Pikeville Medical Center

  • Location: Pikeville, KY
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: October 2012

Past & Present

Pikeville Medical Center (PMC), affiliated with the Cleveland Clinic Heart Surgery Program, first opened its door to the public on Christmas Day 1924 as a 50-bed hospital. The hospital quickly became known as a house of hope and healing. Since then, this 88 year-old institution has evolved into a world-class facility with state-of-the-art equipment, nationally-renowned doctors and the most compassionate, caring employees anywhere.

The hospital's mission "to provide quality regional healthcare in a Christian environment" is the cornerstone of Pikeville Medical Center's success and is fulfilled on a daily basis, as the staff combines teamwork with a sincere passion to help others.

Currently employing more than 2,300 people, Pikeville Medical Center has hired more than 600 employees in the past year. More than 400 services are offered at the hospital, including every major specialty and most subspecialties. A $130 million construction project is under way, providing more than 1,500 temporary jobs and 100 permanent jobs. The new medical office building will house office and clinical space for outpatient surgery, exam rooms, and primary and specialty care physicians, and the enclosed parking garage will feature more than 1,000 spaces.

The combination of first-class facilities, the best equipment available and a highly motivated support staff has enabled Pikeville Medical Center to recruit some of the nation's most qualified physicians. More than 300 physicians are authorized to practice medicine at Pikeville Medical Center, and the number continues to grow. Over the past six years, the hospital has recruited nearly 150 new doctors and added six services or specialties. Among the newer service lines are: Orthopaedic Trauma, Gastroenterology, Gynecological Oncology, Hand Surgery, Rheumatology, Pediatric Endocrinology, Sports Medicine, Ophthalmology, Nephrology and Electrophysiology.

From Good to Great by Hardwiring Excellence

Pikeville Medical Center is committed to providing the "best care possible." To do so, we continually strive toward perfection.

The official contract was signed with the Studer Group in October 2005.

In December 2005, Pikeville Medical Center's President and CEO Walter E. May read the book "Hardwiring Excellence" by Quint Studer. The ideas in the book matched PMC's vision for the future. A copy was given to each of the hospital's senior and middle management leaders.

Pikeville Medical Center began training its employees on Studer's principles and "must haves" in April 2006. With a new focus, the hospital began implementing changes to its organizational structure specifically aimed at improving patient care, customer service and patient satisfaction.

Through perseverance and adhering to the ideas and methods in the book"Hardwiring Excellence," the hospital received a tremendous increase in patient satisfaction, patient outcomes, employee satisfaction and financial success.

Back to the Basics

The basis of Pikeville Medical Center's success can also be tracked to the hospital's adoption of five core values: Christian, Quality, Progressiveness, Service and Teamwork.

The Golden Rule, "Treat others as you would like to be treated," is the basis for these core values. PMC also created a Standards of Behavior, centered on the core values, as a daily guide for employees.

Every day, Pikeville Medical Center employees work to provide the best care possible to patients, visitors and fellow coworkers in a spirit of Christian compassion.

Patients' Point of View

Over the past year, Pikeville Medical Center's overall inpatient satisfaction scores have been in the 90th percentile. PMC prides itself on always putting patient first. By implementing key Studer techniques, such as AIDET, managing up, keywords at key times, hourly rounding and calls to 100% of discharge patients (with a completion rate of 70%), PMC has made the hospital a better place for patients.

Pikeville Medical Center employees often hear positive feedback from our patients. Below are some of their comments.

  • "I chose to have surgery at Pikeville Medical Center because I knew I would be taken care of."
  • "Everyone we have met has been so kind, compassionate and giving."
  • "Everyone treats you like family."
  • "The network of people at Pikeville Medical Center certainly deserved and lived up to the number one title! Thank you from the deepest part of my heart."

When it comes to patients recommending our facility to their family and friends, the HCAHPS Impact Report shows Pikeville Medical Center is in the 90% range in comparison to other hospitals with the same number of beds. PMC is also above the national average.

The hospital's Total Performance and HCAHPS scores demonstrate Pikeville Medical Center's drive for excellence:

Pikeville Medical Center's Composite score of 76 ranks PMC at the 95th percentile by bed size.

Committed to Quality

Pikeville Medical Center's Appropriate Core Measure (ACM) Scores has improved by 14.5% within just the past two years. The hospital currently has a perfect score of 100%. This score is from Press Ganey Associates Inc. and is a composite of our evidence-based practice measures: Pneumonia, Acute Myocardial Infarction, Heart Failure and the Surgical Care Improvement Project.

Pikeville Medical Center is proud to have met an extremely lofty goal of .33 or less pressure ulcers per patient day from March through July 2012. All PMC pressure ulcers were stage two or less.

In 2009, the hospital began implementing measures to reach its pressure ulcer goal. Since then PMC has put into practice the following procedures to reach and exceed the goal:

  • Pressure ulcer education for all clinical staff
  • Individual nurse accountability
  • 24-hour departmental audits
  • Prevalence Booths placed in every unit (not just critical care)
  • Every patient turned at a minimum of two hour intervals
  • Special wound care nurses dedicated to checking every patient each day
  • Skin and wound protocol created by PMC
  • "Braden Zone Magnets" placed on patient's doors with a score of 18 or less on the Braden Scale, identifying that they are at risk and need to be turned, heels floated, and Aloe Vista I preventive cream applied
  • Special mattresses used on appropriate pressure ulcer patients, specific to needs
  • Monthly pressure ulcer meetings to review and research how and why every pressure ulcer occurs
  • Monthly line graphs measuring the hospital as a whole and individual departments
  • Monthly hospital report cards include the hospital-wide pressure ulcer score
  • Annual prevalence studies conducted in-house and compared to national statistics

Employees Speak Out

Studer teaches if an organization is to excel, its employees must feel recognized and rewarded. Pikeville Medical Center values its employees and continually strives to improve their work experience.

Recruiting and retaining dedicated, experienced employees has become easier through offering outstanding employee benefits, employee recognition programs, special employee events, open-communication, employee and physician rounding, employee forums, 30 and 90-day discussions, HML performance conversations and Leadership Development Institute sessions.

To date, more than 96% of Pikeville Medical Center employees are recognized as high or middle performers.
High performing employees can be recognized by patients, visitors and co-workers through PMC's "We Care" and "Hero" programs. Any time an employee demonstrates excellence in their job, they can be acknowledged through paper nomination forms, online forms and voicemail.

Recently, Pikeville Medical Center began recognizing an employee and a department of the quarter. To be eligible for this honor, the employee or department must possess the following characteristics: having a positive attitude, always seek ways to improve service, exceed expectations and challenge the status quo. The names of nominees are submitted by management. Winners receive internal and external recognition, a free meal and a gift card.

Internal publications for employees and physicians also allow employees to be recognized on a monthly basis.

Employees were asked, "What does this organization do to make it a place where people want to work?" Below are some of their answers:

  • Ability to grow and expand skill sets
  • Excellent health plan and benefits package
  • Secure future, continuously growing
  • Christian environment emphasized
  • Competitive pay
  • Having the materials you need to perform your job
  • Employee recognition
  • Bonuses and incentives
  • Exciting future with expansion and improvement of services
  • Good people to work with (like family here)
  • Flexible scheduling
  • Good communication from management to employees
  • PMC goes out of its way to help employees
  • State-of-the-art facility and technology
  • Acts promptly on concerns to make a better workplace

Pikeville Medical Center has been recognized four consecutive years as one of the Best Places to Work in Healthcare in the Nation by Modern Healthcare.

For five years, Pikeville Medical Center has been named one of the Best Places to Work in Kentucky by the Best Places to Work group and the Kentucky Chamber of Commerce.

In 2011, Pikeville Medical Center's Information Technology Department was ranked seventh in the nation in Where to Work: Best Hospital IT Departments by Healthcare IT News.

Financial Success

Pikeville Medical Center's finance team began doing "one on one" departmental operation report review sessions to maintain a constant line of communication between the clinical and financial realms, as well as allow for additional education/training opportunities relating to budget variances. At the same time, PMC changed its budgeting process, switching from annual to quarterly budgets. This allowed for more accurate accounting in the ever-changing health care financial environment.

At the end of the calendar year, Pikeville Medical Center implemented several products dealing with Revenue Cycle Solutions in an effort to make the overall billing and revenue cycle process better. During this same time period, the hospital also implemented Claims Administrator, Pathways Compliance Advisor, Financial Clearance Workstation, pre-bill edits and real-time eligibility.

Also implemented was an online bill pay solution to give our patients another option of paying their bill. This allows patients to pay their bills with electronic checks and credit cards and gives them a central place to view their statements. After implementing these processes, PMC immediately saw a six-day decrease in gross days in AR along with a six- to seven-day decrease in net days. There was also a significant increase in overall cash collections.

The hospital began using Laborvision productivity, allowing clinical areas a bi-weekly view of productivity trends versus industry benchmarks.

Pikeville Medical Center developed a Revenue Cycle Specialist Department. This move placed all revenue coordinators in a central location, increasing the focus on timeliness and identifying new or changing processes. Over time, revenue coordinators have become instrumental in ensuring accurate charge capture on many levels, reconciliation for compliance purposes and have had a positive outcome on clean claim submissions.

In-house monthly physician financial reporting also began in July 2010. This allowed for more timely and detailed productivity reporting.

In February, Pikeville Medical Center implemented the NextGen Electronic Health Record including billing, CPOE, e-Prescribing and electronic documentation. Through this system PMC has improved efficiency and patient care, and has met Meaningful Use Stage 1 requirements.

Community Impact

In FY 2011, Pikeville Medical Center set a new record for charitable care. Through defined policies and procedures, PMC recorded uncompensated care at $38,410,981(services at hospital's established rates).
PMC provides a variety of educational, wellness and preventive health services. Such activities and events include: indigent care assistance, educational/training sessions, support groups, health fairs, free health screenings and other community events. The hospital considers outreach efforts to the public an essential part of its Christian mission, as it seeks not only to treat the sick and injured during their time of need, but also to improve the region's over-all health care.

National Recognition

Pikeville Medical Center has achieved national recognition that many would previously have thought unattainable. In the beautiful mountains of eastern Kentucky, PMC is the nation's only repeat winner of National Hospital of the Year. Other awards bestowed upon the hospital during 2012 are listed below.

  • U.S. News & World Report honored PMC as one of the nation's Best Regional Hospitals.
  • Health Grades ranked PMC among the top 5% in the nation for outstanding patient experience.
  • Women's Certified honored Pikeville Medical Center with the Women's Choice Award, named among America's Best Hospitals for Patient Experience.
  • American College of Radiology gave PMC a Gold Standard in Radiology Accreditation.
  • Kentucky Chamber of Commerce named PMC the #1 Hospital to Work for in Kentucky (Best Places to Work in Kentucky).
  • PMC's PrimaryStrokeCenter received the Gold Seal of Approval from the Joint Commission.
  • PMC became the first hospital in Kentucky and fifth in the nation to receive a Level IV Accreditation with PCI Society of Chest Pain Centers.
  • American Alliance of Healthcare Providers named PMC the National Hospital of the Year (for the third time consecutively) & Hospital of Choice Emeritus.
  • The Medical Leader, Pikeville Medical Center's weekly newspaper, received 38 Kentucky Press Association awards, including General Excellence.
  • PMC volunteer Jeannette Elder earned the Lifetime Achievement Award in the Governor's Awards for Outstanding Volunteer Service.
  • Modern Healthcare Magazine named PMC as one of the 100 Best Places to Work in Healthcare.

President and Chief Executive Officer Walter E. May says these awards are not surprising, because the hospital strives for excellence every day. "We are never satisfied with the status quo," May said. "Pikeville Medical Center set out to become a regional referral center, and we have achieved that goal. We want to ensure the people of our region have the option of receiving the best health care available anywhere, and that's what we work toward every day."

The Future

Excellence is not a destination, but a journey. Our passion for providing the best care possible for our patients, a great place to work for our employees and an organization that benefits everyone in our region has not diminished over the past 88 years.

While our previous accolades are impressive, Pikeville Medical Center will not rest on its laurels. The hospital believes there is always room for improvement, and its institutional vision has not yet been fully realized – the journey is not over.

Pikeville Medical Center intends to improve and grow, and to always pursue excellence. As technology evolves the hospital is committed to keeping pace, and has pledged to continue to recruit the country's best doctors and add specialty services to provide quality health care on a local basis. In the words of President and CEO Walter E. May, "We aren't trying to provide health care that's ‘as good as' anyplace else…we're working to provide health care that's better than our patients can get anywhere else." Based on Pikeville Medical Center's history, current performance and plans for the future, that goal appears to be entirely within reach.

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