The Baldrige Criteria: A Design for Performance Excellence

1. The Baldrige Criteria: A Design for Performance Excellence Katherine J. Wallace Director, Performance Improvement Indiana Hospital Association kwallace@ihaconnect.org 317-423-7740

2. Objectives • Identify the history and structure of the Baldrige Performance Excellence Program • Learn how the Baldrige Criteria for Performance Excellence provide a framework for improvement of bottom-line results • Identify first steps to begin your journey to becoming a role model organization

3. Death by PowerPoint

4. The Important Objectives • Why are you here? • What would you like to know when you leave this session today?

5. Is this stuff easy? “Listen buddy, if I could explain it in fifty words or less, it wouldn’t be worth a Nobel prize.” Attributed to Robert Feynman, 1965 Nobel Laureate in Physics

6. Why Baldrige?

7. Why Baldrige? • Baldrige hospitals, as a group, were about 83 percent more likely than non-Baldrige hospitals to be awarded a 100 Top Hospitals national award for excellence in balanced organization-wide performance. • Baldrige hospitals were significantly more likely than their peers to display faster five-year performance improvement. • Baldrige hospitals outperformed non-Baldrige hospitals on nearly all of the individual measures of performance used in the 100 Top Hospitals composite score.

8. A System for Improvement

10. Why Baldrige? • It is consistent with a “benchmarking” approach • Comprehensive view of the system • Forces self-assessment • Guide to create environments for performance excellence. • Turns the informal into formal • Great feedback report!

11. What can Baldrige do for you? • Help you face the fact that you could be much better • Help you integrate all of your improvement efforts • Help guide you to your areas of weakness • Provide a focus on what you are doing well • Give you a chance to celebrate • Elevate the pride and aspirations of your staff

12. How does it compare to other regulatory bodies and initiatives? • Baldrige is not required. • Baldrige is not prescriptive. • Baldrige criteria provides a framework for self-assessment that guides organizations to create environments for performance excellence.

13. What is it? • Evidence-based, results-oriented criteria aimed at improving organizational performance • Established by Congress in 1987 and named after Malcolm Baldrige, Secretary of Commerce (1981 – 1987) • Created Award program to: • identify/recognize role model businesses • establish criteria for evaluating improvement efforts • disseminate/share best practices

14. Organizations committed to a journey to excellence focus on: • How they meet and exceed customers’ needs • Their strategic challenges and advantages • Knowing the competition • Their systematic approach to performance improvement

15. What does it look like? A winner’s story….

16. Excellent organizations… Have an approach to address what’s important. Systematically deploy or hardwire the approach throughout the organization Use data from what they learn to create cycles of improvement Effectively apply what they have learned to create improvement across the organization that supports organization-wide goals. Describe performance in numerical terms and over a period of time Describe how their performance compares with other organizations

17. Building on the Framework…. Process Review - ADLI • Cycles of Evaluation & Improvement • Encourage Innovation • Sharing Improvements & Innovations

18. What should we expect? • The Baldrige criteria can accelerate performance improvement efforts of all size hospitals, regardless where they are in their quality journey.

19. First Set of Questions – the OP* Who are you? What is it that you do? • Organizational Profile • Initial self-assessment • Clarify operating environment and key relationships • Describe competitive environment • Describe key strategic challenges and advantages • Describe system for performance improvement *Organizational Profile 19

20. Followed by …Process Questions How do you do it? How do you keep improving? • Six “process” categories: • Leadership • Strategic Planning • Customer Focus • Measurement, Analysis, and Knowledge Management • Workforce Focus • Operations Focus 20

21. Finally … Results Questions How well do you do it? How do you know? • Five results items • Each process category is linked to an associated results item, although process categories and results items are not in the same order • Results are expected to be summarized and segmented as appropriate for all key areas and key processes, including comparative data • Measure the things that are important to your success 21

22. Baldrige Health Care Criteria Framework: A Systems Perspective

23. Another Look at the Baldrige Framework Ingredients to Optimum Performance Requirements Meet Delight Patients/ Customers Motivated people Leadership Get results Be valued Strategy Efficient Processes Predict Outcomes Driver Triad Work Core Outcomes Data and scorecard to monitor progress

24. Criteria Structure • Categories (1, 2, …) • Items (1.1, 1.2, 2.1, …) • Areas to Address (a, b, c, …) • Questions • Explanatory Notes

25. “Anatomy” of the Criteria Criteria book – pg 29 25

26. Category 1: Leadership (120 pts.)

27. The Leadership Category • Vision, Mission, and Values • Promoting Legal and Ethical Behavior • Creating a Sustainable Organization • Communication • Focus on Action • Governance System • Performance Evaluation • Societal Well Being • Community Support

28. The Importance of the Vision and Mission • Begin with the end in mind. – Stephen Covey • People often say that motivation doesn't last.  Well, neither does bathing - that's why we recommend it daily. -ZigZiglar

29. Does your Organization have an Effective Vision and Mission Statement?

30. Category 2: Strategic Planning (85 pts.)

31. Strategic Planning Category • Strategic Planning Process • Strategic Objectives • Action Plan Development & Implementation • Resource Allocation • Workforce Plan • Performance Measures • Performance Projections

32. The Importance of Strategic Planning • If you don't know where you are going, you will wind up somewhere else. -Yogi Bera • Meticulous planning will enable everything a man does to appear spontaneous. -Mark Caine

33. Category 3: Customer Focus (85 pts.)

35. Customer Focus Category • Listening to Patients and Stakeholders – Current and Potential • Engagement • Satisfaction and Dissatisfaction • Quantification of • customer needs is the key. Customer- defined value Map and understand value stream Make value stream flow Continuous process improvement • Segmentation • Data Use • Relationship Management • Complaint Management

36. The Importance of the Customer • Whoever understands the customer best wins. - Mike Gospe • 95% of companies collect customer feedback.  Yet only 10% use the feedback to improve, and only 5% tell customers what they are doing in response to what they heard.- Gartner Group

37. Category 4: Measurement, Analysis, and Knowledge Management (90 pts.)

38. Measurement, Analysis, and Knowledge Management Category • Performance Measures • Comparative Data • Patient and Stakeholder Data • Measurement Agility • Best Practice Sharing • Future Performance • Continuous Improvement & Innovation • Data, Information, & Knowledge Management • Property • Availability • Information Resources & Technology • Hardware & Software • Emergency Availability

39. The Importance of Measurement • An acre of performance is worth a whole world of promise. - William Dean Howells • Measurement is the first step that leads to control and eventually to improvement. If you can't measure something, you can't understand it. If you can't understand it, you can't control it. If you can't control it, you can't improve it.- H. James Harrington

40. Category 5: Workforce Focus (85 pts.)

41. 100 Employee Engagement 95 85.6 90 85 79.9 80 75 70.2 70 65 59.6 56.7 60 55 50 2005 2006 2007 2008 2009 Workforce Focus Category • Workforce Capability and Capacity • Workforce Climate • Workforce Performance • Measurement of Workforce Engagement • Workforce and Leader Development

42. The Importance of the Workforce • “Turned on” people figure out how to beat the competition. “Turned off” people only complain about being beaten by the competition. - Ben Simonton • We treat our people like royalty. If you honor and serve the people who work for you, they will honor and serve you. – Mary Kay Ash

43. Category 6: Operations Focus (85 pts.)

44. Operations Focus Category • Work System Design • Work System Management • Emergency Readiness • Work Process Design • Work Process Management

45. The Importance of Operations • If you can't describe what you are doing as a process, you don't know what you are doing. - W. Edwards Deming • A company can seize extra-ordinary opportunities only if it is very good at the ordinary operations. - Marcel Telles

46. Category 7: Results (450 pts.)

47. Results Category Baldrige addresses all results—process, leadership, product, customer, financial, and workforce.

48. Building on the Framework…. Outcomes Review - LeTCI • Appropriate • Industry Leader • Benchmarks

49. The Importance of Results • Don't rate potential over performance. - - Jim Fassel • An acre of performance is worth a whole world of promise. - William Dean Howells

50. Baldrige Application Components Organizational Profile What’s important? Passion Process What do we do and How do we do it? Principles Results Were we successful? Results Linkage and Alignment Across your Organization