Celebrate with Fireworks—and Reflect on the Drive for Excellence

Posted by Christine Schaefer

In anticipating festivities for the birthday of the United States of America this weekend, you’re probably thinking about fireworks. But for inspiration beyond Independence Day, consider how certain organizations reflect foundational values of the nation and its drive for excellence. I’m referring to the high-performing organizations in every sector of the U.S. economy that have received (or are on a path to receive) a Baldrige Award.

Consider how such organizations’ commitment to continuously raise performance levels reflects a longstanding element of the American ethos: the willingness to work hard to pursue a better life.

Consider that Baldrige Award recipients must demonstrate effective and ethical leadership and governance, a well-executed strategy, well-integrated use and management of knowledge and information, innovative and efficient operations, and favorable and improving results. (As Baldrige geeks know, those relate to requirements in categories 1, 2, 4, 6, and 7, respectively, of the Baldrige Criteria for Performance Excellence.)

Looking deeper, consider that the award recipients have adopted—as one of nearly a dozen core values of the Baldrige Excellence Framework—a commitment to valuing people. Consider, too, that the honored organizations have demonstrated a focus on supporting customers, community members, and employees alike (categories 3 and 5 of the Baldrige Criteria). And that their strong focus on customers, key communities, and workforce members is manifest in systematic work processes and trended results.

In pursuing and proving excellence in all areas of the comprehensive Baldrige framework, the 99 recipients to date of the prestigious award honor the legacy of the nation’s founders and earliest settlers in striving to create a better country for their families and future descendants. The Baldrige Award recipients also reflect ideals of generations of immigrants since July 4, 1776, as they too have contributed their labor, ingenuity, and drive for improvement to better U.S. industries, institutions, and communities.

Since the Baldrige Award is a Presidential honor, consider the following statements of the past three U.S. Presidents who have linked the achievements of Baldrige Award recipients to the nation’s drive for excellence:

“The road to greatness in America has been, and always will be, traveled by those who embrace change and work hard every day to be the best; the organizations we honor today with the Malcolm Baldrige National Quality Award exemplify that spirit,” President Obama said. “This year’s recipients have shown how quality, innovation, and an unending quest for excellence help strengthen our nation and brighten the future of all Americans.” (Barack Obama, 44th President of the United States)

“[The Baldrige Award] is a reminder of things that must never change: the passion for excellence, the drive to innovate, the hard work that goes with any successful enterprise.” (George W. Bush, 43rd President of the United States)

“The Malcolm Baldrige National Quality Award, which highlights customer satisfaction, workforce empowerment, and increased productivity, has come to symbolize America’s commitment to excellence.” (William J. Clinton, 42nd President of the United States)

Baldrige flag flies at NIST 8-20-12

Posted in Baldrige Award Recipients, Baldrige Criteria | Leave a comment

A Map for Total Performance

Posted by Dawn Marie Bailey

No one can deny that there are plenty of quality tools out there to improve roadsignarrowperformance—of a team, of a process, of a product—but to integrate those tools and know where to apply them for the good of the whole organization, so that learning can be applied and the system can most effectively use resources, that’s where the Baldrige Excellence Framework comes in. Whether you describe it as a blueprint or a map,  it is the framework that should guide how and where you apply quality tools.

To borrow two quotes from recent interviews with quality experts,

  • “The Baldrige framework is like the blueprint of a building, with ISO used for specific systems within the building such as electrical and air conditioning systems.” (Ron Schulingkamp)
  • “Baldrige is the overall organizing framework that can identify where there are problems. . . . Think of Baldrige like a map that will show the organization where . . . Six Sigma, Lean, and other tools should be deployed. . . . If an organization deploys [such tools] without an overall map as Baldrige, it would be like taking a trip in a car but not having a map to know the way.” (Gene O’Dell)

And here’s another expert from Quality magazine who writes about the Baldrige Criteria’s complementary nature with business process management (BPM) objectives. In “Aligning BPM with the Seven Categories of the Malcolm Baldrige Award,” Forrest W. Breyfogle III, the founder and CEO of Smarter Solutions Inc, writes, “Most organizations use the Baldrige categories to build up a total performance map in order to rule out areas that require improvement. Along with this, organizations may also rely on tools, such as BPM, to devise operations and enhance organization processes.”

He describes BPM as a way to take control of processes, and aligning BPM with the “high-performing business processes” gained from using the Criteria can lead to “economic viability, efficient operations, conservation of natural resources, and social responsibility.”

“Therefore, it can be said that the success of BPM, along with other business process tools, can be improved . . . through the Baldrige Criteria,” he writes. “The effective alignment could be a source of increasing improvement to even more advanced developments. Breakthrough progress gives organizations the highest competitive edge in all circumstances. . . . By relying on the Criteria, businesses are steps closer to attaining higher levels of productivity and profitability, better employee relations, improved market share, and customer loyalty.”

Breyfogle adds, “By taking the seven Baldrige categories into consideration, well-developed and balanced results can be expected. Any misalignment could mean that there is something wrong with the business processes or other areas in the organization, making things easier and more efficient for organizations to implement business and measure performance. . . . The Baldrige Criteria, therefore, serve as strong criteria to conduct self-assessments and benchmark an organization’s processes and methods with those companies rewarded by the Baldrige Award.”

Posted in Baldrige Award Process, Baldrige Criteria, Business, Measurement, Analysis, and Knowledge Management, Operations Focus, Performance Results, Uncategorized | 4 Comments

A Comprehensive Excellence Framework for Post-Acute and Long-Term Care

Posted by Christine Schaefer

Following is an interview with Baldrige alumnus examiner Christopher E. Laxton, executive director of AMDA–The Society for Post-Acute and Long-Term Care Medicine (formerly the American Medical Directors Association). Laxton compares the Baldrige Excellence Framework (which includes the Health Care Criteria for Performance Excellence) to two other approaches used in his sector today to improve the performance of post-acute and long-term care organizations: Quality Assurance and Performance Improvement (QAPI) and Advancing Excellence in America’s Nursing Homes Campaign (AE).

Christopher Laxton, CAE

Christopher Laxton, CAE

Tell us about recent developments in your industry and how those impact the focus on improving the performance of care-providing organizations.

I work in post-acute and long-term care. This sub-sector of the health care field has gained a great deal of visibility and importance lately as many Baby Boomers move into retirement—by some estimates (Pew, AARP) at the rate of some 10,000 a day for the next 18 years.

It is not surprising, therefore, that those who work in this sector and its federal and state regulators are looking for ways to improve the performance of post-acute and long-term care (PA/LTC) provider organizations.

The Baldrige Excellence Framework is a helpful guide for organizations that are pursuing performance improvement. At the same time, there are other performance-improvement approaches in use across the multiple sectors of the U.S. economy. For PA/LTC organizations, two programs that have become more prominent because of their systems approach (like that of the Baldrige framework) to performance improvement are (1) AE, which comes from the provider side of this industry; and QAPI, which comes from the main federal payer and regulatory agency: the Centers for Medicare and Medicare Services (CMS).

Would you please explain first how QAPI is similar to the Baldrige framework and approach?

Yes. I think it is useful to look at how the QAPI and AE programs align to the Baldrige framework, both to understand their many points of connection to Baldrige Criteria categories, as well as to discern what may not be explicit in them.

The CMS’s QAPI program was introduced in 2013 for nursing homes to voluntarily adopt a systems approach to improvement (http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/QAPI/nhqapi.html). The program describes QAPI as “the merger of two complementary approaches to quality management, Quality Assurance (QA) and Performance Improvement (PI). QA and PI combine to form QAPI, a comprehensive approach to ensuring high quality care.”

QAPI is defined as having five elements (see Figure 1): Design and Scope; Governance and Leadership; Feedback, Data Systems and Monitoring; Performance Improvement Projects; and Systematic Analysis and Systemic Action. These will be familiar to those organizations using the Baldrige approach to improve, since they align relatively well with 2015–2016 Baldrige Criteria categories: QAPI’s “Design and Scope” element relates to Baldrige Criteria category 2, “Strategy”; QAPI’s “Governance and Leadership” relates to Baldrige Criteria category 1, “ Leadership”; QAPI’s “Feedback, Data Systems and Monitoring” relates to Baldrige Criteria category 4, “Measurement, Analysis, and Knowledge Management”; and QAPI’s “Systematic Analysis and Systemic Action, and Performance Improvement Projects” relates to Baldrige Criteria category 6, “Operations.”

Figure 1: QAPI’s Five Elements

Figure 1: QAPI’s Five Elements

The five QAPI elements have open, non-prescriptive definitions and guidance for applying them. This is comparable to the Baldrige framework’s approach of asking questions rather than dictating particular solutions, based on the understanding that there is no “one-size-fits-all” solution to organizational excellence. This is especially true in the PA/LTC sector, where—despite years of organizational improvement efforts and extensive regulatory oversight—there is wide variability in provider size, scope, capacity, and quality.

Next, would you please tell us about the AE program and how it compares to the Baldrige framework?

Of course. Advancing Excellence (AE) was founded in 2006 by a coalition of 28 organizations that included nursing home providers, quality improvement experts, and government agencies (https://www.nhqualitycampaign.org/). The Campaign now includes more than 62 percent of the nation’s nursing homes and has a local presence in every state and the District of Columbia through a network of participants called Local Area Networks for Excellence (LANEs).

AE has identified nine quality goals (see Figure 2) that describe areas of key importance to good nursing home care that are often challenging for providers. Those areas are where it is likely that nursing homes will find opportunities for improvement, to use a Baldrige term. The AE goals are organized into two groups that will sound very familiar to Baldrige framework users: four organizational goals, which are process-focused; and five clinical outcome goals, which are results-focused.

The nine AE goals align the Baldrige Criteria in the following ways: AE’s Consistent Assignment goal is a Baldrige Criteria category 5 (“Workforce”) goal, as is AE’s Staff Stability goal. AE’s Hospitalizations goal aligns with Baldrige Criteria category 6 (“Operations”), since it principally relates to item 6.1 (on work processes). AE’s Person-Centered Care goal is clearly a Baldrige Criteria category 3 (“Customers”) goal. And AE’s five Clinical Outcomes goals (Infections, Medications, Mobility, Pain, and Pressure Ulcers) are all Baldrige Criteria category 7 (“Results”) goals, though they each have process elements that are relevant to Baldrige Criteria categories 4 and 6.

Figure 2: Advancing Excellence’s Nine Goals

Figure 2: Advancing Excellence’s Nine Goals

The AE program also identifies a seven-step process that organizations can adopt to systematically address each goal in their organization (see Figure 3). These seven steps have some alignment with the Baldrige process-evaluation factors (approach, deployment, learning, integration [ADLI]) and, to a lesser extent, the Baldrige results evaluation factors (levels, trends, comparisons, integration [LeTCI]).

Figure 3: Advancing Excellence’s Seven Steps

Figure 3: Advancing Excellence’s Seven Steps

With all these similarities, do you see these approaches as competing or complementary with each other?

While the CMS QAPI program may resonate with those familiar with the Baldrige framework, I believe it would be a mistake to “choose” one over the other. One reason is that the Baldrige framework is very inclusive—accommodating all varieties of performance improvement tools, such as Plan-Do-Study-Act, Lean, Six Sigma, and so forth. Furthermore, when you line up both the QAPI and AE programs against the Baldrige Criteria (see crosswalk of 2013-2014 Baldrige Criteria to QAPI and AE), a comprehensive performance excellence framework for the PA/LTC sector is revealed. It is well aligned with the Baldrige Criteria categories, and it is specifically focused on the highly complex and challenging organizational and customer/patient/resident environment found in this sector’s care settings.

These are not simply academic considerations for how quality might be improved in this important and previously neglected sector of U.S. health care. The demographic shift to an older population in this country and around the world—sometimes referred to as the “Silver Tsunami”—is producing major changes in public policy and rapid and massive shifts in market forces that will have a direct impact on the care and support available to our nation’s elders.

What do you believe needs to happen in relation to the Baldrige, QAPI, and AE improvement tools to address the current and coming challenge of caring for more senior citizens?

It is a basic principle of organizational excellence that systems produce exactly the results that they are designed to produce—intentional and unintentional. Having worked in the long-term care field for 30 years and having served as a Baldrige examiner for seven, I am inspired by the existence of such powerful frameworks for improvement.

Now our long-term care leaders must take up these tools and apply them. Who better to do so than those who know intimately the complexity and challenges facing this sector? If they do not, others—with less commitment and connection to preserving and enhancing the health and well-being of our seniors—are sure to impose changes on us that will be neither of our design nor of our choosing.

Posted in Baldrige Criteria, Baldrige Examiners, Health Care | Tagged | 4 Comments

For Manufacturers, Baldrige Could be the “Cure” for Focusing on the Future (Part II)

This blog continues from part I.

Posted by Dawn Marie Bailey

How Manufacturers Use the Baldrige Criteria to Focus on the Future (continued)

Baldrige Award recipient Lockheed Martin Missions and Fire Controls (MFC)
, a $7 billion dollar business, manufactures high-precision systems that protect the country and men and women in uniform; these systems “have to work the first time, every time, because lives depend on it,” said Steven Sessions, then director of supplier quality, speaking at the 26th Annual Quest for Excellence Conference.

He talked about how MFC used the Baldrige model to help improve and manage its supply chain, an effort that began when a senior MFC staff member became a Baldrige Executive Fellow and benchmarked other Baldrige Award recipients on how they handled supply chain management.

“The global recession and budget pressures have probably never been more intense than they are right now. That, along with increased regulations, have really been a big hit to our businesses, and we’re trying to figure out how to account for that,” said Sessions. “But as much as it affects us, it affects our suppliers—and some of them are very small—in a very big way. Because of that, the defense supply chain is a real focus area.”

From the Baldrige learning, MFC created a Supply Chain Engagement Model that maps to the Baldrige model, a process called Senior Leadership Engagement, and Characteristics of Supplier Excellence.

“The Malcolm Baldrige Award that we got really helped open up . . . doors,” Sessions added. “I’m not so sure that we would have had the gains that we’ve made over the last year had we not won the award because that brings with it interest from other companies that want to know how you’re doing business. . . . When you talk about the bottomline . . . for us it doesn’t get much better than this: We outperform the market. We outperform others in our industry. . . . When you get your supply chain working, . . . it helps your costs to come down. Baldrige was a big part of making that happen.”

Professional Development and Bringing the Learning Home

The 2015 Malcolm Baldrige National Quality Award Board of Examiners includes several experts from manufacturing who attend the training to hone their skills for their own manufacturing organization and for personal professional development.

Baldrige examiner Eric Smith, a process control engineer for Caterpillar, said he uses the Baldrige Framework for continuing education. In a supplier development/quality role, Smith said Baldrige training provides additional skills as an auditor and highlights practices suppliers should follow to enable them to improve their organizations. “I use Criteria practices to offer advice on improvements that can be made to management processes that in turn should result in improved products delivered to my organization,” he said; “The Criteria are aimed at senior leadership practices. This is the area that other standards/methodologies do not cover (such as ISO9000 standard).  Learning these practices provides me deeper insight to company operations when I perform audits on my suppliers. When I discover opportunities for improvement in an organization, I have been able to suggest changes in leadership practices that would be beneficial.”

Larry Kimbrough, supplier quality engineer for International Truck and Engine, said Baldrige training has taught him how to look at a process subjectively as it relates to meeting the Criteria. He added, “my organization does not hesitate to ask my advice when it comes to processes and quality issues. By use of the [Criteria] categories (voice of the customer, leadership, results, etc.) and evaluation, I am able to better assist my company when they come to me with process or quality issues.”

Robert Tabler, director of Operational Excellence, Global Equipment, Sandvik Mining, just completed his first year of training as a Baldrige examiner. He said his expectation is that training in the Criteria and his work as a Baldrige examiner “will be used to improve customer focus within my area of responsibility. I hope successes can then be expanded into other areas through sharing and communication.”

What’s the Competitive Advantage for Manufacturers? Can Baldrige Actually Save Them Time?

“Baldrige does separate you from your competition in the eyes of the customer,” said Du Fresne, citing client assessments that rated the company above the competition in seven of eight metrics and 40% of the market share with customers with whom it does business.

Asked his opinion of why more manufacturers are not using the Baldrige Criteria to support their operations, Garvey said,  “A typical manufacturer always gives the excuse I don’t have time for this. I’ve got too many pressing issues. I have customers calling me all the time. I have employees calling out sick. I have equipment that may or may not be running properly. I’ve got creditors that I’ve got to take care of. . . . My response is you don’t have time not to do this. . . . You have to make time to do this. Because once you take the time to investigate and implement these Criteria, then the rest of your day becomes much freer. . . . Once you invest the time, then the return is orders of magnitude.”

Posted in Baldrige Award Process, Baldrige Award Recipients, Baldrige Criteria, Business, Leadership, Manufacturing, Performance Results, Uncategorized | Leave a comment

For Manufacturers, Baldrige Could be the “Cure” for Focusing on the Future

Posted by Dawn Marie Bailey

The Recession and U.S. Manufacturing

When the recession hit in the early 2000s, Michael Garvey left his fast-paced life trading equities on the floor of the New York Stock Exchange to help save the “family farm,” a bronze foundry in Youngstown, Ohio.

Garvey said his parents and many other manufacturers got caught in the “the perfect storm” that led to the implosion of the former heavy industrial belt, or “rust belt,” in the Cleveland/Pittsburgh corridor. He worked hard to restore the manufacturing base that had been his family’s business for almost 100 years but never forgot the pressures that his dad had internalized as he struggled to save the business. “I committed to myself that I would never get myself into that situation,” he said.

Garvey spearheaded a 15-year “phoenix activity” to build a new manufacturing company, M-7 Technologies, an engineering, manufacturing, and research organization. “I wanted to make sure that I created as sustainable a business model as possible,” he said, reading more than 30 books and 100 articles in Harvard Business Review, Industry Week, and the Wall Street Journal, among other journals and industry research.

“All roads kept leading back to the Baldrige process,” Garvey said; “I wanted to learn the Baldrige Criteria from the inside out so that I could really begin to understand how to build performance excellence in a corporation, in a small business. . . . I became convinced that to create a sustainable business model, I had to aspire to performance excellence. That aspiration was realized through the learning process I went through on the Baldrige Criteria. I became so convinced that [Baldrige] was a very powerful program that . . . I signed up to become a [Baldrige] examiner.”

In Vadnais Heights, Minnesota, Robert Du Fresne had the Baldrige Criteria in mind when he started Du Fresne Manufacturing, a precision sheet metal fabricator, in 1991; however, in the early days of the business, the company was in survival mode, chasing opportunities to increase revenue and Du Fresne performing many company roles himself, from sales to human resources to manager on the shop floor.

“I didn’t know the real value of [the Criteria] until 2008–2011,” he said, when the recession hit. “We were looking for a cure to help sustain stronger financial security and job security . . .  because of what happened to us in the recession. . . . [Leaders realized that the Baldrige Framework] has to be our cure to raise us to higher performance and make the competition irrelevant.”

How Manufacturers Use the Baldrige Criteria to Focus on the Future

For both Garvey and Du Fresne, the Baldrige Excellence Framework, which includes the Criteria for Performance Excellence, serves as a road map for performance excellence and a focus on the future.

“[The Baldrige Criteria] bring a sense of stability,” said Garvey. “They build a foundation that gives you a well-organized road map to performance excellence.”

Garvey said the “whole package” of the Criteria support his business, starting with the leadership category that helped him understand the roles and responsibilities of true, visionary leaders; the Criteria outline a leader’s responsibilities not only for the workforce but for customers, stakeholders, the supply chain, and shareholders. “How you create your working philosophy, how you fulfill your responsibilities to your community. Just everything [is outlined in the Criteria],” said Garvey.

Garvey said he learned a lot from the Baldrige Criteria; “As a result of that [learning], we are now one of the highest-performing small businesses in the state of Ohio, complete with having been recognized as the Ohio employer of the year in 2010, that goes back to the workforce component of the Criteria. We outperform our peer group, an average of 2:1 on all key metrics in small machine shops.” And those key metrics include revenue dollars per employee, net income before taxes, and customer complaints.

For Du Fresne Manufacturing, which recently received the Baldrige-based Performance Excellence Network (formerly the Minnesota Council for Quality) Award, the Baldrige Excellence framework has been a “cure for many business strategies and critical sustainability decisions.”

According to Kris Diemer, Du Fresne Manufacturing’s vice president of human development, “The Criteria have provided a structure for us. When a company is doing well, you concentrate on different things, but when you experienced a recession like many manufacturing companies have, you realize that there are things that need to be in place to assure the security of what we call our members as well as our company. And that experience . . . brought us to realize that the Baldrige Criteria are the cure for the stability of our organization.”

Part of that cure has been alignment, which is key to the systems perspective in the Criteria. For example, in 2007 alone, the 25-year old company received more than 16,000 ideas from employees on how to improve processes. “But what Baldrige gave us was the alignment that all of these ideas coming from the employees are now going to be linked to our balanced scorecard,” said Du Fresne. “That was a real advantage we had as an organization. . . . [The Baldrige framework also] helped us align our processes into four key systems. Some of the systems had been around for a while, but it’s the alignment that really woke us up. . . . We realized that they weren’t aligned; that they weren’t always matching up to the balanced scorecard. And they wouldn’t drive us to the human development that we needed. . . . The alignment we’ve got from the Criteria has had a real critical and positive effect on our organization.”

The Criteria helped reinforce the company’s workforce engagement, too, where 7 out of 10 employees were submitting ideas not just to make their jobs easier but to make it easier for the next person to do the job. “That type of engagement, once we get it aligned because of the Criteria, there was no stopping us at that point,” said Du Fresne, citing a company theme of employees’ mettle–facing demanding situations in spirited and resilient ways.

Du Fresne said Baldrige also inspired the moral and ethical responsibility of business owners and leadership teams. The manufacturer now considers human development one of its product offerings—”that’s the whole essence of developing meaningful work that leads to meaningful life,” he said; this focus on development has led to gains in marketshare, gains in the strength of the organization, more ideas submitted, and a very low turnover rate.

Du Fresne is particularly proud of the manufacturer’s business performance model, inspired by the Baldrige Criteria and lessons learned from the recession, that replaces performance reviews with reviews that look to the future. “It’s the first time each employee knows exactly what he/she has to do within the job to advance, get better, reach higher performance, and make more money,” said Du Fresne. To assist with this, the company has developed 900 knowledge, skills, and abilities (KSAs) outlines for each job, in addition to team targets aligned with the balanced scorecard, personal targets determined in collaboration with the manager and team member, and behavioral competencies most important to the culture.

This blog will continue. . .

Posted in Baldrige Award Process, Baldrige Criteria, Business, Leadership, Manufacturing, Performance Results, Uncategorized | Leave a comment