Case Study 3: The Culture of Quality at Arnold Palmer Hospital

Founded in 1989, Arnold Palmer Hospital is one of the largest hospitals for women and children in the U.S., with 431 beds in two facilities totaling 676,000 square feet. Located in downtown Orlando, Florida, and named after its famed golf benefactor, the hospital, with more than 2,000 employees serves an 18- county area in central Florida and is the only Level 1 trauma center for children in that region. Arnold Palmer Hospital provides a broad range of medical services including neonatal and pediatric intensive care, pediatric oncology and cardiology, care for high-risk pregnancies, and maternal intensive care.

The Issue of Assessing Quality Health Care.

Quality health care is a goal all hospitals profess, but Arnold Palmer Hospital has actually developed comprehensive and scientific means of asking customers to judge the quality of care they receive. Participating in a national benchmark comparison against other hospitals, Arnold Palmer Hospital consistently scores in the top 10% in overall patient satisfaction. Executive Director Kathy Swanson states, "Hospitals in this area will be distinguished largely on the basis of their customer satisfaction. We must have accurate information about how our patients and their families judge the quality of our care, so I follow the questionnaire results daily. The in-depth survey helps me and others on my team to gain quick knowledge from patient feedback." Arnold Palmer Hospital employees are empowered to provide gifts in value up to $200 to patients who find reason to complain about any hospital service such as food, courtesy, responsiveness, or cleanliness.

Swanson doesn't focus just on the customer surveys, which are mailed to patients one week after discharge, but also on a variety of internal measures. These measures usually start at the grassroots level, where the staff sees a problem and develops ways to track performance. The hospital's longstanding philosophy supports the concept that each patient is important and respected as a person. That patient has the right to comprehensive, compassionate family-centered health care provided by a knowledgeable physician-directed team.

Some of the measures Swanson carefully monitors for continuous improvement are morbidity, infection rates, readmission rates, costs per case, and length of stays. The tools she uses daily include Pareto charts, flow- and process charts, in addition to benchmarking against hospitals both nationally and in the southeast region.

The result of all of these efforts has been a quality culture as manifested in Arnold Palmer's high ranking in patient satisfaction and one of the highest survival rates of critically ill babies.

Questions:

Would becoming ISO certified benefit more Arnold Hospital than implementing Six Sigma initiatives? Give at least 3 reasons properly explained.

Should management at Arnold Hospital control all processes tightly? Why? Give minimum 2 reasons properly explained?

What in your opinion should be monitored continuously and why?

How could Arnold Hospital thrive towards Excellence? Explain. (give 5 different means).

Develop a fish-bone diagram illustrating the quality variables for the ICU (Intensive Care Unit) at Arnold Hospital. Include causes and sub-causes.

At Arnold Hospital, daily tools adopted are Pareto charts, flowcharts and process chart. Give an example of how can they adopt a Pareto chart and illustrate it (draw it). Give as well an example of how they can adopt a flowchart and illustrate it. Explain assumptions as needed.

Suggest another tool to be adopted by Arnold Hospital and explain its importance. Give an example of how it could be used and illustrate it.