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Carolinas Medical Center - Randolph

  • Location: Charlotte, NC
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: March 2006

CMC Randolph is part of Carolinas HealthCare System (CHS), the third largest not-for-profit healthcare system in the United States. CHS owns, leases and manages hospitals, physician practices, specialty services and long term care facilities in North and South Carolina. CMC Randolph’s inpatient programs operate at a combined 91% occupancy with 100,000 outpatient visits and 16,000 emergency visits per year. The 24/7 clinical, call center fields 120,000 inquiries per year.

The top priority for CMC Randolph staff is providing excellent, compassionate service in an efficient manner to patients and their families. Operating with a goal to treat all county residents needing care in a timely manner, the historic challenge at CMC Randolph has been to maintain excellent customer service in the midst of perpetual demand increase.

In 2003, key organizational leaders attended a Studer Group Institute in Las Vegas, NV. Leaders became convinced that they had discovered the right teacher to lead CMC Randolph through a cultural transformation. According to an ancient Chinese proverb, “When the student is ready the teacher will appear”. In this case, management immediately embraced the philosophy and content of the Studer Group; however, still absent were the tools to make change happen. This conference represented the genesis of cultural transformation at CMC Randolph because it marked the beginning of a process needed to acquire all the necessary leadership tools.

After returning from the Institute, CMC Randolph’s leaders took inventory to find out where they needed to start. Each manager read Hardwiring Excellence by Quint Studer. A collective effort began to develop a strategy. Immediate innovations included the implementation of manager rounding, employee forums, and thank you notes. Leaders put in place monitoring tools to look at patient satisfaction scores on a real time basis, and to evaluate manager utilization of leadership tools. Department managers quickly engaged in the process.

High performers from throughout the organization were appointed to Service Excellence Committees in the areas of Patient Satisfaction, Employee Recognition/Employer of Choice, Standards of Behavior and Emergency Department. Innovative recognition programs like the “Beads for Deeds” program facilitated rapid buy-in from staff members in even the most challenging areas of the organization.

In 2004, Carolinas HealthCare System entered an engagement with the Studer Group to provide Service Excellence coaching and foundation implementation in all Mecklenburg County facilities. With the on-site coaching of Studer Group Coach Mitch Hagins, CMC Randolph received the tools necessary to meet goals. Mitch met monthly with the facility Steering Committee to set and review goals. Additionally, he rounded with managers in all areas of the facility to provide a one-to-one coaching experience without parallel. He worked with physicians, therapists and staff members to hardwire key behaviors to improve clinical, operational and service outcomes.

Leading by example, Laura Thomas, Group Vice President, has assured that the Must HavesSM have permeated every level of the organization. Nine themed, Employee Forums held over the past two years, with 90% staff attendance, have successfully communicated goals and progress to all employees. During April 2004, staff participated in the first Carolinas HealthCare System employee satisfaction survey with a 99% response rate, well above the 80% system goal. Results placed CMC Randolph in the 96th percentile nationally for employee satisfaction. This result was based on the Morehead Associates database that included more than 600,000 healthcare employees nationally.

For three years, all CMC Randolph areas of patient care services have experienced consistent improvement in patient satisfaction. Each has sustained and bettered this improvement:

CMC Randolph % Excellent Scores

  2003 2004 2005   % change 2003 to 2005
IP Overall quality 46.8 49.3 62.4   33%
IP Likely Recommend 42.9 51.8 61.4   43%
OP Overall Quality 41.6 45.3 66.8   61%
OP Likely Recommend 51.1 52.0 66.2   30%
ED Overall Quality 43.1 41.7 53.5   24%
ED Likely Recommend 47 48.2 52.0   11%

CMC Randolph implemented Peer Interviewing in late 2004 with excellent response from staff. All departments have staff teams of high performers trained in the peer interviewing process. After screening and interviews with management, the peer panel interviews each finalist. The recommendation of the peer panel is the hiring decision. This approach results in better retention, improved commitment of staff to the orientation of peers, and strong engagement of both new hires and existing staff with the Service Excellence culture.

Throughout the organization, departments have adopted “key words at key times” to assist staff in responding to patient concerns and reinforcing key clinical requirements. In the behavioral health environment, safety is a primary focus, so patient safety key words were addressed first throughout the facility.

Additionally, the concept of “involuntary commitment” is a special challenge in behavioral health settings. The use of key words can greatly decrease patient anxiety about this status. In all healthcare settings, general anxiety is greatly reduced through the concept of managing up staff. When staff members introduce themselves or other caregivers, they emphasize the experience and training which their colleagues bring to the table. This is important in assuring patients that they are receiving excellent clinical care.

CMC Randolph is proud of the successes experienced because of the commitment to hardwiring excellence. Future challenges will only grow as the scope of services expands to meet new mandates for change embodied in the most recent State Mental Health Plan, North Carolina’s mental health reform initiative. CMC Randolph enjoys excellent support in these and other initiatives from its parent organization, CHS. The commitment to clinical, operational and service excellence positions CMC Randolph and CHS to provide excellent care to patients, an excellent environment for physicians to practice medicine and an excellent place for employees to work.

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