The BKD Indiana Quality Improvement Awards.

• Author: Kaelble, Steve
• Position: Doing It Better

IT'S REMARKABLE WHAT can be accomplished by adopting the right attitude. As this year's winners of the BKD Indiana Quality Improvement Awards demonstrate, dramatic accomplishments begin with a change of mind-set--a decision by management to do something better followed by a transformation of the quality commitment at every level.

The 2003 awards honored a variety of projects, from reducing surgical infections to eliminating defective parts from the production line, from finding a better way to build houses to fixing potholes faster. Though their issues and solutions are company-specific, their stories offer examples of the way a quality attitude can infect an institution and improve the bottom line.

HEALTH-CARE PROVIDERS

When Tim Jarm first walked in the front door of Clark Memorial Hospital in Jeffersonville, he was greeted by a telephone. bolted to the reception desk. The phone carried a sign instructing visitors to dial "0" for assistance. Shortly thereafter, Jarm was hired as CEO, and one of his first orders was to replace the phone with live, smiling humans. It was the start of a quality-improvement effort with a goal that was anything but modest: Become the best community health-care provider in the country. The effort took home both the Gold award in the health-care category and the overall BKD Indiana Quality Improvement Award.

"It was nothing short of a whole cultural transformation for us. To commit the whole organization to quality, we differentiate between merely a program and a way of life," says Jarm. The transformation began when Jarm took the reins three and a half years ago and sensed that many on the payroll were simply putting in their time and collecting their checks, but did not seem truly invested in the hospital's mission. "No one knew what our mission, vision and values were."

The first task was to enhance the experience for "team members," because satisfied employees tend to deliver better service. A key was making employees feel more valued by offering them more ways to provide input. Director of quality Chad Brough says the "Bright Idea" initiative was an important component. "We attempted to engage our team members by asking them what systems and processes could be improved."

The hospital began offering team leaders two days of leadership training every quarter, and told them to encourage team members to submit "Bright Ideas," an average of at least two and a half per employee. Employees submitted hundreds of suggestions, such as attaching long poles to wheelchairs to prevent them from disappearing into patients' cars, and permanently stationing a registered nurse by the CT scanner to do assessments, start IVs and perform other services designed to move patients through the process more efficiently.

The hospital set numerous specific goals, which were broken into 90-day pieces, with progress publicized frequently and discussed at regular forums involving Jarm and hundreds of his employees. Clark Memorial beat its employee-satisfaction goals, surpassing the 95 percentile in satisfaction and cutting turnover by 22.4 percent. The annual turnover rate, which was one-in-five a couple of years ago, has dropped to 14 percent, Jarm reports. Turnover of nurses dropped to 6 percent, half the state average. "When you focus on team-member satisfaction, they are more likely to seek opportunities to do great things to other people," helping the hospital to achieve other quality-improvement goals.

One of those goals was to boost patient satisfaction, and the hospital beat the goal when an external review by South Bend-based Press Ganey Associates put the hospital in the 87th percentile nationally. The hospital also improved from 83 percent to 97 percent in a quality rating by Anthem Blue Cross and Blue Shield, says Jarm.

Strokes are the third leading cause of death in the nation, and Silver award winner Deaconess Hospital in Evansville decided in 2001 to improve its stroke care. Goals included improving its stroke-mortality index, increasing the percentage of stroke patients discharged to home and earning the status of "Primary Stroke Center." To achieve these goals, Deaconess established a task force and numerous subcommittees, set up a rapid-response team, arranged appropriate support services and coordinated educational efforts aimed at physicians, staff and the general public.

Deaconess improved...