Belhaven University Unit 3 Healthcare organizations Quality Measurement Paper Prompt: How does Christian worldview frame the internal and external dynamics of quality measurement?Requirements: APA-compliant, 500-word minimum FRONTIERS
OF
H E A L T H
S E RVIC E S
M A NA GEMENT
The Baldrige Journey:
In Pursuit of Excellence
Feature articles by
Jayne E. Pope, FACHE, Emily Padula, FACHE,
and Debbye Wallace-Dooley
Warren L. Forgey, FACHE, and Tammy Dye, FACHE
Coming in the Winter Issue of Frontiers
Value-Based Care and Reimbursement
Feature articles by Robert J. Henkel, FACHE, and Patricia A.
Maryland and by Becky Kuhn, FACHE, and Chuck Lehn
Commentaries by
Kathleen Jennison Goonan
Janet Wagner
C. David Huffstutler and David Thomsen
VOLUME
32
•
NUMBER
1
•
FALL
2015
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FRONTIERS
O F H E A LT H S E R V I C E S M A N A G E M E N T
Frontiers of Health Services Management is committed to providing our readers with compelling, in-depth
features and commentaries that are of current importance to the practice of health s ervices management by
drawing on the expertise of the best practitioners and scholars.
Editorial
1 T rudy Land, FAC HE
Features
Improving Ourselves for the Sake of Others: Our Baldrige Journey
3 Jayne E. Pope, FAC HE , Emi ly Pa d u la , F A C H E,
and D ebbye Wallace-Dool ey
Small-Town Touch, Big-City Innovation, World-Class Aspirations
17 W ar r en L. For gey, FAC HE, a n d Ta mmy D y e, F A C H E
Sharing Leadership Insights on Our Baldrige Journey to Excellence
40 Jan et Wagner
A Framework for Performance Excellence and Success
45 C. D avid Huffst ut ler and D a v i d Th omsen
Conifer Health Solutions
This publication is made possible in part by the support of Conifer Health Solutions®, an
ACHE Premier Corporate Partner. ACHE would like to thank Conifer Health Solutions®
for its commitment to ACHE and helping us advance healthcare management excellence.
For more information, please visit www.coniferhealth.com.
ACHE and the editorial staff of ACHE publications reserve full editorial control over the content of ACHE publications.
C O N T E N T S
Commentaries
Can Baldrige Build Learning Organizations?
30 Kath leen Jennison Goona n
VOLUME 32 • NUMBER 1 • FALL 2015
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Frontiers of Health Services Management
Maureen C. Glass, FACHE, CAE, Publisher, Foundation of the American College of Healthcare Executives, Chicago, IL
Trudy Land, FACHE, Editor, Health Administration Press, Chicago, IL
Janice Snider, Managing Editor, Health Administration Press, Chicago, IL
Cepheus Edmondson, Layout Editor, Health Administration Press, Chicago, IL
editorial board
LT Temitope O. Ayeni, FACHE, Naval Hospital, Twentynine Palms, CA
Gina L. Calder, FACHE, Executive Director, Clinical Services, Bridgeport Hospital, Bridgeport, CT
LaWanda Courtney, Director, Environmental Services, Moffitt Cancer Center, Tampa, FL
Richelle R. Webb Dixon, FACHE, Vice President, Ambulatory Care, CHI St. Luke’s Health, Houston, TX
Jamie L. Haeuser, Haeuser Health Strategies LLC, Robert, LA
Richard W. Haraldson, FACHE, Chief Executive Officer, Sidney Health Center, Sidney, MT
Neil A. Hilton, FACHE, Wyoming Hospital Association, Cheyenne, WY
John C. Laux, Division of Behavioral Health, Anchorage, AK
Betty Mortensen, RN, FACHE, President, Innovative Healthcare Solutions Inc., Crystal Lake, IL
Gwendolyn H. Parker, MD, FACHE, Blue Cross Blue Shield of Michigan, Detroit
Stephen J. Pribyl, FACHE, Chief Executive Officer, District One Hospital, Faribault, MN
José S. Rosado, FACHE, Chief Executive Officer, Manatí Medical Center, Manatí, PR
Cherie Sibley, FACHE, Chief Executive Officer, Clark Regional Medical Center, Winchester, KY
Maj Statwell G. Sinclair Jr., FACHE, Developmental Director, Air Force Medical Support Agency, Travis Air Force Base, CA
Frontiers of Health Services Management (ISSN 0748-8157) is published quarterly by the Foundation of the American College of
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Editorial
T rudy L and , FACHE
W i t h i n c r ea s i n g p ressure to transform the healthcare delivery
E D I T O R I A L
system, organizations face enormous challenges and opportunities to improve
quality and decrease costs. The rapidity of change has been accelerated by
healthcare reform’s directives that hospitals and health systems develop more
effective and efficient ways of delivering care. What frameworks or process
improvement approaches are being used by hospitals and health systems to
transform their organizations and maximize positive outcomes?
The Baldrige Performance Excellence Program provides organizations
with one such framework to identify improvement opportunities, develop best
practices, and attain and sustain top performance. Hospitals and health systems on the Baldrige journey use “this proven improvement and innovation
framework” to assess their functioning and operations in the following key
areas: leadership; strategic planning; customer focus; measurement, analysis,
and knowledge management; workforce focus; operations focus; and results
(Baldrige Performance Excellence Program 2015).
Many organizations are achieving significant quality, safety, and financial improvements by applying this framework in daily operations. Some have been recipients of the prestigious Malcolm Baldrige National Quality Award, while others
have been recognized for best practices or are on the Baldrige journey. According to
Truven Health Analytics research, a significant correlation exists between Baldrige
Award recipients and 100 Top Hospitals winners, and adoption of Baldrige practices leads to high performance (Chenoweth 2014; Shook and Chenoweth 2012).
The Baldrige journey is a tremendous undertaking. Leadership must drive
the process, integrate it into all departments and services, and focus on improvement opportunities in the delivery of patient care. The impact of using the Baldrige Criteria for Performance Excellence can be significant in improving quality,
reducing costs, and becoming the market leader. Differentiation through demonstration of top performance is essential for survivability and sustainability.
This issue of Frontiers focuses on several organizations that have received
the prestigious Malcolm Baldrige National Quality Award and their journeys to
continually improve their performance in achieving desired outcomes.
Trudy Land, FACHE, is editor of Frontiers of Health Services Management.
Trudy L a nd, FAC H E • 1
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prohibited without written permission. Please contact Copyright Clearance Center at info@copyright.com or visit
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Jayne E. Pope, RN, FACHE, Emily R. Padula, RN, FACHE, and Debbye
Wallace-Dooley share the Baldrige story of Hill Country Memorial Hospital in
Fredericksburg, Texas. Their inspirational journey “in pursuit of remarkable”
is based on the core competencies of relationship building, a values-driven culture, and execution. These key factors differentiate their organization; as the
authors note, they are the “footholds in our climb.
Feature authors Warren L. Forgey, CPA, FACHE, and Tammy Dye, RN,
FACHE, discuss how Baldrige began as a project at Schneck Medical Center
in Seymour, Indiana, but became their business model. They write, “Today,
Schneck thinks and operates differently. We have transitioned into a fact-based,
results-oriented organization.”
In her commentary, Kathleen Jennison Goonan, MD, describes how recipients of the Baldrige Award achieve transformational change through the
use of an effective and systematic approach. She provides a model of key processes and capabilities and a road map to successful organizational change.
In her commentary, Janet Wagner suggests that an engaged leader and
team with strategic direction and a willingness to focus and learn can achieve
and sustain results and continue to evolve.
St. David’s HealthCare, a regional multihospital system in Austin, Texas,
is a 2014 recipient of the Baldrige Award. In their commentary, C. David Huffstutler and David Thomsen note how adopting the Baldrige Framework and
using it to achieve the organization’s goals of exceptional care, customer loyalty,
and financial strength have resulted in significant positive outcomes.
These recipients of the Baldrige Award exemplify the sterling achievements in
quality and cost-effectiveness that can occur in today’s challenging healthcare environment. We congratulate these organizations for their dedication and commitment
to improving processes and care for their patients and the communities they serve.
References
Baldrige Performance Excellence Program. 2015. “Why Baldrige?” Accessed June 15. www.
nist.gov/baldrige/enter/.
Chenoweth, J. 2014. “Correlation Between Baldrige Award Recipients and 100 Top Hospitals
Winners.” Published November 18. http://truvenhealth.com/blog/
correlation-between-baldrige-award-recipients-and-100-top-hospitals-winners.
Shook, J., and J. Chenoweth. 2012. “100 Top Hospitals CEO Insights: Adoption Rates of
Select Baldrige Award Practices and Processes.” Published October. www.nist.gov/
baldrige/upload/100-Top-Hosp-CEO-Insights-RB-final.pdf.
The editor of Frontiers would like to hear from you! If you have comments or thoughts
about this or any issue of Frontiers, please share them by e-mailing hapbooks@ache.org.
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prohibited without written permission. Please contact Copyright Clearance Center at info@copyright.com or visit
www.copyright.com. Visit www.ache.org for more information about the American College of Healthcare Executives
or to subscribe to this publication.
Improving Ourselves for the Sake
of Others: Our Baldrige Journey
J ayne E. P ope , RN, FACHE, E mily P adula , RN,
FACHE, and D ebbye W allace -D ooley
Jayne E. Pope, RN, FACHE, is CEO of Hill Country Memorial (HCM) Hospital in Fredericksburg, Texas. Emily Padula, RN, FACHE, is chief strategy officer at HCM. Debbye
Wallace-Dooley is executive director of business intelligence at HCM.
F E A T U R E
Summary
In today’s healthcare environment, healthcare organizations are trying to balance
one foot in each of two boats: one for traditional fee-for-service reimbursement and
one for population health and pay-for-quality reimbursement. The Baldrige Performance Excellence Program and its associated Criteria will help healthcare leaders navigate this changing environment and improve healthcare outcomes for patients while improving financial performance, enhancing the patient experience,
and creating a positive work environment. This balanced approach, grounded in
behaviors identified in high-performing organizations, provides leaders and their
teams with the key to realizing strategic goals and long-term sustainability. The
Baldrige Criteria alone will not improve an organization; rather, it is the unique
and disciplined application of the Criteria to each organization that makes the
difference. A Baldrige journey is not a sprint, but rather a marathon; it requires a
long-term commitment to improvement at all levels of the organization.
At Hill Country Memorial (HCM) Hospital in Fredericksburg, Texas, we
selected the Baldrige Framework to guide our team as we embarked on a performance excellence climb that would take us from merely average to the national
top 10 percent of performance as evaluated on important organizational metrics.
HCM did not achieve overnight success; instead, we achieved year-overyear improvement in finance and growth, patient experience, quality of care,
and workforce environment and engagement. The story of our climb is one
of perseverance, willingness to learn from our mistakes, pursuit of innovative
best practices both inside and outside of healthcare, and a team committed to
providing the highest-quality service to our customers—our patients and our
community.
Jayne E. Pope, RN, FACHE, Emily Padula, RN, FACHE, and Debbye Wallace-Dooley • 3
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O
ur climb started when our community worked together, making
sacrifices to bring this healthcare system
into being more than 30 years ago, and
it continues to this day. Critical to our
success has been the identification of
our strengths and those we still need to
develop to be successful for years to come.
These strengths became our core competencies, our footholds for the climb: relationship building, values-driven culture,
and execution.
Being named a Malcolm Baldrige National Quality Award recipient is not the
work of the CEO alone or
the CEO along with just
The decision to embark
the executive team. Achievon a journey requires
ing the levels of perfora significant level of
mance and results required
commitment, perseverance, to be named a recipient is
and willingness to learn attainable only when the
entire team is engaged and
from mistakes, as well as
actively pursuing worldthe ability to motivate a class performance. At
HCM, employees, physiteam toward a vision.
cians, and volunteers developed into a high-performing team and
continually improved themselves for the
sake of others. Realization of this goal is
not the end but rather a milestone on our
performance excellence journey.
The decision to embark on a journey,
whether it be climbing Mount Everest or
moving an organization’s performance
from mediocre to remarkable, requires
a significant level of commitment, perseverance, and willingness to learn from
mistakes, as well as the ability to motivate
a team toward a vision. Such was the
mindset of HCM’s board of trustees and
executives in 2008 as we began our performance excellence climb. Like leaders
in many other hospitals and health systems across the nation striving to improve
the quality and safety of care, the patient
experience, and financial performance,
HCM’s leaders looked to organizations
that were consistently outperforming others and found a common element. That
element was the adoption of the Baldrige
Framework to achieve long-term sustainability. The foresight of those leaders led
to our ability to provide world-class healthcare and service to our customers, grow
our market base, and maintain financial
viability in an ever-changing and increasingly challenging healthcare environment.
The journey to achieving our current level
of performance and receiving recognition
as a Baldrige Award recipient was not easy.
The climb was steep, but once we committed to it, we strove to find the best and
most efficient path to the summit. Along
the way, we learned new skills, innovative
approaches, and other lessons to aid us.
History
The history of how HCM got its start is
the beginning of our climb, the bedrock
of our values, and a legacy of the trust
our community placed in us to provide a
healthcare system designed to serve them
for generations to come. It is our stewardship of this legacy that led us to pursue
the Baldrige Framework for Performance
Excellence. Hospitals are havens for healing and hope, centers for compassion and
care. In rural communities like ours, a
hospital often provides the town’s sturdiest
economic and civic foundations. Our interests, successes, and concerns are woven
into the fabric of our community because
the community’s residents created us to
take care of their families, friends, and
neighbors. People reached into their pockets and filled mason jars with nickels and
dimes to fund the hospital at its inception.
Ninety-three percent of Gillespie County
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