Hill Country Memorial is a non-tax-supported, 86-licensed bed facility, with a state-of-art ICU wing and a new surgical department, all delivering programs and services to the Fredericksburg, TX community. It employs nearly 700 staff.
Hill Country Memorial had won the 2014 Malcolm Baldrige National Quality Award for the highest patient satisfaction scores in the country. However, since the Affordable Care Act, all healthcare organizations have been improving patient satisfaction. While Hill Country’s team had great patient management experience, different skills are required to improve effi ciency. There were also concerns that despite those great patient experience scores, a brand new hospital built on the edge of their service area would overcome attitudinal factors. They were afraid the new facility might be deemed better than their middle-aged facility.
Hill Country Memorial engaged CBA, tapping its expertise and 15 years of ensuring continuity and sustainable work through leadership coaching that delivers improved margins while driving change and overcoming obstacles.
Engaging executives, directors and managers in tactical, process-oriented organizational change to increase margin within their cost centers was necessary, both to improve accountability and position Hill Country to achieve its organizational goals.
Hill Country adopted CBA’s 100 Day Workout structure and have completed three 100 Day Workouts to date. This system makes progress, or its absence, instantly visible, thus demanding a corrective response from leadership when unacceptable variations from workout goals occur. To create a sense of urgency and encourage a commitment to change to run throughout the organization, each workout includes a minimum of two (mandatory) successful process changes for all managers and directors per month. The organization-wide focus on making these changes all move the hospital toward its fi nancial goals.
In all, Hill Country Memorial completed 100-Day Workouts focused on the following high-opportunity areas:
Throughout this process CBA also taught Hill Country Memorial’s staff how to leverage its core programs like Rapid Cycle Testing and the resources of the CBA ToolBOX, so they could act on the information they were receiving to improve operating margin as a whole. This approach creates an experimental mind set, reducing the fear of failure, increasing speed and reducing barriers to change.
Most importantly, this introduced CBA’s EXCELeratorTM - an online accountability tool giving Hill Country Memorial a structure for:
While specifi c fi nancial metrics may not always be directly tied to patient experience, the results can be measured in other ways, including in patient satisfaction scores. Everyone can infl uence patient or customer experience regardless of their department.
A 100 Day Workout structure boosts collaboration – gets directors working with people they might not have ever worked with – as they focus on broader goals of the organization.
The hospital’s leadership involvement throughout the planning and implementation processes helped align the new management team, instill buy-in and create a strong culture of accountability.
With just three performance improvement 100-Day Workouts, Hill Country Memorial was able to realize $2.5M in implemented savings, with $1.8M of that fi gure budgeted by the CFO.
Plans were designed with a constant focus on implementation and accountability through executive and one-on-one coaching and mentoring for sustainable results beyond the initial engagement that also improved leadership skills overall for the entire team.
100-Day Workout 1: Quality Waste Recovery – Directors and Physician Leaders
The fi rst 100-Day Workout produced over 302 slated changes with $1.2M in CFO-validated savings - a considerable impact to their overall operating budget.
| Savings from detailed plans | $1.6M |
| Completed changes | $1.6M |
| Validated & budgeted by CFO | $1.2M |
| Director/manager changes | 284: 9.16 per manager |
| Percentage of Plans Implemented: | 114.52% |
100-Day Workout 2: IQS (In Quality Staffi ng)
By the end of this second 100-Day Workout directors and managers amassed over $1.8M in CFO-validated margin improvement.
| Savings from detailed plans | $1.3M |
| Completed changes | $904K |
| Validated & budgeted by CFO | $630K |
| Director/manager changes | 269: 8.68 per manager |
| Percentage of Plans Implemented: | 108.47% |
100-Day Workout 3: Patient Experience
By their third workout, Hill Country wanted to ensure its patient experience levels were still high performing. Several measurable results noted:
| Plans Implemented for Patient Experience | 337 (36% above target!) |
| Targeted Plans | 248 |
| Average Plans Per Manager |
10.87 (well above average of 8)
|
| Plans Implemented for All Workouts | 901 (21% above target!) |
| Targeted Plans | 744 |
| Average Plans Per Manager | 10.14 (well above average of 8) |
| Implemented changes | $2.5M |
| Validated & budgeted by CFO | $1.8M – 227% of goal! |
Caldwell Butler is an innovative fi rm specializing in strategic deployment of Lean-Six Sigma resulting in cost position improvement, fi nancial turnarounds, and patient throughput optimization. Caldwell Butler has assisted hundreds of clients increase productivity, maximize patient throughput, and improve patient satisfaction. Our team is exclusively dedicated to healthcare and brings extensive practical experience in hospital operations to each project. Our knowledge of the healthcare environment allows us to implement effective performance improvement programs tailored to the specifi c needs of your organization. Caldwell Butler is the trainer of choice for both the American College of Healthcare Executives and the American Society of Quality. During the past decade, Caldwell Butler has personally trained thousands of senior hospital executives in the effective healthcare application of Lean-Six Sigma.
Unlike traditional consulting fi rms, Caldwell Butler believes on-site mentoring and apprenticing are the most effective methods for achieving sustainable gains in performance. Our on-site programs empower your employees by providing them with the tools to attain new levels of performance. We offer proven techniques and methods for enhancing personal accountability, monitoring progress of initiatives and tracking your ROI on each project. Where most consulting fi rms are satisfi ed with fi nding “identifi ed savings,” Caldwell Butler works along side your team throughout implementation thus providing you with a sustainable process for managing the entire productivity improvement cycle.