Located in the Village of Dennison among the rolling Appalachian foothills of Southern Tuscarawas County, Ohio, Trinity Hospital Twin City (THTC) is a 25-bed, critical access, not-for-profit Catholic hospital that provides care to nearly 35,000 residents in its primary service area. THTC provides a full range of acute care services, including a group physician practice known as Trinity Medical Group, and is fully accredited and equipped with the latest in digital state-of-the-art technology to meet patient needs.
At THTC, 250 employees provide compassionate care that is focused on the whole person – body, mind and spirit. The hospital mission states, “Guided by our passion for caring, we continually strive to improve the health and wellness of the community we serve.” Many hospital employees think of their jobs as more of a ministry than work. The priority is to provide quality, patient-centered healthcare for every person who walks through the hospital’s doors.
The THTC staff is dedicated to carrying out the core values of Reverence, Service and Stewardship:
- Reverence – believing that each person is created equal in God’s image and likeness. Thus each person is treated with respect, justice and dignity.
- Service – believing that each person is called to achieve full potential of mind, body and spirit. To enable the fulfillment of that potential, service is rendered to all with sensitivity, compassion and commitment.
- Stewardship – believing that each person shares responsibility to fulfill his/her specific role and to promote the proper utilization of the environment, of goods and services. This enables hospital staff to maintain quality relationships and care in the ministry.
Trinity Hospital Twin City began its existence as Twin City Hospital in 1912 when a group of volunteer women began raising money to build a hospital, and a local reverend “sold” the committee the land for just one dollar. Twin City Hospital faced many challenges and celebrations over the course of 100 years, as evidenced by its final tumultuous years before becoming Trinity Hospital Twin City in May 2011.
In 2009, the hospital opened a new 43,000 square foot facility (that was built next to the older facility) to house nearly all of the outpatient and inpatient services. In May 2011, Twin City Hospital was purchased out of Chapter 11 bankruptcy by Sylvania Franciscan Health, then a sponsored health and human service ministry of the Sisters of St. Francis of Sylvania, Ohio.
A New Beginning With a new name and a new leadership team installed by fall of 2011, Trinity Hospital Twin City had a renewed vision and hope for a successful future. Newly installed President, Joe Mitchell, RN, FACHE, challenged both the leadership and management teams to change their thinking about hospital operations. Instead of being a hospital that owned a group physician practice, he shared his vision of the hospital being a group physician practice that happened to be located next to a hospital. “I knew that Trinity Hospital Twin City had an opportunity to become a world class critical access hospital if we could focus on the physician practice and facilitate process change around the ways the hospital departments would engage and support the physician practice as we moved the organization forward,” shared Mitchell.
In 2012, Sylvania Franciscan Health announced a system-wide partnership with the Studer Group and THTC gained access to many tools and resources that would help the leaders and staff on the journey to become a transparent, accountable and ultimately, a high performing organization.
The Studer Journey
“Knowing where you are and where you want to go are the two most important parts of any journey,” explained Mitchell. “We had a vision; we now had a vehicle to get us there; but we needed to know where we were starting from. We started with metrics. As an organization newly emerged from bankruptcy, many processes, both financial and operational, were broken. We implemented employee, physician and patient satisfaction surveys through HealthStream.”
Here is a small picture of how far THTC has come in terms of patient satisfaction scores since the Studer Group partnership started in 2012:
- the overall rating of our inpatient medical/surgical care unit went from the 64th percentile rating in 2012 to the 97th percentile rating in 2014
- urgency shown by emergency department staff in prompt treatment of patient’s condition went from the 59th percentile in 2012 to the 86th percentile in 2014
- emergency department staff’s coordination of care and services went from the 54th percentile in 2012 to the 82nd percentile in 2014
- overall rating of outpatient care staff rose from the 74th percentile in 2012 to the 83rd percentile in 2014
- outpatient pain management went from the 74th percentile in 2012 to the 89th percentile in 2014
- and communication with family members/friends during the course of outpatient treatments and surgeries rose from the 69thpercentile in 2012 to the 99th percentile in 2014
These scores are just examples of the overall improvements in patient satisfaction reflecting the on-going efforts to improve the provision of healthcare services to our patients. While the journey to make these improvements has not been a smooth and continuous uphill climb, the commitment of all THTC staff to improve the quality and safety of the care rendered to our patients has been a continuous and ongoing effort.
Once THTC had initial data in place, work began to implement additional resources and processes from the Studer Group. The hospital’s leadership team engaged employees and trained them on AIDET, Rounding on Patients, and Key Words at Key Times. Additionally, THTC implemented Pull to Full immediate bedding in the Emergency Department and Bed-side shift report on the Med/Surg floor. Hourly Rounding, Patient Call Manager, and Nurse Leader Rounding were also implemented in both of the aforementioned departments.
Aligned goals were set for all managers, and the Leader Evaluation Manager was implemented for tracking and transparency. All managers were trained in employee rounding and monthly meetings for direct reports. Additionally, quarterly forums for all employees and Leadership Development Institutes for managers were initiated. THTC also instituted Cascade Communication from all Leadership Team and Management Team meetings.
The hospital’s leadership discovered quickly that it wasn’t enough to just roll out the new processes and tools. The tools needed to be hardwired, or the desired results would never be realized. More work went into creating compliance and transparency around new standard work. In some cases, hospital leadership had to re-train staff on some of the tactics that were just in the beginning stages. Time was invested to develop and narrate the care that was being given.
With 2015 now underway, THTC’s staff is very proud of the Studer journey thus far and looks forward to continued success. THTC has seen growth and success thanks to a relentless focus on results, and the hard work and dedication of its employees and physicians.
Here are some of the results through the end of 2014:
- An estimated growth of 14.7% in total gross revenue
- An estimated growth of 101% in operating margin
In honor of Trinity Hospital Twin City’s journey and results thus far, THTC is being recognized as the Studer Group’s Rural Healthcare Organization of the Month in January 2015. “We are tremendously blessed and extremely grateful to be recognized for our commitment to our employees, patients and our community,” Joe Mitchell commented. “This award is a true testament to our employees who have worked tirelessly to create a culture of always being focused on delivering exceptional patient experiences.”
While this achievement marks a significant milestone in the journey to become a high performing, world class critical access hospital, there is still work to be done. Recently, the Sisters of St. Francis of Sylvania, Ohio, transitioned the sponsorship of Sylvania Franciscan Health (and THTC) to Catholic Health Initiatives. Once a hospital that struggled to make payroll, THTC is now part of the second largest Catholic health system in the nation. With its new partnership with Catholic Health Initiatives, its continued partnership with Studer Group and engaged employees, THTC is poised for any turn the future of healthcare may take.