November / December 2009

Visit the Heathcare Division Web site at www.asq.org/health

Healthcare Organizations Get “Healthier” Using the Baldrige System for Performance Excellence

Healthcare has accounted for over 50% of the Baldrige applications during the last 5 years. Why? Because it works! Organizations that pursue Performance Excellence are mitigating many of the top issues that keep healthcare executives awake at night. Exceptional healthcare leaders are achieving exceptional results (see Table).

The nine Baldrige healthcare recipients have dealt effectively with the challenges of improving patient care and safety; increased patient, staff, and physician satisfaction; and reduced costs simultaneously. And they have achieved these goals in a way that is sustainable. This article highlights five best practices from two recent Baldrige Award recipients: Poudre Valley Health System (PVHS) and North Mississippi Medical Center (NMMC). (For a free copy of a one-page Baldrige-based best practices assessment, email me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .)

Recipients commit to performance excellence. Efficiency is the result of quality. Processes and protocols are designed to improve the quality of care as well as decrease costs. For example, NMMC implemented best clinical protocols, called care-based cost management, resulting in more efficient and safer patient care processes, fewer complications, shorter lengths of stay, and more than $11 million in savings over the past 6 years.

Recipients set high objectives and benchmark the best. They define their vision of providing world-class healthcare as having results in the top 10% or 90th percentile of national comparative databases. So they say, “Who is doing it better?” And then they accelerate their own progress by learning from others.

Recipients make meeting employee needs their first strategic objective. John Heer, CEO of NMMC, says, “We like to think of it as a formula. The way we look at, if we have fired up, engaged, motivated employees coming to work every day (1), the service or the patient satisfaction is going to be better (2). The quality of the care that we provide is going to be higher (3). If we’re doing those three things well, the financial results will take care of themselves. And if we’re doing those four things well, then we’ll have growth. So people are focusing on the employees and the physicians, and their satisfaction and engagement is the most important part of our leadership system.”

Recipients use data to drive improvement. PVHS leaders sit down with employees in each of the departments and say, “Here are the results. Now what are those items we want to work on?” And then with the staff and employees, they develop action plans.

PVHS has 10 consecutive years of improvement in cost and quality. Their employee turnover rate has decreased every year over the same time. How could they have done this without a system like Baldrige?

Recipients save lives. Rulon Stacey, CEO of PVHS, exclaimed, “It is no exaggeration to say that people are alive today because Poudre Valley Health System made the commitment to continuous improvement through the Baldrige process. We really are able to provide higher quality at a lower cost.”

For example, the average national goal has been under 90 minutes for getting patients’ vessels open through interventional cardiology, which has not been met routinely. Brad Oldemeyer, MD, reports, “We’re now to the point where we have an average of about 50 to 55 minutes thanks to our teamwork and facility.”

Implementing the Performance Excellence System is critical to your organization’s sustained success. If your organization is not improving as quickly as the best healthcare organizations in the world, then your organization is falling behind.

Glenn Bodinson
Editor, ASQ Healthcare Division
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Greetings from the Chair

The past two months have been very busy and productive for the Healthcare Division, particularly with our new alliance with the Society for Health Systems (SHS). I want to highlight some of the work that has been recently accomplished.

New SHS/HCD Joint Conference on Healthcare:
Building Better Delivery Systems
The Abstract Review and Planning Committees have accomplished a great deal in organizing this new multi-disciplinary, multi-professional and breakthrough conference on healthcare. We have used the well-oiled SHS conference planning structure to plan this new joint venture and thank our SHS colleagues for sharing their approach with us. I also want to thank the many volunteers who helped with abstract reviews and recommendations. This new conference will deliver 60 stimulating, cutting-edge content hours in eight tracks, with five pre-conference workshops. This conference will be held in Atlanta, February 24 to 27, 2010, immediately preceding the HIMSS annual conference. It promises to be a truly outstanding educational and networking event for anyone involved with healthcare, hospitals and health systems—globally. You don’t want to miss this extraordinary event, so book it into your calendars now. Come learn, meet, and share with others and become re-invigorated! Pass the news about this eye-opening conference along to your colleagues, especially your clinical friends who might not—yet—see Quality Management/Process Improvement and Systems Engineering as integral to their successful delivery of clinical care.

There are many things in this conference that every healthcare provider, manager or executive will be able to use immediately to improve the quality of healthcare with which they are involved, at whatever level they are engaged. The 8 tracks are:

1.    Lean Six Sigma
2.    Quality
3.    Leadership and Management
4.    Analytics and Systems Engineering
5.    Human Factors
6.    Information Technology
7.    Patient Flow
8.    Potpourri

Web Cast Series: No-Wait Emergency Departments—
This Is How We Do It
Led by Pierce Story, another joint SHS/HCD team is moving forward on this educational initiative. Stay tuned for news on the ASQ/HCD and IIE/SHS web sites about this provocative series of web casts. The series is not just about reviewing new ways of thinking about and managing an Emergency Department. The series is intended to stimulate new ways of thinking about and managing healthcare service delivery settings, anywhere.

News from the Hill
Exciting events continue to evolve quickly in Washington, DC. For this news, please see Joe Fortuna’s “Report from the Hill.”

I’ll see you in Atlanta!

Dateline: Washington
This Is Our Moment
by Joe Fortuna, MD
Chair-Elect,  ASQ Healthcare Division
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By all accounts, the 21st Century Healthcare Caucus on Health IT Implementation, held in partnership with ASQ, was a great success. In his remarks at the event, Congressman Patrick Kennedy (D-RI) summed up ASQ’s opportunity by observing, “This is your moment.”

Things are heating up in DC. Over 35 congressional contacts have been made by Sellery Associates on our behalf, and they are starting to get requests for information from congressional staffs. Our ASQ Team is keenly aware that the legislative process has three distinct impact points for ASQ—or any other group—to influence positive outcomes. Legislation is only the first step. After that, comes the legislative record (Committee Report) that guides those who write the regulations about the intent of Congress (detailing how, when, why, and for what the appropriated funds will be used). The final step is the writing of the actual regulations.

Our Washington team knows that it is generally easier to provide input into the latter two stages, so they are concentrating their efforts on making it possible to have members of the HCD have meaningful conversations with the right decision makers to achieve the results we want. In addition, the HCD is working hard with Sellery and ASQ staff members to develop a feasible, tactical plan to support the health-related components of the ASQ Public Affairs Strategy as outlined at http://www.asq.org/advocacy/issues-actions/200905-washington-priorities.pdf. The HCD seeks to provide assistance and expert support with a seamless, rapid-response process to ensure the just-in-time availability of well-briefed, knowledgeable SMEs from the HCD and other ASQ Divisions (when appropriate).

On another front, preliminary applications have been submitted for funds under the Regional Health Information Technology Extension Center (RHITEC) Program to provide assistance to medical practices in implementing Health IT (http://healthit.hhs.gov/portal/server.pt?open=512&objID=1335&parentname=CommunityPage&parentid=47&mode=2&in_hi_userid=11113&cached=true#3). Practice workflow redesign will be required of those receiving these funds. ASQ members may be able to help in their regions’ RHITEC approach. You may wish to contact the QIO (http://www.cms.hhs.gov/QualityImprovementOrgs/) in your region to find out who has submitted an application.