BLOGRIGE

Can the Health Care Criteria Really Save Lives?

Posted by Dawn Marie Bailey

 

 

When Rulon Stacey, President and Chief Executive Officer of Poudre Valley Health System, a 2008 Baldrige Award recipient, claimed that the Health Care Criteria helped the organization save lives, I believe I heard an audible gasp throughout the auditorium where he was accepting the Award. Or maybe it was just me gasping. 

 

“By having the courage to open themselves to the robust scrutiny of the Baldrige National Quality Program and the fortitude to act on what they learned, [Poudre Valley Health System] has literally transformed the way health care can and should be provided. As a result of [Poudre Valley Health System's] commitment, I’m convinced that there are people who are alive today who otherwise would not be alive.”

 

As a former newspaper reporter, I knew that such a statement could not be made without data to back it up. I needed to further investigate. Here is what I found:

 

• Poudre Valley Health System is a locally owned and private, nonprofit health care organization serving residents of northern Colorado, Nebraska, and Wyoming. In two acute care hospitals and a network of other facilities, Poudre Valley Health System offers a full spectrum of health care services, including emergency/urgent, intensive, medical/surgical, maternal/child, oncology, and orthopedic care.

• The health system reports that its mortality rate for acute myocardial infarction (AMI) patients has consistently improved and remained better than its primary competitor. Poudre Valley Health System also consistently outperforms the risk-adjusted rate predicted for it by HealthGrades. At the time it received the Award, the health system had seen three years of continued improvements for patients with heart failure and pneumonia.

• In 2007 and 2008, Poudre Valley Health System was recognized as the nation’s number one hospital for sustained nursing excellence by the American Nurses Association and the National Database of Nursing Quality Indicators (NDNQI).

• At the time it received the Baldrige Award, for five consecutive years, Poudre Valley Health System had been one of seven U.S. hospitals to be named a Thomson Reuters 100 Top Hospital (for superior outcomes, patient safety, and operational and financial performance).

• In addition, patient satisfaction scores surpass the national top 10 percent, according to the Centers for Medicare and Medicaid Services.

 

“We’ve got lessons learned that are saving people's lives because we participated in the Baldrige process," Stacey said.

 

Based on these data, Mr. Stacey, I believe that you are correct—utilizing the Health Care Criteria to drive improvement does help save lives.

 

(To learn more about the processes that Poudre Valley uses to save lives and the results it has achieved, see its Award application summary.)

 

American Idol....Pshaw!

Posted by Harry Hertz, the Baldrige Cheermudgeon

Okay, today I am exercising the "mudgeon" side of Cheermudgeon. This week we will crown our next American Idol. Now don't get me wrong, I am the first person to cheer for the come-out-of-nowhere person who makes it big. I have even been known to shed a little tear. But where is our sense of balance? How much money has been spent on these new stars? Private plane trips home. Police escorts. What has been spent just on text messages voting for your favorite idol?

But more importantly, as an American citizen, what praise and lavish expenditure do we bestow upon the best small business of the year that has created new jobs and new technology that might drive our future economic engine? What about the big business that has been a governance and ethics model for the country? Or the business that has saved its community in a time of trouble? Or the school district that has superb student learning outcomes on a low per student budget, preparing the next generation of national leaders? Or the health care provider that has donated countless hours on an innovative program designed to improve community health? Or the government agency that delivers effective, efficient services to taxpayers? These should be the American Idols we honor and revere.

And year after year the recipients of the Malcolm Baldrige National Quality Award are these American Idols. In good times or tough times, aren't these the true heroes of our country? Shouldn't we celebrate them? And there is a further benefit...they have strategies that others can emulate. Who was the last singer you were able to study and then have perfect pitch yourself?

Okay, I haven't solved any problems today with this blog entry, but I sure feel better. Now I can watch American Idol with a clear conscience. I have shared the burden with you.....

 

Will they ever be Business Week best sellers?

By Dawn Marie Bailey

 

Calling all organizations interested in using the Baldrige Criteria for improvement, all MBA students looking for a business model, or simply all people curious about how the Baldrige Criteria might actually be applied. . . .

I love novels and good writing. There’s nothing like curling up with a good story full of interesting characters, challenges, and outcomes. So, believe it or not, one of my favorite projects here at the Baldrige Program is editing case studies. Imagine the possibilities in creating a fictitious organization, where no one can lose her job or the organization go out of business, and we the authors decide the patient safety ratings or how many students should pass which tests.

These case studies are used to train Baldrige Examiners (both at the national and, in some cases, state and local levels, as well as in some organizations' own quality training) in evaluating an application for the Baldrige Award. They also are a tool for applicants to use when writing their actual applications or any organization to use to guide self-assessments.

But Baldrige case studies have an even wider appeal. To anyone interested in learning about an organization that utilizes a systems perspective, that demonstrates how to use the seven Categories of the Baldrige Criteria as a business model, and that shows how the Criteria Process Categories (Leadership; Strategic Planning; Customer Focus; Measurement, Analysis, and Knowledge Management; Workforce Focus; and Process Management) and the requirements they comprise can dictate the measurements an organization should consider, then a Baldrige case study might just be that good business read you are seeking.

For me, case studies are an opportunity for so much creativity and learning. They are also a puzzle with lots of pieces that need to fit together, so that when used in training, no key point or fact or character will be distracting. In other words, a good case study must be realistic, completely aligned no matter how many authors contributed, and inspire enough discussion that learning can happen.

At the Baldrige Program, we have been so lucky that our creative, hard-working Examiners have volunteered to write these case studies. Together, we have tried to shape these case studies, usually with specific learning points in mind; for example, what might a nonprofit that depends on a volunteer workforce do to be successful; or how would an organization with multiple customers—with possibly competing interests—sustain itself; or what about an organization forced to contemplate layoffs or outsourcing? At times, we have also sought to create organizations that might generate new thinking among Examiners; for example, what might a profitable rural community hospital look like or how would a government-owned, contractor-operated organization remain competitive? We’ve also tried to represent sector challenges in case studies; for example, how does a college attract the best faculty when those faculty could make more money and have more benefits in private practice?

So, I’m curious what learning points you would like to see in the Baldrige Program’s case studies. What challenges in your sector would you like to see Examiners grapple with? What unique situations does your organization face that you would like Examiners to better understand? What learning points should we be building into case studies so that Examiners can be better prepared to evaluate your application?

Of Pink Slips and Process

 

Posted by Jeff Lucas

Last week a California Superior Court judge granted an injunction against the Los Angeles Unified School District preventing it from using a seniority based policy to lay off teachers at three middle schools that serve primarily low-income students of color. The plaintiffs were students from the three schools and the judge ruled that, although California schools are allowed to use seniority in making the RIF decisions necessitated by the states crippling budget shortfall, the students and their parents (aided by the ACLU) had shown a denial of equal educational opportunity as a result of the layoffs that had occurred this year. 

Looking at the numbers, it's hard to argue with their point.  Students at the three schools had proficiency levels that were only a fraction of those achieved by LAUSD students as a whole (not what we would term "Performance Excellence" to begin with).  In fact, the Governor and State Board of Education, who were both named as defendants in the suit, agreed with the position of the petitioners.  

It's likely that this suit is going to create a real whirlwind in education policy with issues including:  what criteria should be used to decide who loses a job?; who should determine those criteria?; and why did it take a catastrophic budget situation for someone to realize these kids constitutional rights were being violated?

Of interest to those of us in the Baldrige community is what this points out about a general lack of process focus around many of the key decisions that have to be made in K-12 education systems.  Even without going to the Baldrige Criteria requirements on this specific point [5.2a(4) for those of you keeping score] why not proactively design decision mechanisms that would take into account a school system's mission and core values, and would align with the strategic direction of the district?  It frequently seems that such difficult choices are left to policy makers, which then allows district leadership to use the cover of "our hands are tied".  But then again, maybe I am just cranky about all this dreary May weather here in DC.  I am sure you readers will let me know. 

Data Mining on the Web: Are the Data Yours or Mine (to Mine)?

Posted by Harry Hertz, the Baldrige Cheermudgeon

What in the blazes is that man talking about now, you may ask. It all started with my recent statement to Baldrige Examiners that there was a lot of "free" customer listening available on the web and that organizations should be aware of that information. An innocent comment with common sense advice that many social media marketing gurus are giving their organizations or clients. If your customers are blogging or tweeting about you and your competitors, you should learn from what they are saying. It is public information, freely (and generously) given. This is a source of valuable insight, that might not be realized through your own customer surveys.

So far, so good!  

Then a colleague reminded me of an article on "hotels connecting the dots" in the May 9, 2010 issue of the Washington Post. The article contributed by National Geographic Traveler magazine's reader advocate Christopher Elliott tells of hotels who research anonymous guest reviews on popular travel sites and through overlap of information link the review to your hotel loyalty program member account. Write a positive review (anonymously) and you might get a gift basket on your next stay. Write a negative review and you might get a concerned e-mail from the hotel manager, or worse, a black mark in the loyalty program data base. Mr. Elliott goes on to suggest that you not use your real name when reviewing a hotel and make sure your internet handle reveals nothing about you. Wow, and I was recommending innocent use of freely given information.

I got intrigued and came across an article on "how privacy vanishes online" in the March 16, 2010 issue of the New York Times. It reported a study by two Carnegie Mellon researchers, who were able to use publicly available information, such as profiles on social networks to correctly predict (not uncover) Social Security numbers for nearly five million people born in the U.S. between 1989 and 2003. While this was an academic study, inappropriate use of these data would be possible, and in this case, criminal.

So what does this all mean? It means that the transfer of information to knowledge to action must be respectful of appropriate boundary conditions. Critical considerations must be legality, ethics, core values, and transparency. Data mining of freely provided information can be a major source of data for aggregation and analysis for organizational decision-making, but should not be a source for "intrusion of privacy." If it feels wrong, it probably is wrong. My mother taught me that years ago. The Baldrige Criteria for Performance Excellence reinforce my mother's teachings. The Criteria ask about legal and regulatory compliance, ethics, core values, ethical breaches and proof of ethical behavior. And most of the questions are in the Leadership Category of the Criteria, because these concepts must begin with the beliefs and actions of senior leaders.

The web is not an excuse for forgetting what our parents taught us. It is a source of valuable, appropriately-used information.

Got an opinion? Let me know! And thanks!

Cast Your Vote: BLOGRIGE Strengths and Opportunities for Improvement

Posted by Zara Brunner

So we're more than 3 months into this new communication tool--BLOGRIGE--and we think everything is going along swimmingly.  But we're more interested in what you think.  It's your turn to give us feedback: what are the strengths and opportunities for improvement?

Sure we can look at data to tell the number of comments made, the number of page views, and other aggregate metrics (which have been positive).  But that's simply not enough.  In order to know if we're effectively meeting your needs and expectations with this blog, we need to ask you.  We created it as a way to provide you with information and engage you in conversations around important and/or interesting topics related to performance excellence and organizational improvement. 

Can you take a few minutes and tell us what is working and/or what's not?  Are we providing you with the right information?  When you don't comment on a post, does that mean you agree, aren't interested in the topic, or prefer to just be informed? 

Are there certain topics you want more of or less of, such as leadership, strategic planning, customer engagement, measurement/knowledge management, workforce engagement, process management, results, State and Local Baldrige-based Programs, Baldrige Examiners, the Baldrige Award Process and Award Recipients, upcoming performance excellence events, or news for the community?  How about sector-specific information: would you like more posts related to education, health care, manufacturing, nonprofit, service, or small business?

Tell us what you want us to keep doing, or what you would like us to do differently.  It will help us as we think of future blog topics and provide you with the best value in reading them.  Thanks!

Everything Important for Strategic Planning I learned in Quantum Physics Class

Posted by Harry Hertz, the Baldrige Cheermudgeon (or Baldrige Geek this week)

I have seen the future and it's name is agility.

According to a just released McKinsey study of 1,416 executives around the globe, there are four strategically important global developments that will be most important for business and company profits over the next five years. They are:

1. an ongoing shift in economic acivity from developed to developing economies
2. growth in the number of consumers in emerging markets
3. a free flow of information worldwide, enabled by new technologies, and 
4. global labor markets.

Combine these developments with the finding that 63% of McKinsey respondents expect increased overall volatility to become a permanent feature of the global economy and another 23% (that's 86% in total) expect sharply higher levels of volatility undermining the economy's robustness, and agility will be the strategic watchword for the coming decade.

We will need to get out of the crisis mode and assume these characteristics will be a reflection of "business as usual." We will need strategic planning processes that are senitive to early indications of major shifts in technology, markets, and customer preferences (globally). We will need a sensitive process for finding blind spots. Does this sound familiar? It is already embedded in the Strategy Development Item (2.1) of the Baldrige Criteria for Performance Excellence.

In the language of a scientist, we will need quantum planning. As a matter of fact, this very idea is covered in a 2009 book by Gerald Harris, entitled The Art of Quantum Planning. Its basic premise is planning in an uncertain, change-laden, energy-rich environment is the mode of planning that will lead to success. It recognizes the organization as an ever-changing system with significant transfers that defy current practice. It is a layman's adaptation of quantum physics to strategic planning. And I had to take two semesters of quantum physics in college to come to this realization in my mature-baby-boomer years! There you have it and you don't need to be up on your calculus or physics.

Comments are welcomed from strategic planners and physicists, and anyone else willing to dive into my quantum well!

Generation Baldrige?

Posted by Jeff Lucas

A lot of labels have ben suggested; Gen Y, Millenials, Echo Boomers; but why not "Generation Baldrige."  An article in this month's Harvard Business Review entitled "Mentoring Millenials" summarizes research done by Jeanne Meister and Karie Willyerd, co-founders of Future Workplace on what the generation born between 1977 and 1997 are looking to get out of their professional lives.  The top five characteristics that they want in their company?:

• Will develop my future skills
• Has strong values
• Offers customizable benefit options
• Allows me to blend work with the rest of my life
• Offers a clear career path

In addition, the article describes how this highly socially conscious generation wants work to be a key part of their life, not something that they need to balance.  All of these things sound like attributes that the Baldrige Community can tap into.

And here is a program that already has . . .

Lynchburg College teamed up with Virginia's U.S. Senate Productivity and Quality Award (SPQA) to implement an Examiner Intern program for Senior Business students.  A pilot group of four students completed SPQA's Examiner training and then participated as full members of evaluation teams in the 2010 award cycle.  This included Independent Review, Consensus Review and Site Visit.  By all accounts the interns were valuable team members, and this is how one of the four, Elizabeth Eckert, described the experience:  “The SPQA internship offers exposure to a large number of business concepts and processes relevant to our current coursework and future careers.  In addition, meeting and working with professionals from all over the Commonwealth was a valuable opportunity.”

In the future, Dr. Joe Turek, Dean of the School, hopes to build upon the successful pilot by creating a network of similar internships at institutions around the country thereby ensuring a continual supply of young professionals who have been exposed to the Baldrige approach and hopefully take the principles and values forward as they become the leaders of our organizations.

I was fortunate enough to have lunch with Dr. Jan Garfield who leads training and development efforts for SPQA and who coordinated the interns’ participation in the evaluation portion of the program.  She was here at NIST for Baldrige Examiner training last week and was positively beaming about the experience.  As she pointed out, these students were born in the late 80's at just about the same time as the Baldrige program and that seems to have created a special affinity for this first group who have never lived “in a world without Baldrige.”

So, being in my "what if" mode I quickly came up with the following list of half-baked ideas on how we might build a synergy with this group:

• Pairing student interns with Baldrige Examiners in some way - research shows that the millenials relate well to Baby Boomers and most of our Examiners fit the Boomer profile
• Harnessing the power of virtual learning opportunities to bring Baldrige Award Recipients into the classrooms, or dorm rooms, or iPhones, of these interns through interactive video conferencing to enhance the experience
• Providing some customized training for the Business School faculty that will be leading these internship programs to both help them understand the Examiner role and adapt the Baldrige framework in their general curriculum

I know our readers out there will have plenty more ideas, so bring them on.