Sumner Regional Health Systems, Inc.

  • Location: Gallatin, TN
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: July 2005

Three years ago, senior staff members of Sumner Regional Health Systems, Inc. (SRHS) ( Summer Regional Medical Center, Trousdale Medical Center, Carthage General Hospital) caught wind of a service excellence initiative that was sweeping attitudes up out of the gutter and onto the road to success.

While SRHS, which employs more than 1500 associates, was not an organization suffering from any visible signs of low morale, and its financial state was good - in fact, above average - the senior staff had long been committed to the idea of becoming a "stand-out" organization. They also realized that organizations don’t always have to wait until they are in crisis mode before they initiate a plan to go from "good to great." With the leadership of the Studer Group, SRHS was able to subscribe to a simple motto: "Associate and physician satisfaction lead to patient satisfaction and a successful healthcare system."

The SRHS version of this philosophy is "Excellence Express," an initiative that has structured a new way of life for associates working for SRHS. The Excellence Express train serves as the symbol for the initiative; a train on a journey from good to great that makes progress every time an associate commits to laying down more track.

At SRHS, this investment in patient and associate satisfaction has led to measurable results in our organization’s success. Just this year, we learned that SRHS ranks number one in the nation in associate satisfaction among more than 300 hospitals throughout the United States (Sperduto and Associates Survey, 2004)! And, in the healthcare industry, associates are our top commodity. If our associates aren’t happy, quite frankly we believe our patients won’t be either.

Since starting Excellence Express in 2002, SRHS has conducted associate satisfaction surveys to assess the morale within their three different hospitals. Back in 2000, SRHS associate satisfaction levels hovered around the 74th percentile when compared with other organizations (sort of a C-). After two and a half years with the Excellence Express initiative, SRHS ranked in the 99th percentile when compared with other healthcare organizations (A+)! Digging down into the numbers, we can see that positive morale in 2004 is at 79%, nearly unheard of. The national average for positive morale in healthcare organizations is between 40-60% (it’s a mentally draining business!). These figures currently rank SRHS number one in associate satisfaction among 400 healthcare organizations across the country.

How did we make it to the top of Associate Satisfaction?

There are six pillars of focus for SRHS (Service, Quality, Financial, Growth, People, and Community). Our recent ranking as number one in the nation for associate satisfaction falls under the people category, and we think that success has impacted successes in other areas. Investment in associate satisfaction takes many forms at SRHS. The two primary initiatives enhanced by the Excellence Express program that have impacted associate satisfaction include Communication and Rewards and Recognition.


Communicating with associates builds a sense of reliability and credibility for the senior staff of our organization. Associates want to know what’s going on, and our associates get answers to these questions at quarterly forums led by the senior leaders at each hospital. We call this "face time," because every associate has the opportunity to hear directly from senior leaders. We believe this information gives associates incentive to keep us on track.

Senior leaders also visit departments each month and simply ask, "Do you have what you need to get your jobs done?" Associates are invited to reflect on everything from staplers and copy paper to office space and marketing dollars.

A communication board hangs in every department, with the SRHS goals for excellence clearly categorizing all postings. Categories include: People; Financial; Growth; Quality; Service; and Community. These boards help keep our associates focused on our primary goals and have established centralized points of departmental dialogue. A bi-weekly associate newsletter is also distributed to associates includes event follow-ups, important dates and even a section called "Swap ‘n Shop" that allows an associate the chance to participate in an inter-office yard sale of sorts.

Rewards and Recognition

When an associate goes "above and beyond" their daily duties or exceeds the expectations of their peers or supervisors, they are rewarded with a "spike" for having helped drive yet another spike into that train track towards excellence. The spike itself is just a slip of paper with a summary of the associate’s good deed, but when an associate has collected five of them they can be redeemed for movie tickets, restaurant gift certificates, a massage, or even a car wash. Since the program began, over 2,700 spikes have been awarded at an investment of over $42,000.

Rewards and Recognition also extends into other celebratory events. SRHS employs a full-time "Special Events Coordinator" that spends hours planning associate banquets, events and annual picnics, and organizing result-driven celebrations. The motto at SRHS is, "Party with a purpose."

Many other factors put into place with the Excellence Express initiative have contributed to the rise in morale, but the senior staff believes that the positive culture of rewarding and recognizing outstanding behavior has lead its associates into a competition for who can do the best job, rather than who can do the least work.

It has also created a unique culture in which associates have a reason to actively "care" about their jobs and the quality of their work.

Additional successes within SRHS since the initiation of Excellence Express include:

  • Quality
    1. Trousdale Medical Center is a rural critical access hospital. As part of the TMC EMS initiative to provide a high quality of emergency and transfer care, the department developed its own patient satisfaction surveys to monitor the quality of treatment to all patients, including patients transferred to Vanderbilt LifeFlight medical helicopters out of Nashville. LifeFlight medic teams are also surveyed, and results of those surveys so far have been overwhelmingly positive. As a rural emergency response team, the TMC EMS has consistently impressed the LifeFlight professionals with the level of care they provide to trauma patients.
  • Service
    1. Trousdale Medical Center maintained two consecutive quarters of 99th percentile patient satisfaction scores in 2004, and held in the 97th for the remaining two quarters. Because of their efforts to improve scores, their surveyor, Press Ganey, named the hospital as a finalist in its 2005 Success Stories competition.
    2. Sumner Regional Medical Center has seen Inpatient satisfaction scores consistently rise from the 40th percentile in 3rd quarter of 2002 to the 90th percentile in 2005. ER scores have also seen a significant gain from the 27th percentile in 3rd quarter 2002 to the 70th percentile in the 1st quarter of 2005. Home Health has seen a rise from the 1st quarter of 2003 at the 35th percentile to the 90th percentile in the 1st quarter of 2005.
    3. Carthage General Hospital has implemented a "mystery shopper" program in conjunction with a local physician office to survey its level of service.
  • Growth
    1. Increased volumes in nearly every service offered at each hospital in the past two years. Expansions have been made to accommodate a growing number of patients in SRMC emergency, surgery, and sleep study departments; TMC outpatient rehab; new specialty clinics have been added at CGH.
  • People
    1. Our associates ranked SRHS number one in associate satisfaction!
    2. When CGH joined SRHS a year ago, celebration plans were put into place so that associates at each facility could decide what types of celebrations they wanted most (Christmas buffet vs. potluck; Doctor’s Day for physicians only vs. cook-out with staff; individual vs. joint associate awards banquets).
    3. The SRHS Rewards and Recognition program was recently featured in a management guidebook written by national motivational speaker Eric Chester ( Getting Them to Give a Damn, 2005).
  • Financial
    1. SRMC has implemented a Bright Ideas program to challenge all associates to explore cost-saving or efficiency measures.
  • Community
    1. Supporting the community has become a system goal directly linked to individual performance reviews. Associates are asked to find ways to participate in the dozens of fundraising and community activities hosted by Sumner Regional Health Systems throughout the year. SRHS associates help break records in fundraising in events such as Relay for Life and Christmas for Kids throughout the end of 2004 and 2005.
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