Understanding the Baldrige Journey: A Q&A with Henry Ford Health System

What is the history of Henry Ford Health System? Why did Henry Ford—a visionary—start the hospital in 1915? What was the health care landscape like then? How innovative was HFH at the time of its creation?

With the workforce at Ford Motor Company and the population of Detroit rapidly growing, so too were the health care needs of the community. Henry Ford understood the importance of keeping a healthy and productive community, and he envisioned creating a hospital for the working man.

The year 1909 marked the beginning of a movement to establish a new hospital in Detroit. The Detroit General Hospital Association was organized to plan and build the Detroit General Hospital. With Henry Ford as chairman, the Finance Committee purchased twenty acres of land bound by West Grand Boulevard, Hamilton, Byron and Bethune Avenues. Plans of a pavilion type of hospital, drawn up after committees had studied the leading hospitals in Europe and America, were accepted and the work of building began.

In 1912 ground was broken for the first building unit. However, enthusiasm soon lagged and subscriptions were insufficient to carry the project through. The foundation of the building remained unfinished for eighteen months. In 1914, it was suggested that the City of Detroit take over the entire project.

Henry Ford objected and offered to repay subscribers and assume the outstanding debts and contracts for the buildings of the Detroit General Hospital. His offer was accepted immediately. On June 26, 1914, the present site of the Henry Ford Hospital was deeded to Henry and Clara Ford.

On October 1, 1915, the first patients were admitted to Henry Ford Hospital. From the beginning, Henry Ford likened hospitals to hotels and strived to provide the finest accommodations. Although the Hospital interior was not yet completed, a long ward in the Private Patient Building accommodated 48 patients, and several other small buildings housed the surgical pavilion, research quarters, kitchens and laundry facilities, the power plant and garage. About 100 patients were admitted over the next 80 days or so.

Shortly after that, Henry Ford met Dr. William Mayo of the Mayo Clinic in Rochester, Minnesota. Ford was impressed by Mayo's description of new methods for hospital operations, including a closed staff of employed physicians who worked exclusively in and for the hospital. Henry Ford felt it was important to do the same, and he, too, introduced an employed medical staff model and attracted excellent staff members for his new hospital, recruiting two Johns Hopkins physicians to serve as his chief of medicine and surgery.

What are the reasons for HFHS' long-term success?

As we approach our 100th anniversary, one of our success factors is directly linked to the structure that Henry Ford put in place: an employed group of physicians—the Henry Ford Medical Group. As we grew, having the Henry Ford Medical Group integrated into a health system with an insurance arm, an academic medical center, regional hospitals and a vast continuum of services has ensured us success in a changing market.

Henry Ford Health System (HFHS) remains focused on our three Core Competencies—Innovation; Care Coordination; and Collaboration. We leverage these three strengths to achieve the excellence that enables us to improve human lives.

Describe HFHS in terms of size, area served, revenue, employees, etc.

Henry Ford is one of the country's largest health care systems, exceeding $4 billion in revenues, and is a national leader in clinical care, research and education. It includes the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan, Henry Ford Physician Network, 32 primary care centers and many other health-related entities throughout southeast Michigan. In 2010, Henry Ford provided nearly $200 million in uncompensated care. The health system is also a major economic driver in Michigan and employs more than 24,000.

Our vision, which is the foundation for our strategic direction, is:

"Transforming lives and communities through health and wellness - one person at a time."

You serve one of the most economically depressed regions of the country, and yet you have been able to build and maintain a sterling financial record. How have you accomplished that in such a difficult environment?

Contributing factors have been:

  • A long and unwavering commitment to quality, patient safety and healthcare equity.
  • Our strategic geographic positioning, with a continual focus on growth and innovation.
  • Our diversity of businesses, including an insurance arm with the state's second-largest health plan.
  • An organizational culture that embodies a "can-do spirit."
  • A passion for our customers and continuously improving services so that they want to return to us.
  • A dedication to the under-served demonstrated by collaborating with others to provide a safety net for the uninsured and managing their care as effectively and efficiently as possible.

Describe the innovative entrepreneurial approaches HFHS has taken that have been instrumental in your success.

HFHS's leaders model and support entrepreneurism throughout the health care delivery system, research operations, and the Health Alliance Plan. Innovative strategies and solutions have been developed and implemented for the past decade, providing a laser focus on improving care coordination, significantly reducing patient harm, and improving overall health care outcomes.

Using both short- and long-term planning horizons, HFHS senior leaders make decisions that effectively balance the need to provide quality care while also sustaining and building the business. By leveraging partnerships—including those with the University of Michigan, Wayne State University, and academic institutions in Canada—and providing profitable products and services, HFHS is able to offset the cost of its core services (e.g., the hospitals and medical centers) that are less profitable.

Among the best-in-class innovations at HFHS: the No Harm Campaign, focusing on reducing both preventable and unpreventable harm to patients System-wide; the Perfect Depression Program, which uses an evidenced-based, integrated approach to address chronic depression; Home Health Services, Pharmacy Advantage, and OptimEyes (optometry care), all services with a retail presence to increase brand recognition and access to new customers; and the West Bloomfield Hospital, a new facility built with active involvement of the community, resulting in an innovative building design with a "Main Street" that features weekly farmer's markets and a line of retail shops, a Culinary Wellness Program, and a beautiful atrium with a tea kiosk and meditation area.

HFHS is a leader in patient safety. What does that mean how is it manifested in day-to-day patient care?

HFHS's performance on core measures publicly reported for the Centers for Medicare and Medicaid Services (CMS) is at the 90th percentile for 75 percent of the reporting areas across the system's seven inpatient hospitals. HFHS's benchmark performance includes 100 percent compliance with all composite measures for heart attacks at the West Bloomfield Hospital.

HFHS's commitment to patient safety is emphasized through its evidenced-based global harm campaign to reduce or eliminate some 23 sources of harm. According to the Institute for Healthcare Improvement, this program is a national best practice. HFHS's has reduced global harm from approximately 60 harm events per 1,000 patients in the first quarter of 2008 to 40 harm events per 1,000 patients in the second quarter of 2011 (a 27% reduction). A prime example of this success is Henry Ford Hospital's reduction in central-line infections from 10 per year to 3 since 2008. HFHS has accomplished a 40% reduction in mortality since 2004 – a result of successful implementation and spread of several improvements.

Quality is also manifested through our commitment to transparency and Just Culture training; continuous improvement and best-practice sharing through our Quality Expo and System Quality Forum; and our fun culture, like spreading quality messages through our hand-washing video contest.

How is it that the Baldrige criteria are flexible and universal enough to serve an organization as large as HFHS and as small as Schneck Medical Center?

The Baldrige criteria are truly about performance excellence – achieved through aligned and integrated processes and the results to match – applied to any industry or company size. While it's certainly a bigger challenge to deploy these processes and outcomes across all parts of a large organization such as Henry Ford, the underlying principles are the same for all companies following the criteria. We're excited to learn from our fellow recipients about their performance journeys.

Why are the Baldrige criteria so much a part of HFHS' culture?

We started our journey with the intent of using the Baldrige framework to become a better organization—not to just win an award. We integrated the framework into our strategic planning and business operations. It became part of our everyday work. If we hadn't adopted the framework, our culture would not have changed.

What role has the criteria played in HFHS's success?

The criteria added a strict discipline to how we plan, execute and evaluate our performance. They propel us to think "big" and compare our organization against the very best companies across the country.

Describe what you think is HFHS's defining characteristic?

Our people. The culture we have created with our workforce has resulted in a unique energy and a "can-do spirit" that is the foundation of Henry Ford Health System. We have a passion around engaging our people and operate on the belief that an engaged workforce creates in better, safer patient