Building Performance Excellence in Health Care James R. Evans Professor of Quantitative Analysis and Operations Management College of Business University of Cincinnati

What Is Performance Excellence? An integrated approach to organizational performance management that results in An integrated approach to organizational performance management that results in l Delivery of ever-improving value to patients, other customers, and stakeholders, contributing to improved health care qualtiy organizational sustainability l Improvement of overall organizational effectiveness and capabilities as a health care provider l Organizational and personal learning

Baldrige Health Care Award Recipients Bronson Methodist Hospital (2005) Bronson Methodist Hospital (2005) Robert Wood Johnson University Hospital Hamilton (2004) Robert Wood Johnson University Hospital Hamilton (2004) Baptist Hospital, Inc. (2003) Baptist Hospital, Inc. (2003) Saint Luke’s Hospital of Kansas City (2003) Saint Luke’s Hospital of Kansas City (2003) SSM Health Care (2002) SSM Health Care (2002)

An Example of Performance Excellence

BMH Results 99 th Percentile * * Professional Research Consultants, Inc. (Percentile calculated from a database of 19,684 physician responses across 161 hospitals) Physician Satisfaction

The Criteria for Performance Excellence Purposes: Purposes: To help improve organizational performance practices, capabilities, and results, To help improve organizational performance practices, capabilities, and results, To facilitate communication and sharing of best practices information among organizations of all types, and To facilitate communication and sharing of best practices information among organizations of all types, and To serve as a working tool for understanding and managing performance and for guiding organizational planning and opportunities for learning. To serve as a working tool for understanding and managing performance and for guiding organizational planning and opportunities for learning.

Current Baldrige Framework – A Systems Perspective

Summary of Categories/Items 1. Leadership 1. Senior Leadership 2. Governance and Social Responsibilities 2. Strategic Planning 1. Strategy Development 2. Strategy Deployment 3. Focus on Patients, Other Customers, and Markets 1. Patient, Other Customer, and Health Care Market Knowledge 2. Patient and Other Customer Relationships and Satisfaction 4. Measurement, Analysis, and Knowledge Management 1. Measurement, Analysis and Review of Organizational Performance 2. Information and Knowledge Management 5. Human Resource Focus 1. Work Systems 2. Staff Learning and Motivation 3. Staff Well-Being and Satisfaction 6. Process Management 1. Health Care Processes 2. Support Processes and Operational Planning 7. Results 1. Health Care and Service Delivery Outcomes 2. Patient- and Other Customer- Focused Outcomes 3. Financial and Market Outcomes 4. Human Resource Outcomes 5. Organizational Effectiveness Outcomes 6. Leadership and Social Responsibility Outcomes

Core Values Visionary leadership Visionary leadership Patient-focused excellence Patient-focused excellence Organizational and personal learning Organizational and personal learning Valuing staff and partners Valuing staff and partners Agility Agility Focus on the future Focus on the future Managing for innovation Managing for innovation Management by fact Management by fact Social responsibility and community health Social responsibility and community health Focus on results and creating value Focus on results and creating value Systems perspective Systems perspective

Performance Excellence Maturity Model

Bronson Methodist Hospital Complaint Management Process Key characteristics: Systematic and repeatable process Focused on improvement and prevention Capable of organizational learning Knowledge sharing

Satisfaction Results Arbor Associates best practice benchmark since 2001 and Arbor Associates Award for Highest Overall Patient Satisfaction four years in a row.

Baldrige Resources Criteria Criteria “Getting Started…” guide “Getting Started…” guide Award recipients Award recipients Contacts, profiles, application summaries Contacts, profiles, application summaries A variety of other materials and publications A variety of other materials and publications

Supplementary Slides The following slides provide brief descriptions of key indicators of performance excellence in an organization The following slides provide brief descriptions of key indicators of performance excellence in an organization

Key Excellence Indicators: Leadership Personal commitment to patients and other customers Personal commitment to patients and other customers Effective setting and communication of organization’s direction Effective setting and communication of organization’s direction Personal Involvement in developing future leaders Personal Involvement in developing future leaders

Key Excellence Indicators: Leadership Communication of and role model for the organization’s values Communication of and role model for the organization’s values Legal and ethical behavior Legal and ethical behavior Focus on learning at all levels of the organization Focus on learning at all levels of the organization Good citizenship Good citizenship

Key Excellence Indicators: Strategic Planning Balance of short- and long-term views Balance of short- and long-term views Aggressive goal setting Aggressive goal setting Strong work process alignment with strategy Strong work process alignment with strategy Systematic approach to addressing all sources of risk Systematic approach to addressing all sources of risk

Key Excellence Indicators: Strategic Planning Critical targets and goals based on customer requirements and market directions Critical targets and goals based on customer requirements and market directions Strong involvement of key suppliers, partners, and customers Strong involvement of key suppliers, partners, and customers A focus on plan execution and agility A focus on plan execution and agility

Key Excellence Indicators: Patient, Other Customer and Market Focus In-depth market knowledge and forecasts In-depth market knowledge and forecasts Consideration of needs of current and potential patients and customers Consideration of needs of current and potential patients and customers Proactive contact Proactive contact Multiple listening posts to identify requirements Multiple listening posts to identify requirements

Key Excellence Indicators: Patient, Other Customer and Market Focus Focus on enhancing patient and customer relationships and loyalty Focus on enhancing patient and customer relationships and loyalty Effective and prompt resolution of complaints Effective and prompt resolution of complaints High levels of patient and customer satisfaction and loyalty High levels of patient and customer satisfaction and loyalty

Key Excellence Indicators: Measurement, Analysis, & Knowledge Management Use of fact-based decision making Use of fact-based decision making Collection of actionable data Collection of actionable data Use of multiple aligned and interlinking measures (internal and external) Use of multiple aligned and interlinking measures (internal and external) Wide deployment and accessibility of data and information Wide deployment and accessibility of data and information

Key Excellence Indicators: Human Resource Focus Recognition of staff as “internal customers” Recognition of staff as “internal customers” Strong commitment to staff satisfaction, motivation, well-being, and morale Strong commitment to staff satisfaction, motivation, well-being, and morale Reward system related to key organizational challenges and organizational performance Reward system related to key organizational challenges and organizational performance

Key Excellence Indicators: Human Resource Focus Commitment to staff training, education, and development Commitment to staff training, education, and development Links between individual and organizational learning Links between individual and organizational learning Empowered staff Empowered staff

Key Excellence Indicators: Process Management Well-defined health care, business, and support processes Well-defined health care, business, and support processes Focus on processes that create value for all key stakeholders Focus on processes that create value for all key stakeholders Quality designed into all products, services, and processes Quality designed into all products, services, and processes Focus on continuous improvement, cycle time reduction, innovation, and productivity Focus on continuous improvement, cycle time reduction, innovation, and productivity

Key Excellence Indicators: Process Management Strong integration of prevention, correction, and improvement into daily operations Strong integration of prevention, correction, and improvement into daily operations Partnering with suppliers and customers Partnering with suppliers and customers Financial and other resources committed to key processes Financial and other resources committed to key processes

Key Excellence Indicators: Results Tied to l Patient, other customer, and stakeholder requirements l Key processes l Product/service performance l Strategy and action plans l Human resource needs l Financial and marketplace measures l Governance and social responsibilities

Key Excellence Indicators: Results Tracking of levels and trends Tracking of levels and trends Linked to organization-level information and analyses Linked to organization-level information and analyses Use of comparisons/benchmarks Use of comparisons/benchmarks Actionable Actionable