Baldrige National Quality Award for Health Care Organizations

Elaine Reeves

HCA 375 – Ashford University
Paula Arceneaux
December 5, 2011

Quality Improvement in Healthcare Health care is something commonly visited with my family and me. Having three children in the last seven years, my family and I have had our share of hospital and medical office visits. The quality in care does not go unnoticed as I see many areas that need improvement, as well as other areas that are exemplary. One measure that many organizations utilize is continuous quality improvement (CQI). It is a structured organizational process by which personnel plans and executes a constant flow of improvements in order to provide exceptional quality healthcare (McLaughlin & Kaluzny, 2006). CQI is an approach to quality management, where traditional quality assurance is implemented and emphasizes on the systems of the organization. Aside from gaining satisfaction and confidence from patients, quality improvements of a healthcare organization (if applied successfully) can earn prestigious awards. When quality in healthcare meets government regulations and standards, and when satisfactory is met with the public and/or patients, many organizations are recognized for their achievements in quality. Some organizations are rewarded, along with their recognition, with awards reflecting their success. One such award is the Malcolm Baldrige National Quality Award. Stated in the article Four U. S. Organizations Honored with the 2011 Baldrige National Quality Award (2011), the Baldrige Award is named after the 26th Secretary of Commerce, Malcolm Baldrige. Established by Congress in 1987, the Baldrige Award is designed to boost competitiveness and performance of businesses in the United States. In 1999, Congress expanded the program to include health care organizations, and later in 2007 included not for profit organizations. The award promotes excellence in organizational performance, recognizes the achievements of U. S. organizations. This award is a result of The Baldrige Performance Excellence Program. This program is the nation’s public-private partnership dedicated to performance excellence (NIST, 2011). The Board of Examiners looks for achievements and improvements that follow the Criteria for Performance Excellence. Baldrige criteria are also values that are defined as guiding principles and behaviors that embody how an organization and its employees are expected to operate and/or perform. These values reflect and reinforce the desired culture of an organization. The following are the criteria under Baldrige’s performance excellence: * Leadership * Strategic planning * Customer focus * Measurement, analysis, and knowledge management * Workforce focus * Operations focus * Results This year, three out of the four 2011 Baldrige Award recipients are health care organizations. As stated on the NIST web site (2011), the recipients were selected from a field of 69 applicants. One of the recipients is the Henry Ford Health System (HFHS), located in Detroit, Michigan. Henry Ford Health System is one of the nation’s leading complete, integrated health systems. Since 1915, HFHS has committed to deliver quality health care services, and continues to improve the health and well-being of their diverse community. Their health coverage plan (Health Alliance Plan) covers over 467,000 members, and was rated as the top health insurance plans for member satisfaction in Michigan. Customer satisfaction results for the Health Alliance Plan exceeded the National Committee for Quality Assurance’s 90th percentile level from 2007 to 2010. The ambulatory hospitals of HFHS also exceeded the 90th percentile level in a survey by Press Ganey that focuses on improving health care performance. Roughly 80 percent of patients stated that they were likely to recommend HFHS. Henry Ford Health System received the Baldrige Award for their innovative ideas. Leaders of HFHS used innovative strategies and solutions to help reduce unintended patient harm, and established a “zero-defect, no-excuses” approach to their delivery of health care. Senior leaders used short and long-term planning prospects which balanced improvements in quality care while maintaining and building the organization. In addition to providing excellent health care, HFHS and its staff supported and volunteered in various community service activities such as the American Heart Association’s Heart Walk. Another recipient of the Malcolm Baldrige National Quality Award is the Schneck Medical Center (SMC) in Jackson County, Illinois. According to NIST (2011), SMC was recognized for demonstrating high levels of performance concerning patient-focused health care measures. Amid 94 other hospitals in their region, SMC was ranked second in its value-based purchasing (VBP), a method that holds health care providers accountable for quality and costs, through a rewards and consequences system. SMC’s patient satisfaction surveys covering areas of inpatient quality care, inpatient family support, inpatient coordination of care, and inpatient customer service resulted in the top 25 percent level. They commit to a “Patient First” principle which ensures that patients receive the best and fastest treatment for whatever their condition. The award also recognized SMC’s stellar medical staff, especially those who handle patients that are being discharged. Hiring for Excellence Program is the process that SMC uses for selecting new employees. The program involves peer interviewing and current employee feedback in the selection process. Their current rate of staff turnover is a low seven percent (a 26 percent decrease in a four year span). Schneck Medical Center exhibits role-model performance which shows low overall rates in hospital-acquired infections. The third Baldrige Award recipient is the Southcentral Foundation (SCF), located in the state of Alaska. According to NIST (2011), founded in 1982, this nonprofit health care organization provides care to improve health, social conditions, empowerment, and enhancing culture to the Alaskan Natives and American Indian residents. Southcentral Foundation has a unique health care delivery system that combines organizational strategies and processes; medical, behavioral, dental, and traditional practices; and infrastructure which support wellness. The system, also known as “Nuka,” means strength in health care. It is led under four principles: (1) customers drive everything, (2) customers must understand and trust the health care team, (3) patients should not encounter any barriers in seeking care, and (4) employees and supporting facilities are imperative to success. Southcentral Foundation has achieved substantial improvements in several key areas; one of these is same-day access to health care. It is a system that allows patients to see their primary physician on the same day, so long as they call by four o’clock p.m. This guarantees 70 to 80 percent of appointments to remain open at the beginning of the day. SCF makes strong efforts to reduce the occurrence and improve the management of diabetes, a condition where many Alaska Natives and American Indians are at high risk. Their performance is managed by a state-of-the –art database called DataMall. It collects all clinical information and is made available to managers, employees, and patients. The DataMall is also used to track performance, and encourage improvement and innovation. Finally, the senior leaders of SCF created an internal functional committee structure, an organized environment where constant learning, performance improvement, and strategic objectives are accomplished. The structure incorporates quality assurance, performance improvement committees, external benchmarking, and development of leadership into a corporate process. Since 2002, there have been 11 healthcare organizations awarded with the Malcolm Baldrige National Quality Award. According to Kendall & Bodinson (2010), these organizations (though different in size, complexity, or demographics of the community) share the same key characteristics: an unending commitment to patients, a high grade of collaboration, and continuance in high levels of patient satisfaction. Sharp Healthcare in San Diego, California is another organization that was recognized for their commitment to their employees and patients. As a recipient to the Baldrige Award in 2007, Sharp Healthcare was identified as “the best place to work,” “the best place to practice medicine,” and “the best place to receive care.” Their motivation throughout the organization includes a multitude of methods using media to encourage candid, two-way communication. Open and timely communication is one key to employee motivation. Trust is another key element in the workplace. Being trustworthy and trusting co-workers enhance the integrity and overall morale of an organization. These components help Sharp continue to strive to make their medical facility a great and rewarding place to work. According to Kendall & Bodinson (2010), another organization that was named one of “America’s 100 Best Places to Work in Healthcare” in 2008 is Poudre Valley Health System. Their overall staff voluntary turnover was decreased to only eight percent, which is among the Healthcare Human Resources Administration’s top 10 percent. Overall employee satisfaction ranked at a whopping 97 national percentile. Physician satisfaction also ranked high with a 99 percentile. Mercy Health System in Janesville, Wisconsin was named one of the top of AARP’s “Best Employers for Workers Over Age 50” (ranked second in the nation); was also named one of the “100 Best Companies” to work for by the magazine, Working Mother. Physician satisfaction at Mercy Health System ranked above the American Medical Group association 95 percentile. Stated in the article The Power of People in Achieving Performance Excellence (2010), other organizational performance values include market share, improved financial measures, and cost containment. North Mississippi Medical Center stemmed a care-based cost management approach that connects quality in health care and cost containment. This resulted in savings of more than $11 million dollars over a span of six years. The CEO of North Mississippi Medical Center, John Herr refers to this approach as a formula. He suggests motivating and engaging employees to come to work every day; thus creating better service, improved patient satisfaction, improved quality of care, and increased financial results. Leadership and management of healthcare organizations would benefit by using the Organizational Assessment Against Best Practices for Performance Excellence. This would help transform an organization to a high-performance level. Four points for self-empowerment in an organization include: * Understanding your organization’s priorities and what it takes to achieve objectives. Continually explore ways to improve work processes. * Take responsibility for both personal and professional development. Set goals and establish classes and/or training to reach these goals; acquire additional knowledge and proficiency in new skills. * Practice effective communication with co-workers and patients. Make suggestions for communications improvements. * Manage by facts. Identify any gaps in the current performance and delivery in care. Establish a team to find solutions to the gaps. For several years, the Veterans Affairs Cooperative Studies Program (VACSP) Clinical Research Pharmacy Coordinating Center in Albuquerque, New Mexico has been working its way to earning the Malcolm Baldrige National Quality Award (Adrian, 2011). Since 1996, VACSP has been studying and applying the Baldrige criteria for performance excellence. Prior to this goal, VACSP was rewarded two New Mexico Quality Awards, The Santa Fe Business Incubator’s Piñón Award in 1997, and Quality New Mexico’s Zia Award in 2004. In 2009 (three years after the Baldrige Performance Excellence Program made the award available to nonprofit organizations), VACSP received performance excellence honors and were among the nation’s best. As stated by Adrian (2011), VACSP Clinical Research Pharmacy Coordinating Center is a federal government organization in support of multicenter clinical trials that focuses on health issues affecting United States veterans. The center includes manufacturing, packaging, storing, labeling, distributing, and tracking clinical trial materials (drugs and devices). Due to these important activities of the center, VACSP pays close attention to the safety and regulations that associate with the pharmaceutical industry as well as those related to designing and implementing clinical trials. The result of receiving the Baldrige Award validates the center’s commitment to performance excellence. As a center complete with only 112 employees, it was a true honor to have received the award. In addition to the Malcolm Baldrige Award, VACSP became the first Veterans Affairs agency to be certified under ISO 9001:2000, an international excellence standard. According to Adrian (2011), under this standard, VACSP is required to perform internal audits to confirm that personnel are right on course. In complying with the ISO standard, the center must keep a manual that outlines management, organization, and quality measures. The manual also serves as a guideline to keep operations functioning properly in the event ISO 9001 audits take place. Stated by Adrian (20110), VACSP’s quality management system (QMS) is a part of the ISO 9001 system, and is also associated with performance excellence. The system assists the staff in managing documents, correct and resolve problems, and work with auditors. One measure taken was purchasing a software tool (appearing on every computer desktop) which focuses on these particular areas. VACSP has kept customer satisfaction at a high level through loyalty and by creating customer relationships. Ratings for customer satisfaction have improved from 83 percent in 2003 to 100 percent in 2009. As a small organization, VACSP understands the importance of employee engagement (which falls under the criteria for workforce satisfaction). The collective efforts of the coordinating center shows that they are deserving of the awards received, especially the prestigious Baldrige Award. The Malcolm Baldrige National Quality Award is more than recognition to organizations that display performance excellence; it is an incentive to continue excellence. I believe that more health care organizations should strive to achieve excellence such as the organizations described above. These takes ability to strategically plan, establish teams, and properly implement programs. With this in place, health care organizations can not only earn high honors, they can receive ongoing loyalty and confidence in their patients and/or customers.

References
Adrian, N. (2011). Trial and No Error. Quality Progress, 44(1), 46-51. Retrieved December 6,
2011, from ABI/INFORM Global. (ProQuest document ID: 2300017891).
Baldrige Homepage. (2011, December 5). National Institute of Standards and Technology. Retrieved December 03, 2011, from http://www.nist.gov/baldrige/ Huergo, J., & Newman, M. E. (2011, November 22). Four U. S. Organizations Honored with the 2011 Baldrige National Quality Award. National Institute of Standards and Technology. Retrieved December 03, 2011, from http://www.nist.gov/baldrige/baldrige_recipients2011.cfm Kendall, K., & Bodinson, G. (2010). The Power of People in Achieving Performance Excellence. The Journal for Quality and Participation, 33(2), 10-14. Retrieved December 6, 2011, From ABI/INFORM Global. (ProQuest document ID: 2109800361). McLaughlin, C. P., & Kaluzny, A. D. (2006). In Continuous quality improvement in health care (Third ed.). Sudbury, MA: Jones and Bartlett.