Advocate Lutheran General Hospital/Lutheran General Children's Hospital

  • Location: Park Ridge, IL
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: June 2012

The Advocate Experience: Embarking on a Journey to be "Always the Best"

Two years ago the leadership team at Advocate Lutheran General Hospital/Lutheran General Children's Hospital (Lutheran General Hospital), decided to embark on the Advocate Experience journey with the Studer Group to make Lutheran General Hospital the best place for patients to heal, physicians to practice and associates to work. Our goal with the Advocate Experience is clear: to be "Always the Best."

To reach this goal, it was important to understand the current healthcare environment and to evaluate the programmatic benefits to ensure a positive return on investment that would add value to the patient and the organization. By using the right tactics and by ensuring that our efforts were tailored around our Key Result Areas (KRAs), we have been able to quantify the financial impact of our Advocate Experience Journey.

The Supporting Columns

At Lutheran General Hospital, we rely on six KRAs to measure our growth:

  • Health Outcomes
  • Patient Satisfaction
  • Physician Engagement
  • Associate Engagement
  • Funding our Future
  • Growth

These KRAs are reported and reviewed as a score card every month allowing alignment of efforts to achieve our goals. At the same time, this information is shared with all associates, volunteers and physicians through a variety of communication vehicles; being able to share this information, allows us to have participation by everyone in the organization because this presents an opportunity to directly influence and improve patient satisfaction.

The Approach

The Advocate Experience began at the first Leadership Development Institute (LDI) in October 2010. During this LDI, a number of different tactics were presented with the objective to ensure an identified value in every KRA. However different, all tactics had one goal in common - to elevate volunteer, associate and physician engagement; all with the objective of ensuring a positive return on investment that would add value to the patient experience and the organization.

The tactics implemented throughout the organization, directly linked to each KRA are:

  • Behaviors of Excellence (BOE)
  • Hourly patient rounding
  • Executive safety rounds
  • Discharge calls
  • Associate rounding
  • Thank you notes
  • High-Solid-Low
  • AIDET (Acknowledge, Introduce, Duration, Explanation and Thank You)

The successful roll-out and implementation of each tactic relied heavily on the leadership group and the high engagement of each associate. Each tactic had a direct impact on everyone: from associates adopting and living out the Behaviors of Excellence to feeling motivated and recognized for all their efforts; physicians being engaged in decision making within the organization and seeing a breakthrough in their patients' satisfaction scores; to patients receiving and gaining a new perception of care at Lutheran General Hospital through a continuous and strong use of AIDET, hourly patient rounding and discharge calls.

One of the tactics introduced in the first LDI as part of the Advocate Experience -"thank you notes"- in a very short time proved to be a strong key element in motivating associates. As noted by Susan Okuno-Jones, DNP, MA, MS, APN, RNC-NIC, RN-BC, Director, Professional Development & Service Excellence, "Recognizing our associates has proven to be a strong motivator for continued excellence in service provided. In addition, our associates,-through recognition, feel valued as essential members of the health care team."

It is important to note that another key item that helped us reach our goal of being "Always the Best" was the implementation of our "Behaviors of Excellence" (BOE). The BOE (Be Responsive, Be Respectful, Be Professional, Be Accountable, Be Collaborative), are a set of behaviors by which we live out our Mission, Values and Philosophy every day. By implementing these behaviors we are creating a culture where:

  • Patients feel cared for and experience extraordinary service and quality
  • Physicians feel supported and know that their patients are getting great care, and
  • Associates feel valued and know that their work is purposeful, worthwhile and makes a difference

The Financial Impact

The successful implementation of all tactics has also made a positive financial impact on the organization. In 2011, directly related to the Advocate Experience and Studer Principles, we were able to achieve revenue growth of $3.9 million and expense savings of $7.4 million in 2011. This has allowed us to maintain solid operating margin performance during a period of significant reimbursement rate pressures. Some details of our performance include:

  • Health Outcomes: In the area of clinical quality, hourly rounding helped lower our falls with injury rate by 55%, our readmission rate by 14% and our average length of stay by 4%. The improvements in clinical quality allowed us to avoid additional costs of $5.2 million.
  • In Associate Engagement, we finished 2011 at the 96th percentile nationally. One key benefit of high associate satisfaction is the reduction in turnover rate. We were able to achieve savings of $200,000 by lowering the turnover rate in 2011.
  • For Patient Satisfaction, we have achieved top quartile performance in Inpatient HCAHPS and Outpatient satisfaction, and we have achieved top performance in ED satisfaction. With Medicare Value Based Purchasing, a percentage of our Medicare reimbursement is now based on improving and maintaining high performance for Inpatient HCAHPS. In 2011, we raised our score enough to generate an additional $57,000 in reimbursement.
  • Funding our Future is about managing resources in order to maintain a sustainable operating margin. Two key areas of focus for us in 2011 were reducing agency and overtime utilization. We were able to reduce agency by 57% and overtime hours by 16% which combined generated cost savings of $1.3 million.
  • Growth is driven by many different forces but is a good benchmark for the organizational performance relative to your market peers. In 2011, we achieved inpatient growth of 1.2% and outpatient growth of 1.7%. This volume growth translated to additional income of $3.9 million.
  • For Physician Engagement, we continued to exceed the overall system results on our physician satisfaction survey by 16% in 2011. To increase Physician engagement and physician satisfaction, we developed initiatives including a physician's online forum, physician wall recognition and developed weekly lecture series to highlight our physicians' areas of expertise that will benefit the community.

Today and the Future
Being recognized as the Healthcare Organization of the Month represents an honor for our hospital. This honor acknowledges every effort that we have made since embarking in our Advocate Experience journey, and moreover, it confirms that we are on the right path to continue to be "Always the Best."

Today, we continue to work very closely with our associates, volunteers and physicians to ensure we provide top-of-the-line healthcare to every patient that we are fortunate to serve in our health ministry. We are confident that continuing to develop and adopt best practices will help to make Lutheran General Hospital the best place for patients to heal, physicians to practice and associates to work.

About Advocate Lutheran General Hospital and Advocate Lutheran General Children's Hospital
Advocate Lutheran General Hospital and Advocate Lutheran General Children's Hospital in Park Ridge, IL, is a 638-bed teaching, research and referral hospital, a Level I trauma center, and one of the largest hospitals in the Chicago area. It also is home to Advocate Lutheran General Children's Hospital, the only children's hospital in the greater north and northwest suburban region of Chicago. The children's hospital is designated as a Level III perinatal facility (the highest designation) and a Pediatric Critical Care Site by the Illinois Department of Public Health Emergency Medical Services for Children.

Lutheran General Hospital has been recognized 13 times as one of the 100 Top Hospitals and 15 top major teaching hospitals in the country. For the 11th year, Lutheran General was rated by US News & World Report as one of America's Best Hospitals, and has received "top 50 in the nation" rankings for medical excellence and advanced capabilities in many specialties. Our hospital also has been selected four times as one of the 100 Top Cardiovascular Hospitals. In addition, Lutheran General is one of only 2 percent of the hospitals in the country to be re-designated by the American Nurses Credentialing Center's Magnet Recognition Program™ for nursing excellence.

Lutheran General Hospital achieved the best overall surgical morbidity ranking in the country according to the National Surgical Quality Improvement Program of the American College of Surgeons, and is a DNV-certified Primary Stroke Center.

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