Fort Madison Community Hospital

  • Location: Fort Madison, IA
  • Award: Rural Organization of the Month
  • Awarded: July 2014

The why behind our partnership
“When FMCH decided to partner with the Studer Group, we had a vision of the organization we wanted to be –the health care provider most admired for its people, partnership with the community and quality of service.  We knew that if we were not continually improving we would be left behind. We were privileged to hear Quint Studer speak at the Iowa Hospital Association Annual Meeting and felt the passion that he projected and the evidence based tools that he prescribed were exactly what FMCH needed to move us to the next level.  We understood this would take a commitment from every member of the FMCH team; putting in the time and energy necessary to create the health care organization we wanted to be, not only for the short term but well into the future. We have definitely seen the benefit of our decision. We hear it from our patients, from our employees and our community in the perceptions that they have of the culture we embrace, the care that we provide and the value we place on them.”

– Jim Platt, CEO

Our Journey
Fort Madison Community Hospital began the journey of improving culture through our Hardwiring Excellence initiative in 2008. Our first step was to establish an objective leadership evaluation process designed to create greater accountability among leaders and improve overall organizational performance. Working hard remained important, but working hard at the right things became essential.


We embraced the concept that committing to employee engagement would ultimately set the foundation for an improved patient experience and better clinical outcomes.  We began slowly, first establishing an environment of appreciation by implementing thank you notes and building relationships between leaders and staff through senior leader rounding and rounding on direct reports.

Frontline staff was engaged in a multidisciplinary team to develop our new standards of behavior to clearly define what the values of Fort Madison Community Hospital look like in action. Today each employee is expected to sign our Fort Madison Community Hospital Standards Of Behavioras a commitment to the conduct expected from everyone who works in our facility, and they have become part of our annual review process. The Standards are a tangible tool (created by staff peers) designed to help our leaders coach and develop their employees on behaviors expected when they interact with internal and external customers, in addition to performance around goals.  

We dedicated time for leaders to develop new skills to achieve goals and cascaded that learning to staff. One of the most important skill building endeavors related to improved communication techniques included several tactics designed to help build patient loyalty, ease patient anxiety and better assess patient care for improved patient outcomes (AIDET®, Key Words and patient rounding).  Each new initiative was tied to the why before implementation because we learned that people are more likely to participate in change if they understand why that change is necessary and how it will affect them. We explained why we were embracing it as part of our culture; why we needed to do it always and why it brings value to our employees and our patients. Through Rounding for outcomes, we have been able to facilitate stronger relationships and engagement with both patients and employees. It soon became evident that the key to successful rounding was in taking the feedback received and acting on it in real time, both for recognition of positive service behaviors and service recovery opportunities

Our Reward & Recognition Team developed The FMCH SUPER Star program and Employee of the Month to honor our employees for going above and beyond traditional job expectations and living our Standards of Behavior every day. Increasing employee engagement and setting clear expectations for behaviors to improve the workplace have led to exciting results for the organization. FMCH has been awarded the honor of being named a Top 100 Iowa Workplace for mid-size companies in both 2012 and 2013.  This is a direct result of a voluntary employee survey that over 77% of our employees took the time to complete.

With great excitement, Shelly Mueller was identified as the Fort Madison Community Hospital Hardwiring Excellence Champion in 2013 to provide support for leaders as our Studer Group liaison. She has been a constant source of support in administration, but now she has become a positive voice of encouragement and expertise in implementing leading practice behaviors on campus. Shelly works closely with our CEO and Studer Group coach to successfully align current initiatives with organizational priorities. Having Shelly as our internal Studer Group expert has been extremely successful in engaging both staff and leaders throughout the organization.

Within the past nine months, FMCH has also re-energized the Measurement Team to measure what matters and share results transparently to better celebrate when warranted and create urgency when needed. We also repurposed our Performance Improvement Committee – now called Quality Impact Team. This combined group of frontline staff and leaders is embracing continued cultural improvements and establishing a greater sense of ownership for how every employee can affect our patients’ experience on every level. Several examples of frontline staff reaching out to colleagues and vendors with empowered words of wisdom on improving the patient experience are being shared as a result of the work from this team.

Variance in results remained an issue, and in late 2013 our senior team committed to a new focus around compliance with 90 day plans and holding leaders more accountable for consistent behaviors to achieve results. Additional development in writing 90 day plans was provided and making the 90 day plan a part of discussion between the leader and direct supervisor became mandatory. In the first quarter of 2014, FMCH had improved six of eight HCAHPS composites from the first quarter of 2013 — all above the 79th percentile. Clean/quiet and nurse communication demonstrated the greatest results at greater than 49 percentile improvement points each. Nine out of 10 dashboard quality indicators were better than goal and eight of 12 finance indicators were up from the previous year at the time Fort Madison Community Hospital was chosen as the July Healthcare Organization of the Month. In Fact, Fort Madison Community Hospital CFO Brad Kokjohn noted: “The thing I am most proud of is remaining in the black at a time when the entire industry is struggling.”

Fort Madison Community Hospital has always been focused on exceeding our patient’s expectations when it comes to their experience, as well as exceeding our employee’s expectations when it comes to providing a safe, rewarding place to work.  By embracing Hardwiring Excellence, we found multiple best practices to move our Mission forward and create a culture of Always excellence for those we serve and work with. As a result, Fort Madison Community Hospital was recognized with the following awards:

  • 2009-2010 Hospital Value Index™: Best in Value™ Award from Data Advantage, LLC. This designation put Fort Madison Community Hospital in the top tier of hospitals nationwide and further illustrated the excellent value we provide to our patients. By analyzing data from approximately 4,500 hospitals nationwide, the Hospital Value Index™ was able to rank hospitals by measuring their success in quality, affordability, efficiency and patient satisfaction.
  • 2011 Becker's Hospital Review list of 65 Great Community Hospitals, recognizing Fort Madison Community Hospital as high-performing leaders in patient care, clinical quality and community outreach.

Driving culture change is one of the most difficult endeavors one can embark on, but more than ever, today’s healthcare industry requires healthcare leaders and staff to be responsive to the external environment. Fort Madison Community Hospital CEO, Jim Platt has been leading our culture change with consistent support from our volunteer Board of Directors, Senior Leadership Team and a fully committed workforce since the beginning. Without the combined commitment of this fantastic Fort Madison Community Hospital team and our belief in the culture we continue to build, FMCH could not be the high-performing organization that it is today.   

Our Future
As we continue our journey, we recognize that hardwiring the behaviors and processes that result in better care for patients must become seamless and consistent. After nearly 6 years, what we have are Fort Madison Community Hospital behaviors and processes – no longer Studer Group initiatives. We have absorbed best practices into our culture, and we look forward to new ideas and best practices our Studer Group partnership will bring us. Studer Group has provided the tools, and we will continue to operationalize the effective, and consistent behaviors that we know bring our patients the care and service they deserve.

Every year, we get better. Every year, we ask ourselves for more.

About Fort Madison
Fort Madison Community Hospital has a long history of providing quality, compassionate care in Fort Madison and the surrounding communities.  What was once Sacred Heart Hospital ran by the Sisters of the Third Order of Saint Francis was sold to a community group for $1.00 in 1977 becoming Fort Madison Community Hospital. 

FMCH is a rural, acute care hospital licensed for 50 beds.  Twenty-seven years ago the hospital was re-located to a new facility on a campus that allowed for expansion opportunities.  To accommodate the progressive decision to employ our physicians, a clinic was added to the hospital creating a medical mall concept in 1990.  The facility continued to evolve with the changing health care needs of the community. The most recent changes include: the addition of a 23,500 square foot Outpatient Rehabilitation Services Center; a complete remodel of the patient rooms featuring ceiling lifts in all the rooms for patient and staff safety; and a 3,000 square foot addition to our Radiology department housing advanced technology MRI and CT Scan equipment. We pride ourselves on identifying a community need and responding; whether it is taking all of our inpatient rooms to private rooms in 2001; providing a safe place for community members to walk on our indoor walking track; starting the My Care Walk-in Clinic; or converting available space to a non-denominational Chapel. 

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