An Inside-Out Remodel

In 2004, the senior management team at Cabell Huntington (WV) Hospital decided it was time for some major upgrades at the 268-staffed-bed teaching facility. Some areas of the physical plant had not been significantly updated since the 1950s, and the hospital's culture was also in need of repair after suffering a contract-related work stoppage.

So senior leaders at CHH made it their primary business focus to rebuild their hospital-inside and out. To do so, the team decided everyone in the organization had to be involved.

"Healthcare is not an individual sport; it's a team sport," says Brent A. Marsteller, president and chief executive officer at CHH. "We've all got to be working with the same colored jerseys on, working for the same goal. Teamwork was critical to accomplishing our goals."

From the beginning of the construction process, staff members were encouraged to share ideas that would be incorporated into the design. By guiding construction, staff could help ensure that CHH provided the best service for patients, Marsteller says. "They made the decisions on how to build these facilities; their input drove us to these decisions," Marsteller said. "You have to have a team approach-I can't tell you how to improve processes in X-rays or labs, but I guarantee you the people in there do."

Seeing that their opinions mattered helped employees take ownership of the hospital, allowing senior management to overcome any resistance to change and establish a sense of trust among staff. The management team began meeting regularly with physician leaders, managers and other employees to develop strategic and operational goals.

The No. 1 goal was to establish a strong service culture. Senior management decided the best way to achieve this was implementing a balanced scorecard to track key hospital metrics. A cross-functional team that includes representatives from throughout the hospital steers the maintenance and use of the scorecard.

"We think that's important so that everyone in the organization knows what our vision is and how we are doing against that vision," Marsteller says.

Using the team approach through all levels of the organization, CHH achieved financial profitability and secured donations from local philanthropists for the construction project. The "new" Cabell Huntington Hospital is opening in November and will feature a new emergency room, new critical-care areas, a new labor and delivery unit and upgrades to most patient rooms.

The focus on adapting the hospitalwide culture to make it the region's best place to work, practice medicine and receive care has paid off, as well. The CHH emergency department, for example, received the national "Award for Excellence" from the Gallup organization in 2005. Also, a 2007 survey of admitting physicians placed the hospital in the 96th percentile nationwide for "how well the hospital's leadership fosters an atmosphere of trust."

Despite the success, CHH will not rest on its laurels, Marsteller insists and will continue to adapt its culture to make it the best possible facility for patients and staff. "You never stand still in this business. When you do, you sink."

-Ben Cole