BLOGRIGE

So You're a Health Care Role Model, Now What?

Posted by Dawn Marie Bailey

After receiving the Malcolm Baldrige National Quality Award, Bronson Methodist Hospital and North Mississippi Medical Center (NMMC) said the Presidential recognition propelled them forward, but is the organizational improvement sustainable?

Speaking at the 23rd annual Quest for Excellence Conference, Michele Serbenski, vice president, performance excellence and organizational learning, a 2005 Baldrige Award recipient Bronson, said receiving the Baldrige recognition "was the best thing that ever happened to us." The organization has found a commitment to excellence at the highest level, and this includes best-practice sharing, increased engagement and involvement of the medical staff, and leaders asking questions that come straight from the Baldrige Health Care Criteria for Performance Excellence.

 

But Serbenski warned health care organizations beginning their Baldrige performance excellence journeys not to consider Baldrige just a quality fad. Executives should not treat the Baldrige Criteria like skiing, she said, with one ski on executive work and one ski on the Baldrige Criteria. Instead, think of adopting the Criteria like snowboarding, with both feet on Baldrige as your guiding principle. She said the key to adopting the Baldrige Criteria is to "make Baldrige the work of your organization—not a project, not a season, not an executive team that locks itself in a conference room" once a year.

Serbenski said Bronson has learned many lessons from Baldrige:

• Commit to excellence
• Continuously self-assess
• Understand your culture
• Make the Baldrige Criteria your work
• Continuously raise the bar
• Recognize it's an improvement journey that never ends

Karen Koch, director of the Patient-Focused Improvement Department at NMMC, said that after receiving the Baldrige Award in 2006, NMMC became both a magnet for exceptional employees and a magnet for recruiters. But the organization focused on its lessons learned from Baldrige. This led to alignment of services and goals to every employee, the integration of systemwide departments into the Patient-Focused Improvement Department, expanded leadership safety rounds and participation in high-level benchmarking, and the development of patient-safety specialists, among other improvements.

Koch said NMMC continues to benefit from using the Baldrige framework by focusing on the "how" questions of the Criteria.

 

How might other health care organizations improve with the Criteria?
 

These are a Few of my Favorite Things: Top 10 Excellent Practices

Posted by Zara Brunner

Here are a few of my favorite things about the leaders from Baldrige winning organizations' recent presentations at the Quest for Excellence conference in DC.  The blog title may be a bit misleading if you were thinking Sound of Music..not exactly whiskers on kittens.  But close.  Since Nestlé Purina's Incredible Dog Team put on quite a performance for us and their presentations made it very clear that pets--dogs and cats alike--are their customers. 

So here's my list of the Top 10 coolest, most impressive things learned from these high performing, role model organizations that I want the world to know about:

1. Ears, Gears, Cheers, and Peers by MEDRAD is a management model and they work to get out of employees' way and empower them to make decisions based on customer needs.  This leads to results.  Fifty million people receive MEDRAD's products.  They "focus on customers and employees and know that the numbers will follow."  MEDRAD's motto is Performance. For Life.  And those of us who get a CT scan or any of the other medical device and intervention products and services from this company can rest assured that MEDRAD is committed to excellence, and performance does save lives. 
2. Nestlé Purina PetCare Company's research and innovation on products for customers; including all of the company's employees taking a two-day, customized "Skills for Innovation" course.  We heard a great presentation and saw an advertising montage reflecting how they tailor their products and enhance/innovate them based on customer requirements.  Each different market segment gets mined for insights and needs, which leads to innovation in the products, packaging, brand and more. Another interesting thing the company does is put together 40 person cross-functional teams to come together for three days to problem solve and innovate, and then Work Out Groups look at data, prioritize, and make the company better.  They achieve 95% implementation of the action plans that result from these groups.  We hear from leaders all the time that developing strategy is one thing, but the real rub is in execution.  I'd say that this implementation success rate shows that something is working very well. 
3. Want your business to last for 117 years or more?  Look into Freese and Nichols and what they've done.  This small multi-service engineering, architecture, and environmental science firm created a Futures Committee to spot and stay on top of engineering and market trends with a 20 year focus on the future.  The firm has also embedded Jim Collins' Hedgehog Concept into its culture with client service employee rewards programs, senior leader Executive Client Visits, Client Think Tank Panels (also for a future-focus), and classes at Freese and Nichols University--open to clients, of course.  As CEO Bob Pence said, "the first thing we built was our reputation."
4. K&N Management  focuses on guest (not customer) delight (not just satisfy)--read more about how they do this here.  If this small, fast-casual restaurant business can go out and visit the Seattle Fish Market, Disney, two-time Baldrige winning  Ritz-Carlton, Cargill, and the Texas-based Kincaids Hamburger, there's no reason why other organizations can't figure out ways to benchmark from the best.  You want work life balance in your organization? Consider hiring a chaplain to focus on Life Balance like K&N Management did. 
5. Low performers "suck the life out of the organization," so high-performing Studer Group, a virtual consulting company, focuses on selection and reminding everyone of their purpose.  Focus on "alignment of behaviors" not just alignment of goals, and your organization will see breakthroughs.  "It's about living the mission." It's about performance evaluation based on achieving results.  It's about transparency.  It's about culture.  And according to Quint Studer, "culture outperforms strategy every time." 
6. Montgomery County Public Schools in Maryland, the 16th largest school district in the U.S., has 22,000 employees, serves 13 million meals a year, and has buses which travel around the world the equivalent of four times a day.  The school system went from "random acts of improvement" to the use of Baldrige to align systems and structures around a "Call to Action" to get the community involved to help them raise the bar and close the gap for children.  In the last three years, there have been no raises, supplies have been cut back, poverty increased by 57%, more students flooded the system--including English as a second language-- and yet results went up every year.  MCPS is now the largest International Baccalaureate in the US and out scores the state and the country on taking the SAT and scoring.  Look at this post on Putting Race on the Table and, as Dr. Jerry Weast, Superintendent of MCPS said at the conference, "don't tell me Baldrige doesn't make a difference." 
7. Advocate Good Samaritan Hospital focuses beyond satisfaction to a transformational way of "being" towards physicians.  They have a passion for partnerships in order to build loyal relationships.  Such physician loyalty has led to impressive clinical outcomes and national recognition and awards.  CEO David Fox said it's about "true communication-listening deeply.  With our ears, eyes, body, and heart to enter into the physician's world of commitment and responsibility, care and compassion.  Yes, these qualities differ in degree from person to person, among physicains, as among executives and human beings..."  The accompanying chart shows how they measure up on physician loyalty.     
8. Still wondering how or why to use social media?  Check out the socialnomics video referenced by CH2MHill.  They are dealing with elected officials --which some might perceive as not a natural target audience for new media--and have effectively figured out a way to overcome obstacles to use social media to connect with customers. 
9. In times of budget cuts and crises facing cities, counties, states, and the nation, the City of Coral Springs has been using data, not money, to respond to customers' needs.  Budget cuts and the "great recession" can be overcome and customers needs can still be surpassed.  Their recommendations: think strategically and creatively and by all means, make decisions using data and manage by fact.
10. Past Baldrige small business winners MESA Products and Stoner doubled revenue growth with Baldrige (read a previous blog post for full details).

Unfortunately, I couldn't attend all the sessions so I undoubtedly missed some other great pearls of wisdom and best practices.  Harry, The Baldrige Cheermudgeon, captured some in his April Insights column so feel free to keep reading and keep learning.  Then pick one thing--just one thing--to work on for your organization based on this list of great ideas from these high performing organizations. 

Future Ethics

Posted by Harry Hertz, the Baldrige Cheermudgeon

It is hard to believe that it was almost a decade ago that a major theme for the revision to the 2003 Baldrige Criteria for Performance Excellence was business ethics and the role of senior leaders. Here we are in 2011 and the topic is still a significant focal point for organizational leaders and the general public.

Of course, Baldrige award recipients have been role models for ethics before and after 2003. In our current group of recipients two comments from our recent Quest for Excellence conference immediately come to mind: 1. Nestle Purina now being rated the most trusted pet food company for several years running, and 2. Bob Pence, President and CEO, from Freese and Nichols saying the first thing his 116-year old civil engineering firm built was its reputation.

The New York Times has a regular magazine feature by Ariel Kaminer, The Ethicist. Her article on May 15, 2011 was about the ethics of swapping super market id cards used at checkout to get discounts on highlighted products. It generated lively discussion among readers, including a comment about the choice to use the card really being a choice for wealthier consumers and that people less wealthy and on a budget need the discount received only by using the card. This then became a question of whether it is ethical for corporations to extract information from the more vulnerable consumers.

On May 16, 2011, in his first act as mayor of Chicago, Rahm Emanuel signed six executive orders on ethics.

So, has ethics become a catchword for examining everything including everyday acts of grocery shopping. Or is it still a major challenge requiring constant reminders and vigilance, as witnessed by the first act of Mayor Emanuel? I think it is the latter and that the challenges continue to grow as we become a global economy with differing ethical "norms" around the globe.

But why am I choosing to write about ethics again now? It's always in the news in some manner, as seen above. However, it is the results of a recent study and the Daily Show routine from 2009 that bring it to the fore. The 2009 routine dealt with a Harvard MBA Ethics Oath students were refusing to sign and Jon Stewart and John Oliver chose to "highlight." The recent study, published in the March issue of the Academy of Learning Management and Education sampled 759 graduating MBAs from business schools in the U.S. and Europe. The study found that 88.3% of the students would take a pay cut to work for firms with ethical business practices. The average salary they would forego is $8,087.

Is this a hopeful sign or a price tag for ethics? What is your opinion?

Higher Education Interacting and Engaging, Not Just for Students Anymore

Posted by Dawn Marie Bailey

After it received the Malcolm Baldrige National Quality Award in 2004, Monfort College of Business' freshmen applications went up 30%, said Mike Leonard, director of external relations. But staying connected to and engaged with these potential new students, as well as current students, families, alumni, and other stakeholders, are not as simple as sending out paper news releases and letters anymore, he said at the 23rd annual Quest for Excellence Conference. Monfort turned to interactive social media to drive future students to its admissions page, show life at the college, and promote its community.

The University of Wisconsin-Stout, a 2001 Baldrige Award recipient, also has connected students and stakeholders through social media, said Douglas Mell, executive director of communications and external relations, reporting that use of one social media outlet alone led to 134 new freshmen applications. "We use every method that we know to connect with students in a virtual environment," Mell said. "The old ways of sending out paper aren't enough anymore."

Since it began with social media in January 2010, Monfort has increased its total subscribers in January 2011 to more than 1,500; not bad for a college of just 1,030 students. In 2010–2011, freshman applications were up 20% from 2009.

UW-Stout also has tracked social media activity, increasing from about 2,600 fans/friends in July 2009 to more than 6,000 in January 2011. It has tracked news feed impressions, daily likes and comments, and daily active users to measure which content resonates most with students. For example, Mell said when the Wisconsin Governor released his budget in February 2011, students turned in great numbers to the UW-Stout social media sites to discuss and comment.

UW-Stout uses social media to advertise, chat, and interact with students about college fairs and other events, offer topical message boards, allow students to set up their own profiles, share athletic information and conversations, and stay in touch with alumni and families. Mell said the university expected its largest social media demographic to be 13 to 24 year olds but has found its efforts dominated by 25 to 44 year olds. He said to a very large extent alumni are engaging in social media and so are families, including grandparents, who want to connect with their college-age children and grandchildren.

Leonard said it would be a mistake to see social media as just a dissemination vehicle. "It's got to have an interactive component." Monfort College uses social media to begin conversations with both current and potential students, ask questions and invite responses, offer photo contests to depict student life, support events, offer polls to gather student input on such subjects as the best place to study and the best study methods, and gather advice for incoming freshmen. The college also uses social media to engage or re-engage with alumni, including offering alumni information on jobs, mentoring, and donating.

The Education Criteria for Performance Excellence, on which both Monfort College and UW-Stout's Baldrige Awards are based, encourages education organizations to use social media to gather the voice of the customer: those stated, unstated, and anticipated student and stakeholder requirements, expectations, and desires. "Listening to the voice of the customer might include gathering and integrating various types of student and stakeholder data, such as survey data, focus group findings, blog comments and other social media data, and complaint data that affect students’ and stakeholders’ enrollment and engagement decisions," reads the 2011–2012 Education Criteria. Social media is a rather new concept to the Criteria, and education organizations are asked to consider how social media can be used as a mode of gathering insight into students’ and stakeholders’ perceptions of all aspects of their involvement with the organizations.

Leonard's word of caution, however, for using social media is that "it's a busy medium, and you have to stay on top of it to keep the content current, active, and vibrant."

Jerry Poling, assistant director of university communications at UW-Stout, said the university strives to keep its social media activities active and current, posting new content five to six times a day; the intent is to post exclusive content, not just the same content found in press releases.

What are your ideas for how organizations in general can use social media to engage with customers (including students and patients) and stakeholders? How might the Criteria for Performance Excellence continue to provide a framework and considerations for this voice of the customer process? What do you think?

Coughing during a Concert

Posted by Harry Hertz, the Baldrige Cheermudgeon

OK, so this is a somewhat different post. I recently had the opportunity to attend an Itzhak Perlman concert and to be seated where I could not only hear him play the violin, but observe his mastery of the instrument from almost right above the stage. It was wonderful. But that is not exactly the topic of this post. With a performance that involved only violin and piano, every extraneous noise was heard. Two such "noises" caught my attention. The first was the random cell phone going off during the concert and the second was patrons coughing, which miraculously occurred only between movements and involved a significant number of attendees, not a random few.

As I reflected on these noises after the concert, I wondered how some people with cell phones could be so inconsiderate of other concert attendees and how others could be so considerate of them with their coughing. I actually marvelled at the ability to have such self-control over an essentially involuntary act, like coughing. So I decided to do some research and indeed on quite a few symphony web sites I found guidance on how to avoid coughing during a concert. Of course those same sites also comment on cell phone courtesy.

But what, even in my twisted mind, could this have to do with Baldrige. The tie for me was in the courtesy (waiting to cough) and disrespect (cell phone use) aspects of these phenomena. In a time when customer relationship building is a key CEO strategy, why is it that some organizations still fail to see the importance of customers and appear to almost show disrespect to them? In an environment where collaboration, teaming, supply chain partnering are critical for competitive success, why do some companies and workforce cultures not realize it? In a time of global competition, why are many of us late in the game of giving our customers what they desire? Is this a sign of arrogance, bordering on disrespect?

I wish I knew the answers. I do know that the Baldrige Criteria for Performance Excellence ask you all the questions to improve critical relationships for your organization. And our brief "Are We Making Progress?" and "Are We Making Progress as Leaders ?" surveys will help you understand some critical aspects of leader and employee relationships.

What is your take on critical relationships within your organization and with your key stakeholders?

Lives Saved, Costs Reduced: Preparing for Health Reform

Posted by Dawn Marie Bailey

 



Is your hospital ready for reform?

Premier Inc., a 2006 Malcolm Baldrige National Quality Award recipient, has gathered more than 240 hospitals across 34 states in a comprehensive collaborative committed to not only preparing for reform but, more important, saving lives and reducing health care costs. In fact, the charter member hospitals of Premier's QUEST^® collaborative have saved 22,164 lives and an estimated $2.13 billion in health care costs.

But how did they do it?

According to Jan Englert, Premier QUEST^® director for Client Services, the member hospitals make a difference by working together on innovative solutions to improve patient care, which have resulted in saving lives, safely reducing the cost of care, delivering reliable and effective care, improving patient safety, and improving the patient experience. The collaborative has also recently added the dimension of decreasing avoidable readmissions.

What does this have to do with the Baldrige Health Care Criteria for Performance Excellence? The member hospitals make a commitment to measure, compare, and share best practices to care for patients. This type of measurement is at the heart of the Health Care Criteria that reflect validated, leading-edge management practices against which an organization can measure itself.

And among the Premier QUEST^® members are other Baldrige Award recipients (all of whom have been recognized by U.S. presidents as national health care role models): AtlantiCare (2009 award recipient), Heartland Health (2009 award recipient), and North Mississippi Medical Center (2006 award recipient). Other member hospitals are currently on their Baldrige journeys to improve performance.

According to Englert, "Others on a high-level Baldrige journey . . . find themselves MUCH better off because of their collaboration with other hospitals that are 'early adopters' of change and improvement."

How has your hospital made a commitment to improve and prepare for health care reform?

 

 

Great Education Requires Great Support Processes

Posted by Dawn Marie Bailey

 

Imagine if you came into work on Monday and all of your support processes were gone.

Now imagine that you are a school system and support processes have a huge impact on your teachers being able to focus on classroom instruction and on your number-one goal of helping students learn. By saving teachers' time worrying about support processes, how much additional time would they have for students?

Michael Perich, consultant for continuous improvement at Montgomery County Public Schools (MCPS), a 2010 Malcolm Baldrige National Quality Award recipient, asked a similar question, "If all of your employees [involved in support processes] resigned on a Friday, and you had the great fortune of being able to fill all of their positions over the weekend, how would the new employees know what to do?"

At the 23rd annual Quest for Excellence Conference, Perich said MCPS learned that good process management (i.e., formalizing key processes and understanding the difference among key processes, tasks, and activities) helped lead to its Presidential recognition as a national education role model.

Giles Benson, who is recently retired from materials management at MCPS, said, "If you focus on your processes, your outcomes will be achieved."

Benson told a story of the impact of copiers breaking down across the school system, which is the 16th largest in the United States. He said MCPS staff makes approximately 425 million copies per year, and when a copier is broken the instructional program is affected. Through process management and performance monitoring—key aspects of the Baldrige Education Criteria for Performance Excellence—the school system found that it would be better for students and more cost-effective for the system to repair its own copiers.

So what does managing copiers have to do with the Baldrige Education Criteria? Because managing your key processes, MCPS proves, is part of the systems approach of the Criteria, and the interrelationship of processes is key to teaching and learning. By following Category 6 of the Education Criteria and focusing on formalizing and managing its processes, MCPS has documented major accomplishments:

• Construction projects completed within budget improved from 87% in 2007 to 100% in 2009
• From 2004 to 2009, no buses were pulled from service for more than 24 hours from a fleet of 1,250 buses
• Increase in recycling rates from 27% in 2007 to 38% in 2009
• Increase in energy cost avoidance from $632,000 in 2006 to $2.5 million in 2009
• Increase in Kilowatt Hour Avoidance from 6.4 million in 2006 to 18.6 million in 2009

Imagine what the Baldrige Education Criteria and process management can do for your school system?
 

Oh, What a Week It Was!

Posted by Harry Hertz, the Baldrige Cheermudgeon

 

Week one of our four weeks of Baldrige examiner training for 2011 is now history. I am looking forward to the start of week two with joy, excitement, and anticipation.  It was a great first week. It is always wonderful to see old friends and to make new ones. I particularly enjoy the conversations about Baldrige Criteria-related topics. For two reasons: 1. the discussions frequently result in refinements to the Criteria in future revisions, and 2. the discussions frequently allow us to explore some of the more challenging concepts at the leading edge of validated management practice.

 

So let me share two of those latter topics that received discussion this week. The first was the topic of “intelligent risk” and what it means to organizations. This topic was actually addressed in some detail in my December 2010 Insights column, so I will refer you there. The second topic was not new to the Criteria this year, but was new a few years ago and was enhanced this year. This topic is “work systems” and “work processes.” An understanding of these important concepts can, in my opinion, lead to significant competitive advantage when put into practice. It can also lead to cost savings and greater system productivity. Both work systems and work processes are defined in the Baldrige Criteria. Essentially work systems are how you produce your goods and services. Work processes are those parts of your work systems that are accomplished by your workforce. The work processes frequently encompass your core competencies. The rest of your work systems are accomplished with the aid of suppliers, partners, and distributors. So, to take an example from the Baldrige Program, one of our key work systems is education and promotion of performance excellence. Some of our key work processes are conduct of our conferences (Quest for Excellence and regional conferences), preparation of case studies and other educational materials, and conduct of examiner training (remember that’s where I started this post). Other contributors to this work system include our Award Administrator, ASQ, and the member programs of the Alliance for Performance Excellence. ASQ and the state and local programs are significant suppliers and partners in our leveraged model for achieving education and outreach.

 

And as a matter of fact, many of our examiners come to us having had experience in their state Baldrige-based programs, so our training and development efforts have been enhanced by our upstream partners in the states.  So, there you are, a description of work systems and work processes and a work system that led to the success of week one of examiner training.  You knew I would get back to topic, didn't you? 

 

Week two, let's go!