By TIM OBERMILLER
For his Homecoming “Back to College” class, Bob Page shared some tips on how the University of Kansas (KU) Hospital moved from the bottom to the top in national rankings in patient satisfaction and other measures. “This is not a cookbook; it’s not the only way to do it,” he warns. Still, for any struggling organization, KU’s story offers hope. “When you’re fat and happy, you won’t make changes,” says Page. When troubles are catalysts for change, it can make you much stronger in the long term.
Sometimes it takes a crisis to admit you have a problem. That’s what Bob Page and his colleagues at KU faced in 1998. If things didn’t turn around, and quickly, the hospital would be closed or sold.
At that time, Page was the hospital’s vice president of organizational improvement and the unofficial bearer of the bad news. Meeting doctors and nurses, housekeepers and food-service workers, Page wanted everyone to know how dire the situation was.
“Our platform was on fire. The problem was nobody knew it,” says Page. “So the first step was to admit we have a problem. It’s like the 12-step program.”
Page knew he also had to offer hope. “You can demoralize your workforce if you tell them how bad things are without giving them a bridge to the future. What do we want to be when we grow up?”
Page and the other hospital leaders “set our vision as high as you can possibly go. We set our vision to lead the nation. … And I’ll tell you that when you set that bar, that sets a clear vision. It gives people a sense of where you want to go.”
Page credits business author Jim Collins for the concept “that your organization is a bus. The first thing you have to do is to make sure you have the right people on your bus. And the second thing is to make sure you have people in the right seats on the bus.”
He gives the example of a surgeon “who is a cancer in your organization because he upsets everybody who works with him,” and many of them leave. While a typical hospital might keep the surgeon around because of the revenue he brings in, Page counters that “if that surgeon doesn’t fit your culture, maybe he should leave. And I’m not picking on surgeons. It could be anybody in your organization.”
While some may need to get off the bus, others need to change where they sit. Watching the hospital’s lab director interact so effectively with patients and staff inspired Page to offer her a new job as head of customer-service training. One reason she is so effective is that she can tell trainees, “You can treat people like this because I’ve been here 20 years and I do it every day.”
When KU Hospital made patient satisfaction a priority, Page noticed that measures of satisfaction were coming in just once a quarter. “Now we get patient-satisfaction scores every week,” which are accessible to every staff member.
“A lot of organizations don’t want to measure,” Page adds. “They just want to talk about it. … If it’s that important to your organization, then measure it and be honest and transparent about the results. If it’s bad you need to improve it, and if it’s great you need to celebrate it, but you need to measure it.”
It’s no coincidence, Page says, that in great organizations, “you can change seats at the top and not miss a beat, because it’s about the culture; it’s not about the individuals.”
Teams do need leaders, though. Page points out that while doctors are superb technicians, “if they want to be leaders, you have to teach those skills.” KU supports a leadership academy for doctors and also has a structure in which “we have a hospital leader and a doctor partner together on everything. We don’t have one leading over the other.”
Another innovation was pairing first-year and senior nurses. Because it’s such a tough profession, many new nurses get discouraged and leave. The guidance of more seasoned nurses can help them weather that first year, says Page. Since the program was launched, “our retention rate is 96 percent for first-year nurses.”
Teams can also use some cheerleading. Page and his fellow KU executives regularly take around a candy cart “with some apples for the healthy people,” he jokes. “And then we go out and say thank you. And you do it at midnight when the staff doesn’t expect you to be there. And you do it at 7 a.m. And people remember that.”
Celebrations, Page adds, “are also really important.” The first time that KU moved up slightly in the patient-satisfaction rankings, it threw a party. “Because if you don’t celebrate the small wins, you’re never going to get the momentum to get where you need to be.”