Baldrige National Quality Program
2007
Baldrige: A Roadmap for Patient
Safety and Quality Improvement
Harry S. Hertz
August 22, 2007
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What Is Baldrige?
Why Baldrige?
Lessons Learned & Results
Next Steps
Baldrige National Quality Program
2007
What Are the Baldrige Criteria?
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A set of expectations or requirements
A structured approach to performance
improvement
A framework for a systems view of
performance management
Baldrige National Quality Program
Basic Goals of the Criteria
To help organizations enhance their
performance by focusing on
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delivery of ever-improving value to patients, other
customers, and stakeholders, contributing to
improved health care quality and organizational
sustainability
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improvement of overall organizational
effectiveness and capabilities
organizational and personal learning
………performance excellence
2007
Baldrige National Quality Program
2007
Criteria Purposes
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To help improve organizational performance
practices, capabilities, and results
To facilitate communication and sharing of
best practices
To serve as a tool for understanding and
managing performance
Baldrige National Quality Program
Baldrige Health Care
Criteria Framework:
A Systems Perspective
2007
Baldrige National Quality Program
2007
Beginning the Journey - 2000
Organization
Situation:
Recognized Crisis:
Location:
Reason for Baldrige:
A&T
PROGRAMS
AEROSPACE
SUPPORT
Manufacturing
Service
Troubled
New/Emerging
Yes
No
Primarily
One
Geographically
Dispersed
Turnaround
Improvement
Saint Luke’s Hospital
Sustaining Performance Excellence
Lessons Learned
• Leadership drives and sustains the
process
• Leadership at all levels is important
• More difficult to change the culture
than to learn the tools
• Valuable team building experience
• Trust is extremely important
Saint Luke’s Hospital
Sustaining Performance Excellence
Lessons Learned
• There are no “quick fixes”
• Must always focus on the customer
• Should never be satisfied with the
present level of quality
• Decisions must be driven by data and
compared to “best”
• Employees make it happen!
Baldrige National Quality Program
2007
Lessons Learned by Education
and Health Care
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Baldrige is a systems perspective
Self-assessment facilitates learning
Measurements and data are critical
Baldrige focuses on results and outcomes
Organizational “silos” are pervasive
Need to improve internal communication
Baldrige National Quality Program
2007
Lessons Learned by Education
and Health Care (cont.)
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Many activities, few processes
- “What” is not the same as “how”
The customer concept is challenging
Improvement is the goal
The process itself is educational
Baldrige National Quality Program
2007
Bronson Methodist Hospital:
Cardiac Services % Market Share
60
55
50
45
40
35
30
1999
2000
2001
BMH
2002
2003
Competitor
2004
JanSept
2005
Baldrige National Quality Program
BHI: Results
2007
Baldrige National Quality Program
2007
Organizational Knowledge
Baptist Daily
• Modeled after Ritz Carlton
best practice
• Began in 2001
• Evolved into facilityspecific
Baldrige National Quality Program
2007
1999 & 2000 Award Process Mean Item Percentage
Scores: All Business Categories (Stage 1 and
Award Recipients)
70.00
Mean Percentage Scores
60.00
50.00
40.00
30.00
Award Recipients
20.00
10.00
Stage 1
0.00
1.1 1.2 2.1 2.2 3.1 3.2 4.1 4.2 5.1 5.2 5.3 6.1 6.2 6.3 7.1 7.2 7.3 7.4 7.5
Item
Baldrige National Quality Program
2007
Baldrige Role Model
Characteristics: 1999-2004
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Visionary Leadership Guidance (1.1)
Process Drive (6.1)
Customer and Market Knowledge (3.1)
Baldrige National Quality Program
Early Adopters: 1999-2004
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Process Driven (6.1)
High Performance Work Systems (5.1)
Customer and Market Knowledge (3.1)
Visionary Leadership Guidance (1.1)
2007
Baldrige National Quality Program
2007
Harvard
“The next time I go to a hospital, I’d rather see
a Baldrige Award on the wall than a Harvard
diploma.”
Harvey Mackay
Source: Minneapolis Star Tribune 4/6/95
Baldrige National Quality Program
2007
Next Steps
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Organizational Profile
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Are We Making Progress (as Leaders)?
Baldrige National Quality Program
Organizational Profile
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Purpose:
- Describe what is relevant and important
- Ensure common understanding
- Guide selection of information/data
- Identify gaps/lack of deployment
- Serve as first Baldrige assessment
2007
Baldrige National Quality Program
Organizational Profile
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Organizational Description
– Organizational Environment
– Organizational Relationships
Organizational Challenges
– Competitive Environment
– Strategic Challenges
– Performance Improvement System
2007
Baldrige National Quality Program
2007
Are We Making Progress?
Are We Making Progress as
Leaders?
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Employee (Leadership Team) Questionnaires
Seven Category Framework
40 Statements, 5-Point Scale
Compare Results
Focus Improvement and Communication
for Your Organization
Baldrige National Quality Program
Organizational Profile and
Are We Making Progress
(as Leaders)?
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Do you know the answer?
Would your organizational colleagues
give the same answer?
2007
Baldrige National Quality Program
2007
Resources for More Information
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Most Baldrige National Quality Program
(BNQP) documents are available both in
hard copy and on the BNQP Web site.
To obtain these documents,
call (301) 975-2036 or
visit www.baldrige.nist.gov.
Baldrige National Quality Program
Our dilemma is that we hate change and
love it at the same time; what we really
want is for things to remain the same but
get better.
Sydney J. Harris
2007