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A winning culture: Four essential qualities of a Baldrige-winner hospital

Wellstar Paulding Hospital, in Hiram, Georgia, recently received the prestigious Baldrige National Quality Award. It’s a tremendous accomplishment. But if you ask John Kueven, the hospital’s president, he’ll insist that the award is incidental to their work.

“Don’t get me wrong, we’re excited to win,” he says. “But the award was never the object, right? It’s just a validation that we’re doing the right thing for our community and living out our mission to enhance the health and well-being of every person we serve.”

This spirit of service is at the core of Paulding’s culture, which Kueven believes is the driving engine behind the organization’s success.

But how does this culture work, exactly? And how can leaders cultivate the same kind of culture at their own organizations?

Here are four cultural qualities that Kueven believes are essential, along with some practical advice for how to achieve them.

  1. Specific benchmarks

Kueven believes that healthcare organizations can’t afford to be confused about what they want to achieve. To communicate their goals and measure their success, leaders must define their ambitions with as much specificity and precision as possible.

“It’s one thing to say, ‘I need you to improve the patient experience.’ It’s another to say, ‘We’re at the 73rd percentile, and we want to get 80. How is that going to happen?’”

Kueven’s vision for Paulding is to achieve top-decile performance in every arena. That means top marks in both patient experience and clinical outcomes across every department in the hospital.

This stark—but measurable—goal helped ground Paulding’s leadership in the metrics, which Kueven believes was absolutely crucial to their success.

“It kept us thinking about outcomes, about measures,” he says. “We could stay focused on the metrics that mattered, and build our strategy around that.”

  1. An engaged workforce

With meaningful benchmarks in mind, the Paulding leadership team rallied the organization’s staff behind the effort to improve. They knew that to succeed, they’d need to achieve full buy-in from everyone in the hospital.

According to Kueven, the best approach for that is to let employees figure out solutions for themselves.

“You have to respect the autonomy of your team,” he says. “We didn’t come down from our offices and tell our people what to do. Instead, we talked to our leaders about our goals. We asked them to problem-solve and engage their team members in solving problems every single day through our Lean Management System. And that’s been incredibly powerful.”

Following that plan instead of a top-down mandate for organizational improvement, Paulding saw an organic emergence of solutions from individual team members. Because they’d come up with ideas themselves, he says, they were that much more enthusiastic about executing them.

Even so, Paulding’s leadership asked staff members to double down on the solutions they devised. They’d ask staff members to hand-write a personal commitment to achieving the desired outcome.

“On the whole, we want people to feel like they’re part of something beyond just their job titles,” Kueven says. “You’re going to be asked to think. You’re going to be asked to lead. That’s different from a job where you just clock in and clock out.”

This unconventional strategy has reaped enormous dividends for the organization: 83% of Paulding’s team members agree—even during a traumatic pandemic—that it’s a great place to work.  In fact, earlier this year, Great Place to Work® and Fortune named Wellstar Health System one of the 100 Best Companies to Work For®.

  1. Radical transparency

Kueven believes that the foremost component of Paulding’s recent success has been the organization’s commitment to honesty. At every level—from strategic planning, to team communication, to clinical reports from the floor—the baseline expectation is full transparency.

“We have to be brutally honest with ourselves,” Kueven says. “We have to look dispassionately at where we are, acknowledge where our gaps are, and create a culture where we’re open about what we need to do to fix them.”

In particular, Kueven wanted to encourage an unimpeded flow of information about safety events, in order to prevent nosocomial morbidities.

“The average hospital reports 86 deaths due to medical error each year,” he says. “We can’t be average. We consistently strive for zero deaths due to medical error. And if we want that to be the case, we have to reward people for bringing up safety issues, instead of being punitive. We have to embrace that transparency.”

He’s also careful to emphasize, however, that this transparency is a two-way street. Just as he expects the unvarnished truth from his clinical teams, he also delivers brutally honest assessments of his own performance.

“Have I screwed up? Plenty,” he says. “But we have to be ready to fail. To fall off and then evolve and figure it out. A good leader isn’t the one who’s always right. They’re the one who’s willing to make mistakes and own up to them, modify or end a bad decision, and then work hard to get better.”

  1. The facts on the ground

Finally, Kueven believes that one more factor was crucial to Paulding’s success: robust and reliable data about the patient experience.

For that, they turned to NRC Health’s Real-time Feedback solution.

Real-time is a patient-survey platform that automatically reaches 100% of patients, within hours of their care encounters. This gives leaders instant insight into their organization’s performance.

“We needed that intelligence to figure out where we stood, and to inform our decisions about where to go,” Kueven says.

In this way, Real-time helped Paulding avoid misspent energy on initiatives that weren’t critical for process improvement. According to Kueven, it also rapidly accelerated the pace of change.

“Real-time has just been a really amazing tool for us to switch to,” he says. “It’s remarkable how much faster we were able to accomplish our goals. We’ve gone from below the 40th percentile in our in-patient ED, to over the 75th [in terms of patient satisfaction]. And our outpatient units are above the 95th percentile.”

The work is far from over

Kueven and his team are not content to rest on their laurels. They know that if improvement is going to last, they can’t ever let up.

All the same, we want to congratulate Wellstar Paulding for their hard-earned achievement. The Baldrige National Quality Award betokens their commitment to a higher quality of care—and one that deserves our accolades and applause.

Kudos to Kueven, and to the rest of the team at Wellstar Paulding!