Managing for Quality and Performance Excellence 10th Edition by James Evans ,William Lindsay

Exercise 7

Advocate Good Samaritan Hospital (GSAM), a part of Advocate Health Care located in Downer's Grove, Illinois (a suburb of Chicago), is an acute-care medical facility that, since its opening in 1976, has grown from a mid-size community hospital to a nationally recognized leader in health care. However, it was not always nationally recognized. In 2004, Good Samaritan was true to its name-a "good," but not "great," hospital. Quality was generally perceived as good, but nursing care was seen as uneven; associate satisfaction was pretty good but not exceptional, physician satisfaction was mixed, and patient satisfaction was at best mediocre; technology and facilities were increasingly falling behind other hospitals; and it was struggling financially in a highly competitive market. Its leadership was determined to achieve, sustain, and redefine health care excellence, so it embarked on an organizational transformation to take the organization "from Good to Great (G2G)" The rationale for doing this was:
• To make good on its mission to be "a place of healing,"
• To create a framework for inspiring and integrating its efforts to build loyal relationships and provide great care, and
• To differentiate itself and ensure future success by becoming the best place for physicians to practice, associates to work, and patients to receive care.
The first steps that Good Samaritan took included
1. Establishing an inspiring vision: To provide an exceptional patient experience marked by superior health outcomes, service, and value.
2. Enrolling leaders in the vision.
3. Creating alignment, ownership, and transparency to support the vision. Quoting Ghandi, the president recognized that "you must be the change you want to see in the world." He recognized that transforming an organization cannot be delegated. Leadership needed to create a sense of urgency, explain the "why," and overcommunicate by a factor of 10.
By 2006, the G2G journey had achieved some breakthrough results in patient satisfaction and clinical measures, and had spawned leading-edge innovations in health care. However, key questions remained: How would they ensure long-term sustainability? How would they create a legacy for the future? How could they hardwire best practices? How could they achieve repeatable excellence? Their response was to become a process-driven organization by embracing the Baldrige Criteria. The next major step was to establish a systematic leadership process, Good Samaritan Leadership System (GSLS), which is illustrated in Figure 13.2. The boxes represent the process steps, and the arrows represent the leadership behaviors needed to ensure that the steps are accomplished.
The GSLS ensures that all leaders at every level of the organization understand what is expected of them. Patients and stakeholders are at the center of the Leadership System. Driven by their Mission, Values, and Philosophy, all leaders must understand stakeholder requirements. At the organizational level, these requirements are determined in the Strategic Planning Process and used to set direction and establish and cascade goals. Action plans to achieve the goals are created, aligned, and communicated to engage the workforce. Goals and in-process measures are systematically reviewed and course corrections are made as necessary to ensure performance to plan. This focus on performance creates a rhythm of accountability and leads to subsequent associate development through the Capability Determination/Workforce Learning and Development System and reward and recognition of high performance. Development and recognition ensures that associates feel acknowledged and motivated. Stretch goals established in the SPP and a discomfort with the status quo prompts associates to learn, improve, and innovate through the Performance Improvement System. As leaders review annual performance, scan the environment, and recast organizational challenges, communication mechanisms are used to inspire and raise the bar.
FIGURE 13.2 Good Samaritan Leadership System

GSAM has a systematic eight-step governance process that cascades guidance from the Advocate Health Care Governing Board and Senior Leadership to the GSAM Governing Council/Senior Leadership Team and to all associates. Guidelines and procedures at all organizational levels ensure that the overall intent of governance is achieved and tracked through measures and goals. The process ensures transparency and equity for all stakeholders via Governing Council committee oversight, independent audits and through the diverse composition of the board. Annual review of metrics, the mission, vision and philosophy, and Standards of Behaviors ensures accountability and compliance.
GSAM also uses multiple stakeholder and community listening posts as inputs into the strategic planning process to address the societal well being of the community. GSAM considers environmental impact on the community. GSAM's Green Team implements multiple strategies to conserve energy and recycle materials to ensure protection of the environment. In keeping with their mission, GSAM also views societal well-being and community health as providing care for those without the ability to pay. In addition, GSAM actively participates in Access DuPage, an innovative community health approach through which GSAM primary care physicians and specialists provide care to the uninsured population, and GSAM provides all diagnostic tests and treatment without charge. Community fairs, screenings, immunizations, a hospital food pantry for associates, and financial/in-kind gifts also support environmental, social, and economic systems. GSAM contributes to improving their communities by all executive team members having multiple involvements on local boards; as well as the professional nursing staff, medical staff, and other members of the workforce actively participating in numerous service and professional organizations.
Market share has risen; patient satisfaction has exceeded the 90th percentile nationally for multiple segments, and physician and associate satisfaction reached the 97th percentile. The Delta Group ranked GSAM #1 in Illinois and #4 in the US for overall hospital care in 2010, one of 2011 's top 50 cardiovascular care hospitals by Thomson Reuters, and at the 100th percentile for patient safety by Thomson Reuters in 2010.
How does GSAM reflect the concept of strategic leadership?