Someone once said that the ultimate criterion of organizational worth is whether or not the organization thrives. Today’s healthcare environment is one of the most competitive, scrutinized, and regulated. You can only imagine the intense pressures—both internal and external—that hospital administrators face unless you have walked in their shoes. We believe that Pensacola, Florida-based Baptist Health Care, Inc. is an excellent example of an organization that made a decision about 10 years ago to become the “best of the best” and “walk the talk!”*

Baptist Hospital, Inc. (BHI), one of the four Baptist Health Care hospitals, is an example of a dramatic turnaround. In the early 1990s, BHI’s morale and finances were in bad shape, and in 1995, the hospital scored in the 18th percentile for patient satisfaction.* In 1996, Stubblefield and Studer began to redefine the culture of the organization. Studer believed that some of the lessons he learned as a special-education teacher could be applied to healthcare. “Maximizing an organization’s ability is similar to maximizing a child’s potential.” His first step was to diagnose the situation and then set achievable goals. “The higher the goals, the closer the student—or organization—comes to reaching full potential.”*

Have a Goal: Studer believed that Baptist needed to have a measurable service goal and a means of comparison. Hiring a large patient-satisfaction-measurement company that compares Baptist to 500 other hospitals across the country was a start. Every patient gets a survey. The feedback allows the hospital to take corrective action, restate goals, and recognize those employees who have received positive comments on the survey.
Incorporate Training: Training played an important role in the turnaround. All nursing managers, supervisors, and department heads go off-site for two days every 90 days for managerial training and development.
Seek Employee Input: Employee forums were held every 90 days. Employees got an opportunity to make their suggestions and concerns known. Employees were encouraged to identify changes in the workplace that would make it better. Studer and the top management team acted on those suggestions. If a suggestion could not be implemented, the employee understood why.
Report Cards (Metrics): Accountability was the key. All leaders got report cards every 90 days. A typical employee had four measurements: customer service (Baptist’s goal was to be in the top 1 percent of all hospitals in the country); efficiency (how long patients are in their units per diagnosis); expense management (how well managers are controlling costs); and turnover. Everyone got a turnover goal based on his or her unit and its past history.
Break a few rules: Stepping outside the box was encouraged. Studer used the following example: “One of our nurses, Cyd Cadena, called a lady who was hospitalized to see how she was doing at home. She was in a wheelchair, and she was depressed because she didn’t have a wheelchair ramp. Her family was so busy working on home healthcare and a whole bunch of other things that they didn’t get a chance to put in a ramp. Cyd called Don Swartz, Baptist’s plant manager, and he built a ramp. He didn’t ask, ‘Can I do it?’ He just did it; it was the right thing to do! We tell the story about Don Swartz all over the whole organization. We tell our people it is OK to break a few rules. Take a few risks. Don is a star. You have to celebrate your legends.”*
Legendary college basketball coach John Wooden summed it up when he said, “You cannot live a perfect day without doing something for someone who will never be able to repay you.”* Every organization has the potential to create many Don Swartzs, but will they do it?

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Within a few years, Baptist ranked number two in the country for all hospitals in patient satisfaction. Employee satisfaction had improved 30 percent, and physician satisfaction had risen from 72.4 to 81.3 percent. Job turnover for nurses declined from 30 to 18 percent.* A short-term miracle, a one-time blip on the radar screen, or building the foundation built in the late 1990s allows BHI to sustain those accomplishments over the long haul. In his book, Hardwiring Excellence, Quint Studer explains that once systems and processes are in place to sustain service and operational excellence, an organization is no longer dependent on a particular leader to ensure continued success. Results are hardwired!* In 2000, Studer moved on to form the Studer Group, which coaches hospitals on service and organizational excellence. And yet Baptist’s success lives on.

The Moral of the Story: A commitment to excellence requires creating a culture that demonstrates a commitment to employees, setting high but achievable goals, holding people accountable, appraising performance on a regular basis, and taking corrective actions. Our suggestion: “Try it—you will like it!”

Sources: A special thanks to Christina Roman of the Studer Group for her assistance in developing this Contemporary Issue. Material contained in this Contemporary Issue box pertaining to Quint Studer (

Consider each of the following statements.

a. “It’s OK to break the rules.”

b. “If in doubt, check with your boss.”

c. “Rules exist to make things work consistently, but when rules get in the way of meeting customer needs, it is appropriate to question the rule.”

d. “You should always be willing to take a risk!”

e. “Celebrate your success!”

Do you agree with the statements? Why or why not? Recall an instance where you followed each of these statements. Did the situation turn out ok? If not, why not?

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