Nurse monitors
heart rate of patient at Robert Wood Johnson University Hospital
in Hamilton, N.J.
Photo courtesy of Robert Wood Johnson University
Hospital.
Click
on image to download high-res version of this photo.
|
Robert
Wood Johnson University Hospital Hamilton
| Highest-Ranking
Official: |
Christy
Stephenson |
| |
Chief Executive
Officer |
| |
|
| Public
Affairs Contact: |
Diane Grillo |
| |
Assistant Vice
President, Health Promotion |
| |
(609) 631-6875 |
| |
dgrillo@rwjuhh.edu |
Type of Work:
A private, not-for-profit acute care community hospital, Robert Wood Johnson
University Hospital Hamilton (RWJ Hamilton) provides health care services
to more than 350,000 residents in its service area through its network
of caregivers. Primary services include medical, surgical, obstetric,
cardiology, orthopedic, and intensive care for both adults and critically
ill infants and children. Outpatient services provided at the hospital
include diagnostic and therapeutic care, ambulatory surgery, medical and
radiation oncology, and emergency services, including emergent angioplasty.
Community services include health education, health screenings, and disease
prevention programs.
Web site: http://www.rwjhamilton.org/
Revenue:
$160 million (Annual)
Workforce: 1,734 employees, plus an additional medical staff
of more than 650
Location: RWJ Hamilton is based in Hamilton, N.J. In
September 2004, RWJ Hamilton opened a Center for Health and Wellness,
located four miles from the hospital. The Center for Health and Wellness
focuses on community wellness, education, and physical therapy.
Highlights
- With more than
70 percent of inpatient admissions initiated through RWJ Hamilton’s
emergency department, it is the community’s “front door”
to the hospital. In 1998, RWJ Hamilton implemented the “15/30”
program, which guarantees that patients coming into
the emergency department will see a nurse within 15 minutes
and a physician within 30 minutes. This program, combined
with improvement in physician satisfaction, has improved patient
satisfaction with the emergency department from 85
percent in 2001 to 90 percent in 2004, exceeding the national
benchmark. In addition, emergency department volume has grown 100
percent from 1999 to 2003. With steadily rising volume over the last
four years, RWJ Hamilton’s emergency department is a market
leader in the area.
- Over the past
five years, RWJ Hamilton has been New Jersey’s fastest growing
hospital and has steadily improved its market share
while its closest competitor’s share has remained the same or
declined. For example, RWJ Hamilton’s market share in cardiology
has grown from approximately 20 percent in 1999 to nearly 30 percent
in 2003; in surgery, its market share has increased from approximately
17 percent in 1999 to 30 percent in 2003; and market share in oncology
has increased from approximately 13 percent in 1999 to above 30 percent
in 2003.
- RWJ Hamilton’s
Patient-Focused Model includes fully deployed goals
and expected outcomes based on input from a multidisciplinary care
team. Care plans are evaluated daily and patients are included
in the assessment and planning process through inclusion
of their language preferences, cultural needs, lifestyle, quality
of life issues, and organ donation wishes.
- All employees
are expected to provide customers with “Excellence through
Service” and agree to uphold RWJ Hamilton’s 5-Star
Service Standards in eight areas including commitment to
customers; commitment to co-workers; courtesy and etiquette; communication;
privacy; and safety awareness. Employees are recruited, selected,
and evaluated using these standards.
- RWJ Hamilton’s
senior leaders and staff are committed to improving community
health through a number of activities, including financial
contributions, charity care, education programs, health fairs, and
screening services. On average, free health screening
is provided to more than 900 community residents per month. Donations
to community organizations have increased to approximately $140,000
in 2003, up from approximately $80,000 in 1999. Charity Care
Dollars have increased from approximately $5 million in 1999
to approximately $23 million in 2003. Community contributions by RWJ
Hamilton staff members included serving meals at a local soup kitchen
once a month, serving on 88 community boards, and raising nearly $100,000
for several local programs in 2003.
Quality
and Improvement Results
- Inpatient satisfaction
with nursing and with nursing courtesy has improved from 70 percent
in 1999 to more than 90 percent in 2004 and meets or exceeds the Press
Ganey Top 10 percent level. (Press Ganey Associates provides nationally
normed health care satisfaction measurements.) The results are further
reinforced by the Gallup Community survey results, ranking RWJ Hamilton
as having the “Best Nurses” among local competitors in 2000
and 2002.
- Medications such
as aspirin and beta blockers, which help to reduce the heart’s
workload and lower blood pressure, commonly are used by hospitals to
treat patients who have suffered a heart attack or congestive heart
failure. From 2002 to 2004, patients receiving this treatment at RWJ
Hamilton have performed better than those at the top 10 percent of hospitals
evaluated by the Joint Commission on Accreditation of Healthcare Organizations.
- Results for patient
mortality rates at RWJ Hamilton show a steadily downward trend from
1999 to 2003, meeting the Agency for Healthcare Research and Quality
(AHRQ) Best Level in 2003. For example, mortality rates for patients
with congestive heart failure decreased from nearly 8 percent in 1999
to 2.5 percent in 2003. According to the QuadraMed Clinical Performance
System, the expected rate in 2003 was 6.2 percent. (QuadraMed is a national
organization providing comparative statistics for clinical operations.)
- RWJ Hamilton’s
results for hospital-acquired infections, such as ventilator-associated
pneumonia and urinary tract infections, all demonstrate favorable downward
trends since 2000. For example, ventilator-associated pneumonia rates
have decreased from approximately 10 per 1,000 device days in 2000 to
two per 1,000 device days in 2004. This exceeds the top 10 percent of
organizations as reported by the National Nosocomial Infection Surveillance,
a comparative database for hospital-acquired infections.
- Between 2001
and the first quarter of 2004, RWJ Hamilton’s many safeguards
to prevent patients from receiving the wrong medication were successful
in about 93 percent of cases, far exceeding the national median of approximately
64 percent.
- As a result of
RWJ Hamilton’s continuous investment in its technology, equipment,
and facilities, occupancy rates have increased from 70 percent in 1999
to 85 percent in 2003 while the best competitor’s rates ranged
from approximately 57 percent in 1999 to nearly 60 percent in 2003.
- In the 2002 Gallup
Community Survey of customer loyalty, RWJ Hamilton ranked first among
all local competitors in all nine “positive” attributes,
including most improved; most personal care to patients; advanced, state-of-the-art
technology and equipment; best doctors; and best nurses. Seventy-three
percent of customers said they were likely to use RWJ Hamilton again.
- Over the past
four to five years, employee satisfaction has risen in a number of key
areas. Satisfaction with benefits rose from nearly 30 percent in 1999
to slightly above 90 percent in 2003; satisfaction with leadership increased
from nearly 90 percent in 1999 to almost 100 percent in 2003; satisfaction
with participation in decisions grew from slightly above 40 percent
in 1999 to 90 percent in 2003; and satisfaction with employee recognition
has improved from 70 percent in 1999 to 97 percent in 2003.
- Retention rates
for registered nurses as well as other employees show positive trends:
registered nurse retention has improved from 94 percent in 2001 to 99
percent in 2003 and retention of other employees has gone from 80 percent
in 2001 to 98 percent in 2003.
- Training hours
for full-time employees has increased from approximately 38 hours in
2002 to approximately 58 hours in 2003.
Processes
- To determine
patient and customer preferences, RWJ Hamilton analyzes industry, customer
satisfaction, and physician referral trends; examines market research,
demographics, and information on competitors; and evaluates community
surveys. Information is captured in a database called Voice of the Customer.
- Relying
on its Excellence Through Service Leadership System; its Five Pillars
of Excellence– Service, Finance, Quality, People, and Growth;
and its strategic planning process and associated measurement systems
has helped RWJ Hamilton successfully develop and deploy objectives and
detailed action plans throughout the organization.
- To improve key
processes, meet patient and other customer needs, and achieve its overall
vision, RWJ Hamilton uses its Organizational Performance Measurement
System to track daily performance and operations. Key Performance Indicators
are reviewed weekly by senior leaders, monthly by manager, and quarterly
by all employees.
- RWJ Hamilton
shares best practices and other organizational knowledge through a variety
of methods, including the Learning Center Web site and a program called
“Walk in My Shoes,” in which employees spend time working
in and learning the processes of an area or department other than their
own.
Leadership/Social
Responsibility
- RWJ Hamilton
has a “zero tolerance” policy for unethical behavior. The
principles of ethics are built into the 5-Star Service Standards to
ensure integrity in every encounter. All employees are encouraged and
empowered to report any potential breach of ethical standards anonymously
through the Compliance Hotline or to the Corporate Compliance Officer.
Clinical ethical concerns are addressed by a multidisciplinary group
of physicians, employees, and administration.
- Ongoing communication
by senior leaders about organizational performance helps to reinforce
accountability, identify opportunities for improvement, and underscore
a focus on results. Each Executive Management Team member, including
the CEO, attends daily briefings in designated department areas to share
current information with the staff and to answer questions.
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Baldrige
Homepage
Created:
11/23/04
Updated:
December 21, 2004
Contact: inquiries@nist.gov
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