Swedish Medical Center: Operations & Strategic Management

Background and Organizational Overview

Swedish Medical Center is a large medical center located in Seattle and the surrounding suburbs of Washington State. Founded in 1910, it has grown through mergers and acquisitions, most recently absorbing Stevens Hospital in Edmonds, Washington, in 2010. The hospital consistently ranks among the top institutions in the country across a number of specialties, including cancer care, geriatrics, and orthopedics. Swedish continually outperforms other Puget Sound institutions in customer satisfaction and ranks ten points above the national average in patient satisfaction (U.S. News, 2011).

Swedish operates nine campuses and several clinics throughout the Puget Sound area. It maintains over 1,200 licensed beds, nearly 7,000 employees, and 2,300 licensed physicians spanning every medical and surgical specialty. In 2009, the center recorded almost 110,000 emergency room admissions, 41,000 inpatient admissions, and nearly 33,000 surgeries. Due to its national prominence, Swedish manages as many as 600 clinical trials — both federal and commercial — at any given time. As a not-for-profit medical center, Swedish donates approximately $15 million per year in direct charity care to the community. Swedish's income reached $1.4 billion at the end of 2009; however, the organization continues to rely on Swedish Foundation funding to maintain its commitment to medical excellence (Swedish Medical Center, 2011).

Process-Based Capabilities and the Balanced Scorecard

Healthcare organizations now face increasing pressure to improve their operations, demonstrate continued quality, and enhance organizational efficiency. For modern healthcare managers — who have traditionally focused on quality of care — this means changing paradigms mid-stream and reviewing overall management practices for the sake of effectiveness, patient safety, and the adoption of cutting-edge techniques (Kujala & Lillrank, 2006). Reports from the Institute of Medicine suggest that nearly 60 percent of hospital deaths in the United States related to medical errors could have been prevented with proper safety protocols and procedural changes (Institute of Medicine, 2000).

For Swedish, process improvement became part of the overall strategic planning process as a tool to solve local problems beginning in the 1990s. During an expansion phase, the concept of process orientation served not merely as a management tool but as a means of identifying problems in patient flow, resource management, and staff efficiency. This process has evolved over the years into a more robust management system built around the Balanced Scorecard approach, enabling strategic planning to move beyond economic discourse toward a more comprehensive model incorporating patient outcomes, process efficiency, staff satisfaction, and community relations as markers for continued improvement.

Greater emphasis was simultaneously placed on the ability of Swedish managers at all levels to understand, map, and continually improve critical aspects of care management throughout the organization. The Balanced Scorecard is widely regarded as one of the key tools that translates strategy into measurable performance. It provides a clear direction for what the organization should measure in order to balance financial output, retaining financial measurement as a summary of business performance while also highlighting an integrated set of metrics linking customers, processes, resources, and performance to long-term financial success. The scorecard gives management a dashboard view of the business, supporting goal-setting and strategic plan management. By uniting all organizational actions under a common understanding of objectives, the Balanced Scorecard provides feedback on both internal processes and external outcomes to continuously improve strategic performance and results (Langabeer & Napiewocki, 2000; Stevens, 2006).

Resources and Technology

Swedish employs some of the best medical professionals in the country, with a staff of over 1,500 physicians and 4,000 employees. Recent human resource data indicate that within the non-medical field, approximately 25 percent of executives hold an MBA or are actively pursuing an advanced degree, and 50 percent hold at least a bachelor's degree, with most having completed coursework toward graduate study (Crosby, 2011). Because of its national reputation, Swedish also receives considerable private and federal grant funding, much of which supports advanced strategic planning research and development. Beyond general medical and surgical care, Swedish is recognized as a regional referral center, offering specialized treatment in cardiovascular care, cancer care, neuroscience, orthopedics, high-risk obstetrics, pediatric specialties, organ transplantation, and clinical research.

Being at the forefront of the technological revolution in healthcare has been central to Swedish's mission from its earliest days. The rapid pace of scientific and technological advances drives business processes at every stage of care delivery. Demographic pressures compound this challenge: the number of Americans over the age of 65 is expected to double by 2030, placing even greater demands on the healthcare technology infrastructure.

One significant technological advantage for Swedish is its proximity to Microsoft's Redmond, Washington headquarters. Microsoft collaborated with Swedish to develop Amalga, a database management system that allows disparate data — including patient records, billing, medication histories, laboratory tests, surgical records, office visits, and population and resource management data — to be stored, accessed, and used as a strategic tool across multiple facilities (Tu, 2011). Swedish President and CEO Rod Hochman, M.D., commented: "Healthcare reform requires health systems to do more with less. Amalga is a key technology enabler that will allow us to efficiently combine data stored in disparate IT systems across multiple facilities and use it to uncover opportunities to improve performance and the quality of patient care across the care continuum" (Microsoft News Center, 2011).

Amalga addresses a common and critical challenge facing healthcare providers: integrating vast amounts of clinical, administrative, and financial information flowing through disparate information systems, and tailoring that information for use by physicians, analysts, laboratory technicians, nurses, and administrators. By leveraging existing health IT investments, Amalga enables the entire organization to gain rapid access to data and transform that information into actionable knowledge that facilitates better decision-making and improved patient outcomes (Microsoft News Center, 2011). In addition to Amalga, Swedish remains committed to cutting-edge technologies in imaging, cancer care, osteopathic medicine, neurology, and — of national importance — the treatment of Hepatitis C and liver disease (Swedish Medical Center, 2011).

References

Arnold, E. (2007). Service-dominant logic and resource theory. Journal of the Academy of Marketing Sciences, 36(1), 21–24.

Crosby, J. (2011, November). Human resource — Swedish Hospital.

Institute of Medicine. (2000). To err is human: Building a safer health system. National Academy Press.

King, D. (2008). Designing the digital experience: How to use experience design. Information Today Press.

Kujala, J., & Lillrank, P. (2006). Time-based management of patient process. Journal of Health Organization and Management, 20(6), 512–524.

Langabeer, J., & Napiewocki, J. (2000). Competitive business strategy for teaching hospitals. Quorum Press.

Microsoft News Center. (2011, September 21). Swedish enters agreement with Microsoft Corp. Retrieved from http://www.microsoft.com/Presspass/press/2011/sep11/09-21SwedishPR.mspx

Stevens, P. (2006). Metrics, targets and performance. National Institute Economic Review, 197(2), 80–89.

Swedish Medical Center. (2011, March). Advanced technology and treatment. Retrieved from

Swedish Medical Center. (2011, January). Institutes and services. Retrieved from http://www.swedish.org/Services

Swedish Medical Center. (2011, November). Overview — facts and figures. Retrieved from

Swedish News. (2011, October 5). Providence and Swedish to join forces to improve health care. Retrieved from

Swedish News. (2011, September 19). Rise in patients without commercial insurance. Retrieved from

Swedish News. (2011, October 26). Swedish set to fully open new hospital in Issaquah. Retrieved from

Tu, J. (2011, September 21). Swedish Medical Center to implement Microsoft's Amalga healthcare technology. The Seattle Times. Retrieved from http://seattletimes.nwsource.com/html/microsoftpri0/2016271770_swedish_medical_center_to_implement_microsofts_ama.html

U.S. News. (2011, January). Swedish Medical Center. Retrieved from http://health.usnews.com/best-hospitals/swedish-medical-center-first-hill-6910006