News from the 2012 National Client Conference – Hartford Hospital’s Journey Toward Excellence

The 12” retractor a surgeon left inside a patient in 2007 was hardly representative of the quality of care provided at Hartford Hospital, an 867-bed, urban Level I trauma center. But the incident was emblematic of how the flagship of Connecticut’s Hartford HealthCare was introduced in 2008 to its new president and CEO, Jeffrey A. Flaks, as “a place of bad news.”

With razor thin margins, static market share and poor staff morale, Flaks and Jamie Roche, MD, vice president of patient safety & quality, rolled out H3W (How Hartford Hospital Works), a comprehensive strategy that over four years would lift the then 155-year old hospital out of probationary status and raise patient satisfaction from 15% to 54%. They built an operational structure centered on balanced scorecards and mandatory monthly work groups for all employees. Designed to improve quality, communications and performance, the facilitator-led work groups are rigorously structured to foster employee involvement and serve as a place for ideas to percolate and develop as change processes unfold.

“Before, every unit, including each of our 22 nursing units, had their own processes, so creating change was impossible,” explained Flaks. “Now everyone follows the same process.”

Organization-wide issues are brought to the work groups with plenty of lead time to support a culture of ownership and transparency, and garner input and buy-in. And the work groups are required to spend the allocated quarter of a million dollars to celebrate and recognize their achievements.

“The structure is built around idea generation, and every idea must have a resolution, even if it’s a decision not to address it,” said Flaks.