My discussions of the various aspects of CHRISTUS’ Journey to Excellence in previous posts should make clear CHRISTUS’ belief that if health systems are to reach excellence, they must have clearly defined goals accompanied by metrics which incrementally increase over reasonable time periods based on the previous improvement.
This is critical, because most changes in health care do not occur in a straight line or linear fashion, but rather have very slow improvement in their initial phases, then hit a tip-point and have more rapid improvement over the following several years. This clearly has been our experience in measuring our improvement in our four Directions to Excellence as part of CHRISTUS Health’s Journey to Excellence over the last 9 years. This can be easily seen in the map of our Journey below:
However, a Journey to Excellence often requires a leadership team to deal with present operational issues which are more often dealt with in a “crisis mode” of intervention. In order help us sustain our vision of the potential and rapid changes that can occur post-tip-point, we believe it is important to set clearly-defined stretch goals with metrics to be reached every three years. In CHRISTUS, we call these our “summits” on our Journey to Excellence, and these parallel governance conferences where we bring in our key board representatives from both the U.S. and Mexico, along with the regional and business unit CEOs to not only review our successes, but to lay the expectations for the next summit.
By doing this, we recognize what changes might be needed in the organization to successfully complete the next leg of our Journey. During the conference, we can then present workshops filled with the right learning experiences and new tools to aid leadership to reach these higher expectations.
For June of 2009, our next summit, we have outlined specific goals which we have been talking about for the last three years in particular, and several of them have been our focus for the last 9 years. Two have to do with our metrics for our four Directions to Excellence, advocacy and philanthropy; three are related to our internal and external audiences and three are related to recognitions we hope to achieve.
The first category, those related to our four directions, include reaching all of our Journey to Excellence goals in each direction. Our performance on these metrics must be at or better than the 90th percentile of similar-sized organizations, both in the U.S. and Mexico. For philanthropy, our goal is to achieve fundraising which will be equal to 1.5 to 2 percent of our net revenue. Regarding advocacy, we will continue to measure the number of issues we have brought to the attention of our local, state and national governments, and how much money we have saved in the form of reimbursement in regard to the specific issues we have advocated for.
In addition, we recognize that not only reaching these metrics is critical, but sustaining the gain over long periods of time is really the ultimate goal. Therefore, sustaining excellence is a second goal for our 2009 summit. We discussed previously that there were two periods in CHRISTUS’ history where we did not make the planned progress in all of our directions to the degree that we had hoped. Those periods were our Fiscal Years 2002 and 2007. Although we had good reasons and explanations for this lack of progress, an excellent organization will hardwire their processes in place to mitigate these periods of stabilization or even decline in improvements.
Hence, sustaining excellence and learning the best practices to make this happen, which is evident in many of our facilities at present, is a must for our entire organization by June 2009.
The three goals we have for both our internal and external audiences include educating all of our Associates, physicians, patients, residents and their families so they might understand the best ways to deliver excellent health care and the best ways of incorporating excellent health into their practices of daily living. We also wish to influence both our internal and external audiences to make sure that when they ask themselves, “Where is excellent health care delivered?” they immediately think of CHRISTUS facilities, programs and clinics. A specific example would be embedded in our hopes that we would be invited to the discussion that the new president of the U.S. will have on determining the best ways to redesign U.S. health care. Our third goal under this category is to provide appropriate rewards to both our internal and external constituencies so as to appropriately stimulate a culture of excellence and innovative thinking.
With regard to the award category, we are hoping by 2009 to enhance the locations where we are considered to be the employer of choice, because we know that if our Associates (employees) and physicians are happy and choose to work with us, they will most likely provide outstanding service to everyone who enters our doors. This will, of course, help us attain our metrics in our service quality direction. And because we have done a comparison of our Journey to Excellence goals, the Joint Commission goals, Magnet status and the Baldrige award, and found their goals and requirements to be almost identical, we are hoping to expand the Magnet nursing status to a majority of our acute, inpatient sites and at least apply for the Baldrige award for our entire system on or shortly after we reach the June 2009 summit.