Building Performance
Excellence in Health Care
James R. Evans
Professor of Quantitative Analysis
and Operations Management
College of Business
University of Cincinnati
What Is Performance Excellence?
An integrated approach to organizational
performance management that results in
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

Delivery of ever-improving value to patients,
other customers, and stakeholders, contributing
to improved health care qualtiy organizational
sustainability
Improvement of overall organizational
effectiveness and capabilities as a health care
provider
Organizational and personal learning
Baldrige Health Care Award
Recipients
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Bronson Methodist Hospital (2005)
Robert Wood Johnson University
Hospital Hamilton (2004)
Baptist Hospital, Inc. (2003)
Saint Luke’s Hospital of Kansas City
(2003)
SSM Health Care (2002)
An Example of
Performance Excellence
BMH Results
Physician Satisfaction
Physician Satisfaction with IT at Bronson
100
95
90
85
80
75
70
65
60
55
50
99th Percentile*
85.6
79.9
70.2
56.7
2001
59.6
2002
2003
2004
2005
* Professional Research Consultants, Inc.
(Percentile calculated from a database of
19,684 physician responses across 161 hospitals)
The Criteria for Performance Excellence
Purposes:
 To help improve organizational
performance practices, capabilities,
and results,
 To facilitate communication and
sharing of best practices information
among organizations of all types,
and
 To serve as a working tool for
understanding and managing
performance and for guiding
organizational planning and
opportunities for learning.
Current Baldrige Framework –
A Systems Perspective
Summary of Categories/Items
Leadership
1.
1.
2.
Senior Leadership
Governance and Social
Responsibilities
Strategic Planning
2.
1.
2.
1.
2.
1.
2.
2.
3.
6.
Patient, Other Customer,
and Health Care Market
Knowledge
Patient and Other
Customer Relationships
and Satisfaction
7.
Measurement, Analysis, and
Knowledge Management
4.
Measurement, Analysis
and Review of
Organizational
Performance
Information and
Knowledge Management
Human Resource Focus
1.
Strategy Development
Strategy Deployment
Focus on Patients, Other
Customers, and Markets
3.
5.
Work Systems
Staff Learning and Motivation
Staff Well-Being and Satisfaction
Process Management
1.
2.
Health Care Processes
Support Processes and Operational
Planning
Results
1.
2.
3.
4.
5.
6.
Health Care and Service Delivery
Outcomes
Patient- and Other CustomerFocused Outcomes
Financial and Market Outcomes
Human Resource Outcomes
Organizational Effectiveness
Outcomes
Leadership and Social
Responsibility Outcomes
Core Values
Visionary leadership
 Patient-focused excellence
 Organizational and personal
learning
 Valuing staff and partners
 Agility

Focus on the future
 Managing for innovation
 Management by fact
 Social responsibility and
community health
 Focus on results and
creating value
 Systems perspective

Performance Excellence
Maturity Model
Bronson Methodist Hospital
Complaint Management Process
Key characteristics:
Systematic and repeatable
process
Focused on improvement
and prevention
Capable of organizational
learning
Knowledge sharing
Satisfaction Results
Arbor Associates best practice benchmark since
2001 and Arbor Associates Award for Highest
Overall Patient Satisfaction four years in a row.
Baldrige Resources
www.baldrige.org
Criteria
 “Getting Started…” guide
 Award recipients

 Contacts,
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profiles, application summaries
A variety of other materials and
publications
Supplementary Slides

The following slides provide brief
descriptions of key indicators of
performance excellence in an organization
Key Excellence Indicators:
Leadership
Personal commitment to patients and
other customers
 Effective setting and communication of
organization’s direction
 Personal Involvement in developing future
leaders

Key Excellence Indicators:
Leadership
Communication of and role model for
the organization’s values
 Legal and ethical behavior
 Focus on learning at all levels of the
organization
 Good citizenship

Key Excellence Indicators:
Strategic Planning
Balance of short- and long-term views
 Aggressive goal setting
 Strong work process alignment with
strategy
 Systematic approach to addressing all
sources of risk

Key Excellence Indicators:
Strategic Planning
Critical targets and goals based on
customer requirements and market
directions
 Strong involvement of key suppliers,
partners, and customers
 A focus on plan execution and agility

Key Excellence Indicators:
Patient, Other Customer and
Market Focus
In-depth market knowledge and
forecasts
 Consideration of needs of current and
potential patients and customers
 Proactive contact
 Multiple listening posts to identify
requirements

Key Excellence Indicators:
Patient, Other Customer and
Market Focus
Focus on enhancing patient and
customer relationships and loyalty
 Effective and prompt resolution of
complaints
 High levels of patient and customer
satisfaction and loyalty

Key Excellence Indicators:
Measurement, Analysis, &
Knowledge Management
Use of fact-based decision making
 Collection of actionable data
 Use of multiple aligned and
interlinking measures (internal and
external)
 Wide deployment and accessibility of
data and information

Key Excellence Indicators:
Human Resource Focus
Recognition of staff as “internal
customers”
 Strong commitment to staff satisfaction,
motivation, well-being, and morale
 Reward system related to key
organizational challenges and
organizational performance

Key Excellence Indicators:
Human Resource Focus
Commitment to staff training, education,
and development
 Links between individual and
organizational learning
 Empowered staff

Key Excellence Indicators:
Process Management
Well-defined health care, business, and
support processes
 Focus on processes that create value for
all key stakeholders
 Quality designed into all products,
services, and processes
 Focus on continuous improvement, cycle
time reduction, innovation, and
productivity
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Key Excellence Indicators:
Process Management
Strong integration of prevention,
correction, and improvement into daily
operations
 Partnering with suppliers and customers
 Financial and other resources committed
to key processes
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Key Excellence Indicators:
Results
Tied to
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Patient, other customer, and stakeholder
requirements
Key processes
Product/service performance
Strategy and action plans
Human resource needs
Financial and marketplace measures
Governance and social responsibilities
Key Excellence Indicators: Results
Tracking of levels and trends
 Linked to organization-level information
and analyses
 Use of comparisons/benchmarks
 Actionable
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