Wisdom Of The Baldrige AwardPosted: September 24, 2012
Another hospital performance evaluation was released last week – this one by the Joint Commission (JC), having announced its Annual Report on Quality and Safety. A list of Top Performers was included in the report. The amazing thing to many of us working in quality and safety is that there seems to be little consistency between the evaluation outcomes of this newest assessment and those released over the last few months, such as: The Leapfrog Group, US News & World Report, Consumer Reports, and HealthGrades. While all these organizations use somewhat different criteria to choose their Top Performers list, one would hope some consistency would exist among those anointed top performers–at least to reassure all of us that the conclusions drawn are valid. For instance, not one of the top ten hospitals in the US News & World Report is included as a top performer by JC. HealthGrades’ list of the top 50 hospitals in the country, with over 75% of their grading based on quality and safety measures, looks quite different from the JC top quality and safety performers. It makes many wonder why organizations that have access to the same metrics all come up with quite different results when evaluating performance.
Which brings me to the Malcolm Baldrige Quality Award. I had the pleasure of visiting Poudre Valley Health System (PVHS) this past week. Members of their leadership team – William (Bill) Neff, Ric Detlefsen and Stan Gunstream – attended our Telluride Patient Safety Roundtable this past summer, and shared the story of their hospital’s commitment to high quality care, including having earned the Malcolm Baldrige National Quality Award in 2008 for their efforts. Their story, and their commitment to do the right thing for their patients no matter how difficult the journey, struck a chord in me this summer. I had asked if I could visit their hospital later in the year and observe the work they had shared with us in Telluride. Here is Rulon Stacey, CEO of Poudre Valley Health System, accepting the award:
My day began at 7:00am with their Quality Improvement Update meeting. When I entered the conference room, over 100 people including all members of their C-Suite were already in the room, eagerly awaiting the start of the meeting. Over the next sixty minutes, five teams presented Rapid Improvement Experiment (RIE) data in five different value streams. Each multi-disciplinary team consisted of 8-10 caregivers, who had been given a full week away from clinical responsibilities to redesign and trial the process improvement and was given 6 minutes to present their work. (The hospital bought out the time of MDs on each team during the week they worked with other team members on quality and safety innovations). These presentations were followed by five additional teams, who were given 3 minutes each to update data from RIE work completed the month before. Leadership provided feedback to each of the teams for the last 10 minutes of the hour-long meeting. The energy in the room was contagious, the sense of accomplishment palpable, and the commitment to quality improvement exciting to witness.
During the next few hours, Bill, Ric and Stan shared the story of their ten-year journey en route to winning the Baldrige Award, the nation’s highest honor for innovation and performance excellence awarded by the president of the United States. PVHS was one of three organizations to receive the award in 2008, and the only healthcare recipient, making it one of the best hospitals in America. What is most impressive about the team at PVHS is their modesty and business-as-usual attitude about the award itself. The challenges and dedication to the journey in the best interest of their patients is what they stressed the most–the award was the icing on the cake. In fact, the year they did win the award the caregivers were just looking forward to receiving the Baldrige evaluation report that came each year so they could see where they needed to focus their quality improvement energy for the coming year – the annual report had become their roadmap to high quality care. They were surprised and delighted they had won the award. It’s amazing to see what good people can accomplish when focused, and pointed in the same direction. A second post will follow on their lessons learned.
About the Baldrige Award
Congress created the Baldrige program in 1987 to promote quality awareness, to recognize the quality and business achievements of U.S. organizations, and to publicize these organizations’ successful performance strategies. Stand-alone hospitals, and large health systems nationwide can use the Baldrige criteria to improve their operations and sustain world-class results. Organizations being considered for the award undergo a rigorous review of:
- Their leadership
- Strategic planning
- Customer (patient) and staff focus
- Knowledge and process management
- Clinical, regulatory and financial results
When it comes to recognizing high quality healthcare, the Baldrige Award is one “High Performer” assessment model that uses stringent review criteria, incorporating site visit evaluation methodologies that are difficult to question.
From their website:
The Baldrige Criteria help health care organizations achieve and sustain the highest national levels of
- patient safety and patient loyalty
- health care outcomes for acute myocardial infarction, heart failure, pneumonia, and other conditions
- physician and staff satisfaction and engagement, especially among registered nurses
- revenue and market share
- community services
The Baldrige Criteria for Performance Excellence provide a system’s perspective for understanding performance management. They reflect validated, leading-edge management practices against which an organization can measure itself. With their acceptance nationally and internationally as the model for performance excellence, the Criteria represent a common language for sharing best practices among organizations. The Criteria are also the basis for the Malcolm Baldrige National Quality Award process.
Regardless of what other quality and safety rankings might tell us, I would give PVHS a top performer quality score. Can’t argue much with the Baldrige assessment methodologies when compared to many of the other models.