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| Cover Story | |
| Written by Jill Rose | |
| Thursday, 01 October 2009 | |
 Seeing the aftermath of Hurricane Katrina as a rare opportunity, Ochsner Health did more than serve its community in a time of need—it expanded and improved.  But when you talk with Warner Thomas about how the hospital is run, the reasons for the fast response and strategic expansion quickly become clear. Careful planning, detailed reporting, and fast-thinking, empowered staff are par for the course at Ochsner, where Thomas is president and COO. “Everyone worked as a team and knew what they needed to do, versus me or someone else telling them what to do,” said Thomas. “People stepped up, knowing they could take risks, knowing they might make some mistakes but we could live with that and keep moving on. Because of that, we fared well.” Even with a fantastic staff and a strong plan, the period following Katrina was difficult, to say the least. Thomas noted that about 65% of Ochsner’s workforce turned over during that time. Still, there was tremendous opportunity for those strong and daring enough to take advantage. While one team concentrated on running existing operations, another began reaching out to physicians inside and outside the hospital network to offer assistance and provide an opportunity to come back to the area, Thomas explained. He and his team have worked hard to preserve the focus that served the organization so well during the post-storm period. “When you’re in a disaster situation, you’re very focused on what you have to do. When you go back into the day to day, you have a lot of things going on, and it’s more of a challenge.” He knew that concentration would be needed as the organization transitioned from one hospital and 20 clinics to seven hospitals with 41 clinics. Thomas’s team turned to GE Healthcare for help with improving management systems and organizational processes. “They helped us create more focus around our operating cycle, operating reviews, and three-year planning. We now have a much more regimented process in how we run our business, stay on top of our metrics, and allocate our capital.” Please don’t leave The numbers Thomas and his team track so closely are moving in the right direction, he’s happy to report. “We’ve seen significant financial improvement, our turnover rate dropped from 20% to 13% this year, and our Joint Commission core measures improved in all areas.” Another achievement for the health system is a vast improvement in ED wait times. Thomas explained that at the time of purchase, one of the hospitals had a left-without-being-seen rate of 25%. It’s currently under 1%. He credits ED medical director Joe Guarisco with re-engineering the system’s EDs to reduce wait times and increase patient satisfaction, noting that Guarisco originally trained as an engineer before becoming a physician. On a recent day, wait times listed on Ochsner’s Web site ranged from zero to 16 minutes, and Thomas points out that time is door-to-doctor, not a triage nurse. Re-engineering to take waste out of processes is not limited to the ED. In fact, Ochsner has an executive whose only job is to run lean initiatives across the organization. Overall, the organization has 10 lean leaders and well over 100 that have been to lean training. Thomas said the pace of that training is increasing in preparation for anticipated lower reimbursement rates; about another 100 people will receive lean training in the next year. One initiative involving both process and technology aims to reduce the amount of phone calls to hospitals and clinics. Two Ochsner hospitals are testing a sophisticated online appointment booking system. Patients can request a physician by name and book an appointment online (short appointment for consults, long appointment for physicals or multiple medical issues). They can also request to see, for example, a cardiologist. The system will show them the first available appointment along with the location and the physician. Another system is in the works to allow people to request prescription refills. Creating depth One of the newest initiatives at Ochsner is taking its leadership development to the next level. “It’s about continuing to evolve your management team and its capabilities and skills to create depth,” said Thomas.  “The vision I have for this is we start taking our problems and use our leaders to solve them in learning labs,” he continued. “When we’ve got a problem, we should take our top eight people and throw the problem at them. They know the company and situation; we want them to talk to people involved with the problem and come back with a solution. It’s a way to highlight people’s talent while solving our problems.”The new initiative builds on the organization’s already vigorous performance review process in which each division leader sits with the executive team to discuss all the people who report to him/her. “You’re presenting your team, which is a reflection on your leadership. It’s as much about you as it is about them,” said Thomas. The presentation is done annually for all managers, directors, and above, with a mid-year check in. It is also one for the top 70 physicians out of the 750 physicians employed by Ochsner. Thomas said the program, now in its seventh year, has dramatically improved the organization’s performance. “People who are under-performers just leave,” he said. “We don’t have to let folks go; they just realize it’s not a good fit and that they should do something else. People who are great performers excel in this type of meritocracy.” The process is time consuming, but Thomas said he can’t think of anything more important to spend time on. It takes him 40 to 50 hours to prepare reviews for his direct reports, another 15 or so to deliver them, and he sits in the team review meetings for a week each year. “It’s a lot of time, but what else should I be focused on? If I don’t have the right people, I’m going to be going around doing their jobs,” he said, adding that he thinks a lot of healthcare organizations miss the mark when it comes to evaluating their employees. Answer the phone Every Tuesday morning, a conference call is run by Ochsner’s CFO and attended by about 60 people. The purpose is for everyone to understand how the company did the week prior and what the key focuses are for the current week. More in-depth metrics are covered in the monthly operating review process, in which each division meets with the eight-person executive committee to look at quality scores (fall, pressure ulcers, mortalities), patient satisfaction numbers, HR statistics (turnover, vacancies, etc.), volume, and a financial projection for the remainder of the quarter. Raising patient satisfaction scores is the biggest focus for Ochsner at the moment. The goal for this year is 80th percentile, and Thomas and his team want to get to the 90th percentile in the next three years. They also aim to be recognized as a Fortune 100 top place to work. There are initiatives in place designed to move the organization toward that goal, one of which is improved orientation. “I don’t think we’re training our people well enough when we bring them in. Right up front, we need to do a better job,” said Thomas. Overall, the job Ochsner is doing is certainly impressive. At a time when most hospitals are happy to grow 4% or 5%, it will increase its revenue of $1.4 billion more than 10% this year. “In the healthcare industry, that’s pretty healthy,” said Thomas. |
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