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nist-gov/www.nist.gov/blogs/blogrige/leadership-practices-adventist-health-castle
Scott Williams 4063bef310 Initital commit.
2025-03-05 18:59:57 +00:00

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<h1 class="nist-page__title">Leadership Practices of Adventist Health Castle</h1>
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<div class="daterange"><time datetime="2018-05-01T12:00:00Z">May 1, 2018</time>
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<h4>Five-Part Leadership Blog Series</h4>
<p>In this&nbsp;<a href="#series">five-part blog series</a>&nbsp;on the 2017 Baldrige Award recipients’&nbsp;leadership presentations at the&nbsp;<a href="https://www.nist.gov/baldrige/qe">30th Anniversary Quest for Excellence® Conference</a>&nbsp;(April 8–11, 2018), senior leaders of the five new national role models share best practices and stories of how they achieved&nbsp;excellence.</p>
<h3><strong>History of a&nbsp;Community in Need of Care</strong></h3>
<p> </p><figure class=" align-right nist-image" role="group">
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<img alt="Kathy Raethel Quest Speaker photo" height="220" loading="lazy" src="/sites/default/files/styles/220_x_220_limit/public/images/2019/08/16/kathy-raethel-qespeaker.jpg?itok=zkE348Rt" title="Kathy Raethel Quest Speaker photo" typeof="foaf:Image" width="198">
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<figcaption class="nist-image__caption">Kathy Raethel<br><br>
Adventist Health Castle<br><br>
2017 Baldrige Award Recipient
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As a faith-based organization, <a href="https://www.nist.gov/baldrige/adventist-health-castle">Adventist Health Castle</a>&nbsp;embraces its spiritually based mission of “Living God's love by inspiring health, wholeness, and hope” (in Hawaiian language: <em>E ola mau ke Aloha o ke Akua i ke olakino, i ka pono iho, a me ka mana'olana</em>), according to the president and CEO Kathy Raethel.&nbsp;<br>
&nbsp;
<p>In describing&nbsp;her&nbsp;community health system’s history, Raethel said it&nbsp;was established&nbsp;in the wake of two tragedies, becoming&nbsp;the only hospital to serve&nbsp;the community on the windward side of the Hawaiian island of O’ahu.&nbsp;In the late 1950s, a&nbsp;local government agency&nbsp;did not want a hospital built in the area, she explained. But community perceptions that accidental deaths could have been&nbsp;prevented&nbsp;with closer&nbsp;access to an emergency room created&nbsp;momentum for the board of health to approve&nbsp;a plan to construct&nbsp;a local hospital.&nbsp;Castle Medical Center was established in 1963, named after the man who donated land for the hospital.</p>
<p>Employing 1,046 people today, Adventist Health Castle (AHC) offers&nbsp;24-hour emergency care, inpatient acute care, a&nbsp;birth center, a joint care center, inpatient behavioral health services, multi-specialty surgical services, cardiovascular services, neurological services, a center for metabolic and bariatric surgery, outpatient services, a chemotherapy clinic, imaging services, and a&nbsp;wellness center.</p>
<h3>Leadership System and&nbsp;the Baldrige Framework</h3>
<p>Raethel stressed that AHC’s mission, vision (“We will transform the health experience of our community by improving health, enhancing interactions and making care more accessible”), and values (integrity, compassion, respect, and excellence) drive her organization’s leadership system. This&nbsp;system incorporates&nbsp;concepts from the&nbsp;<a href="https://www.nist.gov/baldrige/publications/baldrige-excellence-framework">Baldrige Excellence Framework</a>, she&nbsp;said, noting,</p>
<div class="nist-callout">
<p>“Everything has [become more] effective since we’ve defined Baldrige as the way we work.”</p>
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<p>The AHC&nbsp;Leadership System (depicted above) depends on an integrated strategy and leadership structure. The leadership structure consists of five key teams—the Patient Experience Team, the Playbook Team, the People Team, the Operations Council, and the Improvement Council—all of which&nbsp;report to the President’s Council and, in turn, share information with and from the organization's quality resources, clinical information systems, and information technology function.&nbsp;The seven categories of the Baldrige framework and Health Care Criteria for Performance Excellence are represented in this structure, from the President’s Council representing the&nbsp;Leadership category;&nbsp;the five teams accounting for Customers, Strategy, Workforce, Operations, and Results categories, respectively;&nbsp;to&nbsp;AHC’s information resources aligning&nbsp;with the Measurement, Information, and Knowledge Management&nbsp;category.</p>
<h3><strong>Love Matters</strong></h3>
<p>In order to&nbsp;“transform the culture&nbsp;and deliver&nbsp;results,” AHC defines its core competencies as (1) “Love Matters,” (2)&nbsp;“Tenacity for Excellence/We Chase Zero Harm,” and (3) “Execute Strategy.”&nbsp;As conveyed in Raethel’s presentation, following are key&nbsp;practices through which the&nbsp;organization demonstrates that&nbsp;“love matters”:</p>
<ul><li>We bring our compassionate, healing ministry to the forefront in all that we do.</li>
<li>We provide care with the same Aloha spirit that makes our island home so unique, creating a palpable environment frequently articulated by patients, associates, and community partners.</li>
<li>Always Behaviors support our values and help our associates know exactly what behaviors are expected.</li>
<li>The “In Their Shoes” empathy workshop is required in first 90 days of employment.</li>
</ul><p>Related results presented by Raethel showed that AHC has achieved physician engagement results in the 99th percentile of national hospital survey data maintained by&nbsp;the Centers for Medicare and Medicaid Services (CMS). Therefore, “Our physicians are amongst the most engaged in the nation!” Raethel shared.&nbsp;She also highlighted AHC’s exemplary workforce and patient engagement results. For example, data show that AHC is in the top decile of CMS&nbsp;results&nbsp;for inpatient overall satisfaction as well as inpatient engagement/loyalty.</p>
<ul></ul><h3>Tenacity and Chasing Zero Harm</h3>
<p>In relation to&nbsp;AHC’s&nbsp;second core competency, Raethel provided&nbsp;this statement,&nbsp;“We are tenacious about quality improvement, especially in regard to chasing zero harm to our patients. We have honed our approach to performance improvement over decades into a rigorous, transparent, and well deployed approach. However, the strength of this capacity is in our tenacity to never accept anything less than excellence.”&nbsp;</p>
<p>Making clear that&nbsp;AHC is delivering on its aim&nbsp;of causing zero harm to patients, Raethel&nbsp;highlighted several of the organization’s excellent safety results. For example, for patient falls, data presented from recent years show&nbsp;that AHC has been&nbsp;outperforming a national&nbsp;benchmark and is still improving. In addition, data presented show that AHC’s birth center&nbsp;has met its high target&nbsp;of zero&nbsp;early elective deliveries from 2013 through 2017, thus performing in the top decile of national comparisons collected&nbsp;by The Joint Commission (TJC). And for two common hospital-acquired infections (catheter-associated urinary tract infections and central-line-associated blood stream infections), AHC has outperformed&nbsp;national comparisons by achieving an infection rate of zero and&nbsp;nearly zero, respectively, for&nbsp;at least four of the last five years, according to results presented by Raethel.&nbsp;</p>
<p>Also demonstrating its core competency of tenacity for excellence, AHC has been a&nbsp;TJC Annual Top Performer Award Recipient for four years in a row for its results for treatment of acute myocardial infarction,&nbsp;community-acquired pneumonia, and heart failure, as well as&nbsp;for measures of surgical and perinatal care.</p>
<h3><strong>Strategic Alignment and Accountability</strong></h3>
<p>
</p><div class="align-right nist-image--lightbox nist-image" data-lightbox="https://www.nist.gov/sites/default/files/styles/2800_x_2800_limit/public/images/2019/09/03/ahc_playbook.jpg?itok=oKWffOL6" data-media-id="449491" data-copyright="Stock Photo">
<img loading="lazy" src="/sites/default/files/styles/220_x_220_limit/public/images/2019/09/03/ahc_playbook.jpg?itok=m6Um3Ybc" width="220" height="124" alt="photo depicts beautiful ocean scene on the cover of the 2016-2020 strategic playbook of the organization" typeof="foaf:Image">
<div class="nist-image__credit">
<span class="nist-image__credit-label">Credit:</span>
AHC; used with permission
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As&nbsp;presented by Raethel, AHC’s processes for strategy are&nbsp;aligned and&nbsp;focused on taking action on what matters most. For example, AHC’s Strategic Planning Playbook is aligned with that of its parent organization Adventist Health.
<p>The organization’s strategy cascades to all&nbsp;AHC leaders&nbsp;through measurable goals to which they are held accountable through use of an evaluation management tool. The strategy also cascades to staff members, through practices such as regular&nbsp;leadership rounding and “Top 5 Boards” that&nbsp;are displayed in staff-only&nbsp;areas to highlight&nbsp;the latest goals as daily reminders.</p>
<h3>Transforming Health Care</h3>
<p>With its aim of “transforming the health experience,” AHC has been making progress in meeting the need for&nbsp;population health care. As shared&nbsp;in&nbsp;Raethel’s&nbsp;presentation, AHC has achieved performance in the top decile or higher on 14 out of 17 key indicators (e.g., mammography, cervical and colorectal cancer screenings, and diabetic eye exams), making it the leading health care organization in the state of Hawaii for population health. For these results, AHC has improved from the bottom quartile to the top decile of&nbsp;comparison data&nbsp;over the past five&nbsp;years.</p>
<h3>Financial Strength&nbsp;</h3>
<p>Raethel&nbsp;also highlighted financial&nbsp;practices of AHC that have delivered excellent results. These practices include a focus on proactive, vigilant management of budgets and&nbsp;expenses; a focus on achieving 100 percent productivity; a focus on maximizing quality incentives (e.g., Value-Based Purchasing by CMS, for which AHC is achieving at the level of&nbsp;the top 3 percent&nbsp; of U.S. health care organizations); and a focus on exercising good financial stewardship. She connected such practices with strong&nbsp;financial performance&nbsp;and&nbsp;growth of AHC’s physicians network and future&nbsp;expansion.</p>
<h3>Sharing Lessons</h3>
<p>Raethel concluded her presentation with these lessons from AHC’s journey to excellence:</p>
<ul><li>Create a culture where love matters and permeates all relationships and everything you do.</li>
<li>Because love matters, seek excellence and chase zero harm—any patient harm is unacceptable.</li>
<li>Deploy integrated strategy and performance management to create a “remarkable ability to execute.”</li>
</ul><p>She encouraged other organizations to learn more about by&nbsp;attending AHC’s Sharing Day at its Hawaii site on September 4, 2018.</p>
<p>View more results from&nbsp;<a href="https://www.nist.gov/baldrige/adventist-health-castle">Adventist Health Castle</a>.</p>
<h4>Five-Part Leadership Blog Series: Previous Blogs</h4>
<p><a href="https://www.nist.gov/blogs/blogrige/leadership-practices-city-fort-collins">Leadership Practices of the City of Fort Collins</a>&nbsp;(Nonprofit)<br><a href="https://www.nist.gov/blogs/blogrige/leadership-practices-bristol-tennessee-essential-services">Leadership Practices of Bristol Tennessee Essential Services</a>&nbsp;(Small Business)<br><a href="https://www.nist.gov/blogs/blogrige/leadership-practices-stellar-solutions">Leadership Practices of Stellar Solutions</a>&nbsp;(Small Business)<br><a href="https://www.nist.gov/blogs/blogrige/leadership-practices-southcentral-foundation">Leadership Practices of&nbsp;Southcentral Foundation</a>&nbsp;(Health Care)</p>
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<h2>Baldrige Excellence Framework</h2>
<p>The <a href="https://www.nist.gov/baldrige/publications/baldrige-excellence-framework">Baldrige Excellence Framework</a> has empowered organizations to accomplish their missions, improve results, and become more competitive. It includes the Criteria for Performance Excellence, core values and concepts, and guidelines for evaluating your processes and results.</p>
<h3><a href="https://www.nist.gov/baldrige/publications/baldrige-excellence-framework"><strong>Purchase your copy today!</strong></a></h3>
<p>Available versions: <a href="https://www.nist.gov/baldrige-performance-excellence-program/baldrige-excellence-framework" title="Business / Nonprofit Criteria">Business/Nonprofit</a>, <a href="https://www.nist.gov/baldrige/publications/baldrige-excellence-framework/education">Education</a>, and <a href="https://www.nist.gov/baldrige/publications/baldrige-excellence-framework/health-care">Health Care</a></p>
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<div class="text-with-summary"><p>Christine Schaefer is a longtime staff member of the Baldrige Performance Excellence Program (BPEP). Her work has focused on producing BPEP publications and&nbsp;communications. She also has been highly involved in&nbsp;the Baldrige Award process, Baldrige examiner training, and other offerings of the program.</p><p>She is a Phi Beta Kappa graduate of the University of Virginia, where she was an&nbsp;Echols Scholar and a double major, receiving highest distinction for her&nbsp;thesis in the interdisciplinary Political &amp; Social Thought Program. She also has a master's degree from Georgetown University, where her studies and thesis focused on&nbsp;social and public policy issues.&nbsp;</p><p>When not working, she&nbsp;sits in&nbsp;traffic in one of the most congested regions of the country, receives consolation from her&nbsp;rescued&nbsp;beagles, writes poetry, practices hot&nbsp;yoga, and tries&nbsp;to cultivate&nbsp;a&nbsp;foundation for three&nbsp;kids to direct&nbsp;their own lifelong learning (and to PLEASE STOP YELLING at&nbsp;each other—after all, we'll never end wars if we can't even make peace at home!).</p></div>
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<span class="nist-comment__author"><span lang="" typeof="schema:Person" property="schema:name" datatype="">Sharvari P Joshi</span></span>
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<span class="nist-comment__date">June 27, 2018 6:56 AM</span>
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<div class="text-long"><p>Thanks for sharing the useful information. It is really a great blog.</p>
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