Upson Regional Medical Center is a great example of a hospital that changed its culture and significantly improved its outcomes with the help of a Studer Group partnership.
Upson is a 115-bed hospital in middle Georgia. As one of its region's largest employers, Upson employs more than 600 and has an annual payroll of more than $27 million. It is the hospital of choice for more than 5,000 patients annually, and it is a major economic engine for the region. Its emergency department alone cares for more than 32,000 patients each year and is the origin of more than 93% of all admissions.
In 2006, Upson's Board of Trustees decided to invest in and commit to a journey of excellence with the Studer Group. Since that time, board members, leaders, most physicians, and some staff have attended Taking You and Your Organization to the Next Level.
Over time, the hospital's culture from the top down has shifted from silos to a singular focus on the patient, and the difference can be found in improvements in service, quality, finance, growth and caregivers who work with absolute purpose -- for their patients.
Here are a few highlights of recent accomplishment:
This year, Upson achieved the milestone of its 60th anniversary, which gave us pause to appreciate the existence of our hospital.
A local paper published in 1951 wrote: "The undying faith of a few weathered 15 years of planning, set backs, a war, inflation, more planning and finally the realization of their dream. From the child who told the superintendent 'I just want to see how it's coming along -- I've got a nickel in it,' to the group that contributed $100,000, people gave unselfishly…"
In 1951 the hospital cost a mere $1,122,000, and its impact 60 years later is priceless. We owe a debt of gratitude to those who had the vision for this hospital and tenacity to see it to fruition, and we recognize our place in its history and our opportunity to leave a rich legacy for the future.
Upson's journey to Service Excellence began with a focus on patients' perception of care and measurement of the "Likelihood to Recommend" metric. Five years into the journey, Upson is seeing improvement in consistency of service delivery and evidence that hard work pays off. Upson's HCAHPS scores by question exceed the national average, and "Likelihood to Recommend" rankings steadily have climbed from the 46th percentile in the first quarter of 2008 to the 88th percentile in the first quarter of 2011.
Five years into the journey, Upson is seeing improvement in consistency of service delivery and evidence that hard work pays off. Upson's HCAHPS scores by question exceed the national average, and "Likelihood to Recommend" rankings steadily have climbed from the 46th percentile in the first quarter of 2008 to the 88th percentile in the first quarter of 2011.
Upson understands communication and compassion are the keys to a positive patient experience and that AIDET works. All staff at Upson use AIDET and Upson's Housekeepers were recently recognized by Studer Group as a best practice for high marks and consistency in scores for courtesy and cleanliness.
Always raising the bar, Upson is participating in "Project Red," which is sponsored by Joint Commission Resources and funded by the Agency for Healthcare Research and Quality. The aim of Project Red is to improve the discharge process in such a way that patient satisfaction increases and readmissions decrease.
In January 2011, Upson was recognized by the Georgia Hospital Association and the Partnership for Health Accountability for drastic improvement in quality. In two year's time, Upson raised its Appropriate Care Measure scores from 78 percent in the first quarter of 2008 to 96 percent fourth quarter of 2009. Upson also was named to the Georgia Hospital Association's Presidential Honor Roll for Quality.
More than Core Measures, Upson's Quality performance can be gleaned from reductions in never events, such as falls and infections. Just last year, Upson reduced the number of falls by 15 through increased rigor in Hourly Rounding. And, Upson has an ongoing record of four years without a Ventilator-Associated Pneumonia and two years without a Central Line Associated Infection in ICU.
Always seeking consistency so never events never happen, Upson partners with the Georgia Hospital Association, Johns Hopkins University, and the Georgia Tech's Healthcare Performance Group on innovative pilot projects to improve processes that drive quality care for our patients.
In addition to Project Red, Upson is participating in three additional initiatives to reduce preventable harm -- Medication Reconciliation, Catheter-Associated UTI, and Catheter- Associated Blood Stream Infections.
Upson recently changed its accrediting agency to DNV. Next steps are to implement the ISO-9001 quality management system that will enable us to reach maximum effectiveness and efficiency in our processes and improve outcomes, both clinically and financially.
Financial strength is a major factor in a hospital's ability to provide very good care to its patients. Because of its financial strength, Upson can stand tall during tough economic times and focus on growth rather than reductions.
Upson's sound financial position is perpetuated by good expense management throughout the hospital, particularly management of salary and supply expense. Upson's salary and benefits expense is 37.5% of net operating revenue and supply expense is 11.5% of net operating revenue.
Upson's award-winning Business Office also plays a major role in ensuring a healthy bottom line. Days in accounts receivable consistently are below 27 and recently implemented incentives for upfront patient payments are paying off.
Financial strength and strong quality incentivized Upson in 2010 to enter into medical malpractice self-insurance via a captive program, which will allow the hospital to save substantially on premiums over time.
Upson's financial strength and not-for-profit status allow for continued reinvestment in facility improvements, renovations and expansion.
One area of investment is primary care physician recruitment. In the past two years, Upson has successfully recruited three OB/GYNs and two family practitioners to its medically-underserved service area.
Last month, Upson completed a $600,000 renovation of its cystoscopy-suite. Upson is the first hospital east of the Mississippi and second in the nation to invest the latest urologic technology for its patients.
The hospital's kitchen and cafeteria have been completely renovated, and because having a place to practice is such an important component of physician recruitment, Upson has invested more than $5 million in two Medical Office Buildings with plenty of space to grow.
David Castleberry, CEO