Most of us have heard the term "Good Samaritan" since we were children, a universal term that describes the act of someone going out of his or her way to help someone in need. For Baltimore’s Good Samaritan Hospital, each of its now 2,400 employees is called a Good Samaritan as soon as they are hired. In fact, the hospital’s president, Larry Beck, spends the first hour of each new employee orientation reminding new staff of the biblical story and explaining how stopping to help is part of the institution’s vision "to be Good Samaritans trusted to deliver ideal health care experiences."
To reinforce our commitment to service excellence, a copy of the story of the Good Samaritan is framed in the main conference center (where the orientation takes place), along with posters show casing the hospital’s annual operating plan, its six core values and related behavior standards, and more than a dozen stories of Champion Good Samaritans - or employees that have gone "above and beyond" our code of standards to deliver ideal care to the community.
Though the hospital has made great strides over the past several years, it hasn’t always made the most complete use of its moniker. The 1990s were a period of growth for the hospital, making it one of Maryland’s most financially successful institutions. The downside: Good Samaritan wasn’t a hospital that was necessarily perceived as a great place to work or receive care. Its vision was, like many hospitals, to become "the market leader." This, and other-less-than inspiring business terms, pervaded the values - and so drove the culture - of the organization.
Finally, in 2000, when Good Samaritan leadership was embarking on a new strategic plan, it took a long, hard look at the highly competitive Baltimore region and challenged the organization to truly differentiate itself. That inspiration started with the creation of a new vision. One that didn’t sound like everyone else’s. One that every employee could identify with. A vision that would change the culture so to focus on what is right in healthcare and pervade every communication to the community, internal staff, and physicians.
Also at about this time, the hospital and its parent system, MedStar Health, hosted Quint Studer for an educational session in Baltimore. The days the executive team, as well as leaders identified to head up Firestarter teams, spent learning the nine principles changed the course - and the soul - of the hospital...for good.
A focus on internal communications and recognition. Before the Studer Group came along, Good Samaritan had begun to embrace a commitment to service excellence. Like many organizations, it had hired a full-time service excellence coordinator, whose job is was to oversee and manage the patient satisfaction measurement tool, re-invigorate internal rewards and recognition programs, and provide staff education focused on customer service. The executive team had committed the resource, yet the position was not "top level" enough to get continuous attention. At the same time, the hospital began much more aggressive internal marketing to build pride among the workforce. Dollars once reserved primarily for consumer advertising and promotion were reallocated to this end, in efforts to better communicate the organization’s new "puzzle piece" strategy of key measures. This was the foundation for what would become our five core puzzlepieces(orgrounding"pillars") of service, quality, people, growth and finance.
Improving service leads to immense growth. Equipped with new tools from the Studer Group, Good Samaritan began in earnest to build a culture around great service. The "Ideal Experience (Firestarter) Teams" were formed and used the Studer Group’s standard "big binder of resources" to plot what would become known as their "quick wins." Each of the eight teams was expected to electronically post at least one improvement made per week, noting that small things added together could have a huge impact. And, they did.
Over the course of five years, each of our puzzle piece indicators has experienced gains. When asked what one strategy worked, the hospital’s executives point to the renewed vision - and lots and lots of hardwork to get the right people in leadership positions.
What is truly remarkable is that within that timeframe, the hospital’s inpatient volumes increased more than 35% - well above the average in the competitive Baltimore market.
Our people thrive in a new environment of accountability and purpose. As Good Samaritan was actively charting its course to service excellence, there came the realization that something was missing. The missing component, identified just over a year ago: a tool to uniformly align the leadership group, from front-line supervisors to executives. The implementation of the Leadership Evaluation Tool (LET) ended up being essential to building accountability across all levels of the leadership and throughout every department. With all hospital leaders aligned with their respective patient experience survey (PES) or support service evaluation (SSE) results at up to 40% of their pay structure, the bar moved quickly. Leaders not achieving service results and/or other puzzle piece objectives have left the organization, and inter-departmental rounding is now hardwired.
And the accountability didn’t end there: Good Samaritan didn’t stop at aligning just the leaders to the service goals. It instituted a "team achievement goal" (TAG) to ensure that every employee was tied to his or her department’s service results. Using a scaling approach similar to the LET, departments received a margin up or down for the average merit increases to staff. For example, if a department received a "3" on the TAG scale (meets expectations), it could spread a 3% increase to staff. Those departments not meeting expectations, getting a 1 or 2 on the scale, had to spread a smaller merit pool to staff. Many departments that achieved higher than their expectations got a larger merit pool increase. This change meant that individuals and their performance became much more tied to their team’s performance.
Climbing the wall wasn’t easy. Over the years, Good Samaritan has “hit the wall” a few times. Results for service indicators fluctuated, particularly for inpatient areas. The ER, ambulatory surgery and other outpatient areas who had hardwired service into their culture and teamwork have been achieving 90th percentile and above results for several consecutive quarters. With the help of Studer Group coach Pat Treiber, inpatient units are now achieving above the 85th percentile, somereaching the 99th.
Quality indicators have improved as well. The hospital is working to receive the Medicare Excellence Award and was surveyed in September for the prestigious Magnet Award from the American Nurses Credentialing Center.
Good Samaritan’s growth pushed the bounds for recruitment and retention efforts for the best people. In the past four years, the number of Good Samaritans increased from 1,400 to 2,400. Today, the biggest source of referrals is from the hospital’s own staff.
Results from the 2004 employee survey showed a 9% increase for the employee satisfaction index. In addition to having the highest staff satisfaction throughout MedStar Health, Watson Wyatt Worldwide recognized the hospital for an incredible survey response rate of 95%.
Growth and financial puzzle pieces have benefited tremendously from Good Samaritan’s investment in service, quality and people. While increased pressures from all directions are resulting in vigilant financial analysis, the hospital has maintained a margin well above the Maryland average, ensuring it can reinvest in programs and facilities.
Taking us to a new level. Good Samaritan’s benefactor, Thomas J. O’Neill, envisioned a place for the needy and sick to come for help. While he didn’t want the facility named for him, the board, leadership and staff continue to honor and live his vision. He would be proud of the focused effort on what’s right in health care. Not only are patients receiving the care they deserve, the employees, now more than ever, are enjoying the fruits of their worth whilework. In fact, the Maryland Psychological Association named the hospital as recipient of the 2005 Healthy Workplace of the Year for large organizations.
Without doubt, though, the best rewards are the hundreds of notes and letters that now arrive throughout each year to remind every Good Samaritan of the difference he or she can make, including this one:
"My family and I have had multiple contacts with hospital inpatient care at every level, from emergency to ICU and surgery, in many hospitals in Northern Virginia and Maryland. Barring none, the care extended to my husband and me at Good Samaritan Hospital this week has exceeded all others. From admissions, through pre-op, OR, post-op and several days on 5E, the clerical staff, nurses, physicians, nutritionists, OT, PT, housekeeping, and educator all had a caring and ‘can do’ attitude. In the many hours I spent with my husband on 5E, I only saw one call light (which came on when I was in the hall and was answered before I got to the Nurse’s Station). Not only are the staff kind, considerate and helpful, but they are also competent. I can say this, as I am a nurse manager at the National Institutes of Health Research Hospital. And, I am telling everyone I see, "If you want the best care in the world, go to Good Samaritan, a hospital that truly lives up to its name."