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Hospital Quality: Ingredients for Success—A Case Study of Mission Hospitals

This related report summarizes four case studies of hospital quality, HOSPITAL QUALITY: INGREDIENTS FOR SUCCESS—OVERVIEW AND LESSONS LEARNED

Executive Summary

Mission Hospitals (formerly known as Mission St. Joseph's Health System) is a large health system based in Asheville, North Carolina. While there are other, smaller hospitals in the region, Mission is the primary provider of tertiary care in the Blue Ridge Mountains. Based in a market dominated by small businesses, the hospital's financial position is relatively strong. It receives most of its revenues from government payers, with less than 20 percent of all revenues coming from managed care organizations.

Data from CareSciences, which is supported by information from other sources, indicate that Mission is a high-quality institution. The hospital has qualified a few times for Solucient's lists of Top 100 Hospitals and was recently designated a "Distinguished Hospital" by HealthGrades, a private, Web-based performance reporting organization.

Our research uncovered several organizational factors, as well as tools and processes, which contribute to Mission's strong performance. Organizational and structural drivers of quality include the following:

  • Commitment from the top;
  • Physicians organized into service lines;
  • Physicians integrated into leadership structure;
  • Balanced composition and approach of Performance Improvement Department;
  • Accountability and motivation built into system;
  • A well-credentialed and committed staff; and
  • Financial health

Tools and processes that support quality and quality improvement (QI) include the following:
  • Quality measures packaged for multiple needs;
  • A systematic and well-supported QI process;
  • A commitment to standardizing care and adopting best practices; and
  • Large investment in information systems

At the same time, Mission is making a significant effort to recognize and overcome several challenges to its quality and cost performance, including:
  • Transitioning from being provider-centered to being patient-centered;
  • Standardizing health care practices;
  • Communicating and implementing change;
  • Getting paid for quality; and
  • Moving beyond measuring processes to measuring

Publication Details



Hospital Quality: Ingredients for Success — A Case Study of Mission Hospitals, Jack A. Meyer, Ph.D., Sharon Silow-Carroll, M.B.A., M.S.W., Todd Kutyla, M.L.A., et al., The Commonwealth Fund, July 2004