To John L. Fitzgerald, performing a tracheotomy isn't so different from building a Ford Taurus.
And that's the message he brings to his new position as CEO of the Marriottsville-based Bon Secours Health System Inc.
Mr. Fitzgerald, 42, is reviving the once-troubled company, which operates Bon Secours Hospital in West Baltimore and facilities in four other states. His method: emphasizing, and continually improving, quality.
"That philosophy is not commonplace in health care," he says, acknowledging that he's a fairly recent convert himself.
He learned from Dr. Paul Batalden, a colleague at the Nashville-based Hospital Corporation of America, where Mr. Fitzgerald worked for nine years. "The more I learned it, the more I became a real zealot," says Mr. Fitzgerald, who became the Bon Secours Health System's chief operating officer in October 1989 and took over as CEO at the beginning of this year.
Last year, he visited Ford Motor Co. officials to discuss the intricacies of improving quality. And he brought those lessons home, honing this corporate guideline: "Quality is the continuous improvementof service through understanding and acting on the needs and expectations of those being served."
Mr. Fitzgerald wants to improve every facet of the health system's operations. Even the smallest detail can cause problems for patients -- and the company. "Say you go to the hospital for a birth, and it takes two hours to go through admitting. You remember that."
The quality campaign has refocused a company whose energies were spread thin.
The health system's managers had been preoccupied with long-range strategic planning, Mr. Fitzgerald says. "There was a lot of thinking about 20 years from now, and what we would become. It appeared we were going from 1990 to 2010, rather than concentrating on the incremental steps."
Meanwhile, managers were rushing from one crisis to the next, he says. Paraphrasing quality control guru W. Edwards Deming, he adds, "Just because you put a fire out in the building doesn't mean you've improved the building."
Mr. Fitzgerald's call for a return to basics has boosted the health system's financial performance.
Income from operations, which had fallen from $14.6 million in fiscal 1988 to $12 million in fiscal 1989, has risen again. In fiscal 1990, which ended Aug. 31, income from operations jumped to $15.3 million.
Financial results at Bon Secours Hospital also have improved. In fiscal 1989, the hospital posted an operating loss of $2.7 million. But Jim Dague was named to head the hospital about a year ago, andin fiscal 1990, Mr. Fitzgerald says, the hospital had an operating profit of about $500,000.
The health system includes six other hospitals, seven nursing homes, a rehabilitation hospital and a psychiatric hospital. They are in Maryland, Michigan, Virginia, Florida and South Carolina.
Mr. Fitzgerald says he will consider expanding the health system further into the Southeast -- he often gets calls about nursing homes that are for sale.
But boosting quality -- a process that will take a lot of time and money over the next few years -- will get priority from company executives.
A return to basics is crucial to Bon Secours' long-term health, he says, adding, "If you're running a tire business, you damn well ought to know how to make a tire."