How a struggling rural hospital learned from a tragedy and became a thriving operation

The death of a 13-year-old in 2009 in Fredericksburg, Texas (Best Places map)—after an inattentive emergency room doctor failed to properly treat the boy—helped lead to changes, saving the rural hospital from closing and transformed it from a struggling entity into one of the top 100 hospitals in the country, Sarah Varney reports for PBS NewsHour.

Dr. Michael Williams, then Hill Country Memorial Hospital’s chief executive officer, told Varney, "We had a clear opportunity to either do what most hospitals do and what we had done previously, which was get our attorneys involved, be prepared for a lawsuit. Or we could take a different approach and work directly, reach out to the family and ask them to partner with us in really transforming the hospital... The hospital was in the red on an annual basis. The patient satisfaction was very low. The employee satisfaction was very low. And across the board, what we heard from people, was that this used to be the community’s hospital, and now people are leaving the community to go get their care elsewhere.”

Williams said he studied the Toyota plant in San Antonio and hired former Toyota employee Jeff Darnaby to help bring the car company’s revered assembly line principles to the hospital, Varney writes. Darnaby told Varney, “The Toyota production system basically allows you to identify waste, and remove that waste from your processes. Anything that doesn’t add value to the customer, to the process, is considered waste.” Williams also "turned to a former executive with Southwest Airlines to remake the hospital’s values and culture, and he hired a former trainer from Ritz Carlton, known for its legendary customer service, to change how patients and families were treated."

Each department at the hospital now "candidly displays specific goals for everyone to see: reduce ER wait times, eliminate falls and improve customer satisfaction," Varney writes. Williams told her, “We took the approach that if we took patients and we treated them better than they’d ever been treated before, that at the end of the day, they would drive the bottom line."

Varney writes, "The sweeping changes can be seen everywhere: staff members, including physicians, greet visitors in the hallway and ask if they need directions; during a daily afternoon quiet time, the hallway lights darken so patients can rest; and the kitchen staff, in an attempt to reduce waste, cut their egg budget in half. Along with other cost saving measures, the hospital cut costs by $600,000." The hospital has since "won the nation’s highest presidential honor for excellence through innovation and leadership."