Clinical Improvement Leads to Financial Stability

When the Sisters of Charity of the Incarnate Word healthcare systems in Houston and San Antonio merged to form Irving, TX-based CHRISTUS Health in 1999, the new leadership team faced a host of challenges. The system was plagued by financial losses, discouraging results in clinical quality measures, and low satisfaction rates among its patients and employees. The system introduced a program to generate  marked improvements–not only in their day-to-day operations, but also in patient and employee satisfaction.

One of the leadership team’s first moves was to craft a strategy for improving four key areas within the system: clinical quality, service quality, financial stability and community value.

Deemed the “Journey to Excellence,” the initiative set out to reach incremental, measurable goals of improvement in each of the four areas.

“Excellence is not a luxury, it’s a necessity.”

“The four components of the Journey to Excellence program were clear to us. We have to offer the right product to the right person. We have to deliver that product in an exemplary way. We have to offer affordable care but also create a revenue stream by offering the lowest cost, highest quality healthcare. And finally, we have to bring value to our community. It really is just a matter of common sense if you are truly committed to excellence,” — CEO Tom Royer.

Completing the 60-month plan to achieve excellence, defined by CHRISTUS’ leadership team as being in the 90th percentile in service and clinical quality, has not been without its stumbling blocks, however. Realizing their improvement action plans were either not being fully implemented or were not being “hard-wired” into each of the system’s regional operations, the senior leadership team ramped up its efforts at cultivating a culture in which all employees are held accountable for their actions.

“To maximize brain power and people power, we started teaching and embracing what I call ‘professional backtalking.’ We want our team members to push back and tell us honestly and openly what’s working and what could work better, so we as a team can come to a consensus about what needs to be done to improve,” Royer says, adding that he’s been able to create an environment in which employees at every level feel comfortable “talking back” by having senior leaders in place who are confident in their leadership abilities and are willing to listen to and act on constructive criticism.

The Financial Return

Since the Journey to Excellence initiative was put in place in 1999, the system has seen marked improvement in all four areas of focus. In fact, net operating income at the system–which at the formation of CHRISTUS Health was negative $146.1 million–has increased to $107 million.

After having seen such success with the first round of their Journey to Excellence program, the team decided to implement a second phase. “We expect to be at 90th percentile for all four goals by 2009. If we’ve already reached that goal, we expect to show that we’ve been able to sustain it. We will make sure we sustain those goals and have them hardwired into our system to create more of a culture of excellence.”

Filed Under: Clinical Improvement • Featured Articles • Financial Performance