How does GSAM reflect the concept of strategic leadership?

QUALITY in PRACTICE ' Leadership at Advocate Good Samaritan Hospital\" Advocate Good Samaritan Hospital (GSAM), a part of Advocate Health Care located in Downer's Grove, Illinois (a suburb of Chicago), is an acute-care medi- cal facility that, since its opening in 1976, has grown from a mid-size community hospital to a nationally recognized leader in health care. However, it was not always nationally recognized. In 2004, Good Samaritan was true to its namea "good," but not "great," hospital. Quality was generally perceived as good, but nursing care was seen as uneven; associate satisfaction was pretty good but not exceptional, phy sician satisfaction was mixed, and patient satisfaction was at best mediocre; technology and facilities were increasingly falling behind other hospitals; and it was struggling financially in a highly competitive market. Its leadership was determined to achieve, sustain, and redefine health care excellence, so it embarked on an organizational transformation to take the organiza- tion "from Good to Great (GZG)." The rationale for doing this was: - To make good on its mission to be \"a place of healing," . To create a framework for inspiring and integrat- ing its efforts to build loyal relationships and pro- vide great care, and 0 To differentiate itself and ensure future success by becoming the best place for physicians to practice, associates to work, and patients to re- ceive care. The first steps that Good Samaritan took included: 1. Establishing an inspiring vision: To provide an ex- ceptional patient experience marked by superior health outcomes, service, and value. . Enrolling leaders in the vision. 3. Creating alignment, ownership, and transparency to support the vision. Quoting Gandhi, the presi- dent recognized that "you must be the change you want to see in the world." He recognized that transforming an organization cannot be del- egated. Leadership needed to create a sense of urgency, explain the "why," and overcommuni cate by a factor of 10. M By 2006, the G2G journey had achieved some breakthrough results in patient satisfaction and clini- cal measures, and had spawned leading-edge innova- tions in health care. However, key questions remained: How would they ensure long-term sustainability? How would they create a legacy for the future? How could they hardwire best practices? How could they achieve repeatable excellence? Their response was to become a process-driven organization by embracing the Baldrige Criteria. The next major step was to estab- lish a systematic leadership process, Good Samaritan Leadership System (GSLS), which is illustrated in Figure 13.2. The boxes represent the process steps, and the arrows represent the leadership behaviors needed to ensure that the steps are accomplished. The GSLS ensures that all leaders at every level of the organization understand what is expected of them. Patients and stakeholders are at the center of the Leadership System. Driven by their Mission, Values, and Philosophy, all leaders must understand stakeholder requirements. At the organizational level, these requirements are determined in the Strategic Planning Process and used to set direction and establish and cascade goals. Action plans to achieve the goals are created, aligned, and com municated to engage the workforce. Goals and in-process measures are systematically reviewed and course corrections are made as necessary to ensure performance to plan. This focus on perfor- mance creates a rhythm of accountability and leads to subsequent associate development through the Capability Determination/Workforce Learning and Development System and reward and recognition of high performance. Development and recognition ensures that associates feel acknowledged and mo tivated. Stretch goals established in the SPP and a discomfort with the status quo prompts associates to learn, improve, and innovate through the Per- formance Improvement System. As leaders review annual performance, scan the environment, and recast organizational challenges, communication mechanisms are used to inspire and raise the bar. GSAM has a systematic eight-step governance process that cascades guidance from the Advocate Health Care Governing Board and Senior Leadership to the GSAM Governing Council/Senior Leadership Team and to all associates. Guidelines and procedures at all organizational levels ensure that the overall in- tent of governance is achieved and tracked through measures and goals. The process ensures transpar- ency and equity for all stakeholders via Governing Council committee oversight, independent audits and through the diverse composition of the board. Annual review of metrics, the mission, vision and philosophy, and Standards of Behaviors ensures accountability and compliance. GSAM also uses multiple stakeholder and com- munity listening posts as inputs into the strategic planning process to address the societal well-being of the community. GSAM considers environmen- tal impact on the community. GSAM's Green Team implements multiple strategies to conserve energy and recycle materials to ensure protection of the environment. In keeping with their mission, FIGURE 13.2 Good Samaritan Leadership System Set Direction Establish Goals Understand Stakeholder Requirements Inspire & Role Model & "Raise the Bar Mission Build Commitment Values Philosophy Physicians Community Learn, Improve Volunteers & Innovate Associates Patient Suppliers Organize, Partners Plan & Align Families Integrity Passion Communicate, Motivate & Engage & Empower Acknowledge Caring Develop, Reward Accountability Perform to & Recognize for Results Plan Advocate Good Samaritan Hospital GSAM also views societal well-being and com- Market share has risen; patient satisfaction has munity health as providing care for those without exceeded the 90th percentile nationally for multiple the ability to pay. In addition, GSAM actively par- segments, and physician and associate satisfaction ticipates in Access DuPage, an innovative commu- reached the 97th percentile. The Delta Group ranked nity health approach through which GSAM primary GSAM #1 in Illinois and #4 in the United States for care physicians and specialists provide care to the overall hospital care in 2010, one of 2011's top 50 car- uninsured population, and GSAM provides all diag- diovascular care hospitals by Thomson Reuters, and at nostic tests and treatment without charge. Com- the 100th percentile for patient safety by Thomson munity fairs, screenings, immunizations, a hospital Reuters in 2010. food pantry for associates, and financial/in-kind gifts also support environmental, social, and eco- Key Issues for Discussion nomic systems. GSAM contributes to improving 1. How does GSAM reflect the concept of strategic their communities by all executive team members leadership? having multiple involvements on local boards; as 2. What leadership behaviors, practices, and theories well as the professional nursing staff, medical staff, are evident in this example? and other members of the workforce actively par- 3. How does the GSAM Leadership System model ticipating in numerous service and professional align with the categories in the Baldrige Criteria organizations. framework