Healthcare and Science thomsonreuters.com

I find Silver Cross Hospital's story to be very compelling. You might regard it as somewhat of a "Cinderella story": a community hospital on the poorer side of town is now a top performing hospital.

When I first visited Silver Cross, I immediately noted the friendliness and atmosphere of the place. As I dug a little deeper I found outstanding performance in clinical quality, patient safety, and customer service. My background is in performance improvement, particularly using Six Sigma and Lean methodologies.  So, I was somewhat surprised to learn that Silver Cross had accomplished all of these spectacular results without using formalized improvement techniques. What I discovered was an outstanding culture of accountability, alignment, and integration - all focused on producing measureable results that improve the quality of care and experience of patients.

But being a Thomson Reuters 100 Top Hospitals once or twice isn't enough for Silver Cross. The bar is constantly being raised. Silver Cross wanted to continue to improve and utilizes benchmarking and measurement to understand where we stand relative to other top-performing hospitals.  We are now utilizing formalized improvement methodologies that are designed to help us "improve how we improve".

So we have recently started on a journey of formalizing our performance improvement program, though it's really more of an organizational transformation that augments our existing culture. When a patient moves through our care delivery system, they interact with dozens of processes. Not only do these processes of care delivery have to achieve the desired clinical result for our patients, we have to do it in a way that ensures compassion, caring, and communication for our patients and their families.

Sometimes organizations struggle to demonstrate sustainable success. Even if they do, it's a whole different matter achieve sustainability of that success. I mean, basically, we are asking people to do their job differently - sometimes very differently - and that can create resistance unless you provide the vision and the tools to do the job, as well as the leadership to take us where we need to go.

And that's why I believe Silver Cross is going to continue to be successful.
Today at Silver Cross we are going to reduce our costs. I see millions of dollars of waste in our system, things that cost money but do nothing to actually help patients to get better. Our employees and physicians have to sometimes work around bad processes.  Defects, rework, inspection, et cetera, are all unnecessary if we can design processes to prevent problems in the first place.

You can spend a lot of time and money on solutions, and you may be trying to fix the wrong problem. That is where statistics comes in. To have the information, the data, to know how and where to act, is very powerful. That's what we do. We try to understand where we stand, set targets based on top performance. Then use the data to understand the root causes of the problem and design solutions that fix those problems.

We use the indicators associated with the Thomson Reuters 100 Top Hospitals award on a frequent, almost daily basis to see where we stand. We make real decisions based on what we find. And we believe they impact on the quality of care and quality of life of our patients.

Medication reconciliation is a good example. Although we've been performing around the 75th percentile or better nationally, we compare ourselves to hospitals that are performing in the top ten percent and set process improvement activities to close that gap. We looked at the Thomson Reuters data to benchmark where we need to improve our performance.