even years
ago, Syracuse, New York’s, Crouse Hospital struggled to survive bankruptcy and was
forced to undergo painful budget cuts and layoffs. The air was rife with rumors
that central New York’s largest acute-care institution would be broken up or sold
outright.
But instead of going under, Crouse chose to reinvent itself.
Management brought together employees from all levels and allowed them free rein
to remake virtually every aspect of the organization, from refocusing the hospital’s
mission to reinventing processes from the ground level to improve efficiency.
The result: Crouse not only regained its status as a regional
market leader, but also achieved new heights in economic performance, productivity
and quality.
Crouse’s financial resurrection has been impressive. Compared
with a $15 million net loss in 2000, Crouse last year had $11 million in net income.
And through the first seven months of 2008, the institution earned a net income
of $6.2 million, 230 percent of its projected goal—a striking performance in New
York state, where most hospitals break even or lose money.
At the same time, the hospital is providing more services
to the community. In 2007, it handled 55,000 emergency services visits and discharged
22,971 patients, both tops in the region. Crouse spokesman Bob Allen notes that
families come from as far as 200 miles away to take advantage of Crouse’s neonatal
intensive care unit, which has regained its stature as one of the finest in the
nation. The hospital has improved quality at all levels—streamlining its pharmacy
system, for example, to reduce the time it takes for the first dose of antibiotics
to reach a patient from 3.9 hours to just 1.9 hours, about twice as fast as the
industry average.
Additionally, Crouse has achieved remarkable improvement in
its relationship with its employees, according to key metrics. Annualized workforce
turnover has declined from a high of 49 percent in 2001, before the hospital’s culture
change, to just 18 percent today. Employees’ belief that they are treated fairly
by senior management has risen from below industry-average levels to a high of 74.5
percent, significantly above the industry norm of 67 percent. Overall job satisfaction
has climbed to 91.9 percent, above the industry average of 87 percent.
The key to Crouse’s turnaround has been staff involvement
in the process and an emphasis on improving quality at all levels, explains Derrick
Suehs, the hospital’s chief quality officer. "We adopted the philosophy that if
you do the right thing, the finances will follow," he says.
"Everyone in the organization has accepted this approach,
because it resonates with people," says Dr. Paul J. Kronenberg, a veteran physician
who has been Crouse’s CEO since 2004.
The new philosophy began to emerge at an off-site corporate
retreat in early 2002, when middle and senior management met for a frank, uncensored
discussion. Gradually, the attendees realized that to truly fix all of Crouse’s
problems, they needed to shift to the more philosophical level of mission, vision
and values. The hospital ditched its verbose mission statement and replaced it with
12 simple words: "To provide the best in patient care and to promote community health."
Based upon that mission statement, the attendees also developed
a list of six core values for the organization, corresponding to the letters in
Crouse’s name: Community —working together; Respect—honor, dignity and trust; Open
and honest communication; Undivided commitment to quality; Service to our patients,
physicians and ourselves; and Excellence through innovation and creativity.
To help transform those abstract concepts into real change,
senior management appointed an 18-member oversight committee consisting of volunteers
from middle management and staff. Suehs led the oversight group—which was dubbed
the Simply the Best committee—in creating a culture-reinvention process that would
help achieve the hospital’s mission. The group has since grown to 25 members.
For structure, Suehs chose the National Institute of Standards
and Technology’s Baldrige performance-excellence criteria, a self-auditing process
that an organization can use to improve overall performance.
The reinvention process also spawned scores of smaller group-discussion
sessions to which employees at every level of the organization were invited to participate.
The small groups grappled with how to translate the mission statement and values
into specific behaviors that would improve customer service and other aspects of
performance. In the first year alone, the small-group process generated more than
900 recommendations. Crouse put the ideas into a project management process, and
assigned each one to a member of management who would guide it to fruition. At the
end of the first full year, Crouse achieved an 85 percent implementation rate.
In recognition of its success across a range of workforce
challenges, Crouse receives the 2008 Optimas Award for General Excellence.
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 Located
in Syracuse, New York, Crouse Hospital has 506 licensed beds. In
2007, the hospital handled 55,000 emergency services visits and
discharged 22,971 patients, both tops in the region. The hospital
has 2,7000 employees. Last year it had $288 million in revenue and
net income of $11 million.
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Crouse
Hospital is a regional health
care facility that focuses on providing a range of services,
including trauma, neonatal intensive care and high-risk
maternal/obstetrics care, to communities in the Syracuse region.
Crouse operates one of the first and largest one-day surgery centers
in the nation.
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