May 26, 2006

Meeting highlights rounding as key to elevate pillars

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Kevin Myatt leads a discussion on the community survey during this week's elevate Leadership Development Institute session.
Photo by Dana Johnson

Meeting highlights rounding as key to elevate pillars

This week, a group of about 850 managers and faculty leaders from Vanderbilt University Medical Center got their first look at results from a recent employee satisfaction survey.

They were gathered for a daylong seminar in the practice gym at Memorial Gymnasium, the sixth in a quarterly series devoted to elevate. Half the group attended on Tuesday, the other half on Wednesday.

To start of the day, they heard about the progress of elevate from Steven Gabbe, M.D., dean of the School of Medicine, whose presentation followed a now familiar elevate format — delving into quality, service, patient and employee satisfaction, financial performance and growth.

“Quality is the central pillar and the central goal,” Gabbe said.

When academic medical centers compare their mortality rates, they first take into account how sick all their patients are, which yields an expected mortality rate for each center based on the collective experience of all organizations. The goal under elevate for fiscal 2006 is to reduce mortality to 85 percent of the expected rate. Gabbe announced that VUMC is exceeding the goal: through March, the cumulative mortality rate has dropped to 76 percent of the expected rate.

“We control quality by controlling processes of care,” Gabbe said as he began reviewing year-to-date results in meeting quality targets associated with treating heart attack and pneumonia, lowering surgical infection rates and preventing medication errors.

Gabbe said that, despite the restructuring of TennCare and a resulting sharp increase in uncompensated care, the Medical Center is on track to exceed its bottom line goal for the fiscal year of $41.1 million.

He concluded his presentation by asking everyone to borrow his presentation slides and present them to their staff and faculty.

“Just as every one of you contributes to these goals, so does every member of your team, and getting them connected to these goals is an important objective.”

Later in the morning, a consultant gave the group pointers about rounding. The exercise is no longer just for doctors and their inpatient teams — VUMC managers and faculty leaders are expected to round with their staff, faculty and department's internal customers; nurses are expected to round with inpatients; and senior leaders are expected round anywhere and everywhere their authority extends.

The format for each of these types of rounding is a little different, but the purpose is the same: to improve communication and learn what might be done to make it easier for people to do their jobs. Managers and faculty leaders had been introduced to rounding in previous seminars.

“Why focus on rounding again?” asked Kathy Matney, a consultant from the Studer Group. Because, she said, it's the single most effective tool for improving customer satisfaction, and because not enough VUMC managers and faculty leaders have made rounding part of their routine.

Attendees also pooled their suggestions about what the organization might do, given these fresh results of the University's employee satisfaction survey, to raise satisfaction further.

The afternoon session brought a preview of an elevate initiative to improve service to internal customers, presented by Jeff Balser, M.D., Ph.D., associate vice chancellor for Research.

Balser defined an internal customer as “someone within the Medical Center who needs information from you, needs you to complete a task, or needs you to fill a role or function that is necessary to complete their work. Satisfying internal customers is an important step in making satisfied customers,” he said.

“We've established a method for assessing patient satisfaction; we've established goals and we're evaluating based on those goals. In the next year we want to begin doing the same thing with our internal customers.”

Balser announced that, later this year, departments will begin experimenting with internal customer satisfaction surveys.

The next elevate management seminar is scheduled for Aug. 24 and 25.