Columbus Regional Hospital: Deliberate and Disciplined - Health Executive - RedCoat Publishing - Inside Healthcare

In July, Columbus Regional Hospital became the first hospital in Indiana to be awarded the American Hospital Association (AHA)-McKesson Quest for Quality Prize. The 225-bed regional referral center’s success in receiving one of the highest quality recognitions in the industry is the result of a continuous quest to raise the bar on quality.

Jim Bickel, President and CEO

In the last three years, CRH has also received AHA’s Most Wired Hospital award two years in a row for its IT best practices; won a number of recognitions in clinical excellence for stroke, heart care, and critical care; and was designated one of the best places to work in Indiana two years in a row by the Indiana Chamber of Commerce. But even with these achievements, and the many more not listed here, the message Jim Bickel, president and CEO, wants to pass along is, “We’re relentless about patient quality and service excellence.

“Our vision is to be the best in the country at what we do,” he continued. “Patients don’t need to leave our market area to receive better care. We have a moral and ethical obligation to our patients to deliver that care in Columbus.”

All aboard
CRH serves a 10-county area in South Central Indiana and is the largest hospital located in the triangle of Indianapolis, Cincinnati, and Louisville. The impetus behind its customer service surge, which has enabled the organization to raise patient satisfaction scores from the low 50th to the upper 90th percentile, came from the administration’s realization that CRH was registering at a far lower level in the Press Ganey database than other hospitals.

The team understood that having all leadership on board to improve these scores would inspire the rest of the hospital’s stakeholders. After deciding what direction to go, the administration partnered with The Studer Group to assist CRH in rising to the next level. “We partnered with Studer Group to hardwire and deploy the confidence we had that, regardless of when and where patients encountered us, they would have a consistently positive experience,” Bickel said. “Years later, it remains a baseline for us. We can never ignore it. It is now built into new employee orientation, training, and education. When we bring in new leaders, they’re brought up to speed with our principles, strategies, and tactics.”

When CRH began its relationship with Studer Group, it ranked in the 75th percentile for patient satisfaction. When the yearlong process with the group was done, CRH had risen far above that, and 2007 marked the second consecutive year the hospital ranked at or above the 90th percentile. Even though the 40% increase in patient satisfaction is a significant milestone in the hospital’s 90-year history, the work will never be done.

“We’ve reached our goal, but we aren’t satisfied, and that is one of our next challenges,” Bickel said. “How do we make sure that we not only maintain that success but also take it to the next level? It’s something you can never lose sight of. The minute you do, you’ll see it erode.”
Beyond patient satisfaction

In 2006, evidence of the hospital’s desire to improve patient satisfaction turned physical when plans to embark on a significant building project were developed. One of the primary driving forces behind the $108 million project is making all inpatient rooms private, which will mean the addition of about 60 rooms.

Bickel believes the trend for patient satisfaction will move all hospitals to provide private inpatient rooms, but the benefits go beyond patient satisfaction. “A growing perspective is that private rooms help with infection control, along with other quality and safety issues,” he said.

The project will also touch on the growth CRH has experienced in its ED. Each year for the past four, the hospital’s ED has grown between 8% and 10%, and, in 2007, it was just shy of handling 40,000 visits. Consequently, the 20-bed ED needs more space. At the end of 2007, the development team finished the schematic design and floor plan and was quickly moving into design development.

CRH developed room mock-ups of both the private patient rooms and the rooms within the ED to give staff a feel for their new work environments. “It’s one thing to get a two-dimensional drawing. It’s another to walk into a space and see it and know how it will feel to work in it,” Bickel said. “Those rooms will evolve as we move through the design process, and it is a fabulous way to engage staff.”

Level of dedication
As with many hospitals, CRH’s busiest area is the outpatient arena, and competition with freestanding outpatient service providers to retain the marketshare for those services has increased. As referring physicians began complaining about the wait time for patients needing, for example, a CT scan, the administration realized the days of delaying a patient’s scan for a week or even a day was no longer acceptable. To remain competitive, the hospital needed a faster turnaround.

Two years ago, CRH solved its problem by embarking on Lean Sigma, a mix of Six Sigma and lean principles focused on getting the waste out of a system. When the project began, the hospital had two CT scanners and was considering purchasing a third. After pulling together a group of radiology staff to analyze their processes, the idea of a third CT scanner went out the window. Rather than going through the entire process of consultation and preparation in the CT room, the processes were changed, the control room was modified, and now only the actual scan is done in the scan room.

“The technicians do most of the scheduled work on one CT, and the second is freed up for unscheduled patients without any disruption,” Bickel said. “We can now tell those physicians to send their patient right over.”

CRH also has seven Black Belt-certified employees working in various departments to develop efficiencies, another example of CRH’s commitment to its vision. “We talk about our vision to be the best in the country at everything we do. It’s truly become a mission and vision we all live,” Bickel said. “Service excellence isn’t something you automatically know how to do. You have to be deliberate and disciplined all the time.”

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