A year ago, NYU Langone Health captured the attention of the world with the surprise announcement that all their medical school students would receive full tuition scholarships. That announcement was only the latest in a series of stunning moves by the New York medical center that has transformed from a faded, money losing institution into a world class academic medical center.
Over the course of a decade, NYU Langone went from an unprofitable, poorly ranked medical institution to a global leader in patient care, education, and research, while generating a substantial surplus. The story of NYU Langone Health offers lessons for enterprise transformation that transcend healthcare. If you are in a retail business, the story will help you improve customer service and satisfaction. If you are in manufacturing, the NYU story will help achieve zero fault. If you are in the service business, the NYU Langone approach to information systems and dashboards will help you improve performance and accountability. If you are a university, this story will help you achieve excellence in teaching and improve your rankings.
Embedded within the NYU Langone story is what I call “levers of change.” These are the levers that were used to pry the organization from its past behaviors and put it on the path to a productive future. Before describing those critical levers of change, it’s important to understand the magnitude of the transformation of NYU Langone.
In 2007, NYU Langone Health was ranked 60th out of 90 academic medical center hospitals in quality and safety. Today, they are regularly ranked either number one or number two in the country. In 2007, the NYU Langone medical school was ranked 34th in the country. Today, the school never falls out of the top ten. In 2007, NYU Langone struggled with an annual deficit of $ 150 million. Today, that deficit has been transformed into a surplus of $ 240 million.
What were the levers of change employed to move the institution from mediocrity to become the world class leader of today?
Transforming from a culture of complacency to one of aspiration and inspiration.
Cultural transformation is the most important of the levers. Under the leadership of a newly appointed Dean and CEO, Dr. Robert I Grossman, and the chair of the NYU Langone Health Board of Trustees, Ken Langone, the culture changed from one of complacency to what Grossman has called an aspirational culture, the desire to be the very best.
Matching delivery of services to the needs of the consumer.
For NYU Langone, this meant a fundamental shift away from delivering care in hospitals to delivering care in ambulatory care centers in communities and in homes.
Shifting to a relentless focus on quality and total patient satisfaction.
Instead of focusing on costs, NYU Langone shifted to a relentless focus on improving patient satisfaction and the quality of care. The NYU Langone mantra over the past ten years has been focus, focus, focus on the clearly stated goal to become a world class, patient centered, integrated academic medical center.
Building a first rate modern information environment.
As I’ve written about previously in this column, advances in information technology allowed NYU Langone to implement an information system that was comprehensive, integrated, actionable, interface free, and made data available in real time horizontally and vertically across the organization. This meant everyone at NYU Langone involved in patient care, teaching research, and administration could be evaluated on objective data based upon performance standards.
These levers of change, when applied in unison to the problem of transformation, create the momentum behind a flywheel of change, one that can transform any institution from failure to success. In upcoming posts, I will take a closer look at each of these levers. In our nation’s continuing debate on how to pay for healthcare, we seem to forget a fundamental lesson: We must focus on what we get for our money as well as how much money we spend. All too often the focus is on cost, not quality. We should only buy excellence.