ASQ Healthcare Division Newsletter
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).
| Critical results | PVHS | NMMC |
| Employee satisfaction | 97th percentile | 90th percentile |
| Employee retention | > 92% | > 89% |
| Physician satisfaction | 99th percentile | 99th percentile |
| Patient satisfaction | 80% excellent or “top box” | 90th percentile |
| Financial | Top 10% financial stability Top 10% profit per discharge |
$11 million saved in past 6 years |
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 Glenn@Baldrige-Coach.com.)
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.
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
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.