Drive Clinical Quality with Objective Leader Evaluations
"Translating overall organizational goals into meaningful and aligned department goals is key to moving the organization's results forward," explains David Fox, president of Advocate Good Samaritan Hospital, a 340- bed facility with 2400 employees in Downers Grove, IL and a leading performer in Advocate Health Care. Advocate is the largest integrated health system in Illinois.
He adds, "It's important because our patients are counting on us to use evidence-based clinical interventions that promote their recovery and life span. And the best way to hardwire that is to rely on evidence-based leadership tactics like an objective leadership evaluation. It creates clear expectations and accountability at all levels of the organization."
Since 2004, Good Samaritan has been on a rigorous journey from Good to Great. In fact, the Institute of Healthcare Improvement (IHI) named the organization as a prestigious mentor hospital in its 1000,000 Lives Campaign last year due to its dramatic gains in clinical practice and patient outcomes.
Of particular note: Good Samaritan was also one of 24 hospitals recognized by IHI for its groundbreaking work on a cardiac alert protocol. By the third quarter in 2006, the protocol had reduced door to balloon time for 100% of acute MI patients to less than 90 minutes, one of CMS' compliance standards for the core measures AMI bundle. Prompt care is critical for these patients. In fact, each 30-minute delay in coronary reperfusion with angioplasty increases one-year mortality 7.5%1.
How to Hardwire Results Like These
1. Set clear, weighted goals. Good Samaritan credits its success with setting clear, weighted quality goals on every leader's evaluation that align and cascade from the CEO to each manager. Every member of Advocate's executive management team is evaluated 30% on systemwide achievement of clinical outcome goals.
2. Align goals organizationwide. While the weighting of clinical goals and results differs depending on the influence that individual directors and managers have on clinical outcomes, all quality goals align so that Good Samaritan meets its organizational objectives for core measure bundles, complications, and IHI targets. For example, the director of critical care will be evaluated based on AMI, CHF and pneumonia bundles (core measures) as well as VAP and BSI (adverse events). Goals for med/surg nurse managers include smoking cessation counseling (CHF/pneumonia/AMI bundles) and pneumococcal screening and evaluation. Nurse managers have a goal with respect to discharge instructions for CHF.
3. Hold individuals accountable. From the organization to the individual, goals are tracked real-time and transparent to all so there are no surprises at evaluation time. Everyone can see how the organization is tracking as a whole and monitor their personal performance.
A Studer Group coach for Good Samaritan Hospital, Page Sternung has more than 20 years experience in health care. Her experience in clinical, service, and operational excellence give her credibility with leaders at all levels for results that last.
1 Circulation 1999, Berger; 100:14-20
2 Per the IHI website. The mortality rate associated with BSI is 18%.
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