel inhibited or disconnected. Finally, everyone needs to have the tools to do their job, feel the organization is investing in their development, and know what's expected of them — then they're operating in an environment that lets them work at their highest possible level." — Louis Shapiro

Leadership

"Walk the talk. Be visible and approachable. Make sure people know you. Don't lose your connectivity to what is happening on the frontline with the people doing the real work in the organization." — Louis Shapiro

Read the full story at beckershospitalreview.com.