The Neurologic & Orthopedic Hospital of Chicago (NOHC) was ranked the top hospital in Illinois and among the top 5 percent in the country for spine surgery in 2008, according to the latest HealthGrades Hospital Quality in America study, released earlier this year. The study is an annual assessment of mortality and complication rates in nearly 5,000 hospitals nationwide performed by HealthGrades, a for-profit healthcare ratings organization.
In addition to receiving the top rankings, the study, which analyzed Medicare discharges between 2004 and 2006, also concluded that NOHC earned top five-star ratings for spine surgery, spinal fusion and back and neck surgery. The hospital’s success is a result of years of hard work and
dedication to offering first-rate patient care, says Stephanie Spiegel,
president of NOHC.
“At the end of the day, that’s what it’s about for us — our patients should have the absolute best care and outcomes possible,” she says. “That’s something you work on every single day to make sure you can be as efficient as possible.”
Spiegel shares the following six reasons to explain how the hospital has developed and maintained such a high level of quality.
1. Patient-first philosophy. While the HealthGrades awards may primarily focus on NOHC’s outcomes, the root of all of NOHC’s success, including its excellent outcomes, stems from the philosophy instilled by its medical directors, Leonard Cerullo, MD, and John Hefferon, MD, Ms. Spiegel says.
“They’ve always said that when you have a patient, it’s not your patient just for the day; it’s your patient for life,” she says. “From the moment they pick up the phone and call you or when they first step in this hospital, they are
ours forever.”
Good outcomes are not just a result of what happens in the operating room, she says. It’s about the entire patient experience. NOHC’s administration emphasizes that everyone in the hospital, regardless of their position, impacts every patient or family or friend, directly or indirectly, and they can significantly influence the patient’s impression of his experience.
“You can have patients that have a great outcome but if their experience wasn’t good — the food was terrible, they couldn’t get through on the phone, family couldn’t visit — they become frustrated, or their family or friends do, and then all of the good that you’ve done has gone for naught,” Ms. Spiegel says.
Since many of the hospital’s referrals come via word of mouth, there is also an understanding amongst the staff that a great patient experience can potentially lead to future patients.
2. Responsiveness to patients is a top priority. Few things frustrate patients more than feeling as if they’re not important, and the way to make them feel unimportant is to fail to respond to their questions and concerns. NOHC has made responding to patient queries a top priority, but responding does not necessarily mean having an answer to their question.
“It doesn’t mean you have the answer right then and there, but to set an expectation when you’re going to get back to them (with an answer) is key,” Ms. Spiegel says. “At least that patient knows they have a voice.”
Staff try to avoid making promises they cannot keep when telling patients how soon they can expect an answer. But they also work to make sure an answer does not take an excessive amount of time.
3. Recognizing physicians as important customers, too. The physicians at NOHC are very important — second only to the patients, Ms. Spiegel says. The hospital’s administration works to find ways to show appreciation for the physicians’ hard work and commitment to quality care.
Similar to their responsiveness to patients, NOHC administration also recognizes the importance of responding to the physicians’ needs and requests. Whether it is feedback regarding patient care, operating room supplies, staff utilization, marketing, or whatever, physicians respond very positively to the open dialogue, collaboration and attention to their concerns they receive at NOHC.
NOHC also involves physicians in major decisions, such as purchasing new technology. Physicians serve on a few committees involved in overseeing such significant decisions. Ms. Spiegel makes sure the number of committees is minimized to ensure meetings do not interfere with the physicians’ work, but see their involvement in key decision making as a good method of serving both the hospital’s and physicians’ needs as well.
Ms. Spiegel believes that such supportive actions keep physicians feeling appreciated and respected, which can only help with the physicians’ relationships at the hospital.
4. Frequent staff recognition. NOHC did not view the HealthGrades awards as recognition for the excellent work of just the clinical team. It was recognition of the entire staff’s performance. Ms. Spiegel sent out two e-mails congratulating and thanking the staff; a banner was hung in front of the hospital pronouncing it the top hospital for spine surgery in Illinois; and the entire staff was treated to lunch.
“Celebratory occasions are critical,” says Ms. Spiegel. “If you make sure you take the time to be better and correct things, you better be sure you take the time to say, ‘thank you’.”
The hospital has also developed both incentive and recognition programs to reward staff. Incentive programs are typically used within specific departments to reach quantifiable financial or operational goals, such as cost savings or recruitment quotas, for example. Recognition programs, on the other hand, are rolled out across the hospital and allow patients and supervisors to recognize exceptional customer service within
the organization.
The staff at NOHC has always been treated as a unit and not independent departments performing separate roles. When the hospital was developing its mission, vision and core values, individuals from throughout the hospital, including maintenance, housekeeping, senior management and physicians participated in putting them together.
5. Administration is connected. Spiegel has
visited other hospitals and seen administrations that she feels are too far removed from the patient experience to make a strong positive difference.
Although she is NOHC’s president, Ms. Spiegel holds regularly scheduled meetings with every department in the hospital. During these meetings she provides updates on the current state of the hospital, including new ventures, new technology and marketing efforts. She then asks the staff for honest feedback and suggestions for improvement.
“Who better to ask than those at the front line,” says Ms. Spiegel. “And then I have a process where I get right back to the staff” with how NOHC will address their concerns or ideas.
Ms. Spiegel also makes regular rounds to interact directly with the patients and to ask how the hospital can make their experience better.
“It might be something that is not even clinical; it might be something that is totally non-clinical that they have a suggestion for the hospital,” she says. “It’s about making sure you aren’t too far removed that you forget what they’re going through and you overlook what could be better.”
Ms. Spiegel is not the only member of NOHC’s administration taking such an active role within the hospital. The hospital’s board of directors interacts frequently with the staff, including attending the celebratory lunch. This interactivity has served the hospital well as even the housekeeping staff can recognize the board and has come to know them by their first names.
6. Patient feedback is followed. When NOHC conducts patient satisfaction surveys, it asks the few questions that are required by CMS. But the hospital includes additional questions, such as whether the patient would recommend using the hospital, and provides an opportunity for patients to discuss what aspects of their stay were positive and which areas could use improvement.
“We take that feedback to heart,” Ms. Spiegel says. “The senior management team reviews it and reports it to med-exec committee as well.”
During a medical executive meeting earlier this year, Ms. Spiegel recalls that only a few minutes were spent discussing the hospital’s financials; the rest focused on areas for improvement and suggestions provided by patients and staff.
“It was all about what we could do better,”
she says.
Contact Rob Kurtz at rob@beckersasc.com.
