Room temperature:
• All individual heating systems in each room were cleaned and upgraded.
• Individual room thermostats were added with signage explaining how to adjust the
temperature.
• Individual fans were provided as requested.
• Window darkening coating was placed on the interior of the windows.
• The return (fresh) air flow was increased to the pediatric unit. In addition, the venti-
lation unit was replaced. (10/03)
Staff sensitivity to inconvenience and staff attitude toward visitors:
• Families were provided 20 percent cafeteria discount cards. (9/01)
• Parents choosing to stay with their child were given hygiene supplies. (9/00)
• A VCR was placed in every child’s room with appropriate controls. (11/02)
• “Please Do Not Disturb” signs were placed in the unit. (1/02)
• All units had distributed welcome pamphlets (and signs were updated). (5/03)
• Snack, soda, and juice vending machines were made available in an area conve-
niently adjacent to the pediatric floor.
The changes that were instituted were measured by the results of the Press Ganey
Report results from July 1, 2003, to September 30, 2003 (see Exhibit 16.7). An
increase in scores was shown in all five areas of the needs assessment.
CASE #3: Point of Star—Cost and Quality
Title: “Guidelines for the Use of Interventional Cardiology Medications in the Cardiac
Catheterization Lab—A Multidisciplinary Approach”
Project team leader: Howard C. Cook
Utilizing the principles of value analysis and evidence-based medicine, a program
was developed highlighting guidelines for the use of glycoprotein IIb/IIIa inhibitors
(abciximab [ReoPro], eptifibatide [Integrilin]), and the direct thrombin inhibitor
bivalirudin (Angiomax) in interventional cardiology procedures. The goal of this
project was to assure optimum patient outcomes and maximum financial efficiency.
It was recognized that abciximab was utilized in approximately 60 percent of all
cases involving these agents. This agent was also the most expensive of the three
agents usually employed. A thorough review of the medical literature was

were highly correlated with employee friendliness and courtesy. As part of the analysis,
St. Luke’s examined the questions that were highly correlated with the likelihood of
patients to recommend the hospital to others. Following the assessment, a plan was
devised based on the principle that happy employees correlate to satisfied customers,
which in turn leads to patients that will recommend St. Luke’s to other people.
Following the research and assessment of the future goal, the first step in the
implementation process began by creating a customer service program. This program
was mandated and was designed to illustrate the necessary steps to implement
appropriate customer service behaviors and standards of performance. Key areas
ranged from conflict resolution to service recovery and etiquette. The second step
was creating the employee recognition and reward committee. This committee of
staff members is charged with awarding the PCRAFT (pride, caring, respect,
accountability, flexibility, teamwork) award to twelve hospital employees per year
(see Exhibit 16.2). These employees are required to consistently exhibit the values of
the organization, and documented examples have to be included in their respective
nomination form. The third key step in the strategy process was the implementation
of awards for departments’ patient satisfaction scores. The objective of the
departmental quarterly recognition program was to reward and recognize
employees, managers, and departments for outstanding achievement related to
patient satisfaction. To achieve recognition, a department must receive one of the
following:
• Highest percentile ranking on the survey
• Overall mean score that is highest above the hospital mean score
• Highest percentile ranking consistently (three quarters or more)
• Largest improvement in overall mean score
ST. LUKE’S HOSPITAL AND HEALTH NETWORK
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Following a win of this award, the department managers receive up to $100 to
be used on the department, accompanied by recognition from the COO and at

goal, accountability grids were created following each leadership forum. The
accountability grids (Exhibit 16.8) contained expectations for senior and middle
management leaders with defined timelines as appropriate. The expectations
contained within each accountability grid related to the education provided at
the leadership forum.
Several works, born out of the leadership forum, have contributed sig-
nificantly to the organization’s definition of leadership skills. One of these
works is the leadership core competencies, which was the result of work
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accomplishments by the entire leadership team. Seven key competencies were
identified:
• Motivator
• Team builder
• Goal orientation
• Communicator
• Commitment to service
• Organized, prioritizing
• Resourceful
Each of these competencies has specific behavioral identifiers that further
define each competency. The management performance evaluation was
redesigned by an ad hoc group of managers who participated in the leadership
forum. This group designed a new management evaluation tool that incorpo-
rated the core leadership competencies (Exhibit 16.9).
An additional work that originated out of the leadership steering committee
was the development of a booklet on service excellence standards of perfor-
mance. This booklet clearly defines, in a behavioral way, the standards set for
“concierge service delivery” on the part of all members of the hospital team. All
new employees are required to attend concierge training as part of the orienta-

This vision will be achieved by
• Continuously improving patient, employee, volunteer, and physician
satisfaction
• Benchmarking clinical outcomes and improving the processes that lead
to optimal care
• Managing the resources of the network to minimize costs
• Partnering with physicians and other providers, recognizing our success is
dependent on cooperation and common goals
• Continuously updating our view of “reality” consistent with a rapid change
in the environment, technology, and the practice of medicine
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