Metro Health is a regional healthcare organization with a 208-bed general acute care osteopathic teaching hospital and numerous offsite locations, including neighborhood outpatient centers offering primary care and common diagnostic services, a cancer center, an ambulatory surgery center, a sleep center, comprehensive sports medicine services and more. Metro serves more than 250,000 patients in Kent and surrounding counties.
More than a decade ago, leaders at the organization envisioned a new Metro Health Hospital that would ensure the organization was prepared to care for the community well into the future. The new facility would be bigger and designed so that care givers could provide the right care to patients at the right time and in a healing environment. In 2007, the vision became reality when the hospital relocated to a new development, called Metro Health Village. The Village is a 170-acre campus with the hospital positioned at the center surrounded by medical offices, medical retail, an able-to-play community park, a state-of-the-art YMCA and more.
Metro has appeared on the 100 Top Hospital list three times in recent years, has been named one of Most Wired hospitals in the nation and has won numerous awards for quality care. Metro Health became a Studer partner in 2009 and launched its Passion for Excellence program as a means of keeping alive the positive energy and incredible success of the hospital move and exploding patient base. Through the Passion for Excellence program all team members are encouraged to connect their work, whether providing direct patient care or support for care givers, to the patient experience and the success of the organization.
People - Retaining the Best of the Best
Metro Health has long worked to hire the best candidates from the community. As part of the Passion for Excellence program, Metro also makes a concerted effort to retain the best of its team. Rewarding high performers and encouraging low performers to achieve more was the goal when the organization launched high-middle-low (HML) performer conversations in 2010. These mid-year discussions emphasize recognizing high performance, coaching middle performers to become high performers and providing low performers with constructive performance improvement plans to help them become successful. In 2011, 1,492 of 1,570 employees were recognized as high or middle performers.
Those HML conversations, along with attention to employee satisfaction, contribute to achieving Metro's goal of retaining the best of the best employees. Since 2009, Metro's turnover rate has dropped from 19% to 9.4%, well ahead of the goal set at 12.75%. Metro Health understands that patients, employees and the community benefit from having well-trained, long-term employees who truly care about the care they provide their patients.
Other initiatives contribute to keeping Metro's best employees engaged in the organization, also. Under the Passion for Excellence program, Metro launched the "You Rock" Program. Under this program, employees are invited to fill out a form recognizing other employees and telling them why they "rock." Metro also re-launched "Bright Ideas" and "Best of Metro" programs, bringing new energy to programs that had been at Metro for years. The Bright Ideas program invites employees to make suggestions and the Best of Metro program monthly rewards an employee and quarterly rewards a physician for their positive contributions to the organization.
Communication plays a large role in engaging employees. Metro communicates with employees each month with a newsletter called "Metro Monthly." At the beginning of the fiscal year, the newsletter highlights the year's Passion for Excellence pillar goals. Each month afterwards, the newsletter highlights what is happening under each pillar to help achieve those goals. Each department hosts a bulletin board organized around the pillar goals that highlights organizational happenings and news supporting the pillars.
Finance – Managing Expense, Investing in the Future
While the country and Michigan continue to climb out of what has become the great recession and the national debate on healthcare reform continues, hospitals everywhere are challenged more than ever to contain expenses and live on tighter margins. The Metro team has consistently risen to the challenge of increasing efficiency to cut costs where ever possible. The result has been reducing the average cost per admission and increasing margin. The increased margin translates into money that Metro can invest back into new technologies to improve patient care.
Outreach to Our Community
Being good citizens in the community is more than just lip service at Metro Health. The Passion for Excellence program has established goals for leadership to contribute volunteer hours to community events. It's common to see Metro's leadership team present in the community and at Metro Health outreach activities leading health education, providing healthcare at athletic events and serving those in need.
The leadership team also uses its Leadership Development Institute (LDI) meetings each quarter to support a community project. Through the last years, the team has collected food, baby supplies, holiday gifts and more for neighbors in need of help. Below are some pictures of a community service project to create warm fleece blankets for our community.
Metro's also turned its green initiatives into community goals. The organization actively encourages composting and recycling throughout the organization. Plus, for six years it has hosted a community-wide farm market during the local growing season, encouraging employees and the community to eat healthy and support local farms.
Serving More of Our Community - Growth
With a brand new facility and a growing community, it only made sense for Metro's Passion for Excellence goals to include increasing the number of hospital discharges and increasing outpatient visits. Metro also recognized the opportunity to decrease the number of no-shows in outpatient facilities as a way to grow.
With growth in mind, Metro Health has expanded services to better meet the needs of the community. Whereas Metro historically employed only primary care physicians, the organization now employs a growing number of specialists, including cardiologists, ENTs, neurologists, oncologists and more. The organization also launched the Metro Health Medical Group, which includes both employed and aligned physicians and mid-levels. With the medical group working closely with the hospital and entire organization, Metro can offer a much more broad range of services to patients—an ever more important option as the industry moves toward bundled payments and other reforms.
Outpatient offices instituted a system of calling patients prior to appointments to ensure that patients don't miss their appointment without an opportunity for the office to reschedule someone else into the time slot. Adding simple communication tools has reduced the number of unexpected openings in their schedules.
Moving the Needle on Patient and Physician Satisfaction - Service
Very few people approach a health care experience looking forward to what is happening to them. Patients come to providers anywhere from calmly anxious to desperately fearful, so making the experience positive is a challenge in any healthcare setting. At Metro, the goal is to provide the Best Patient Experience, and under the Passion for Excellence program that translates into increasing patient satisfaction.
Along with raising the bar on patient satisfaction, Metro has another goal of providing the Best Physician Experience and, thus, increasing physician satisfaction. The challenges are great here, too. In an environment where healthcare reform and the age of electronic health records challenge the way physicians have historically done business, Metro strives to make itself a place where physicians want to practice and feel they can provide the best patient care possible.
On each of these fronts—and in increasing employee satisfaction—rounding has played a key role. Regular rounding on patients, physicians and employees helps Metro quickly identify opportunities for improvement and areas where the organization can celebrate success.
Improving hand-off communication, bedside reporting and a communication board in every patient's room are also making a difference. Bedside reporting and the in-room communication board keep the patient connected to his or her care. Providers changing shifts give report at the bedside and allow the patient to participate in communicating what is happening and about questions. The in-room board helps patients know when their care giver is returning to the room and who their care giver is; additionally, it provides a place for the patient or a loved one to jot down questions to ask the care giver.
Looking at Metro's HCAPS scores, it's clear that improvement efforts are paying off.
Only the Best Care - Quality
Keeping patients safe while in the hospital and improving outcomes are key components of Metro's Passion for Excellence. Through goals set in the program, Metro has worked hard to reduce 31-day readmissions, reduce fall rates, reduce hospital-associated infections and achieve quality scores that ensure the hospital receives 95-100% of available pay-for-performance dollars.
To reduce fall rates, the hospital launched a multi-disciplinary fall committee, including two clinical directors, a pharmacist and the Chief Nursing Officer. The group meets monthly to review all falls and develop education and feedback that is presented to all of nursing leadership. Efforts have paid off, with fall rates consistently trending down.
These are the main action steps the group identified to achieve this success:
Adopted hourly rounding so that patients know when care givers will be in the room.
Purchased new personal alarms that allow the nurse to be immediately alerted via Vocera and the call light system that a patient is up without supervision.
Purchased special cables that connect the call light system and Vocera to the patient's bed to alert the nurse in real time a patient is getting up
Required use of gait belts when ambulating patients at high risk for falls
Report monthly fall rates to staff to increase awareness
Don't leave patients at high risk for falls alone in the bathroom
Pharmacist screens all patients with a fall score > 45 for medications that can increase the risk for falls. The pharmacist then contacts the patient's physician to discuss possible alternatives.
Changed the standard administration time of diuretics to be earlier in the day, which decreases the likelihood of nighttime trips to bathroom.
Pharmacists review all patients who fall to determine if there was any aspect of the fall that could have been the result of a medication.
With an already low rate for hospital-associated infections, hospital leaders could have been tempted to focus efforts on other important projects. But, Metro leaders knew that HAIs are serious threats to patients and decided to adopt goals for even lower rates. Today, the hospital uses a mix of low and high-tech methods to combat HAIs. On the low-tech side, the organization encourages and educates employees about hand hygiene, has hand sanitizer stations located throughout the organization, posts signs reminding employees and visitors to practice good hand hygiene habits and more.
On the high-tech side, Metro invested in cutting-edge technology to add another component to room-cleaning protocols. IRiS uses UV-C light to denature viruses and bacteria in patient rooms. It is used in rooms that have held patients who were in isolation or had particular health issues. UV-C rays from IRiS bounce around the closed room touching every exposed surface in the room – even inside open drawers. This extra layer of protection ensures that human error in cleaning a room will not be a threat to the next patient or care giver in a room.
The results of these combined low and high-tech efforts have been great. While the national average for HAIs is about 5 per 100 patients, Metro Health's HAI rate is 0.24.
The Metro Health team is honored to be selected as a Studer Health Care Organization of the Month. Every member of the team—from those who provide direct patient care to those who support care givers—plays a role in helping the organization deliver on its Passion for Excellence goals and helping the organization provide the community, patients, physicians and fellow employees with the best experience. We look forward to the challenge ahead to continuously improve and raise the bar for our patients and ourselves.
If you'd like to learn more about Metro Health, go to www.metrohealth.net.