1. A bold vision for community health: Use framework to align resources, improvements

    July 31, 2016 by ahmed


    Originally posted on Blogrige by Dawn Bailey

    Teenage pregnancy, obesity/lack of physical activity, drug use, and student drop-out rates are all issues on which Baldrige Award recipient Charleston Area Medical Center Health System (CAMCHS) has been working directly with its community for more than 20 years, said Brenda Grant, chief strategy officer. However, such efforts to improve the population’s health weren’t always focused or forward thinking (i.e., systematic), she added during a June 2016 HealthDoers Learning Lab on Collaborative Leadership: Part III, from Population Health to Healthy Communities.

    Through her health systems’ work with the Baldrige Excellence Framework, Grant said she became aware of the Communities of Excellence 2026, a nonprofit organization that is adapting the Baldrige framework for use by whole communities “to achieve and sustain the highest quality of life for their people” and to give such community efforts a framework for improvement and alignment.

    “I have seen the Baldrige framework help us become a better organization by answering and responding to the questions [in the Baldrige Criteria within the framework] and making sure we have strong approaches to deployment, learning, and integration,” said Grant, “so I am excited about the framework being established for communities of excellence and really think that could be a guide for us as we move into the future for our community.”

    Grant said CAMCHS’s involvement in population health started by looking at the needs in the community and developing programs around those needs. In 1994, a steering committee called the Kanawha Coalition for Community Health Improvement was formed to include other county hospitals, the United Way, the school system, behavioral and family health organizations, churches, and many others. The committee’s mission is to identify and evaluate community health risks and coordinate resources. But Grant said when they started the coalition for improvement, they realized that reacting to problems was really the process for how problems would be addressed.

    “There were a lot of different people working on problems but not really in a coordinated manner,” she said. Now, the committee is moving through early systematic approaches to aligned approaches using a community needs assessment, which includes random telephone surveys, focus groups for low-income and minority populations, and targeted surveys, as well as forums where the community identifies the top issues. Using available data, the committee then comes up with 10–15 community priorities. At a community forum, education is provided on those topics, random voting is conducted, and the community selects the issues for work groups to pursue.

    Rick Norling, retired CEO of Baldrige Award recipient Premier, Inc., said such work in the community reinforces “the value of a collaboratively generated community strategic plan to pull all of these efforts together as community-based priorities.” He added that health care organizations increasingly need to move toward partnering with their communities not just for compliance but for improving population health.

    “I personally believe [a community health needs assessment and implementation strategy] can be a powerful driver for improving the health of our communities, so that’s why I really want to focus on taking the work that we’re currently doing and moving it even in a more substantial manner,” said Grant. “We have a long history of trust, working with the community. But the potential is still there to be a powerful driver for health. That’s why . . . the Baldrige journey has really been helpful for us. . . . One of the core values of Baldrige is a systems perspective that talks about managing all parts of your organization as a unified whole to achieve your mission. And that really was helpful to us internally as we looked at health care transformation.”

    Norling defined population health management as building a partnership among a health care system and members of a community. The best hospitals and health systems, he said, are building a strategy of becoming population health managers.

    “To pursue population health management, the sites of care go well beyond a traditional health system, all the way to the family home, a key site of care,” he said. “Retail pharmacy, minute clinics, grocery stores, wellness centers, senior housing, they bring a whole new dimension of complexity to the systems of care required and the need for much more collaborative leadership.”

    Norling said the Communities of Excellence (COE) criteria have been created in conjunction with the Baldrige Performance Excellence Program and are currently being piloted in communities. The first pilot is Live Well San Diego, which has been adopted by the San Diego County Board of Supervisors as its strategic plan, said Norling; over 150 community organizations have become Live Well partners, agreeing to collaborate and with the county health and human services department organizing the effort. Norling said the criteria are being implemented and improved concurrently.

    Live Well San Diego’s performance will be enhanced by adopting the criteria, and feedback from attempting to adopt those criteria will provide us feedback to improve them, said Norling, adding that other community pilots are taking place around the United States.

    “I think what’s happening in San Diego County is a pretty exciting example of what this kind of systems thinking in a community can create,” Norling said. “It would seem that hospitals and health systems should be active participants, if not the leaders in this journey, and the culture of health requires this kind of broad perspective.”

    Added Stephanie Norling, managing director, Communities of Excellence 2026, “The COE framework really represents the next logical iteration in the current population health movement. CAMCHS is a great example of a health system’s journey from clinical care to population health, and the addition of a systems-based, community-wide framework is really the next step in achieving the kind of breakthrough results we need for our communities and their residents.”

    In regards to results, which are part of any Baldrige assessment, the COE framework also brings with it the element of measurement, something new to many community initiatives. “[Baldrige] provides the opportunity for us to have the framework to respond to questions that will make us a better community. It will also help us with results,” said Grant. “One of the things that we struggle with is how do you measure community health improvement, how do we know that we really are improving. . . . Having a group of communities to benchmark [that are using the COE framework] would just be invaluable to us in the future.”

  2. The Organizational Profile: Most valuable preface ever written?

    July 27, 2016 by ahmed


    Originally posted on Blogrige by Christine Schaefer

    What are your main product offerings?

    What is the relative importance of each to your success?

    What mechanisms do you use to deliver your products?

    What are your stated mission, vision, and values?

    What are your organization’s core competencies, and what is their relationship to your mission?

    What is your workforce profile?

    What recent changes have you experienced in work­force composition or your workforce needs?

    What are your workforce or employee groups and segments, the educational requirements for different employee groups and segments, and the key drivers that engage them in achieving your mission and vision?

    Those are the first eight questions from the preface to the Baldrige Criteria for Performance Excellence, known as the Organizational Profile.

    In many books, the preface is not essential reading: giving scant attention to a prefatory section will not usually make it impossible for the reader to meaningfully complete the rest of the book. But that is not the case with a Baldrige Excellence Framework booklet when you are using this resource to assess the performance of an organization.

    As stated in the 2015–2016 Baldrige Excellence Framework booklets (which include Business/Nonprofit, Health Care, and Education versions), “The Organizational Profile is the most appropriate starting point for self-assessment and for writing a [Baldrige Award] application.” Here are three reasons the profile is criti­cally important:

    • It helps you identify gaps in key information and focus on key performance requirements and results.
    • You can use it as an initial self-assessment. If you identify topics for which conflicting, little, or no information is avail­able, use these topics for action planning.
    • It sets the context for and allows you to address unique aspects of your organization in your responses to the Criteria requirements in categories 1–7.

    Many organizations that have used the Baldrige framework to raise their performance, particularly Baldrige Award recipients, have affirmed the value of the Organizational Profile as a beginning and ongoing tool for performance assessment and improvement.

    For example, Lisa Muller, assistant superintendent of teaching and learning for 2005 Baldrige Award-winning Jenks Public Schools, provided a testimonial regarding the value of the Organizational Profile in which she described four benefits of using it as a tool for performance measurement and improvement:

    • It encourages valuable conversation about the organization’s identity.
    • It provides opportunities to discuss the organization’s strategic situation.
    • It creates a snapshot in time of the organization, how it operates, and the challenges it faces.
    • It introduces the idea of core competencies.

    In a recent Blogrige interview, Dr. Meridith Drzakowski—a senior Baldrige examiner and assistant chancellor at the Baldrige Award-winning University of Wisconsin–Stout—also promoted use of the Organizational Profile. Drzakowski described its value in regard to how an organization can ensure, when faced with the need to make budget cuts, that it protects its strategic priorities: “I think in terms of the Baldrige framework that the Organizational Profile really can help organizations … to identify what’s most important and be able to handle those kinds of reductions in strategic ways,” she said.

    In addition, Dr. John Timmerman, chief scientist of customer experience and innovation at Gallup, said in a 2014 Blogrige interview, “I encourage organizations to complete the Baldrige profile assessment because it gives them the context to assess the appropriateness of best practices for their business model.” (Timmerman, a member of the judges panel for the Baldrige Award since last year, served as corporate vice president of quality and operations for the two-time Baldrige Award-winning Ritz-Carlton Hotel Company during its journey to excellence).

    At the upcoming Baldrige Regional Conference in Chicago on September 8, the session “How to Get Started on Your Baldrige Journey” will also encourage use of the Organizational Profile. The presenter is Dr. Melanie Taylor, deputy superintendent of curriculum and instruction at Iredell-Statesville Schools in North Carolina, a school district that received the Baldrige Award in 2008.

    When asked recently to share her key guidance for Baldrige beginners, Taylor responded, “If you’re looking to get started using the Baldrige Criteria to improve your organization, doing some deep, honest self-reflection is a great way to begin the journey. You may want to start with the Organizational Profile. That will clarify your context so you can begin to identify your organizational strengths and opportunities for improvement. Then you will have set off on the Baldrige journey to improvement.”

    Are you or other people in your organization not yet familiar with how to use the Baldrige framework in your improvement efforts? If so, consider, as an introductory step, working together in groups to answer the Organizational Profile questions. Completing the Profile can build a common understanding within your organization of all the key factors of your structure and situation. You can download a copy of the Organizational Profile for free from the Baldrige Program’s website here (PDF file).

    Make the Organizational Profile the most valuable preface ever written by you!

  3. South African Quality Institutes latest news

    July 24, 2016 by ahmed

    South African Quality Institute (SAQI) http://www.saqi.co.za is the national body that co-ordinates the Quality effort in South Africa. Their monthly newsletter is an excellent source of information to keep up with the latest quality issues in South Africa.


    • Benchmarking in education systems, by Rubab Malik, Dr. Robin Mann, and Prof. Nigel Grigg
    • Around the world on Solar power, by Terry Deacon
    • Sobering message from less privilaged childern, by Terrnance M. Booysen
    • Quality in schools: Dare to dream, by Richard Hayward

    Click here to download this newsletter.








  4. A Pillar of the Baldrige Community

    July 20, 2016 by ahmed
    Dr James Tew

    Dr James Tew

    Originally posted on Blogrige by Christine Schaefer

    Dr. James Tew is widely respected within the Baldrige community in his home state of Texas. He also is held in high regard for his contributions to the Baldrige Performance Excellence Program (BPEP) starting from the national program’s earliest years in the late 1980s. Now retired, Tew worked at Texas Instruments Incorporated, Defense Systems & Electronics Group (DSEG) before, during, and after the company earned the Baldrige Award in 1992.

    Invited by BPEP’s first director, Dr. Curt Reimann, to participate in the inaugural training and cohort of Baldrige examiners in 1988, Tew embraced the opportunity to serve. That same year, he was a member of the examiner team that made the first site visit to evaluate an applicant organization (a manufacturer) as part of the Baldrige Award process. Several years later, as award eligibility was expanded to the health care and education sectors, Tew also was part of the Baldrige examiner team that conducted the program’s pilot site visit to an education organization.

    Tew became a galvanizing force—together with other like-minded quality pioneers—in founding a state program in Texas. Today the Quality Texas Foundation continues to administer a Baldrige-based state award for performance excellence as well as providing training on using the Baldrige Excellence Framework (which includes the Criteria for Performance Excellence) to assess and improve organizations throughout the state. By giving numerous presentations about the benefits of the Baldrige Criteria before senior leaders of Texas organizations, as well as teaching related college courses and mentoring future business leaders, Tew encouraged countless organizations and leaders to adopt the Baldrige framework to achieve long-term excellence in their leadership, strategic planning, knowledge management and performance measurement systems, customer- and workforce-focused processes, operations, and results (the seven categories of the Baldrige Criteria).

    Among Tew’s admirers is Dale Crownover, CEO of Texas Nameplate, Inc., a two-time recipient of the Baldrige Award. “I’ve always regarded [Tew] as my favorite mentor,” Crownover shared. “I was as proud to tell [him] we won [the Baldrige Award] as I was when I told my dad.” According to Crownover, Tew patted him on the shoulder the day he was notified of his small business’s achievement as a Baldrige Award winner. To Crownover’s long-lasting amusement, he remembers that Tew told him, “You’ve done well, Dale; now don’t screw it up.”

    Laura Longmire worked with Tew both as a colleague at Texas Instruments DSEG and as a fellow volunteer judge for the Quality Texas Foundation’s award program. Longmire recently praised Tew’s performance in both roles. She said that at Texas Instruments, Tew “was the go-to person or knowledge keeper for the Baldrige Criteria, ISO [International Organization of Standards] processes, and also our training to meet customer requirements in quality for many of our Department of Defense contracts.” Recalling his help when she was a new program manager at the company, she said, “I’ve often reflected on his gracious knowledge sharing and directional support.”

    Longmire also observed that when she was training as a judge for the Texas award program, Tew “led the panel of judges with great knowledge, skill and inclusion of all inputs from the other judges.” She added, “When it was time to make final determinations for applicants, he was thorough and spent hours if not weeks on each applicant’s information. He was always fair and impartial. He helped train the rest of the judges through his diligence, knowledge, and broad mindedness. As an avid “benchmarker,” he never thought within the box. [He] saw what could happen by stepping out into new and innovative approaches. He left a thorough, documented process for the judges to follow when he retired.”

    Genie Wilson Dillon, the first administrator of the Quality Texas program, has known Tew since the mid-1980s. She worked with him at Texas Instruments DSEG and then in various Quality Texas Foundation activities and processes that Tew helped to influence and shape. Dillon recently noted, “Over all this time, James has remained focused on what is best, with a quest for identifying what can be improved. [He] demonstrates an innovative spirit in design [and] always encourages systematic deployment so whatever is developed has integrity, repeatability, and excellence. He has always suggested improvements for the future—and is still doing this today. He is not satisfied with status quo, and this passion for improvement has helped make Quality Texas the outstanding program it has become today.”

    Tew recently responded to questions about his many pivotal experiences in the early years of the Baldrige programs at the national and state levels. Following are highlights of that interview.

    1- Could you please describe what it was like to be a member of the charter board of Baldrige examiners and a member of the first site visit team?
    It was the very first year, and I believe it was 1988. Curt Reimann was the key to the success of it. Curt really became a role model for me, and he had an outstanding staff. The way he worked planning the Baldrige Award and the approach he took was outstanding—we all learned from and benefitted from it.

    Out of the clear blue, I received in the mail an invitation from the Baldrige Program to serve as an examiner. I knew about the effort because professional peers, including other members of the American Society for Quality Control (now known as ASQ), had been talking about getting Congress involved in doing things [to help U.S. businesses]. … The real problem we were facing was the low quality of products and services that we were selling on the international market, which affect the national balance of payments. Baldrige listened to us.”

    After I was invited to training at NIST [the National Institute of Standards and Technology, which houses the Baldrige Program], I was sent a Criteria booklet and a case study to complete prior to training. The training was intense. At the first training meeting, I found I was associated with some outstanding people. In fact, I may have been a bit intimated. Quality leaders from both small and large corporations were actually serving as examiners.

    Evaluations of Baldrige Award applicants was performed individually, and then we worked together by phone. For the first site visit, I served on a team that evaluated a manufacturing organization. This was the first official site visit. … The thing we learned was how much effort the company had put into preparing for the visit. Through the consensus process, the team worked through our differences. This was one of the most important processes I had to learn.

    2- You had a major role in the founding of the Quality Texas award program, as well as in developing key components of that state program (such as its Fellows group); could you please share more about those events and your aims?
    The actual very beginning goes back to Curt Reimann. As examiners going through training, we learned that Curt would support having feeder groups toward the national award. We were so impressed by the award and its potential that we decided that at the state level maybe we could do something to create a feeder [program]. So I hosted a luncheon at Texas Instruments in Dallas. We had people from different parts of the state come and discuss what we could do, and we decided we should contribute as a feeder group to the national award to get people ready. We decided to adopt the Baldrige Criteria.

    A supporter of the Texas state effort was Raymond Marlow (Marlow Industries received the Baldrige Award in 1991), who went to high school with the then-governor Anne Richards; she learned what we were doing and became supportive of it and wanted to expand the scope to include health care and education organizations. … So we had a series of meetings over several years. … Finally we were able to get a program together, with Texas Instruments providing the first contribution (of $100,000) distributed over four quarters.

    [Note: According to Dillon, The American Productivity & Quality Center was another founding contributor, and numerous Texas organizations also contributed funds and in-kind resources to launch the Quality Texas Award program in 1993.]

    We’ve gone through some tough years, but the Texas program is still intact. We’ve got more people involved and newer thinking into the process, and I am very proud of today’s program. Dale Crownover (of Texas Nameplate) helped a lot in those tough years. I have seen many examples of success and improvements in Texas companies, and to the best of my knowledge Texas still has more Baldrige Award winners than any other state.

    The main problem today nationally is that leaders of organizations feel intimidated or embarrassed by problems and improvements needed that may be revealed by the Baldrige Award process. I’ve long counseled organizations: “Adopt the Criteria as the way to run your business before even thinking of being an applicant.

    3- You worked at Texas Instruments (DSEG) when it received the Baldrige Award in 1992; could you please share highlights of that accomplishment and its impacts?
    The first time we applied, we did not receive the award, and it’s the best thing that could have ever happened to us. Initially there was interest in the program internally, but there was resistance also. People were complaining it was too costly, “it won’t do anything for us,” and so forth. [But after] I was invited to a high-level meeting to make a presentation, the senior leaders said, “Go for it.” And they cleared the path to our applying.

    When we did not receive [the award that year], there was great disappointment because they thought we were really good. Some people decided we should never apply again. I remember having lunch with our Group President one day and asking him, “What are we going to do now.” And he said, “Once you have been to the Super Bowl, you always want to go going back. And we’re going back.”

    The second time [the company applied for the Baldrige Award], we learned more and made more improvements. Let me give you an example: We used to have cost review meetings trying to account for every dollar spent. We finally said, “Why are we doing this?” We learned that cost-review meetings are lagging indicators. Money lost due to scrap, rework, repair, and corrective action is gone. The leading indicators are our processes. Controlling the processes prevents the beginning of loss.

    4- How do you see the value of the Baldrige framework to businesses today in terms of addressing current challenges faced by leaders?
    I think it’s just as valid today as it’s ever been. And the reason is that every [two years] it is reviewed to try to make sure it reflects the current problems we’re facing. I think [the Baldrige Program has] done an outstanding job of keeping the Criteria current.

    5- Would you like to share any other insights?
    One lesson I learned is that job titles don’t impress me. I learned to look for those who have personal power rather than just power of position. Another lesson I learned is that some people will tell you, “This is a great organization. We do great things.” That’s all fluff. I’m listening for people who speak in quantitative terms, for example, “Our turnover rate is less than a tenth of a percent.”

  5. The Baldrige hockey puck

    July 15, 2016 by ahmed


    Originally posted on Blogrige by Harry Hertz

    I recently had a conversation with some of the Baldrige Program staff about the new Baldrige Framework diagram issued in 2015, and sometimes referred to as the “Baldrige Hockey Puck.” The conversation reminded me how much symbolism is built into the diagram and that this symbolism may be obvious only to the creators. So this posting is my take on the meaning of this diagram, depicting the components of a well-designed organizational performance management system.


    I will start with the base of the hockey puck. It comprises the Baldrige Core Values and Concepts (core values). These eleven core values are the beliefs embedded in the Baldrige Criteria for Performance Excellence. They are the underpinnings of the Criteria. It is not intended that these core values be adopted as the core values of organizations using the Criteria, but that they be beliefs the organization can ascribe to as a basis for their organizational performance management system.

    The background for the organizational performance management system is the Organizational Profile. It is always present as a key influencer of your performance management system. All responses to Items in the Criteria should be responsive to the specific factors that govern your organizational environment, key relationships, competitive environment, and strategic context as described in your Organizational Profile. We talk about using this Profile to “load your lenses.” You should see your organization through the lenses provided by this information, that defines who you are as an organization.

    Leadership, Strategy, and Customers are categories 1, 2, and 3, respectively, of the Baldrige Criteria. They are shown as adjoining, interlocking hexagons because we believe leadership sets the tone and vision for the organization and this includes leading strategic thinking and a focus on the customers of the organization. If leadership is not focused on strategy and customers, the organization is not likely to be either. These are key contributors to the organization’s ongoing success. Therefore, we refer to these three categories as the leadership triad.

    Workforce, Operations, and Results are categories 5, 6, and 7, respectively, of the Baldrige Criteria. They are shown as adjoining, interlocking hexagons because we believe the results the organization achieves are the outcome of the people (workforce) and processes (operations) that produce the organization’s goods and services, implement the organization’s strategy, and serve its customers. Therefore, we refer to these three categories as the results triad.

    Measurement, Analysis, and Knowledge Management is category 4 of the Baldrige Criteria. It is shown as a rectangle that supports and serves as the foundation of the organization’s performance management system. Category 4 provides the fact base that allows for data- and knowledge-driven decision making in the organization. Measurement, analysis, and knowledge enable all the other functions in the organization (categories 1-6) to deliver successful outcomes (category 7).

    The hexagons for the Leadership and Results categories are framed in white to call heightened attention to these two categories and to indicate (see the horizontal arrowheads) the clear relationship between leadership and the results the organization achieves. If Leadership isn’t focused on all key results for the organization (not just financials), the organization is not likely to have ongoing success. And Results must feed back to Leaders key information that they will use in guiding and steering the organization. The importance of these two categories is further emphasized in the Baldrige Scoring System, where they have more points assigned than any of the other categories. Furthermore RESULTS is shown in capital letters because this category alone is assigned 450 out of the 1000 possible points in the scoring system. The organization’s performance management system must be focused on achievement (results) to drive ongoing success.

    The four arrowheads with the word Integration in the center depict that the questions in the criteria force systems thinking and emphasize the interdependencies that make a performance system rather than simply a set of building blocks. The arrowheads also point to the Organizational Profile and category 4 to again indicate that the system is dependent on who you are as an organization and that a systems approach is fact-based, relying on a foundation of Measurement, Analysis, and Knowledge Management.

    So, in this case, a picture is worth almost a thousand words!