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Michael Williams: The hospital of tomorrowMay 17, 2013
Hospitals all talk about patient-centered medical care, but Dr. Michael Williams says they have never really focused on patients, and that’s a big problem.
“To me, no hospital is really focused on patients – in their mantras and mottos, maybe, but patients have never been the real focus of how we operate hospitals. The focus has always been about the success of the health care organization.” Williams said.
And, he says, that’s what he told the presidents and CEOs of a dozen of the most prestigious hospitals in the country when editors of U.S. News and World Report asked their newly appointed Hospital of Tomorrow advisory council, “What keeps you up, awake at night?”
“We went around the table, and I was the last of the nine or 10 people to answer, but I was the first to even mention patients,” Williams said following the first meeting of the Hospital of Tomorrow advisory council, which includes the presidents of the Cleveland Clinic, Mount Sinai Medical Center, Johns Hopkins Hospital, Duke University Medical Center, Brigham and Women’s Hospital and Williams, among others.
Williams is interim president of the University of North Texas Health Science Center in Fort Worth and former CEO of Hill Country Memorial Hospital, an 88-bed general hospital in Fredericksburg.
“Heath care has never been about patients and their families,” said Williams, a board-certified anesthesiologist. “Too often physicians think their needs and considerations should be first, but we are partners in care. Patients are the customers, and they should be first.”
At Hill Country Memorial, Williams served on the board for five years before quitting the board and his medical practice to become CEO in 2008. There, he said, he “tried to change the focus from the traditional focus on financial operations and appealing to the physician staff to truly making it about the patients and their families.”
The idea was to operate the hospital as a business with patients as the all-important customers. The goal was to move from a provider-centered, cost-based focus to a patient-centered, value-based system, he said.
To help with that transition, Hill Country Memorial provided staff training from well-run businesses with the values the hospital sought already imbedded in their organizations: Southwest Airlines for employee satisfaction – “a value-centered culture where people want to work so we can attract and retain the best talent and give the best care to our patients;” Zappos for emotional engagement with their customers and “amazing customer service;” Toyota for value realignment, and the Ritz Carlton for hotel amenities because, Williams said, “A hospital is a hotel for sick people.”
Little things – landscaping to provide more curb-side appeal when patients and their families drive up; a greeter in a golf cart who offers a ride and a cold bottle of water to each new arrival – began to add up.
“We wanted our customers – patients and their families – to have a good experience from the time they parked their cars to when they walked out the door and got their bills, the whole comprehensive process,” Williams said.
The most important factor in a “good hospital experience” is, first, to eliminate all preventable harm – take an active role in dealing with patients and their families, and take particular care with patients who have had an adverse outcome, no matter who was at fault, Williams said.
He introduced “Chasing Zero,” a program to eliminate preventable harm, including mix-ups, wrong medications, wrong treatments, accidents and bad decisions even if they were made with the best of intentions.
“We brought in patients to help us identify preventable harm,” Williams said. “At first everyone thought I was crazy. Our malpractice lawyers were very apprehensive about the whole idea when I said we should include patients and board members on our quality control committees and be willing to admit, ‘it looks like we screwed up here.’”
However, the idea was extremely appealing to patients and their families. Hill Country Memorial went from three or four lawsuits a year to zero last year.
That’s the kind of experience Williams says he will take to the advisory council, which will present a national forum in Washington, D.C., in November to address critical challenges facing the health care industry, spotlight pioneering strategies and create