Saint Luke’s Hospital of Kansas City
Founded in 1882, Saint Luke’s Hospital (SLH) is the largest hospital in the Kansas City, Mo., metropolitan area. Affiliated with the Diocese of West Missouri of the Protestant Episcopal Church, it is a not-for-profit comprehensive teaching and referral health care organization that provides 24- our coverage in every health care discipline. SLH is driven by its vision, “The Best Place to Get Care, The Best Place to Give Care,” and its core values of Quality/Excellence, Customer Focus, Resource Management, and Teamwork. Under the leadership of Chief Executive Officer G Richard Hastings, SLH employs 3,186 staff and 500 physicians.
Saint Luke’s is committed to providing leadership, volunteers, and funding to many community health organizations, including the federal Women, Infants and Children program; the Metropolitan Organization to Counter Sexual Abuse; and The Cancer Institute. The level of financial commitment to community health care education has steadily increased from $9.6 million in 1999 to $12.7 million in 2002.
Specialized care capabilities for very ill people are Saint Luke’s hallmark. These include the Mid America Heart Institute, which treats complex cardiovascular diseases; the Mid America Brain and Stroke Institute, which includes a nationally recognized program dedicated to preventing and treating stroke; a highly rated trauma center and neonatal intensive care nursery; and the only comprehensive maternofetal diagnostic and treatment center in the Kansas City area. Many of its treatment regimens are among the best in the nation. For example, in treating ischemic stroke, a leading cause of death and permanent neurologic disability, SLH leads the nation in the percentage of diagnosed patients receiving Tissue Plasminogen Activator (tPA) to help restore circulation and reduce permanent brain injury. In the second quarter of 2003, 27 percent of SLH patients received tPA versus a national average of 3 percent.
From 1999 to 2002, SLH’s financial performance has steadily improved, showing that pursuing and implementing innovative treatments is compatible with sound business practices. In total margin and operating margin, SLH currently ranks among the top 5 percent of the nation’s hospitals. In total revenues, SLH outperforms the Council of Teaching Hospitals top quartile.
Highlights
- In 2002, Consumer’s Checkbook ranked SLH 35th in the nation out of 4,500 hospitals evaluated.
- Since 1997, studies of regional health care providers by the National Research Corporation have shown that patients believe SLH has the best quality health care and the best doctors and nurses of the 21 facilities in the market area.
- SLH has 12 “Customer Contact Requirements,” including “Address patients/guests by last name unless otherwise told” and “Address all complaints within 24 hours or less.”
- SLH outperforms the Council of Teaching Hospitals top quartile in financial performance and ranks in the top 5 percent of hospitals nationwide in total margin.
Listening, Learning, ImprovingSaint Luke’s Hospital accomplishes its mission of “providing excellent health services to all patients in a caring environment” by listening to its customers and designing new and improved ways to deliver health care. SLH uses a continuous-loop model, known as the Performance Improvement Model, to plan, design, measure, assess, and improve the way it delivers health care services. Used in all hospital departments, employees are introduced to the model during orientation and process owners and PI team members receive extensive training on its use.
Saint Luke’s “Listening and Learning” process helps to determine patients’ requirements. The process includes formal methods, such as surveys, focus groups, and follow-up calls, and informal ones, including daily conversations that SLH employees have with patients, families, and others. A customer satisfaction research program continuously gathers customer and market requirements and helps measure customer satisfaction.
One outcome of this input is a better understanding of how patients want to be treated and a set of 12 customer contact requirements known as the “Commitment to the Four Core Values.” The 12 requirements include “Address patients/guests by last name unless otherwise told” and “Address all complaints within 24 hours or less.” All employees carry these requirements on a Very Important Principles Card and they are prominently posted throughout the hospital.
Care PathwaysTo assure the best possible clinical outcomes and high patient satisfaction, Multidisciplinary Care Teams, comprised of physicians, residents, students, clinical nurses, patient care technicians, and information associates, work with patients and their families to design individualized “care pathways.” Patients get their own version in a format that allows both the patient and the family to understand and follow the day-today delivery of health care. Teams also have developed 134 clinical pathways for high-volume, high-cost diagnoses that standardize care and reduce variation in treatment. Sixty percent of Saint Luke’s patients receive care that is based on a clinical pathway.
The constant cycle of listening, learning, and improving is paying off in patient satisfaction. In 2002, Consumer’s Checkbook, a consumer education organization, ranked SLH 35th in the nation out of 4,500 hospitals evaluated. The hospital received an overall score of 7669 compared to a national average of 5418. Consumer’s Checkbook rating for SLH physicians was 86 percent compared to a national average of 33 percent.
An independent study by the National Research Corporation shows that patients believe SLH delivers the best quality health care and has the best doctors and the best nurses of the 21 facilities in the market area. This top position has been sustained since 1997. Additionally, the study found that patients believe that SLH delivered the best cardiac, neurology, and orthopedic care, and ranks it among the top four hospitals in obstetrical care.
A Focus on Excellence and EmployeesSaint Luke’s “Leadership for Performance Excellence Model” captures all of the elements that drive its focus on performance improvement and excellence, including the strategic planning and performance management process, process improvement model, and a commitment to excellence assessment model based on the seven Baldrige performance excellence categories. Saint Luke’s vision, mission, core values, and strategy sit at the top of the model and influence all of the organization’s plans and processes.
A robust strategic planning approach consists of three phases and seven steps that integrate direction setting, strategy development and deployment, financial planning, and plan management. At a series of retreats, the leadership team develops strategy and a 90-day action planning process to deploy the strategy to all departments. The balanced scorecard process produces a measurement system that aligns all departments with the strategy and ensures the proper focus in key performance areas throughout the organization.
A highly empowered, high-performing workforce is key to Saint Luke’s success. To ensure that everyone is in tune with the hospital’s focus, all employees take part in the Performance Management Process. The process helps employees develop action plans and goals that are aligned with the organization’s strategy and core values and identify personal commitments which contribute to SLH’s values. The process also defines primary customers and competencies needed for each position and sets expectations for each employee. A Process Improvement Model provides employees with the information they need to effectively design, manage, and improve hospital processes.
Factors that determine employee well-being, satisfaction, and motivation are uncovered through formal surveys, open forums with senior leaders, targeted focus groups, senior leader “walk rounds,” “staying” and “exit” interviews, and the Peer Review Grievance Process. An intense focus on ensuring that its workforce reflects the diversity of the community, including diversity training for all employees and “lunch and learn” sessions about diversity-related topics, has led to an increase in minority managers and professional staff, from 3 percent in 1998 to almost 10 percent in 2002. Employees also are staying at Saint Luke’s longer, another indicator of growing employee satisfaction. For the past five years, results for employee retention have exceeded the Saratoga Institute’s median and is approaching 90 percent.
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