California Pacific Medical Center San Francisco named one of Six 2003 Success Story Winners by Press Ganey

Subject: How to Succeed at Building a Culture of Excellence In a Large, Complex Organization

Publication Name: Press Ganey
Published Date: 01/01/2003
California Pacific Medical Center San Francisco, California

Patient Satisfaction is a top priority at California Pacific Medical Center. However, patient satisfaction survey scores did not reflect this. When CPMC began working with Press Ganey, a baseline study was conducted in 2001 and scores were in the 14th percentile. A Pareto analysis of the patient comments from surveys in 1998 through 2000 indicated that the same issues were occurring and had not been resolved. The primary areas for improvement in the patient comments were consistently, Nursing, Comfort and Cleanliness, Food Service and Room Amenities.

The Planning Process

A presentation was made to the Senior Management team identifying the problem. The leaders committed in May of 2001 to initiate a performance improvement plan for service. The planning process involved contacting the Health Care Advisory Board to identify organizations that were achieving superior results in patient satisfaction. Many organizations were contacted and interviewed. The information was shared with our Service Excellence Steering Committee, and several leaders decided to visit Baptist Hospital in Pensacola, Florida, and attend a two-day seminar conducted by the Studer Group. They became convinced that something special was going on there and wanted to make it happen at CPMC. A culture was being developed around service that could be felt when speaking with employees.

A decision was made to bring the two-day seminar to the entire CPMC Management team (more than 200 managers and supervisors). There was complete agreement, and more than that, managers were inspired and motivated to become a part of the change process.

Service Excellence Improvement Commitment

We built a structure around service excellence. Our President and CEO were identified as our Service Excellence Commitment Sponsors, the Chief Operating Officer as Executive Champion, VP of Nursing as Leadership Development Champion, VP of Academic Affairs as Accountability Management Champion and Customer Service Director as Service Excellence Champion. Service Excellence Team leaders and members were selected and trained. Each team submitted 90-day action plans throughout the year. Service teams linked improvement strategies to survey results. Some teams focused on employee and physician satisfaction.

We implemented some recommendations by the Studer Group to begin to drive the culture change. Every manager began to send at least one thank you note to employees for providing good care to patients and contributing to a positive work environment. Managers sent e-mail messages to Vice Presidents acknowledging employees who were doing good things for patients and Vice Presidents sent at least five thank you notes a week to employees. We redesigned our Employee Forums and increased attendance from less than 100 employees to more than 800. This event is upbeat, inspirational, a great learning opportunity, and now has "standing room only" in our largest meeting rooms.

We improved communications with employees to the extent that they better understand the vital role that they play in the organization?s success. We kept our employees informed on patient satisfaction survey results and gave them concrete examples of what they could do to help us improve. Patient satisfaction data was provided monthly to all units and every department manager created communication boards organized under five pillars: People, Service, Finance, Quality and Growth. We implemented quarterly two-day leadership development sessions for all managers and supervisors to enhance their skills. The survey and the top ten priorities were used as a guide for improvement strategies.

We developed service standards and began to reward employees for improvements in patient satisfaction and for living the standards.

Results

Consistent incremental improvement has been achieved over the past year. Inpatient satisfaction scores moved from the 14th percentile to the 52nd percentile. Staff morale has improved, along with the cheerfulness of the hospital. We implemented a "Five-Ten" rule to address the cheerfulness of the hospital and this score has moved from the 18th to the 80th percentile. We also implemented service standards to improve how staff interacts with patients and their co-workers. Scores improved in the "likelihood to recommend the facility" from the 40th to the 80th percentile. The scores for the question "How the staff works together, as a team, to care for you" moved from the 26th to the 84th percentile. We also had one of our best financial years in 2002.

We designed customer service training for nurses and implemented communication improvement strategies and have seen satisfaction in nursing move from the 17th to the 54th percentile. "Key Words at Key Times" and leader rounding were implemented in food service and we have seen the scores move from the 11th to the 51st percentile. We implemented a leadership and employee team in the Emergency Department to focus on ED service excellence, and the scores have improved from the 47th to the 73rd percentile.

We set a goal to achieve the 50th percentile by the end of 2002 and we worked aggressively to achieve it. It was a great year! We appreciate all of the support that we have gotten from our teammates at Press Ganey. You contributed greatly to our success and we thank each of you for the great level of support you have provided us on our journey from "Good to Great" and our Service Excellence Commitment!