Hospital pioneers ISO certification
2000 standard very customer-focused
Leelanau Hospital, a critical access facility in Northport, MI, has become the first general medical and surgical hospital in North America to be certified to ISO 9001:2000 standards (the International Organization for Standardization). The facility, an affiliate of Munson Healthcare, includes 15 acute-care beds, 72 long-term care beds, two rural health clinics, and an intergenerational center for child care.
What led the administration to seek out "pioneer" status in ISO certification? "For the last five years or so, we have been very focused on using Baldrige management criteria for performance excellence," says Jane Bull, RN, BSN, MBA, the facility’s CEO. (The Baldrige National Quality Program is in Gaithersburg, MD.) "The piece we thought we knew most about but really understood least was process management. When I heard a presentation on ISO 9000, I realized immediately it would get us the process piece of Baldrige that we were missing," she says.
The new 2000 standard is very customer-focused, which appeals to Bull. "You’ve got to identify customers’ needs up front," she says. "You can’t write process without it." The other aspect she likes is the creation of a stable process to reduce variation. "It gives you a much better feel for what the outcome will be," she asserts. Preparing for certification "was certainly busy, but because we had been so Baldrige-focused, our whole culture was already about improvement," Bull recalls.
"When I started to talk to staff about things like work instructions, they said, Now I know I will have orders, and I will know exactly what to do.’ Before, they weren’t provided enough detail to help them do their jobs." The hardest part of the process has been paper control, Bull says. "Health care just has so many policies and procedures and pieces of paper. It’s still a challenge."
The audit piece of the process is particularly valuable, she says, "because you don’t have to guess if people are doing what they’re supposed to. We also talked a lot about the value of ISO, to make sure our middle managers really understood the process. We trained 10 of them to become internal auditors."
Through ISO 9000, Leelanau has been able to streamline a number of processes, such as its dining procedures. "We have made a number of changes, from eliminating the tray line in the kitchen to bringing the food up and serving it more restaurant-style, all the way to noting who is in the dining room with the residents," Bull says. "We have dropped steps out of processes, and yet we are certainly seeing improved outcomes."
She also has found that ISO lends itself to cross-training. "If I could have just one title for everyone here, caregiver, that’s what I’d do," Bull says. "When you start to say that my job stops here and yours starts there, you lose some productivity. We always ask, Who’s the most equipped to do this task?’"
As a result of the ISO 9000 process, there is no longer a housekeeping department at Leelanau. "We have trained all our housekeepers to have a joint role as caregiver, with specific duties attached to those roles," she says. "As a result, we have reduced our hospital staff by three [full-time equivalents], out of a total of 130."
Most important, the process has helped the hospital fulfill its mission: to delight its customers and improve the health of the community. "Before assigning a task, we ask, What will make the customer delighted, and who is best equipped to do that?’" Bull concludes.
Need more information?
For more information, contact: Jane Bull, RN, BSN, MBA, CEO, Leelanau Hospital, 215 S. High St., Northport, MI 49670. Telephone: (231) 386-0026.
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