Issue link: https://tmcpulse.uberflip.com/i/699873
t m c » p u l s e | j u ly 2 0 1 6 11 Q | When you took the helm in 2002, did you ever imagine that you would build Memorial Hermann into one of the largest health care systems in Texas? A | No, I did not set out for that kind of distinction. The vision was to really turn a relatively struggling system in the right direction with a singular focus. The focus was to be the best health system in the United States from a quality, safety and service standpoint. My belief, and what I sold this organization on, is that if we could get quality and patient safety right and tie that to outstanding customer service, then the patients and physicians will seek us out and the business side will take care of itself. That was the general philos- ophy in 2002. We were relatively small. We were, at best, average on quality and patient satisfaction, and we didn't have a strong balance sheet. It was a chal- lenge. What we focused on was stabilizing the System, creating a new culture where people felt they could be successful and setting a new vision that Memorial Hermann would be a preeminent health system. We knew this would take a while, but that's what we set out to do. Q | You've always been known to be creative, but you're also known for executing a vision. When I think about the number of programs Memorial Hermann has implemented over the years, specifically in regards to issues of quality, is timing a factor of success? A | That's a good question. Yes, it's all about timing. In the late 1990s, a report came out called, 'To Err is Human.' It really came down hard on the hospital industry about causing preventable harm, particularly death, to patients. The bulk of the industry just dis- carded it by saying, 'Oh, it's not true. Our patients are sicker and that's a factor in our mortality rates.' They rationalized it away. I read that study and re-read it, and it was disturbing to me. Here are people—our neighbors, our family—who likely know very little about health care services and put their trust in us. Yet, according to this article, the health system was failing them. It didn't sit well with me. As an industry, we were not providing a reliable, high-quality product to our patients. I became a believer of the study and article and said, 'No, we as an industry can do better. We must do better. Why not establish Memorial Hermann as a model?' The prob- lem was, in 1999, when I joined the organization, and even in 2002, our System was not ready for the change. It's a significant change. But we did it. As we started to roll out the execution plan there was some expected resistance. With any change process, you need to find a few people who share your vision and beliefs and use them to assist in the change management process. We identified physicians and employees who had the same passion for safe, reliable care and we invested in their education; we brought them into our internal teams, developed them through leadership programs, and then had them take that back to the rest of the clinical and administrative staff. Over time, the culture changed and the single focus on high reliability care set solid roots in our System. It wasn't until we were able to show some progress that things really turned around. We had great success in the early-to-mid-2000s, and we thought we were pretty good at quality and patient safety. We were winning national awards. Then we had two safety events, and I remember sitting back and saying, 'Man, we're not as good as we thought we were. How did this occur?' When you peeled that onion back, it was basically because we hadn't changed the fundamental culture of care in our System. It's natural for employees and physicians to revert back to old habits of taking care of patients, partic- ularly when they have a very heavy workload. We decided there must be a better way. That is when we decided to get out of the parochialism of the health care industry, which only looks inside itself for solutions to problems, and said, 'Other industries have figured out a way to have zero harm. What can we learn from them?' Q | So it was ultimately the realization that you can't have variability if you want excellence. A | Yes. The commercial airline industry was one of the industries we wanted to study. I grew up in that era—'60s and '70s. Planes were going down all the time. I remember three major crashes when I grew up in Cincinnati. It was tough. We also studied the military. How can they take nuclear-powered aircraft carriers and submarines and never have a problem? They're producing bombs in the bottom of the aircraft carrier, and they've got young soldiers assembling them, and they never have a problem. What do they do? What about nuclear subs? What about nuclear energy? We studied all of those industries and then brought some of our findings home. Today, we have Red Rules that clinical teams follow before every single procedure; rules that can never be violated. To address the cultural change that needed to happen to ensure high reliability and a high-quality care environment, I went to the Board and asked for an additional $28 million in the budget. I wanted to remove people from the floor for one week of culture training in this new world of high reliability, and I needed some dollars to get the clinical teams trained. Once we went down that road, it's just been a pretty linear 'up.' We're not perfect today, but I'm proud to say that we are well on our way to becoming a high-reliability organization. According to The Joint Commission, we are considered among the best in the country in terms of preventing patient harm. We go months and quarters, and in some locations years, without a single event in our hospitals. It's a cultural change and people take it seriously. When we do have an event, we ask, 'What can we learn from it?' We look into what was the real cause of the problem. We take it seriously and make sure that it doesn't happen again. Every event that may have caused serious harm is also reviewed in the Boardroom. We don't hide anything; we practice full transparency. WOLTER MAN WOR K ED 895 Weeks or 6,265 Days D A N W O LT E R M A N P resident and CEO M e m o r i a l H e r m a n n Source: Memorial Hermann 20 02–2016 MEMOR IAL HER MANN Number of Hospitals 10 14 Ambulatory Centers 1 80+ Patient Beds 2,672 3,803 ED Visits 337,010 564,052 Admissions 126,112 154,033 Outpatient Surgeries 49,930 131,782 Deliveries 18,885 24,850 Employees 10,861 24,108 MHMG Employed Physicians 0 200 Health Center for Schools 6 10 Dental Vans 2 3 Neighborhood Health Centers 0 3 Convenient Care Centers 0 9 Then & Now That's always been my motto: Surround yourself with the best talent possible, give them your expectations and a vision, and get out of their way.