Malcolm Baldrige National Quality Award
2014 Award Recipient, Health Care
St. David's HealthCare (SDH)—one of the largest hospital systems in Texas—is a unique partnership between St. David's Foundation, Hospital Corporation of America (HCA) and Georgetown Health Foundation. With locations throughout Central Texas, SDH operates six hospitals, six ambulatory surgery centers, four free-standing emergency departments, four urgent care clinics, rehabilitation facilities and numerous physician practices. SDH is the fourth-largest private employer in the Austin, Texas, area, with a workforce consisting of more than 8,000 employees, contractors and volunteers. Net revenue for the system in 2013 was $1.4 billion.
- SDH’s composite performance on core measures reported by the Centers for Medicare and Medicaid Services (CMS) is at or better than the top 10 percent of health care systems nationally for each disease group—a level of excellence SDH has achieved since 2009.
- SDH was the first health system in Texas to be named “Texas Employer of the Year” by the Texas Workforce Commission. It also has been recognized as one of the “top 100 best places to work” by Modern Healthcare magazine.
- Through its “Service Excellence Initiative” and other efforts to address patient and customer needs at all stages of the health care experience, SDH’s patient satisfaction scores, as assessed by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), have improved each year since 2009.
- Since 2008, SDH has provided more than $1 billion in uncompensated care, with the amounts increasing each year. SDH also has provided at least 6 percent of its net revenue to charity care since 2007—150 percent more than is required under St. David’s Foundation’s nonprofit status.
Superior Standards That Save Lives
- SDH's composite performance on core measures reported by the Centers for Medicare and Medicaid Services (CMS) is at or better than the top 10 percent of health care systems nationally for each disease group—a level of excellence SDH has achieved since 2009.
- Representing a performance level among the nation's best, SDH has ranked in the American College of Cardiology's top 10 percent since 2010 for its "door-to-balloon" time in treating the most severe form of heart attack known as STEMI (in which the coronary artery is completely blocked off by a clot). The "door-to-balloon time" refers to the amount of time between a heart attack patient's arrival at the hospital and the point when intervention such as a balloon angioplasty is received.
- In 2013, marketing research firm Professional Research Consultants (PRC) presented SDH with its top honor, the President's Award, "for an organization that pushes the healthcare industry to innovate ways to provide better experiences for employees, physicians and patients." SDH was recognized for achieving superior PRC scores for every year since 2008.
Recognizing People Are the Heart of Success
- SDH was the first health system in Texas to be named "Texas Employer of the Year" by the Texas Workforce Commission. It also has been recognized as one of the "top 100 best places to work" by Modern Healthcare magazine.
- Physician satisfaction teams use results from an annual PRC survey of the medical staff to derive actions to improve SDH based on the physician's perspective. Because of this, "engagement at work" scores on the survey have increased significantly in all nine areas measured since 2010. SDH has outperformed PRC's top 10 percent nationally in six of the nine factors, and it performs in the top 20 percent for the other three.
- SDH innovatively retains nurses through its Specialty Nurse Accelerated Program (SNAP) that trains high-performing nurse graduates to work in specialty areas. Retention for first-year nursing graduates who participated in SNAP was 100 percent in 2013, compared to a 70 percent retention of such first-year graduates nationally.
Customer Focus = Customer Satisfaction and Loyalty
- Through its "Service Excellence Initiative" and other efforts to address patient and customer needs at all stages of the health care experience, SDH's patient satisfaction scores, as assessed by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), have improved each year since 2009.
- Compared to a Gallup survey database used to track patient satisfaction across the nation, SDH's scores were in the top 10 percent for emergency departments and in the top 25 percent for outpatient surgery and treatment.
- Patient loyalty scores for 2014, as measured against the Gallup survey question indicating "likelihood to recommend," put SDH in the top 10 percent nationally for inpatient care and in the top 25 percent nationally for outpatient and emergency care.
Fiscal Health Facilitates Quality Health Care
- SDH has demonstrated exceptional performance in net revenue growth through expanded operations and operational discipline between 2007 and 2013, with an increase of more than 70 percent. Additionally, the return on assets has increased from approximately 17 percent in 2007 to 33 percent in 2013, far exceeding the 4.7 percent average benchmark for Moody's AA-rated organizations.
- SDH's financial strength allows it to reinvest in its facilities each year without incurring any long-term debt. More than $1 billion has been allocated in capital investments for facilities over the past 12 years.
- SDH has increased its inpatient market share every year since 2008, growing from approximately 42 percent in 2008 to 48 percent in 2013.
Lone Star Love for Community
- St. David's Foundation has contributed more than $200 million to community programs since 2007. Each year, grants are provided to over 55 local agencies that provide primary care, mental health programs, community health programs and dental health vans. Since the inception of its dental program, 81,500 children and adults have received preventative and restorative dental care.
- Since 2008, SDH has provided more than $1 billion in uncompensated care, with the amounts increasing each year. SDH also has provided at least 6 percent of its net revenue to charity care since 2007—150 percent more than is required under St. David's Foundation's nonprofit status.
- To address the environmental well-being of the communities it serves, SDH participates in a collaborative effort with vendors, facility management teams and local energy suppliers to reduce the organization's environmental footprint. One of these initiatives, the Single Stream Waste Initiative, focuses on reducing solid waste. From 2008 to 2013, the total number of recycled material containers increased from 26,000 to 32,000; pounds of plastic kept out of landfills increased from 58,000 to 96,000; and the pounds of carbon dioxide emissions prevented increased from 40,000 to 56,000.