Capítulo 6 The Culture of Quality at Arnold Palmer Hospital

Summary

The Arnold Palmer Hospital in Orlando, Florida, prioritizes delivering quality healthcare to women and children. With a focus on continuous improvement and total quality management, the hospital employs process improvement teams, empowers employees, and uses tools like Pareto and flowcharts for benchmarking. They measure patient satisfaction through detailed surveys and a 24-hour bedside call service, ensuring prompt resolution of issues. This dedication to quality has led to top national rankings in patient satisfaction and survival rates for critically ill babies.

Takeaways

• 🏥 Quality in a hospital is defined by the ability to meet customer needs, including the care for patients and their families, as well as effective communication.
• 🌟 Arnold Palmer Hospital in Orlando, Florida, is a top priority for delivering quality healthcare, being one of the largest hospitals for women and children in the U.S.
• 🔍 The hospital focuses on continuous improvement and total quality management, involving employees at all levels and using process improvement teams.
• 📊 Benchmarking is key, with the hospital comparing its performance against national standards and consistently scoring in the top 10% in overall patient satisfaction.
• 📝 Patient feedback is crucial, with in-depth surveys sent out two weeks post-discharge to gauge patient expectations and the quality of care received.
• 🤝 The hospital places significant emphasis on the question of whether patients would recommend the hospital to family and friends, viewing it as a key indicator of quality.
• 📊 Various tools like Pareto charts and flowcharts are used for visual representation of performance against internal goals and external norms.
• 💪 Employee empowerment is a core part of the hospital's culture, allowing staff to take initiative and respond quickly to patient concerns, even providing gifts up to $200 for complaints.
• 📞 A 24-hour bedside call service was implemented, allowing for immediate response to patient issues, aiming to resolve them before the patient leaves.
• 🏆 The hospital's efforts have resulted in high survival rates for critically ill babies and a top national ranking in patient satisfaction.
• 🛡️ Service quality is determined by tangible outcomes, process effectiveness, meeting expectations, and handling of problems, with Arnold Palmer Hospital excelling in all four areas.

Q & A

What is the definition of quality in the context of a hospital as described in the script?

In the script, quality in a hospital is defined as the ability to meet customer needs, encompassing not just the medical treatment received but also the care for the patients and their families, effective communication, and the professionalism of the staff.

What is the significance of the name 'Arnold Palmer Hospital'?

The Arnold Palmer Hospital in Orlando, Florida is named after the golfing legend Arnold Palmer, reflecting its commitment to excellence in healthcare, much like Palmer's excellence in golf.

How does the Arnold Palmer Hospital measure patient satisfaction?

The hospital measures patient satisfaction by mailing an in-depth survey to patients two weeks after discharge, asking for feedback on various aspects of their care and experience.

What is the key question that the Arnold Palmer Hospital focuses on in patient surveys?

The key question the hospital focuses on is whether the patient would recommend Arnold Palmer Hospital to their family and friends, which is considered a strong indicator of patient satisfaction.

How does the hospital involve its staff in the process of continuous improvement?

The hospital involves its staff by forming process improvement teams across different services, empowering employees, and moving authority down to the lowest levels possible, encouraging everyone to take ownership of process improvement.

What is the role of benchmarking in the hospital's quality management?

Benchmarking helps the hospital to select and compare against demonstrated standards of products, services, costs, or practices that represent the best performance, allowing them to identify opportunities for improvement.

What tools does the Arnold Palmer Hospital use to measure its total quality management efforts?

The hospital uses tools such as Pareto charts, flowcharts, and an executive dashboard to provide a visual overview of performance against internal goals and external norms.

How does the hospital respond to patient complaints?

The hospital empowers its employees to address complaints quickly, even allowing them to provide gifts of up to two hundred dollars to patients who have complaints about services like food, courtesy, or cleanliness.

What is the 'At Your Service' initiative implemented by the Arnold Palmer Hospital?

The 'At Your Service' initiative is a 24-hour bedside call service where patients can directly communicate their questions, concerns, or issues to the hospital administrators, aiming to resolve problems immediately.

How does the Arnold Palmer Hospital ensure a culture of employee empowerment?

The hospital ensures a culture of employee empowerment through extensive orientation on quality and customer satisfaction, giving staff the freedom and ability to respond quickly to issues, and involving them in the continuous improvement process.

What are the four components of service quality that the Arnold Palmer Hospital focuses on?

The four components of service quality the hospital focuses on are: 1) Tangibility - the success of the medical treatment; 2) Reliability - the competence and effectiveness of the medical staff; 3) Responsiveness - the hospital's ability to meet service quality promises and handle problems; and 4) Assurance - the communication and professionalism of the staff.

Outlines

00:00

🏥 Quality in Healthcare: Arnold Palmer Hospital's Approach

The first paragraph discusses the concept of quality across different sectors, with a focus on healthcare at Arnold Palmer Hospital in Orlando, Florida. It highlights the hospital's commitment to delivering quality healthcare, emphasizing the importance of patient care, communication, and the involvement of medical staff. The hospital's dedication to total quality management is underscored by its continuous improvement processes, employee empowerment, and benchmarking against national standards. The hospital's use of an in-depth survey to gauge patient satisfaction and its focus on the key question of whether patients would recommend the hospital to family and friends are detailed. The paragraph also mentions the hospital's high scores in patient satisfaction and the various quality initiatives and process changes implemented based on feedback.

05:01

📊 Measuring and Enhancing Quality at Arnold Palmer Hospital

The second paragraph delves into the tools and strategies used by Arnold Palmer Hospital to measure and enhance its quality of service. It describes the hospital's use of the executive dashboard to track key performance measures across service, quality, human resources, and financial quadrants. The paragraph explains the hospital's use of Pareto and flow charts for visual analysis of performance against internal goals and national norms. The importance of grassroots-level staff involvement in quality initiatives and the empowerment of employees to address patient concerns are highlighted. The hospital's 24-hour bedside call service, introduced in response to patient feedback, is detailed as an example of its commitment to immediate resolution of issues. The paragraph concludes by noting the hospital's high survival rates for critically ill babies and its top national ranking in patient satisfaction, attributing these achievements to the hospital's adherence to the four components of service quality: tangibles, process, reliability, and responsiveness.

Keywords

💡Quality

Quality refers to the standard of something as measured against other things of a similar kind, often defined by the ability to meet customer needs. In the context of the video, quality in a hospital setting is not just about the physical environment or the professionalism of staff but also encompasses the care and communication provided to patients and their families, as well as the hospital's commitment to continuous improvement.

💡Arnold Palmer Hospital

Arnold Palmer Hospital is a specific example used in the video to illustrate the concept of quality in healthcare. Named after the golfing legend, it is one of the largest hospitals for women and children in the United States, emphasizing the importance of delivering high-quality healthcare to its patients.

💡Total Quality Management (TQM)

Total Quality Management is a philosophy and approach to business that seeks to improve and stabilize work processes and product quality. The video highlights TQM's application in healthcare, where the hospital embarks on a never-ending process of continuous improvement with the goal of perfection, involving employees through empowerment and benchmarking against other hospitals.

💡Process Improvement

Process improvement involves the continuous enhancement of business processes to increase efficiency and effectiveness. The video script mentions several process improvement teams at Arnold Palmer Hospital, which work on various services to ensure the delivery of quality healthcare.

💡Benchmarking

Benchmarking is the process of comparing one's business processes and performance metrics to industry leaders or best practices from other companies. The hospital uses benchmarking to compare its services and performance against other hospitals, aiming to identify areas for improvement and maintain a high standard of care.

💡Patient Satisfaction

Patient satisfaction is a measure of how content patients are with the services they receive. The video emphasizes the importance of patient satisfaction surveys at Arnold Palmer Hospital, which are used to gather feedback and make improvements based on patient experiences.

💡Empowerment

Empowerment in an organizational context refers to giving employees more authority and responsibility. The video describes how Arnold Palmer Hospital empowers its employees, allowing them to take initiative in improving processes and even provide gifts to patients as a form of service recovery.

💡Executive Dashboard

An executive dashboard is a tool that presents key performance indicators in a clear and accessible manner. The video mentions the use of an executive dashboard at Arnold Palmer Hospital to communicate key measures and goals to the team, ensuring alignment and focus on quality and service.

💡Pareto Chart

A Pareto chart is a graphical tool in decision making that helps to identify the most important factors in a problem. The hospital uses Pareto charts to identify critical issues affecting quality and prioritize them for improvement.

💡Flowchart

A flowchart is a type of diagram that represents a workflow or process, showing the steps as boxes of various kinds, and their order by connecting them with arrows. Arnold Palmer Hospital uses flowcharts to graphically describe processes, aiding in understanding and improving them.

💡Service Recovery

Service recovery is the process of compensating for a service failure to restore customer satisfaction. The video script mentions the hospital's 24-hour bedside call service as an example of service recovery, allowing for immediate response to patient concerns and issues.

💡National Ranking

National ranking refers to the position of an organization or entity within a country when compared to others in the same field. Arnold Palmer Hospital's high survival rates and top 10% ranking in patient satisfaction are examples of national recognition of its commitment to quality healthcare.

Highlights

Quality in a hospital is defined by meeting customer needs, encompassing ambience, professionalism, and care for patients and families.

Arnold Palmer Hospital in Orlando, Florida, focuses on delivering quality healthcare as a top priority.

The hospital's size is not the force behind quality patient care; continuous improvement and quality initiatives are emphasized.

Process improvement teams are divided among various services, with every staff member involved in process improvement.

Total quality management involves a never-ending process of continuous improvement with perfection as the goal.

Employee empowerment is key, with responsibilities and authority distributed throughout the organization.

Benchmarking against the best performance standards is crucial for identifying areas of improvement.

Arnold Palmer Hospital uses in-depth surveys to gather patient feedback on quality of care and services.

National benchmark comparison is utilized to score in the top 10% in overall patient satisfaction.

The key question in patient surveys is whether they would recommend the hospital to family and friends.

Daily focus on patient satisfaction is a top priority for the hospital's leadership.

The executive dashboard is used to track key measures and establish standards across various quadrants.

Tools like Pareto and flow charts provide visual overviews for hospital personnel to assess performance.

New employees receive extensive orientation on quality and customer satisfaction, emphasizing their role in continuous improvement.

Employees are empowered to address issues promptly, including providing gifts to patients with complaints.

The hospital implemented a 24-hour bedside call service to ensure immediate response to patient concerns.

Performance data is shared with the National Association for children's hospitals, generating high rankings.

Arnold Palmer Hospital meets all four determinants of service quality, earning a top national ranking.

Transcripts

what is quality in a hotel it might be

embodied in the ambience of the building

or the professionalism of the staff in a

manufactured vehicle it might mean it is

defect free for a restaurant quality

could be reflected in the level of

service provided or the taste of the

food served but what about hospital

quality its taken care of not just our

baby but us as a family and it's also

communication and letting us know what's

going on in a situation people who care

nurse and staff that really cares for

the patients and families the best

medical staff for my child great masses

quality is defined in your text as the

ability of a product or service to meet

customer needs as you've just heard

quality in the eyes of customers may

mean better performance nicer features

and other improvements in this video

we'll see what quality means at the

Arnold Palmer Hospital in Orlando

Florida here delivering quality health

care is top priority

named after the golfing legend the

Medical Center is one of the five

largest hospitals for women and children

in the United States with over 2,000

employees 431 beds and a service area

covering 18 counties in the Central

Florida area administrators know however

that size isn't the force behind a

quality patient care experience we try

to continually improve our processes and

continually improve our quality

initiatives we have several process

improvement teams that are divvied up

between women's services children's

services infant services and medical

staff services and everyone that works

here is involved with that to some

degree or another and everyone owns the

process improvement

here when organizations focus on total

quality management they embark on a

never-ending process of continuous

improvement where the belief is that

there is always room for improvement and

perfection is the goal they also involve

employees through empowerment adding

responsibilities and moving Authority

down to the lowest levels possible in an

organization benchmarking is another key

ingredient this involves selecting a

demonstrated standard of products

services costs or practices that

represent the very best performance

let's take a look at what approaches are

used at the Arnold Palmer Hospital here

the hospital provides a broad range of

medical and surgical services such as

neonatal intensive care pediatric

intensive care pediatric oncology labor

and delivery and care for high-risk

pregnancies to determine whether each

patient's expectations of quality have

been met the hospital mails an in-depth

survey two weeks after discharged to

everyone asking for feedback the

hospital participates in a national

benchmark comparison against other

hospitals and has consistently scored in

the top 10% in overall patient

satisfaction question I look at first in

the patient surveys is the question

would you recommend Arnold Palmer

Hospital to your family and friends that

is the key question for us and we're

very fortunate to have had very high

scores in that particular area but I

look at patient satisfaction every day I

come to work every single day that is

the most important thing that I focus on

we do have other measurements

initiatives but that is the most

important thing here and we're very very

proud of the high scores that we have

the survey itself is very detailed and

there are a whole host of categories

that I look at involving respect access

the quality of your care the quality of

the medical staff where's your care

coordinated did you receive the

education you needed did you receive the

discharge information you needed so I

you know I look at all of that but the

key question is would you recommend us

to your family and friends and in many

cases if our scores drop we plan quality

initiatives and process changes based on

those survey results often new measures

start at the grassroots level with the

staff closest to an area wanting to

track performance key measures are

delivered to the team via the executive

dashboard the hospital's digital answer

to paper documents the executive

dashboard measurements are really are a

corporate focus the criteria is

established at the executive staff level

we look at four primary quadrants we

look at service we look at quality we

look at human resources and we look at

the financial quadrant and within each

of those quadrants then each of the

hospital sets their own standards and

their own measurements but it really

helps us to focus on the same goals

helps to focus on the same vision I

think that's very important for

everybody to be in the same boat and to

be directed in the same way in order to

achieve the results that we all need to

achieve as your text shows there are

tools used by many organizations to help

measure their total quality management

efforts they include check sheets

scatter diagrams cause and effect

diagrams Pareto charts flow charts

histograms and statistical process

control

the Arnold Palmer Hospital uses Pareto

charts and fluff charts to give hospital

personnel a quick visual overview of

what's happening in house versus

internal goals and external national

norms Pareto charts identified the few

critical items as opposed to many less

important ones flowcharts graphically

describe a process or system this

benchmarking is critical for

understanding where opportunities exist

for improvement

administrators are quick to recognize

that quality isn't just the

responsibility of senior management new

employees are given an extensive

orientation on what quality and customer

satisfaction mean and their role in

continuous improvement this culture of

employee empowerment gives staff the

freedom and ability to quickly respond

when something needs to be addressed in

fact employees are empowered to provide

gifts in value up to two hundred dollars

to patients who find reason to complain

about any hospital service such as food

courtesy responsiveness or cleanliness

one recent response to a need identified

at the grassroots level was the

implementation of the hospital's 24-hour

bedside call service we pride ourselves

in the customer service that we provided

Arnold Palmer Hospital about a year year

and a half ago we instituted an at your

service what we did was we put at each

patient's bedside a little table card

that said if you have any questions

concerns issues with your stay at Arnold

Palmer Hospital we'd like to hear from

you we have a cell phone that is linked

to all of the administrators and we

carry this phone 24 hours a day seven

days a week

we may get calls as easy as can i turn

on my Nickelodeon can you help me with

food but certainly if there are issues

of concern related to the care of that

patient we want to know about it right

away our goal is to make it right before

they ever leave our facility

so they will have long lasting good

impression of Arnold Palmer Hospital

this environment is very unique and

there aren't too many jobs that you can

have that you can have such a positive

impact on someone's life and here we do

that every day and I'm so proud to say

that what happened is here really

matters the effort is paying off Arnold

Palmer Hospital shares performance data

with the National Association for

children's hospitals and related

institutions which generates rankings of

thousands of members the hospital has

one of the highest survival rates of

critically ill babies and is currently

ranked in the top 10% nationwide in

patient satisfaction total quality

management and service organizations

like hospitals includes four components

we discussed in the text one they're

tangible how successful was the medical

treatment received to the process for

the doctors nurses and staff competent

reliable courteous and effective

communicators 3 meet expectations to the

hospital deliver the quality of service

it promises and for handling problems

did the hospital have a plan for dealing

with less than perfect conditions Arnold

Palmer Hospital meets all four of these

determinants of service quality that's

how it has earned its top national

ranking

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