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Vanderbilt University Medical Center

  • Location: Nashville, TN
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: October 2006

Two years ago Vanderbilt University Medical Center launched Elevate, a medical center-wide effort to improve the environment for patients, physicians, employees, trainees and students. Vanderbilt was already nationally recognized for excellence in many areas. But Dr. Harry Jacobson, Vice Chancellor for Health Affairs had ambitious goals, including that Vanderbilt become one of the nation’s top 10 academic medical centers and a Fortune 100 employer – something that an academic medical center has never achieved. Elevate was designed to help achieve these and other goals by focusing on three important areas: Service, People and Quality.

After its first two years, how does the organization measure its success? Well, first by its Pillar Goal results which are highlighted below. But there’s also the letters and comments - here’s one great example:

“The culture has changed at Vanderbilt, and that is what is so wonderful about Vanderbilt today.…..What I appreciate is the manner in which people conduct themselves from the doctor all the way down to the individuals who restock the supply closets. Everyone is friendly, personable, and approachable. Every effort is made to immediately assess the patient’s needs and get them to a level of comfort; therefore, decreasing their anxiety, stress and pain. Family members are listened to and encouraged to actively participate in the patient’s recovery. Our spiritual needs are addressed immediately along with any physical needs we may have whether it is locating the restroom or bringing the patient or family member food or a soft drink. When I call after the doctor as he/she is leaving our hospital room because I forgot one more question, the doctor’s body language is extremely open to me. When it is obvious in the hallway of the hospital or clinic area that an individual is lost or is exhibiting signs of distress and I see a physician stop and patiently give directions, I am astonished, but proud.

There is no doubt in my mind that the level of medical care at Vanderbilt is beyond excellent, but as I read about Vanderbilt’s goals and mission statements (the columns) outside the executive suite near the Round Unit, it was so reassuring to me to see each one of those principles being cared out by each staff member in numerous departments.”

As the model for Elevate was developed, one of the “Must Haves” for Dr. Jacobson was that it be inclusive. So efforts were made to engage all areas of the medical center, and as many leaders as possible in the Elevate initiatives:

  • The Steering Team includes several key physician leaders, and many of the systems teams and care teams are headed by physicians or have physician members.
  • Vanderbilt has been first school to apply the SG principles to education and research. The academic enterprise has been integrated into Elevate, and has established its own Pillar Goals.
  • Vanderbilt’s quarterly leadership institutes reach over 1,000 leaders, with more than 200 physician leaders included.
  • Leaders in the clinical and academic enterprises are included in the Leader Evaluation process.
  • Many of the University’s department leaders participate in Elevate.
  • The School of Nursing is working with Studer Group to develop a customized model for nursing schools.
  • Elevate training, with a special emphasis on AIDET, is being provided to all faculty and residents.
  • “It’s Who We Are” represents the Vanderbilt credo behaviors, which involved over 600 employees in developing and validating standards that are specific and apply to all employees, including physicians.

There are many role models among Vanderbilt leaders. Steve Gabbe, Vanderbilt’s Dean of the School of Medicine has incorporated the principles of Elevate into his daily actions. He rounds regularly, including on the Chairs as well as medical students and others. He uses recognition to acknowledge the good work of others. During his recent remarks at the White Coat ceremony for incoming medical students he talked about the description of Quint Studer as a fire starter, “someone who has brought significant change and improvements to health care.” He then asked the medical students to be fire starters during their careers in medicine.

Vanderbilt is extremely focused on the Quality Pillar and Clinical Excellence. They achieved most of their ambitious Pillar Goals for FY 06 (see below) and have raised the bar again significantly for FY 07. A recent JCAHO survey was quite successful. Along with an excellent review, comments from the survey team included: “Vanderbilt sets the standard”, “Your staff really gets it…they’ve shown us what great healthcare is all about” The medical center is also waiting the results from their recent MAGNET recognition site visit. Vanderbilt will take quality to the next level by working collaboratively with Studer Group. Together we will develop simple technology, tools and a coaching process targeted for hospitals that want to achieve clinical excellence.

Based on organizational vision, leadership, goals and results Vanderbilt has been selected for recognition as a Fire Starter Organization.

Elevate Pillar Goal Results Highlights

People – Vanderbilt is a great place to work and will be on Fortune 100 Best Employer List by 2007

  • In the most recent Community Survey of employee satisfaction, 85% of employees gave feed back, with every single item showing improvement. Results were above 4.0 for three of the four domains.
  • Vanderbilt’s turnover rates are considerably lower than the nation’s average.
  • Vanderbilt conducted its first-ever surveys of physician satisfaction and resident satisfaction, establishing baselines for next year’s improvement goals.
  • Scientist magazine ranked Vanderbilt as one of the “Best Places to Work for Practicing Scientists” (top 5 of 125 organizations) in November 2005

Service – We will continuously improve how we serve others

  • Six of the seven Vanderbilt patient satisfaction surveys had results above the 90th percentile for FY 06 on the Likelihood to Recommend question
    • University Hospital 93rd percentile
    • Children’s Hospital 95th percentile
    • Adult Emergency Department 91st percentile
    • Children’s Emergency 99th percentile
    • Outpatient Surgery 98th percentile
    • Outpatient Technical Services 98th percentile
    • Vanderbilt Clinics 82nd percentile
  • Vanderbilt medical students rated their level of satisfaction (AAMC 2005 Graduation Questionnaire) very significantly higher than the average.

Quality- We will provide safe and high quality preventive, acute and chronic patient care

  • Vanderbilt has a highly successful team approach to quality and clinical excellence. Physicians in all specialties work with their care teams, and the organization is at or near the top in many of the publicly reported measures. The long-range goal is to be in the top 10% for all measures.
  • Vanderbilt has achieved a .7491 rate of observed to expected mortality.
  • Vanderbilt is frequently cited for their work in evidence based medicine, and many of its leaders are national experts, speakers, and first movers in this area.
  • JCAHO’s recent survey yielded excellent results, and Vanderbilt is currently anticipating results of its just-completed MAGNET review.

Growth – We will be the leading provider of health care services in the region

  • Vanderbilt more than doubled its ranking in 10 years, moving from 4th place to 1st place in consumer hospital preference
  • The organization continues to experience significant growth year-overyear in virtually all areas of the medical center
  • Fastest growing in the nation in NIH funding

Finance – Vanderbilt financial resources attract world class faculty, staff and students to heal, teach and discover in state-of-the-art facilities

  • Vanderbilt significantly exceeded its net revenue budget again this year and therefore increases the margin necessary to support its multiple missions.
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