Centura Health is considered Colorado's largest healthcare organization, inclusive of a 12-hospital system. The company's mission includes celebrating the value inherent in each individuals life and working collaboratively to "lift the burdens of others" by offering comprehensive and loving care to all customers and patients served by Centura (Centura, 2005). The mission statement of the organization is to "extend the healing ministry of Christ my caring for those who are ill and nurturing the health of people in our communities" (Centura, 2005).
The vision includes fulfilling the organizations covenant that guarantees excellence and integrity of service, creating partnerships with community members and patients for life (Centura, 2005). The organization has identified multiple core values which include: integrity, stewardship, spirituality, imagination, respect, excellence and compassion" (Centura, 2005).
Current Centura operates as a non-profit agency and structures key decision making using what they refer to as a "Values Impact Analysis" (Centura, 2005). This tool helps organizational representatives weight the costs to benefits of selected decisions as applied to the organizations core values. The process adopted by the organization is considered "dynamic and rigorous" with the intent of enabling "conscientious decisions respectful of stakeholders needs" but also in line with the values and needs of patients (Centura, 2005). The organizational model includes a hierarchical system with the following: President/CEO, Executive Vice President and COO, Sr. Vice President, CFO, Chief Medical Officer and supporting management staff (Centura, 2005).
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Key to the governance model includes collaboration with other medical providers and health agencies throughout the state of Colorado. The decision making model adopted by Centura involves use of the Values Impact Analysis process that helps key management staff make decisions that are not only fiscally sound but also reflect the organizations core values and perspectives of patients that may be impacted by decisions. The organization makes use of an on site Mission and Ministry whose role includes providing "reflections, a prayer chain" and various other resources for employees and associates of the organization (Centura, 2005).
In addition the organization utilizes a SHARE program that resembles a rewards and recognition program to highlight outstanding achievements among employees, customers and co-workers (Centura, 2005). Centura has also adopted a collaborative environment where communication is promoted through a "Mastery Development Plan" (Centura, 2005). This plan provides team members within the organization a method of facilitating personal and professional development and communication by providing training for technical and support staff and providing communications training to all staff to encourage greater collaboration and community connections among employees (Centura, 2005).
Centura has also adopted quality improvement measures focusing on patient populations, physician and clinician teams to help promote "excellence in care" (Centura, 2005). The organization to this effect has created what they refer to as a "Quality, Safety and Outcomes Management department" whose sole role includes supporting a solid communications infrastructure and commitment to quality improvement (Centura, 2005).
Centura's approach to quality involves defining 'value directed' services and providing value directed management to customers both internal and external. This is a solid approach to instilling quality within the organization. Arogyaswamy & Simmons (1993) point to the important of using value-directed management approaches to ensure the best possible service to customers.
Further the authors suggest that organizations must approach total quality and empowerment of staff through articulated measures to achieve "stronger market positions" by establishing "an unquenchable thirst for improvement" (Arogyaswamy & Simmons, 3). Ways to do this include through integration and shared vision (Lambert, Hylander & Sandoval, 2003). Barusch, Merkman & Maramaldi (2005) note that within the health care organization standardized measures are necessary to ensure control and power are properly delegated and that quality is ensured in all patient interactions and outcomes.
Care benchmarks, satisfaction tools and quality assessors currently adopted by Centura fall in line with recent studies suggesting that routine attention to performance measurement via various standardized methods help improve organizational efficiency and continuous improvement (Holzer & Julnes, 2001). Further risk management is best assessed by gathering quality data from standardized reporting systems that provide detailed summaries of the industry, characteristics of service and help regulate distribution of services and procedures within the healthcare organization (Blankmeyer, Knox & Stutzman, 2001).
Centura uses multiple benchmarks to currently reap information regarding quality and service protocols, including the Values Impact Analysis and the Master Development Plan. The values impact survey acts as a standardized reporting system providing mangers and staff with detailed cues regarding employee and organizational performance.
The Master Development Plan serves as a tool that can enhance performance management and train various staff members including nursing staff members to achieve their highest potential within the organization. Key issues a nursing staff coordinator may address within this organizational context is whether incumbents are consistently reporting on their progress and achievements using the values impact analysis and master development program. These programs do offer detailed information regarding potential areas of weakness and improvement within the organization. At present the strongest elements of Centura's organizational structure include its commitment to shared knowledge and communication among staff members. Additionally the organization is committed to empowering employees to excel in their job functions and dedicated to continuous training.
The organization may benefit from an overhaul of the performance measurement protocols adopted for individual employees. Most organizations fall short of identifying to as great an extent possible the level of staff satisfaction with performance measurement protocols. Turnover within the organization at present is relatively low suggesting that employees are however receiving the feedback they need to excel on the job.
At this point in time when problem areas are identified using the quality assessment tools in place management turns to focused committees to resolve issues. The organization would benefit by involving more primary care nurses and other direct staff involved in decision making processes that involve improving quality improvement. Because Centura is a hierarchical organization, most decisions are made from the top down. Recent studies suggest however that continuous quality improvement and risk management efforts are enhanced significantly when organizations adopt a flat approach to knowledge management and quality improvement. This means that employees at all levels of the organization must be empowered to help make decisions and share information regarding continuous improvement measures. One way to adopt this philosophy at Centura may be to establish various committees designed to help solve specific problems within their scope of expertise or knowledge.
Overall Centura Health provides a superb foundation for providing quality care and direction for staff and the patients and community it serves. The organization is committed to quality improvements, knowledge sharing and partnerships within the community to reduce any risk associated with delivering care and to improve its knowledge sharing ability within the community. At present the organization has adopted various standardized instruments, which consistently provide accurate measurements of quality benchmarks within the organization. The top down management approach may be the sole factor limiting consistent knowledge sharing and hence risk management reduction or continuous improvement within the organization.
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