Fire Starter

Homestead Hospital

Homestead, Florida

In 2003, Homestead Hospital embarked on a "Good to Great" initiative to achieve a culture of excellence. Through a partnership with Studer Group®, the hospital's strategic objectives and operational processes were aligned to the five pillars of People, Service, Quality, Finance and Growth. We achieved, and in many areas, surpassed our goals for measures of patient satisfaction, employee engagement, physician satisfaction and clinical quality.

In May 2007, the hospital relocated to a brand new facility. The $135 million Homestead Hospital was built to meet the needs of a rapidly growing community and replace an aging facility that had served the community for nearly 70 years. Our visibility as a cornerstone of the community was elevated by the support of a first-class facility built with the latest technology and modern design. Maintaining our reputation as a fine, well-respected organization whose employees and medical staff value quality clinical outcomes and patient care remained at the forefront of our not-for-profit mission of caring for the community.

Community support of the new hospital was overwhelming. A grand opening celebration attracted more than 7,000 visitors. In the first month at our new location, emergency visits jumped 30 percent, admissions increased 13 percent and the number of babies born increased 35 percent. The increased emergency volume led to longer wait times, put a strain on overall hospital operations and resulted in decreased patient satisfaction.

In addition, with an 89 percent occupancy rate, Homestead Hospital had more patients per bed than any other hospital in South Florida in 2008.

With the assistance of Studer Group Coach Cynthia Schafer, we renewed our commitment to service and operational excellence, placing an emphasis on increasing patient satisfaction beyond the 80th percentile.

The first step was for senior management to recommit resources to "Good to Great" initiatives. Investments continued in the area of leadership development by presenting quarterly educational sessions for managers and supervisors. Service teams comprised of employees from throughout the hospital were renewed to advance communication, inpatient satisfaction, measurement, service recovery, reward and recognition and service standards. Managers and supervisors continued to identify high-, middle- and low-performing employees to ensure a dedicated and effective workforce. Management accountability was enforced with the rejuvenation of nurse rounding, senior management rounding, report cards and 90-day plans.

Three rounds of Employee Forums have been held at the new hospital, and a 92 percent attendance was achieved at the most recent sessions. In the area of rewards and recognition, more than 5,600 thank you notes have been sent to staff in the last 15 months to acknowledge outstanding acts of service excellence.

Reinforcing Studer Group Nine Principles® and maximizing the tools, coupled with the continued dedication of Homestead Hospital leaders and staff, have led to the following successes:

SERVICE

As calculated by Press Ganey, overall patient satisfaction at Homestead Hospital in 2008 reached the 96th percentile, and outpatient surgery and outpatient services achieved the 99th percentile for three consecutive quarters. Emergency Department results continue to improve after increasing from single digit percentiles.

This year Homestead Hospital tied with two other hospitals as Number One in the nation for physician satisfaction compared to hospitals of similar size, as measured by the national independent research company HealthStream Research.

Honoring excellence, job creation, economic development and innovation, Homestead Hospital received the 2008 Healthcare Services Award from the Beacon Council, Miami-Dade County's official economic development partnership.

QUALITY

Homestead Hospital achieved the 90th percentile or above for 16 of 18 measures that are part of the National Quality Initiative and has been consistently ranked one of the highest-scoring hospitals in Miami-Dade County since the inception of the national initiative.

Homestead Hospital received a financial reward from the Centers for Medicare and Medicaid/Premier Hospital Quality Incentive Demonstration project for placing in the 98th percentile for the treatment of heart failure and heart attack and in the 93rd percentile for the treatment of pneumonia.

The hospital's nuclear medicine, MRI and non-invasive vascular lab achieved accreditation from their respective national accrediting bodies.

The hospital implemented computerized systems for clinical documentation, physician order entry, medication administration and nursing assessments.

FINANCE

For the current fiscal year, the hospital is significantly better than budget, maintaining its number of full time employees per 100 adjusted admissions at seven percent below budget.

The hospital operated significantly better than budget throughout 2008.

PEOPLE

For the past four years, Homestead Hospital's employee satisfaction has achieved the 86th percentile, which is measured and defined as "world class" by The Gallup Organization. The hospital scored in the 90th percentile in the 2008 employee opinion survey.

Employee turnover for the current year is eight percent, significantly lower than the industry average of 14 percent.

Four medical staff and four managers are completing a one year leadership program to strengthen leadership effectiveness and accountability. The group is engaging physicians in significant quality improvement projects such as computerized physician order entry and decreasing length of stay.

Baptist Health was the only Florida-based healthcare organization listed as a top employer (94th) on the FORTUNE "100 Best Companies to Work For" list published in the February issue of Fortune Magazine.

GROWTH

Increases in patient volume for the current fiscal year include:

Adult admissions: +18 percent
Emergency visits: +27 percent
Births: +14 percent
Outpatient surgery: +7 percent
Outpatient visits: +5 percent

Just after one year at the new hospital, an additional 27-bed medical-surgical unit was built to accommodate an increased census. The hospital was relicensed as a 142-bed facility.

The number of employees working at Homestead Hospital grew 14 percent in the last 15 months.

Homestead Hospital is part of Baptist Health South Florida, the largest not-for-profit healthcare organization in the region. The 142-bed hospital has more than 1,500 employees, physicians and volunteers who care for 8,300 admitted patients and more than 22,000 outpatient visits each year. Because it is the only hospital in 18 miles, Homestead Hospital has one of the busiest Emergency Departments in the area, treating nearly 50,000 patients annually.

The belief that exceptional healthcare includes an emphasis on human qualities such as warmth, compassion, and communication drives Baptist Health's approach to service. Service and operational excellence is so important to the organization that 50 percent employees' annual performance evaluations are based on service.

We continue to work hard to maintain and hardwire a culture of service excellence at Homestead Hospital. Our efforts are enabling us to achieve excellent clinical outcomes, making Homestead Hospital a great place for patients to receive care, physicians to practice and employees to work.

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