As a critical access hospital, Lady of the Sea General Hospital’s role in healthcare is often the patient’s first experience. As a group of dedicated care-givers, our staff has been focused on one goal – strengthening our commitment to create exceptional experiences for patients, patient’s families, visitors and health care providers.
Established in 1956, LOSGH is a 25-bed critical access (CAH) not-for-profit hospital in Galliano, Louisiana. With the support of our community, Lady of the Sea employs over 300 healthcare workers that provide compassionate, high quality healthcare, close to home. We are the closest medical facility and the first responder for oilfield workers in the Gulf of Mexico off of the Louisiana coast, as well as the primary provider of healthcare for the residents of the South Lafourche community.
As a small hospital that primarily provides family medicine and general surgery services to our community, we realize exactly what our role is in the continuum of care for our patients. We have established great relationships with the larger healthcare facilities in our general area, to ensure that our patients have continuous access to specialized care when it’s needed.
Located in the lower portion of Lafourche Parish, surrounded by the bayou and marsh, the experience of having to travel for medical services is a challenge for our community. The closest larger hospital facility is 40 miles away, and we have partnered with Cardiology, Oncology, Dermatology, Nephrology and ENT providers from our surrounding area to come to our facility each week and provide services to our community members, so that they don’t have to travel far from home for necessary outpatient care. While offering more healthcare options closer to home is an advantage to our patients, it’s also an advantage for our dedicated staff members who get to experience a larger role in their patient’s overall healthcare. We are the only CAH hospital in Louisiana that owns a dialysis unit, which again is a service we provide to save our patients from having to travel long distances for necessary healthcare.
One Common Goal
Eight years ago, we realized that our personalized, “treat you like family” atmosphere is the cornerstone of our patient satisfaction rates. Realizing that our patient’s expectations of their healthcare providers were changing, we sought out ways to be proactive in approaching what healthcare would look like in five years to the people of South Lafourche.
After a group of our managers attended Studer Group’s Rural Health Institute in August 2006, we formed a committee of employees to formulate our Standards of Behaviors. This endeavor started us on the road to excellence, and we’ve been steadily making great strides ever since.
After rolling out our Standards of Behaviors to all employees in January 2007, we began training our managers on how to round on their employees in April 2007. In 2006, prior to putting employee rounding into place, 58% of our employees gave us a rating of 7-10 on how well we communicated at our hospital. In 2011, we had increased to 83%, and in our most recent employee survey, 95% of our employees gave our directors a rating of 7-10 on communication with employees.
We began training at quarterly Leader Development Institutes in January 2008. This has continued quarterly ever since. Even through hurricane warnings and evacuations and the BP oil spill that taxed our staff and resources, we never backed off of training our managers to lead their staff to higher levels of excellence in patient care.
Quarterly Leadership Development is like a shot in the arm for our management staff. 100% of our managers have been brought up “from the ranks” without true management experience prior to being promoted. Our LDI’s really help them to focus on not only their patients and the patient experience, but also on the employee and what it means to be seen as the “leader”. We believe that our LDI’s and the consistent support of our management team is the reason why 85% of our employees give us a rating of 10 to the survey question: Using Any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital as an employer?
Our core committee works diligently on training opportunities for our managers, our supervisors and our employees. In 2006, 54% of our employees rated the support received from their managers, and the availability of their managers as a 9-10. After putting leadership training into place regularly, and using High, Middle, Low Conversations for employee performance improvement, in 2011 we moved to 74% of our employees rating our management team as a 9-10, and today, 95% of our employees reported that their managers are available to them daily, and open to new ways of doing things.
In addition to LDI’s, we also began mandatory Forums for all employees. Each quarter, our employees have the opportunity to attend our forums led by our CEO, Karen Collins, and our “firestarter” trainers. Our attendance rates are above 95% because of the commitment by both our management team on scheduling and ensuring that their employees attend, and the commitment of our employees to come to one of the forums (9 forum times are offered for each session) and participate.
As we rolled out behaviors such as hourly rounding, and nurse leader rounding, we continued to send our managers to Studergroup trainings. We have had 99% of our manager and supervisor staff attend TYYO trainings, 70% of our ER staff attend the Nuts and Bolts of the ED training, all charge nurses from Med / Surg attend TYYO, our C-Suite team and firestarters attend WRIHC annually, and all of our family medical physicians and 50% of our ED physicians have attended the Physician’s Institute, as well as our C-Suite team who supports our physician group.
We believe that by attending these professional trainings, we have had the opportunity to develop traction in moving our facility toward higher patient satisfaction and job satisfaction for our staff overall. During the final quarter of 2013, our facility achieved the 90th percentile in all 8 domains of the HCAHPS survey, and the 99th percentile in 6 out of the 8 domains, including Communication with Nurses, Communication with Doctors, Hospital Environment, Pain Management, Communication about Medication and Discharge Information. On the communication about meds domain, Pharmacy and Med/Surg worked together for the entire year, and scored 100% top box for both questions: explained what meds are for, and described side effects. We also had 100% top box for the following questions:
Nurses courtesy and respect, Nurses listened, and Doctor explained things in a way you can understand.
In 2009, we realized that it was time to improve our evaluation system, and we began researching the LEM. Through our LEM research, we decided to become a Studer Group Rural Partner in October 2009. Not only has the LEM assisted our management team in focusing on measurable, sustainable improvement, our coach, Carolyn Laughlin has also proven to be a great partner for us in keeping us focused on the next step, and celebrating our accomplishments.
Throughout 2010 and 2011, we focused on hardwiring AIDET and Key Words and Key Times with all of our employees. Through our forums, we had practice sessions and many of our departments assigned AIDET captains that were drawn from our employee group. These captains encouraged their fellow employees to use AIDET and KWKT while also congratulating their co-workers when they heard them doing it right. After making great strides with AIDET and KWKT, we have found that the majority of our employee group is more inclined to consider WHY we communicate with our patients and HOW it’s best to deliver certain messages to our patients and families to ensure excellence in health care.
In 2011, we hardwired the Monthly Meeting Model between our manager level and our C-Suite. These monthly meetings have given us a specific timeframe to review all LEM goals along with their measurement and 90-day plans, rounding takeaways and recognition, issues to address, budget compliance, and overall manager communication. We believe by instituting the monthly meeting model, our employee satisfaction and communication between employees have greatly improved.
In 2012, we rolled out Peer Interviewing with a team of trained employees who developed a software rating system and bank of behavioral based questions to assist in the process. Although we have experienced resistance from some of our directors, our Board of Commissioners used the peer interviewing system in 2013 to hire our new CEO and CNO. The support of this process shown by our Board of Commissioners has led to greater acceptance of the peer interviewing process.
We kicked off 2013 with hardwiring skills labs for our nursing staff. Skills labs have been used as both a learning tool as well as a hardwiring tool for different behaviors at the bedside. Our coach, Carolyn Laughlin was with us for our first skills lab exercise in 2012, and gave us the necessary feedback and tools to make this process successful in our organization.
In 2013, we rolled down the LEM to all employees on every level. Each employee has a minimum of 2 and up to 5 goals that they are working on and reporting on monthly to their manager. Their individual LEM goals support their manager’s LEM goals. The department LEM goals support our overall organizational goals. This cascading of goals and metrics has assisted us in accomplishing our annual goals, which support our 3 -5 year strategic plan.
Also in 2013, we hardwired the cascading of communication model from Studer Group. Our monthly board meeting takes place at noon, and on the same day in the afternoon, our CEO holds a directors meeting and immediately passes down critical information to our department heads. This information is then expected to be passed down via department meetings or team huddles within one week. Our CEO also has challenged our directors to each bring a “win” to our monthly meetings, which are announced to all in attendance. This is an additional way of keeping everyone informed of what is happening at our facility and encourages our staff to see the positive outcomes as well as the challenges facing us.
As we turn toward planning our next fiscal year, Lady of the Sea General Hospital is facing the construction of a new family medicine clinic, as well as the opening of community pharmacies within our service district. We are excited about the potential for growth in the years ahead, and believe that the Studer Group principles we have in place will continue to serve us well.