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Bon Secours St. Francis Hospital

  • Location: Charleston, SC
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: January 2007

"Bricks, mortar and technology don't create a sustainable competitive advantage, people do," said Allen Carroll, Bon Secours St. Francis Hospital CEO.

Bon Secours St. Francis Hospital (BSSF) is known for quality and compassionate patient care and as the first Catholic hospital in the state of South Carolina and the only one in Charleston.

The hospital traces its mission back to 1882 when five Sisters of Charity of Our Lady of Mercy opened the St. Francis Infirmary in a small wooden framed building in downtown Charleston. As medicine evolved and the population and need grew, so did the hospital. St. Francis faced one of its biggest challenges in December 1996 when the entire hospital moved to a suburban area seven miles across town, after 114 years of service in downtown Charleston. The move necessitated a reduction in workforce by 400 FTEs. Staff and employees were able to come together during this difficult time and make a successful and positive transition as reflected in employee satisfaction scores.

While the facility was shiny and new with the latest technology inside, the hospital's longstanding goal and mission remained constant… to care for the "whole person" physically, spiritually and emotionally. A merger with Roper Hospital in 1998 formed the system known today as Roper St. Francis Healthcare.

Roper St. Francis with member hospitals Roper and St. Francis partnered with the Studer Group in the Fall of 2005. Employees, staff and the St. Francis Board under the direction of board chair Admiral Jim Flatley, were eager to embrace the Studer Group's methodology. Through that partnership, St. Francis has seen positive results including improved employee, physician and patient satisfaction, increased staff participation in outreach efforts, increased nursing certifications, and overall refinements throughout the system.

St. Francis recognizes the Studer Group for helping further efforts already underway to implement better consistency of care and services provided. SG can also be credited with accelerating the integration of two very different and independent hospitals through quarterly Leadership Development Institutes as part of the system's Journey to Excellence. The development of our Standards of Behavior has energized and unified the health system.

PEOPLE PILLAR:

  • Employee Satisfaction: St. Francis has maintained top decile performance over the last five years for employees rating the hospital as an excellent place to work with performance at the national 96th percentile ranking in 2005 & 2006. In 2006, BSSF received nine national awards for performance in the top decile, one award for performance in top quartile and one award for performance in 100th percentile ranking.
  • Physician Satisfaction: St. Francis has maintained top quartile performance over the last two years and received two national awards in 2006 as a place to practice medicine and for anesthesia services.
  • Increase in Certifications: In 2006, 35% of eligible nurses at St. Francis are certified. That is up from just 5% in 2004. There are certified nurses working in all inpatient areas, critical care, emergency department and peri-operative services.
  • Voted "Best Place To Give Birth" in 2006 by readers of The City Paper, a local, weekly publication.

QUALITY PILLAR:

  • Patient Satisfaction: BSSF Hospital has received many national awards each year for performance in inpatient, outpatient, outpatient surgery, and emergency room patient satisfaction. In 2006, BSSF received seven national awards for top decile performance, one award for top quartile performance, and one award for performance in 100th percentile ranking.
  • CMS/Core Quality Measures: We have seen significant improvement in the past year with a number of CMS/Core quality measures that are favorable to current national top decile performance with a yearend rate in 2005 at 39.2% and year-to-date rate through third quarter 2006 at 61% compliance. Implementation of process changes to better identify these high-risk patients upon admission as well as concurrent checks by multiple disciplines working as a team has helped insure we are providing best practice to our patients.
  • IHI 100K Lives Campaign: BSSF Hospital participated in many improvement projects in 2006 related to the intervention projects recommended by IHI – Institute for Healthcare Improvement.
    July 2006 5.64
    August 2006 2.68
    September 2006 1.46
    (Rates are calculated per 1000 patient days)
    • Reduction in Ventilator Associated Pneumonias (VAP) – Through implementation of a ventilator weaning protocol paired with closer monitoring of elevation of head of bed and better oral care, BSSF Hospital was able to reduce their ventilator associated pneumonia rate per 1000 patient days by 57% from 2004 to 2005 and become favorable to the CDC recommended threshold. In 2006, BSSF Hospital maintained VAP rate favorable to the CDC recommended threshold and also had five consecutive months with no VAP’s after implementing revisions to the ventilator weaning and care bundle protocols based on national best practice recommendations from IHI.
    • Reduction in Central Line Associated Blood Stream Infections (CLABSI): Implementation of a dedicated PICC Team; upgrading of insertion kits to include chlorhexidine, antimicrobial catheters, sterile gown and gloves and maximum barrier drapes; upgrading dressing changing kits to include chlorhexidine; employee and physician education, and increased monitoring of consistent compliance with sterile technique for insertion and maintenance of central lines allowed BSSF Hospital to reduce the rate of CLABSI per 1000 line days by 48% from 2005 to 2006.
    • Implementation of Rapid Response Team: After many months of preparation, St. Francis implemented a Rapid Response Team in December 2006 and will closely monitor its progress in 2007.
    • Reduction in Patient Falls and Implementation of Hourly Rounding: We implemented an hourly rounding pilot on our Med-Surg Units, 3rd St. Luke and 4th St. Vincent, in June 2006 following staff training in May. As a result, we have seen a significant decrease in patient falls. The rounding involves the nursing staff seeing the patients every hour and asking them specific questions about any needs for pain meds, positioning or toileting. Below are the combined fall rates for the two units:
  • The first annual "Eastman Kodak Quality Awards" were presented to two RSFH employees for their roles in supporting and successfully changing analog radiographic technology to digital imaging at BSSF in 2006.

FINANCIAL PILLAR:

  • The hospital's operating margin is 4.5 times greater than the Moody's Median A rated hospitals.
  • We have been able to achieve these earnings by holding charges significantly lower than local for-profit hospitals.
  • St. Francis has been able to achieve this earnings position by remaining one of the lower cost providers as noted by the decreasing trend of salaries as a % of total revenue 40.5% in 2002 vs. 33.9% in 2006
  • St. Francis has not utilized local agency nursing labor since 2001.

GROWTH PILLAR:

  • We have commenced a 60-bed expansion to bring the total number of beds at St. Francis Hospital to 204.
  • Will break ground on a new Oncology Center in 2007.

  Adjusted Discharges ER Visits
2002 14,982 33,865
2003 15,936 34,308
2004 16,516 34,395
2005 17,489 36,098
2006 17,933 37,729

SERVICE PILLAR:

  • 395 staff and employees participated in the Trident United Way Annual Giving Fundraiser in 2006 donating $54,861.28.
  • Volunteers have given 33,500 hours of time throughout the hospital in 2006.
  • Employees and staff have donated more than $19,000 dollars to the American Heart Association through the Heart Walk in 2006. Money was raised through individual contributions and fundraisers held throughout the year.
  • St. Francis has generously donated services for providing prenatal testing and labs, other support labs, all cultures and ultrasounds for the Sisters of Charity for Our Lady of Mercy Outreach Wellness. We have provided those services since 1999. The clinic serves an indigent population in and around rural Johns Island, SC.
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