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| Covenant Health System: Keeping It Together |
| Hospital Systems | |
| Written by Amanda Gaines | |
| Thursday, 31 January 2008 | |
 Melinda Clark and her team are partnering with physicians to improve the quality and efficiency of this faith-based health system.
Employee and physician engagement is on the wish list of every healthcare CEO. In July 2007, Melinda Clark relinquished her title as president and COO and became president and CEO of Covenant Health System in an effort to focus on just that.  Melinda Clark, President and CEO Covenant Health System is the result of the 1998 merger of St. Mary of the Plains Hospital and Lubbock Methodist Hospital System, both based in Texas. Since the merger, the organization has grown by expanding into Eastern New Mexico, adding a specialty hospital, and developing a network of leased and managed community hospitals and healthcare centers. But over the years, physician dissatisfaction has grown as well. Justifiably, in her new position, Clark’s first order of business to meet with the 40 most active inpatient and outpatient physicians of the organization and ask them three questions: what is Covenant Health System doing well, what can it do better, and in one year, what is one thing you would like to see changed? “I’ve used that information to drive our change,” Clark said. “We’re using their responses to guide our strategic plan for the next three years.” Although the strategic plan is still in the early developmental stages (in December, the initial draft of the key strategies and milestones had just been completed), the administration has taken steps to address the physicians’ primary concerns. “They told us we take great care of their patients, but we need to consider the economic impact of the industry changes on physicians,” Clark said. “We are also finding new ways to partner with them to improve efficiency and cultural stability.” Time to lean In September 2007, Covenant began working with Simpler Consulting, a lean-based process-improvement consulting group headquartered in Iowa, to improve workflow efficiency while putting the patient first. The hospital system underwent an organization-wide analysis and developed metrics to pinpoint areas needing the most attention. “We identified our ED, general medicine, and surgery departments as our key areas,” said Clark. “Length of stay is a key metric for general medicine, and in the OR and ED, it comes down to patient turnaround and throughput.” After picking its areas of focus, Covenant turned to training and as of December had completed 60% of the training necessary to implement lean techniques across the organization. The goal is to do rapid cycle improvement, Clark said, with each lean work team following a specific plan to ensure results. As results are shown, each team will move into the next phase of its plan. As a part of St. Joseph Health System, a 14-hospital and California-based nonprofit organization with a tier governance model, Covenant strives to give each of its facilities a structural framework while maintaining a level of independence. “Those hospitals and healthcare centers have some autonomy at the local level to manage their businesses,” she continued, “but we try to set high-level policies and practice expectations at the system level.” Employee satisfaction To improve its culture, Covenant enlisted the help of the Studer Group in 2006. The formal contract between the two organizations ended in October 2007, but Clark believes her organization is now poised to improve beyond where the instruction ended. Several employees across the organization were trained on Studer methodologies and are now developing and creating their own customer service programs. “We have the highest employee satisfaction across the St. Joseph Health System,” Clark said. “We give our employees surveys to respond to changes and tell us where we can further improve, but we also hold town hall meetings.” During the 45-minute town hall meetings, which are guided by an employee communication team that decides the topics, employees interact with the president and her administrative team. When Clark first arrived in January 2007, roughly 500 of the organization’s 5,000-plus employees were attending. By the end of the year, that number had risen to 2,500. Members of the administration answer all employee questions, no matter how tough they are, and their commitment to these meetings shows in the organization’s turnover rate, which is down to 16%. “For every question we’re asked, we give a written response,” said Clark. “It’s not always what we want to answer because they ask tough questions, but transparency and employee inclusion is critical to our success.” Clear path Covenant recently invested $40 million in Meditech, which will be the system’s new mainframe and EMR. In addition to four hospitals and numerous healthcare centers, Covenant has a 225-physician employed medical group called Covenant Medical Group. To enhance the medical group’s connectivity to each of the system’s hospitals and medical centers, Clark and her team are extending their EMR development to the practice.
The system is also implementing a full clinical integration program that partners private physicians with Covenant Medical Group. Covenant Health Partners will give physicians the opportunity to help Covenant improve its quality. Roughly 290 physicians have already signed up to participate. |
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