Shared Values

Shared Values: The Root of Our #1 Ranking

In the midst of the national discussion on the affordability and quality of healthcare, Willamette Valley Medical Center received notice that it had been ranked number one in value in the Portland Metro Area (see “About the Award”).

Although recognition for quality is always welcome, long-time nursing supervisor Cindy Hall, who has worked at the hospital since 1987, said the values Willamette Valley Medical Center embraces to provide such high quality care have been in place much longer than the two-year-old ranking system.

For this article, we talked to people who work in a variety of capacities in the hospital – from the cafeteria staff to the medical staff – to discover the values they share – those internal values that have brought Willamette Valley Medical Center external recognition in the region and nationally.

Value: Teamwork

“One of the advantages of our hospital is that we really work as a team,” said Miller. “We communicate well,” she added. “Team members know each other as professionals and also go to church together or their kids go to school together, or we see each other in the grocery store. It makes it easy to work together as a team when people respect each other’s roles.”

Hall echoed Miller’s comments. “We have excellent relationships with our physicians. I think it’s because the doctors are outstanding and respect nurses and the nurses respect them. I have never been in a hospital where there are such good relationships.” Hall said those good relationships extend to the staff who provide other key services, like housekeeping, dietary and engineering. “If I have a call button that doesn’t work, the engineers are here to help.”

Rubio agrees. “I really love working here. I like the nurses and my boss. I work in the cafeteria now, but I used to prepare the food for the patients. We all work as a team. If patients want something that’s not on the menu, the dietician talks with them.” Rubio explained that if the patients’ diet allows it, “We try to get them what they want.”

Teamwork Initiatives

Recognizing its importance, the hospital has initiated programs to foster teamwork:

• Teams of nurses meet regularly to make suggestions to improve patient care.
• Upgraded and integrated software gives physicians access to patients’ charts to avoid having to duplicate tests or procedures and helps speed diagnosis.
• Quality improvement teams of doctors, nurses, and therapists work on each nursing unit to find ways to improve patient quality of care and service.
• A team member watches telemetry monitors 24/7 for quick response if a patient needs attention.
• To expand the care team, the hospital employs hospitalists–physicians who are specialists in internal medicine and devote themselves exclusively to caring for patients admitted to the hospital.
• Any time a nurse needs extra help with a challenging patient, the nurse has a team of people to call who come to the location of the patient and lend assistance. One example of how teamwork is advantageous to patients is the “code team” in the hospital who responds to any emergency, such as cardiac arrest. In addition to doctors and nurses, a pharmacist is included on the code team so questions about medications can be answered immediately, including those to alleviate pain.
• Having housekeepers assigned to a specific are also encourages teamwork because they are more likely to get to know staff in their area of responsibility. It also provides consistency and continuity of cleanliness.

Value: Listening

“For us, patient care has always been number one,” said Hall. According to Hall, an effective way to provide great care is to listen. “We listen to our patients. For example, when building our new building, the patients said they preferred private rooms, so we made all the rooms private. Patients said they preferred full baths to sponge baths, so staff is now specially trained in making the bath a relaxing experience. It sounds like a small thing, but it’s the small things that count.”

In the cafeteria, Gabriela Rubio serves customers who sometimes share their concerns with her. “Listening is really important, even if it's not about my area,” said Rubio who brings the concerns to her supervisor. “We try to fix the problem,” she said. Rubio, who has worked at the hospital since 2001, added, “Every time I am here, I do my best for customers. I always try to figure out the best way that I can help them to be happy.”

“The people that walk into the hospital have some level of anxiety,” explained Dan Ordyna, chief operating officer. “We have an obligation to care for them in a personal way, like we or our family members would want to be cared for…that drives everything we do.”

Dr. Margaret Miller, a pediatrician who has been a practicing physician at the hospital for 15 years and now serves as the hospital’s chief of staff, agrees, and said listening to patients about the kind of services to offer is also important. She explained, “As someone who has elderly parents in our community, I can tell you it really eases the burden, particularly of older people, to keep quality services available locally.”

Listening Initiatives

In addition to paying attention to patient concerns expressed informally, there are several programs the hospital has initiated to solicit and respond to patient feedback:

• All nurses are equipped with cell phones so patients, families and doctors can contact them at anytime.
• Nurses are assigned patients not just based on numbers, but on the amount of care those patients need.
• In addition to their assigned nurse, there is an additional nurse whose responsibility it is to talk with each patient daily to find out if there is something else the staff can do to make them more comfortable during their hospitalization.
• Housekeeping leaves a card with contact information in each room so if there is a concern, the patient can contact them quickly and directly.
• The hospital participates in third party surveys about patient satisfaction and the results are available to the public.

Value: Caring about Quality Care

“Quality care is a priority of the physicians,” according to Miller. “That certainly is what all physicians put first and something we put forward as a value.”

Hall agrees. “Patient care has always been number one here.” She said their ongoing training for nurses is to make sure “we can give the patients the best care.” She explained that nurses receive training for new equipment and techniques. “Everyone is here for the patients, and the administration supports us.”

Pain management for patients is a high priority and a key contributing factor to patient comfort. In addition to the pain management training nurses are mandated to pass to receive their license, Hall said the hospital’s nurses participate in annual competency training that addresses new pain medications or new ways to deliver pain medication to assist patient comfort.

“Every meeting that we have is focused on how we can best provide excellent patient care,” added Ordyna. “It’s all about the patient experience-the centerpiece of our culture is this incredible dedication to our patients.”

Care also means having specialty care close to home, added Miller. “We are able to provide a wide variety of quality services. Physicians here work together to make that happen.”

“The centerpiece to our culture is this incredible dedication to patients,” said Ordyna. “That’s the by-product of everything we do.”

Quality Care Initiatives

“Quality care, close to home” is the motto of the hospital, and steps have been taken to maintain this high standard:

• A nurse educator oversees competency trainings for all nurses to ensure they are aware of the latest techniques, equipment, policies and pain management options.
• The hospital's medication reconciliation project safeguards patients from medication incompatibility, errors, duplications or omissions.
• The hospital employs hospitalists: Physicians who are specialists in internal medicine and devote themselves exclusively to caring for patients admitted to the hospital.
• Each floor has a nursing supervisor and manager. Hospitalists and ER physicians are in-house 24/7.
• After rooms have been cleaned, housekeeping supervisors asses each one for thorough cleanliness.
• Specialists are actively recruited so patients can avoid having to travel far distances for care.
• Services like the Cancer Center and Wound Care Center were opened to provide specialty care locally.
• Hospital clinics strive to provide access to quality healthcare regardless of a person’s income level.
• The hospital provides advanced diagnostics with a high speed CT, open MRI and digital mammography.
• A $40 million expansion was completed last year to improve facilities and equipment, including decreasing wait times in the emergency department.

About the Award

By analyzing data from approximately 4,500 hospitals nationwide, the Hospital Value Index™ ranked hospitals by measuring their success in quality, affordability and efficiency, and patient satisfaction. Willamette Valley Medical Center earned four different 2009-2010 awards: Best in Market™, Best in State™, Best in Region™ and Best Kept Secret™. The hospital was ranked number one in value in the Portland Metro Area and among the top 15 percent of hospitals nationwide. Data Advantage LLC, an independent healthcare data company, conducted the study, and survey results are available at www .data-advantage.com .

“At a time when the nation is focused on discussing how to provide both high quality and affordable healthcare, it’s great to earn recognition for doing just that,” said Rosemari Davis, chief executive officer of Willamette Valley Medical Center.