July 19, 2007 — Declaring "What's 'good enough,' isn't good enough," for the Schneider Regional Medical Center, Rodney Miller told a packed auditorium Thursday morning, while introducing a dramatic new initiative for the facility.
Miller, SRMC president and CEO, said the goal of the facility's broad new program S.O.C.C.A., Satisfying Others by Changing Our Attitudes and Actions, is to transform the operational culture of the facility's healthcare system to one of a patient-focused, outcome-oriented model of safety and efficiency.
Clearly enthused by the large audience, Miller said, "This is an historic day for us. We are going to change the way we do things, and make this the world-class institution we have talked about for five years."
The project will be led by Miller and Dr. Russell Massaro, consultant and president of RPM Health Group International, LLC., who has been working with the project teams since May.
Amos Carty, SRMC COO and general counsel introduced Massaro, whom he said, "was the architect of our Joint Commission on Accreditation of Healthcare Organizations.
Massaro said, "the need for redesign and improvement in hospital care systems is clear, but many”, as Miller said, “think 'good enough' is good enough." He said, "the need for significant process in hospitals of all types is clear, but few have the courage to commit to such an effort."
He chose to help SRMC over many other hospitals because of his experience in working with the facility. “This hospital is a winner and I like working with winners,” Miller said.
Massaro, who has led comprehensive hospital transformation projects nationally and internationally, said, "the Schneider Regional Medical Center is to be congratulated for its foresight and innovative spirit."
Dr. David Shulkin, president and CEO of Beth Israel Medical Center, a premier New York institution with more than 1,300 beds in New York and Brooklyn, was the morning's keynote speaker.
Shulkin is a nationally recognized physician executive, experienced entrepreneur and a health services researcher. He is one of the country's foremost experts in quality of care, patient safety, medical management, information technology and consumer-directed healthcare services.
Before coming to Beth Israel two years ago, Shulkin founded and was Chairman of Doctor Quality, Inc., one of the first credible sources of information that assessed and evaluated quality and safety for consumers, providers and purchasers of healthcare.
Shulkin illustrated what Massaro was talking about when he said most hospitals think their performance is 'good enough.' He showed a pie chart illustrating what hospital employees think of other hospital's care, which reflected a low ratio, compared to their own institution, which they rated in the top percentile, thinking problems didn't exist in their institutions.
He brought out some sobering statistics, citing one 350-bed hospital, which in a period of nine years had 598 instances of patients being given the wrong medications, and
66 cases where patients died due to hospital mistakes." And eight times surgeons had to remove instruments or sponges left in the patient after surgery," he said. "We're not the only industry who makes mistakes," he said, citing some bizarre instances in the communications industry. "But, we must learn from our mistakes."
Shulkin named the key characteristics which lead to a hospital's "healthy" culture:
— Open communication;
— No secrets;
— Sense of ownership; and
— No excuses.
Regarding secrets and communication, Shulkin noted NASA's experience. He said many in the NASA chain of command knew the program had flaws which could lead to the fatal errors that have occurred in the space program, but "they were afraid to speak up."
He said the new initiative will encourage all hospital personnel to speak up if they think they see something that is wrong. He said the "red rule" would be instituted. As he said this, there was an audible gasp from his audience.
The red rule permits a hospital employee to alert a supervisor to perceived incorrect procedures. "Yes," Shulkin said, "this could mean a nurse calling out a doctor. But, we will stand behind the nurse and look into the situation; in time, they will learn not to be afraid of speaking up."
The program is far reaching and Shulkin described many aspects of the new care to be instituted, including timely care, and allowing patients to have say in how they are treated. One new process will be having what's called a "white board" over a patient's bed.
The board will list pertinent information on the patient's medications, allergies, special needs and anything else a health care person needs to know on entering the patient's room. Patients and their families will be allowed to view their charts as well, Shulkin said. This marks a dramatic departure from the usual procedures, Shulkin noted.
June Adams, SRMC board president, said she didn't know what S.O.C.C.A. was at first. "I thought it was a contest I had won," she joked. Getting down to basics, Adams talked about a simple smile. "When I walk down the corridors, I smile. When you smile, I smile. Do it, even if you don't feel like it."
Actually, there was a contest in the hospital to name the new program, Miller said. "It was named by radiation therapist, Alesia Degrosiellier." He awarded Degrosiellier with a certificate for a cruise for two. Degrosiellier said it was really a team effort.
The project is all teamwork. Adeline L. W. Connor, performance improvement office is the project mentor, with Christine deJongh-Lewis as project manager.
First lady Cecile deJongh was on hand to praise the hospital. "I've had three children who were born here, and we have always had the best care," she said. "It is one of the best places I've ever received health care."
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