Neighbors in Health Care Focus on Community, Core Competencies, Lean

“Health care can no longer be this building that you go into when you are sick, and you leave when you are well,” said John Kueven, senior vice president and hospital president of Baldrige Award recipient Wellstar Paulding Hospital (WPH).

Such thinking is the foundation of WPH’s motto “neighbors caring for neighbors” and pervades the organization’s action-oriented values: “We serve with compassion. We pursue excellence. We honor every voice.”

Deep Community Ties

WPH, located in northwest Atlanta, in one of the fastest-growing counties in Georgia, has deep ties to the community, said Kueven during a leadership presentation at the 32^nd Baldrige Quest for Excellence® conference.

He defined WPH’s patients and community service area as neighbors. “Our passion comes from being more than just a neighbor that lends a cup of sugar to our community. We want to be someone that our neighbors can count on in difficult times.”

And the communities surrounding WPH, as well as the hospital itself, have certainly gone through some difficult times.

During the COVID-19 pandemic, both WPH and its communities cared for each other. WPH ensured that patients didn’t lose family connections by deploying tablets to their rooms and helped ease patients’ loneliness by acts of kindness, such as making Valentine’s Day cards. The community gave back, too; the Chamber of Commerce worked 24 hours a day to print personal protective equipment (PPE) for staff members using 3D printers, and community members donated thousands of meals, medical supplies, snacks, masks, gift bags, and other items, underlining the phrase, “To serve those serving them.”

In addition to the high demands of the pandemic, Kueven said WPH, like other U.S. hospitals, has strategic challenges, including capacity constraints, access to care, and workforce recruitment/shortages. The hospital is consistently over 100% occupied, so growth has to be carefully considered.

The pandemic also exacerbated workforce challenges, with top talent often being stolen away, Kueven said. “How do we keep up with that? How do we create a culture that ensures our people want to stay?” he asked.

Stick to the Fundamentals: Build a Culture

Because health care is complex both for patients and staff members, Kueven said the hospital breaks complexity down by focusing on its core competencies: patient safety and team member engagement. He said,

Kueven added that WPH “sticks to the fundamentals of the mission, vision, and values. . . . Our team works every single day with that blueprint for our neighbors to strengthen our culture, very systematically, very intentionally, every single day.”

Kueven said WPH’s goal is to be the safest hospital in the country, and this goal statement is the basis for an open staff member discussion “that sets the expectation. . . . Our mission, vision, and values; core competencies; and Lean Management System help us build our house for engagement.”

Be Integrated: Build a House

WPH “boldly integrates Lean into all of the work that we do,” said Kueven.

During the 32^nd Quest conference, Nichole Rydahl, assistant vice president of operations, echoed this, saying that Lean has become the bricks that WPH uses to build its symbolic house in the neighborhood. Key WPH functions integrated with Lean are strategy, team member engagement, performance reviews, knowledge management, performance improvement and innovation, and process design and management, she said.

Rydahl said WPH’s Lean Management System is built around Plan, Do, Study, and Act. The hospital has added elements of standard work to “prevent us from rolling backwards once we make an improvement that is beneficial to the organization.”

Lean is used to execute the Strategic Planning Process (SPP) to reach strategic objectives, said Rydahl. A key part of the SPP is “how can we best take care of our neighbors daily.” She said WPH uses a strategic A3, a problem-solving tool, to plot its “true north” and determine strategic objectives and how to execute them for the next three–five years. According to Rydahl, multiple people come together across the organization to develop the A3, which is how knowledge is managed. Other strategic A3s and problem-solving A3s are created based on defined strategic tactics and countermeasures.

“Lean and process improvement are a journey, so we’re always documenting our key learnings and next steps based on what we learned as we implemented some of the countermeasures and target initiatives,” said Rydahl.

At WPH, Lean is also taught to front-line staff members to help them be problem solvers and to help the hospital meet its strategy by deploying goals in a systematic away, said Kueven. A personal commitment is made by every team member to help WPH achieve that strategy, he added.

In addition to Lean, in a literal sense of building a house, WPH used a Safety 4 building model to incorporate elements “to be the safest hospital in the world,” including a standby power system with high-intensity ultraviolet irradiation in the air-handling system to reduce transmission of infection and a geothermal heat pump that uses the earth as a thermal battery, resulting in zero building emissions. Its GEO-thermal building is one of only a handful in the country, said Kueven.

Build a Great Place to Work

WPH sets very clear expectations in the leadership system on what it means to be a leader, Kueven said.

“We know if we execute correctly in our leadership system, our neighborhood will continue to strengthen,” said Kueven. “That community connection . . . couldn’t have been more important than it was in the last year,” he said. As a way of giving back to the community, all leaders serve on volunteer boards and/or in volunteer programs.

Nurses’ connections with patients are emphasized at WPH, too. WPH has a decentralized nursing model—small stations throughout a unit to ensure staff members are as close as possible to patients.

“Even through the pandemic, as challenging as it was and as many incentives as there were for nurses to take travelling positions, we still maintained a low nursing turnover,” he added.

According to Kueven, volunteers have a key role, too, and the hospital is proud that on the Great Place to Work® survey, volunteers have consistently rated the statements, “I feel proud that I have made a difference,” and “I’m proud of what we do as a team” at 100%.

But for WPH and its community, excellence is measured not just by statements, measures, or awards, but by the validation of its community, its neighbors. He said,

As a 2020 Baldrige Award winner, WPH sure seems to be on the right track.
 

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