Baldrige Philosophy Adopted and Adapted

Posted by Harry Hertz, the Baldrige Cheermudgeon

In a recent conversation with Gary Floss, a former chair of the Baldrige Panel of Judge and current Alumnus Examiner, I learned about the work of Arnie Weimerskirch and the Veritas Institute at the University of St. Thomas in Minneapolis, MN. I was intrigued by what Gary said and it gave me an opportunity to reconnect with Arnie, who served on and chaired the Baldrige Panel of WeimerskirchPortrait-280x300Judges in the years 1992-1994. Arnie has applied Baldrige philosophy in the development of two assessment tools, one related to the six Catholic moral principles for health care and one to the ISO 26000 standard for social responsibility.

Let me share a little information about Arnie Weimerskirch first. He was the VP of Corporate Quality for Honeywell, Inc. at the time he served on the Panel of Judges. He authored one of the early guides to the 1990’s era Baldrige Criteria entitled Baldrige for the Baffled. Arnie is the originator of the phrase stating that the Baldrige Criteria represent “the leading edge of validated management practice.” This phrase has been our mantra since he stated it and was only slightly modified in 2015 to “the leading edge of leadership and performance practice.” Since leaving Honeywell he has been associated with the School of Engineering and more recently the Opus College of Business at the University of St. Thomas.

Weimerskirch believes at the heart of Baldrige is the philosophy that organizations can develop criteria questions on important topics to accomplish two purposes: to self-assess and to improve. The self-assessment should allow the identification of strengths and opportunities for improvement. The strengths and opportunities for improvement should be the basis for reflection and then prioritized improvements.

The two assessment tools developed by the Veritas Institute are the Business Ethics Assessment Method (BEAM) and the Catholic Identity Matrix (CIM). BEAM consists of seven paragraph descriptors, one for each of the seven core subjects in ISO 26000, and a series of questions tied to the 37 issues addressed in the standard. BEAM has a simplified scoring rubric to gauge on a level of 0-5 the maturity of the organization’s process approach and deployment relative to the 37 issues. You can see the Baldrige underpinnings.

The Catholic Identity Matrix was developed in 2005 to help “a Catholic health system or hospital assess and enhance the degree to which it has integrated the six Catholic moral principles within its operating policies, processes and practices.” The CIM has been used by approximately 50 hospitals through a process of assembling background data and an on-site workshop with two CIM facilitators to collaboratively address the assessment questions associated with the six moral principles: solidarity with those who live in poverty, holistic care, respect for human life, participatory community of work and mutual respect, stewardship, and acting in communion with the church. In a very Baldrige-like manner the aim of the CIM is to help organizations address the challenge of mission integration and improve.

I enjoyed the opportunity to catch up with Arnie and see how he continues to apply the Baldrige philosophy in his work. The Baldrige Program is currently working in collaboration with Communities of Excellence 2026 to apply the philosophy to creating high-performing local communities across the U.S. What topics might you choose for applying the Baldrige philosophy?

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2016 World’s Most Ethical Includes Baldrige Recipients

Posted by Dawn Marie Bailey

Among honorees from 21 countries, 5 continents, and 45 industries, several Baldrige Award-winning organizations (as well as other organizations on Baldrige journeys) made the Ethisphere Institute’s 2016 “The World’s Most Ethical Companies” list of just over 100 organizations.

Ethisphere Institute is identified as “a global leader in defining and advancing the standards of ethical business practices, recognizing companies that go beyond making statements about doing business ‘ethically’ and translate words into actions by promoting ethical business standards internally and exceeding legal compliance minimums through best practices.”

Among the honorees are

Others on the list with a connection to a Baldrige Award recipient include 3M Company (3M Dental Products Division was a Baldrige Award recipient in 1997) and Hospital Corporation of America (2014 Baldrige Award recipient St. David’s HealthCare (SDH)—one of the largest hospital systems in Texas—is a unique partnership between St. David’s Foundation, Hospital Corporation of America, and Georgetown Health Foundation).

According to its website, Ethisphere uses a proprietary rating system called the corporate Ethics Quotient, which is comprised of multiple-choice questions that represent a company’s ethical performance. Organizations are invited to apply, with the majority being corporate and large in size.

Within the Baldrige Excellence Framework (versions of which all of the organizations noted above had fully implemented at the time of their Baldrige Award wins), ethics is part of a Core Value and Concept present in all high-performing organizations. In addition, within Category 1 Leadership, considerations are given for how an organization fulfills its ethical responsibilities and promotes ethical behavior, and in Category 5 Workforce, considerations are offered for how workforce and leader development supports ethics and ethical business practices. Further, in item 7.4 Leadership and Governance Results, results for ethical behavior, including stakeholder trust in senior leaders and governance, and breaches of ethical behavior, are considered.

How would your organization rate among the world’s most ethical?

Posted in Baldrige Award Recipients, Baldrige Criteria, Business, Health Care, Leadership, Operations Focus, Uncategorized | 1 Comment

The “Great Value” of the Baldrige Framework to a University

By Christine Schaefer

The University of Wisconsin–Stout earned the first Baldrige Award in higher education in 2001. Dr. Meridith Drzakowski worked at the state university that year as an institutional planner. Today she is the assistant chancellor for planning, assessment, research and quality. Beyond UW–Stout, she is a senior Baldrige examiner, now serving for her sixth consecutive year on the federal program’s Board of Examiners (which may be the hardest-working volunteer corps of cross-sector professionals in America!).

To share how UW–Stout continues to improve and innovate to sustain its success, she agreed to provide an update through a group interview of senior leaders. Following are highlights of the recent interview, which included Dr. Bob Meyer, chancellor; Dr. Patrick Guilfoile, provost; and Drzakowski.

  1. What are some key ways in recent years that UW–Stout has used concepts from the Baldrige Excellence Framework (education version) to achieve improvements, innovation, and excellence?

Bob Meyer:

I believe that the Baldrige process and Criteria really helped shape the university in terms of its strategic planning process. I think that’s probably one of the most critical tools that we’ve adopted and perfected over time. Pursuing the Baldrige Award encouraged us to refine our strategic planning process and create a process that’s inclusive, responsive, and transparent. By inclusive I mean that it’s designed to engage a broad group of stakeholders to gather ideas on how to look at a future vision for the institution and what continuous-improvement items we need to tackle next. It’s responsive in that if it’s done right, then you should have a plan that is responsive to or reflective of the input you’ve collected and responsive to the needs that were suggested. And it’s transparent from the point of view that we have constant communications. We’ve developed our communication systems that support the planning process, so everyone knows what’s going on and everyone’s aware of it.

Because of that, we have a common road map or a common vision of where we want to go. And when you have that, you have alignment of resources and people so that you can attain outcomes more effectively and quickly even though you invest more time up front doing the planning and gathering the input. … Because you have a buy-in and it’s not solely a top-down process—it’s top-down, bottom-up and you’ve come to a consensus on where you want to go—I think there’s much faster implementation, and the plan is much more embraced or supported. So I think that’s probably one of the most impactful things that the Baldrige process has brought to the university.

I also believe that our decision making and our processes are information- or data-informed. If they work, then we celebrate that they work; if they don’t work, we learn from the fact that they didn’t and we try something else. You don’t have a failure if you’re measuring what’s going on and you learn from it.

UW–Stout’s strategic planning process attracted me to become chancellor because it’s very mature here. If you don’t have a strategic plan process where your action items are actually being worked on and appropriately resourced and you’re seeing movement on them, then you lose momentum.

Meridith Drzakowski:

Particularly in the area of strategic planning, I think the Baldrige framework has helped us take some risks in the area of innovation. A specific example would be that at the time that we applied [for the Baldrige Award] in 2001 we had something called Listening Sessions, which we thought were innovative [then]. And that was a series of eight or nine separate sessions, an hour in length each, where we would share with the campus some of the major initiatives that we were hoping to implement and ask for feedback.

We got some good information from that process, but there were also a number of concerns, in particular, a lot of the same people would be showing up at the events, a limited number of people would be comfortable speaking up, and there was a perception by some people that they were there to be listeners rather than contributors.

So we … completely restructured the format. So now as part of the “Welcome Back” events, we have what’s called an Engagement Session, where we first all get together in one central location, … we present these major ideas to the campus, and then we split into 35 separate rooms. So all faculty and staff are randomly assigned to these rooms where they have a facilitated discussion about the proposed initiatives, and there’s a facilitator and note taker in every room. We get hundreds of pages of comments back, which are reviewed by our Strategic Planning Group and then used to make changes and improvements to those initiatives.

UW–Stout faculty and staff members participate in a discussion at an annual event the university hosts to gather feedback on proposed strategic initiatives at the start of the school year.

UW–Stout faculty and staff members participate in a discussion at an annual event the university hosts to gather feedback on proposed strategic initiatives at the start of the school year.

Students are invited as well, but it’s primarily our faculty and staff who participate. … Over half of our faculty and staff show up for the event, which starts at 8 a.m. and ends with lunch. …

A second innovative example (again tied to our planning process) would be something called the “You Said, We Did,” [which is] really tied to the learning aspect of the Baldrige process. We have, since forever, been listening to feedback from the campus and taking action based on that. But we came to learn that a lot of people were not making the connection between the feedback that they provided and the actions that we were taking, and we learned that we needed to be very intentional about that. So we started with these “You Said, We Did” sessions, which happen during the “Welcome Back” for the beginning of the second semester and where we have people who had a role in these initiatives present. And what they present are examples of specific feedback provided during the Engagement Sessions, … specific actions taken based on that feedback, and … the people who made it possible. We started out having it be a report-out like that, but over time we wanted to make it fun and engaging and more of a celebratory atmosphere.

Drzakowski then described how the university has made the annual event more celebratory in recent years through adjustments such as ordering party hats and noise makers for the presenters and audience at the January 2015 session, as well as encouraging sunglasses to be worn widely and arranging to have guitar music played on stage at the January 2016 event.

It’s really turned into a celebratory event where we really thank the campus for what they’ve provided and demonstrate that we’re using their feedback.

UW–Stout Chancellor Bob Meyer celebrates employee ideas alongside other audience members at the university’s annual “You Said, We Did” event in January 2015.

UW–Stout Chancellor Bob Meyer celebrates employee ideas alongside other audience members at the university’s annual “You Said, We Did” event in January 2015.

Patrick Guilfoile:

I’m still [relatively new here] … so I’m seeing things through different eyes. … but as I’ve been on campus, I’ve asked a lot of questions about why we do things; I almost never remember hearing “because that’s the way we’ve always done them.” So I’ve really seen an openness on campus—maybe it would fall under the [Baldrige core value] of managing for innovation—to explore different ways of doing things. And that’s really impressed me during my time on campus here.


  1. What differences have you observed between how your institution focuses on continuous improvement (or performance excellence), in comparison to practices at other educational institutions?


Celebration is important. A comment about continuous improvement is that you’re always looking at what little foible is wrong that we need to improve. So you can come away from that thinking that we’re always criticizing the institution. But that’s really not true.

Our university culture embraces the idea of change and how we can do something better, but we want to keep it positive. Celebrating success is really important because otherwise people think, “This whole continuous improvement process seems negative because you’re being critical of how we do things.”


As an example of a unique process at UW–Stout, Guilfoile first described a rigorous and innovative data-collection, measurement, and review process, overseen by Drzakowski’s office, that aims to verify and ensure that tuition dollars allocated for student services such as tutoring centers are having the intended effect.

In my own experience elsewhere, I hadn’t seen that kind of attention to collecting the right kind of information to validate whether or not the money is being spent in a way that really is being helpful.

[As another example,] the program review process on campus is very detailed and very in-depth and that’s been helpful to provide administrators with information on resources needed… in the current more resource-constrained environment. … There’s been a real openness on campus to have discussions and develop processes … to incorporate elements that can be controversial [such as looking at costs and revenue generated by programs] in our longstanding program review process. … From the perspective of being a new person on campus, I’ve been very impressed with how quickly people here move forward with that even though there are controversial aspects and really try to work through and come up with the best solution. So that’s another example related to differences with other institutions.


  1. Would you please share details about your recent initiative to develop and implement a cascading scorecard for the organization?


Category 4 [the Baldrige Criteria section that assesses measurement, analysis, and knowledge management] was our lowest-scoring category in the Baldrige Award process [when UW–Stout applied for and received the award]. … So we’ve really spent a lot of time working on trying to improve there. And I think our most significant issues … were in the areas of deployment and integration.

We have metrics that we use as part of our strategic planning process that we’re regularly monitoring, but there was room for improvement in terms of how many people were looking at them, what processes they were integrated into, and at what levels of the organization they were being used.

Our strategic plans are five-year plans, and at the beginning of each plan, we develop what we call performance indicators, which are a small set of metrics that we use to assess the overall success of our strategic plan. So it’s about 25 metrics that we develop every five years, and they’re reviewed regularly by our Strategic Planning Group. And we do have many examples of how we used those results to develop initiatives at the university level, but fewer initiatives at lower levels of the organization. And primarily we felt that was because we weren’t systematically presenting data segmented down to the major units, departments, and program levels.

So the first step we took was to create what we called Program Facts, which were static dashboards [showing for a point in time] how the college was performing on metrics that could be drilled down to the program level. From that we’ve migrated to what we have now with the cascading scorecards, an interactive dashboard that has our performance indicators on it at the university level, and you can drill down to the college, unit, department, and academic program levels. And there’s additional segmentation by gender, student level, minority status, and such.

This screenshot shows measures on the university’s cascading scorecard.

This screenshot shows measures on the university’s cascading scorecard.

That has helped us in the conversations with the Strategic Planning Group to see where it is that we’re doing well and where it is that we can improve, and I think that it has led to more targeted initiatives. But where we still see room for improvement is better integrating these into existing processes on campus. So what we’re working on now is integrating these into processes for academic program review [etc.]. So we’re intentionally integrating these into those processes so that there will be more outcomes … both in the area of opportunities for improvement as well as better sharing of best practices.


Meridith has done a really good job of making sure that we’re not tracking so many different things that it’s impossible to manage all of those. In conversations I’ve had with her, she’s been reluctant, for very good reason, to add something without taking something away. That kind of discipline has been very helpful to ensure that we’re not overwhelming people with an enormous number of things to track.


  1. Could you please give key reasons that you believe other organizations in the education sector, particularly in higher education today, could benefit from using the Baldrige Excellence Framework (including the Education Criteria for Performance Excellence)?


I think the great value of the Baldrige framework is that it gives you a structure under which to plan and implement a vision forward, or a future state, and you can do it in a way that engages both external and internal stakeholders.

Meyer then explained that external stakeholders are included in UWStout’s visioning sessions that initiate the five-year cycle for creating new strategic plans.

The significant engagement that we have starts, first of all, with the Strategic Planning Group that helps facilitate it. This group deliberately has many employee types as members, and the Engagement Process literally involves everyone across the institution. One of the reasons I think that’s a helpful model is that engagement creates a common road map that everybody can rally around and understand. If you have that level of engagement up front creating the vision and the road map, you’re going to have much better alignment when you go to deploy and implement it. The process allows for all of our employees to be working in the same direction.

With the level of engagement that results, there’s ownership on the part of the employees. … Consequently, they are stewards of the road map, and you can feel that in the culture. In fact, it really feels good when you work here and you don’t have to push the staff at all; in many ways, they’re pulling the leadership along with them.


Prior to our adopting the Baldrige framework, we were tracking too many metrics—well over one hundred. … the Baldrige framework has helped us—and can help other organizations—to identify what is most important for the organization.

Drzakowski added that she considers this critically important in higher education given the trend toward an increasing number of accountability processes, for example, with state and national scorecards.


Meyer next described how UW–Stout has used its strong strategic planning process to help it effectively manage recent state funding cuts that resulted in a 10.4 percent reduction in the university’s discretionary operating budget.

At the previous institution where I worked and also previously when I was a dean at UWStout, we implemented funding reductions across the board as a percentage. … This time around, we really wanted to be strategic about how we navigated our reductions.

In the same way that we do strategic planning, we had the same levels of engagement in terms of how we looked at creating our reductions. It’s not as much fun as thinking big about what your future looks like. But I think it’s really important because what we tried to do was protect our strategic plan and associated action plans. We came up with a set of principles for how to do that. So we did not do across-the-board cuts. We did our cuts strategically. We actually downsized a lot of our administration and tried to keep the instructional area held harmless as much as we could. So I’m proud of that. In addition to using strategic planning to grow, we’ve now used it as way to shrink a little bit, too.


I think in terms of the Baldrige framework that the Organizational Profile really can help organizations with what Bob is talking about, to identify what’s most important and be able to handle those kinds of reductions in strategic ways.


  1. Would you please suggest a few tips for using the Baldrige framework to support high performance across your organization?


  • Follow the Baldrige Core Values, particularly valuing people and managing for innovation. In the area of valuing people, establishing trust is so critical for us, and I think it’s the Baldrige framework that helps us do that. We just finished an accreditation visit; we had a team here, and they [said] it was evident that the campus had trust in the leaders, and they asked what our magic formula is for accomplishing that. And I think it’s about having the difficult conversations regularly and whenever issues come up.


  • Communicate! If you think you’ve gotten to the point of communicating enough, you’re in trouble. I think one of the best things that Meridith did was set up these “You Said, We Did” sessions. It’s really important to show your stakeholders the evidence that you’ve used their feedback.


  • Thank people for their role in your engagement and improvement processes. This reinforces employees’ engagement and ownership in continuous improvement. Even those who filled out a survey are asked to stand and be recognized at the “You Said, We Did” sessions for contributing their input.


  • Build trust [through the above actions]. When people trust one other, things can happen more expeditiously. I want to reiterate the importance of that principle.


To learn more, attend UW–Stout’s presentation Using a Cascading Scorecard System to Track Performance at the Organizational, Unit, and Program Levels” at the Baldrige Regional Conference in Chicago, Illinois, on September 8.

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Tips from Five Baldrige Award-Winning Organizations

By Christine Schaefer

Every fall and every spring, Baldrige Award recipients openly share their best practices with other organizations that want to improve their performance. This sharing and learning happens at two regional conferences in September and at the annual Quest for Excellence® Conference in April.

For the benefit of those who missed those events last September and this April, below are five sets of tips shared by Baldrige conference presenters over the past year.


How to Adopt the Baldrige Framework for Long-Term Use

The following tips are from Joseph (Joe) Brescia, director for strategic management and process improvement; and James (Jim) Caiazzo, team leader for the Office of Strategic Management, at U.S. Army Armament Research, Development and Engineering Center (ARDEC), a 2007 Baldrige Award winner in the nonprofit sector. For the full blog interview, see

1. Establish a sense of urgency.

The Baldrige Excellence Framework is a vehicle for establishing and maintaining transformational change in your organization. The responsibility of great leaders is to align the mission, vision, and values within the organization. Paint the vision of what change looks like and how the Baldrige framework gets you there.

2. Use the Baldrige Criteria to provide a common language across your organization to discuss improvement so that everyone is using the same vernacular.

3. Make sure you focus on results.

In other words, the way to institutionalize the Baldrige framework is to actually use it to manage the business. That comes down to establishing a formal venue for senior leadership to review results and make changes as required. This way, when you have changes in leadership, with the venue institutionalized, it doesn’t live and die with the leadership that started it.


How to Use the Baldrige Framework to Drive Your Desired Results

The following tips are from Jayne E. Pope, CEO of Hill Country Memorial (HCM), a 2014 Baldrige Award winner in the health care sector. For the full blog interview, see

1. Align and integrate processes within the workforce.

Align all processes and the workforce to achieve strategic goals, with all processes supporting this alignment and integration. For example, when refining the workforce performance system, HCM asked how the redesign could integrate the system with the organization’s strategic plan. The organization developed quarterly coaching plans and an annual performance appraisal that aligns individual goals with strategic goals.

2. Streamline processes and make them as easy to use and understand as possible.

For example, HCM wants individuals to be experts at their jobs but doesn’t expect them to be performance improvement experts, so it developed easy-to-use worksheets that walk employees through process design and the Plan-Do-Check-Act (PDCA) methodology. Having such user-friendly tools allows every member of the workforce to be involved in performance improvement.

3. To achieve strategic results, identify key action plans and monitor progress.

Just having goals is not enough; develop robust action planning and monitor processes. For example, through HCM’s Strategic Breakthrough Initiative process, executives identify those key short-term action plans that will move the organization toward achievement of its strategic goals. These are 90-day action plans, and the team reports out progress on a weekly basis to the executives. This weekly report-out supports accountability and ensures that team members have the support and resources needed to achieve their goals.


How to Get Started with Baldrige-Based Organizational Improvement

The following tips are from Pete Reicks, senior vice president of performance excellence at Elevations Credit Union, a 2014 Baldrige Award winner in the nonprofit sector. For the full blog interview, see

1. Embrace the journey, make the investment, and leave a legacy.journey_road

You owe it to yourself, your workforce, your customers/students/patients, and your community. The hardest step is setting the goal. You have to commit. The journey is an investment. Just get started, regardless of the reasons to delay. The only better decision is to have started sooner.

2. Use the power of the Baldrige framework and the magic of ADLI and LeTCI to affirm your Why (your organization’s mission and purpose).

Become systematic in your How (approaches) and appreciate the WhoWhat, and When (deployment) occurring within an interdependent system (alignment and integration). Meaningful measurement (levels, trends, comparisons) of (aligned and integrated) results (operations, customers, workforce, leadership, and financial/market performance) drive accelerated cycles of applied learning.

3. Make it FUN (really)!

Celebrate! Make reaching for your goals fun. Have many carrots and few sticks. While gains may be slow at first, committed, talented, passionate people will be attracted to your organization as they see movement towards excellence. They will want to be part of it, to contribute and to attain excellence not only for today, but in an environment built to sustain excellence for generations to come. The Baldrige journey exposes talent, accelerates development, and is a magnet for others.

4. Ensure an operational rhythm.

Bring rigor and purpose to your organizational forums and meetings. Get to a point where your staff can discuss their work with the same fluency with which they dissect their sports team the day after a game. If the water-cooler or happy-hour conversations at the local watering hole are more honest than those in your meetings, you’re not being effective. Measure your performance. How are you doing relative to leaders within and innovators outside your industry? Get comfortable with truthful conversations. Set emotion aside and find ways to work smarter, collaboratively.

5. Recognize that the path of a Baldrige journey is not a straight line.

Realize you’ll take some spills. Learn from them and move forward. Guard against “change fatigue.” Be smart about change. Evaluate new ideas by reconciling them against your core values and strategic plan. Know the difference between good and great. Sometimes you need an outside view. Bring in someone unencumbered by the internal organizational dynamics who can coach you through blind spots as well as affirm your organization’s strengths.

6. Embrace what’s “simple smart” (after you’ve made the “simple easy” improvements).

Simplistic solutions quickly applied to complex problems temporarily address symptoms yet are ultimately rendered ineffective by unaddressed root causes. Fortunately, the answer is often not fighting complexity with complexity. A simple-smart approach requires an appreciation for the hard work necessary to get under the hood, correctly diagnose root cause, and assess the trade-offs presented by potential solutions.


How to Create a Strong Measurement System for Your Organization

The following tips are from Fonda Vera, associate vice president of planning, research, effectiveness, and development; and Bao Huynh, director of institutional effectiveness, at Richland College, a 2005 Baldrige Award winner in the education sector. For the full blog interview, see

1. Begin with your mission, vision, and values in mind. Be sure to measure what you value.

2. Identify key performance indicators and measures that will yield actionable data (i.e. why are you measuring this?).

3. Be sure you are selecting important measures for your organization. Just because you can measure something doesn’t make it important.

4. Commit to your measurement system for a year; then evaluate and revise it as appropriate.

5. Use your results to create the next iteration of your strategic plan.


How to Manage Your Organization’s Key Processes to Achieve Excellence and Innovation

The following tips are from JoAnn Sternke, superintendent of Pewaukee School District, a 2013 Baldrige Award winner in the education sector. For the full blog interview, see

1. Identify a process owner as the “go to” for this process, and have this person document the process so there is a collective understanding of the process throughout your organization.

2. Know what’s key and measure this.

3. Have a systematic review of the process. Remember the “S” and the “A” in Plan–Do–Study–Act improvement methodology. Don’t become so busy doing the process that you don’t evaluate it or refine it.

4. Realize that your organization can ensure innovation through a systematic process, rather than “light bulb moments.” The quest to offer greater value to stakeholders drives both process improvement and innovation.


For more tips from Baldrige Award recipients of recent years, see other Blogrige posts based on interviews and presentations of role-model organizations in the business, health care, and education sectors. And consider registering for the next Baldrige regional conferences!

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How Baldrige Can Help Realize the ACO Promise

Posted by Dawn Marie Bailey

A recent paper “Realizing the Promise: Overcoming the Barriers to ACO Success” explores the promises, doubts, hopes, and future of accountable care organizations (ACOs), with the caveat “it is imperative that you proactively position your organization to take advantage of this opportunity. . . . The number of lives covered through ACOs is anticipated to grow exponentially, reaching more than 105 million patients by 2020, compared to just over 20 million today.”


But me being a staff member of the Baldrige Performance Excellence Program, I was struck by this quote, “The success of any ACO really comes down to the culture. Creating an environment that encourages effective behavior and best practices happens through open, transparent, and passionate leadership.”

While the work of creating and sustaining an ACO seems daunting, the Baldrige Excellence Framework (Health Care) can help—with redefining a culture, creating an environment for effective leadership and behavior, and sharing best practices. The bottom line, Baldrige resources support and enable high-performing ACOs. For example, category 1 of the Criteria (within the framework) provides all of the considerations that leaders need for creating a successful organization now and in the future: an environment for the achievement of your mission, improvement of organizational performance, transparency, organizational learning, and learning for people in the workforce. The Criteria also include considerations for creating a workforce culture that fosters customer engagement, an environment for innovation, and a culture for patient safety.

According to the white paper, “ACOs brought to reality by the Affordable Care Act were designed with a promise: by banding together, physician organizations, hospitals, and other care delivery organizations could share risk, reduce costs, and deliver better holistic care to their patient populations. For a vast majority of ACOs, however, those shared savings have yet to materialize—leaving many doubting that this program solves health care challenges around care coordination and sustainability. There’s still hope, however, for the success of ACOs. Their structural ability to deliver on the tenets of the triple aim— improve the patient experience of care, improve population health, and reduce costs —is strong.”

The white paper lays out four critical barriers to success:

  • Effectively lowering costs. According to the white paper, part of this is looking at “cost and utilization metrics to reduce overall spend while maintaining, or improving, quality, as well as having the right clinical decision support tools available to use in maximizing the efficiency of your workflow.” In the Criteria, category 4 guides a health care organization in measuring, analyzing, and then improving organizational performance, as well as managing organizational knowledge assets, information, and information technology infrastructure. The Criteria do not prescribe which “clinical decision support tools” an organization should use but provide a framework to guide an organization as to which tools make the most sense and where to use the tools.
  • Dealing with shortages of expertise. “Creating an environment that attracts primary care physicians and specialists will be a key determinant between success and failure for any ACO,” says the white paper; however, the industry will face a shortage of 46,000 to 90,000 physicians by 2025. In the Baldrige Criteria, physicians are not only critical members of the workforce but in health care organizations with separate administrative/operational and health care provider leaders, “senior leaders” refers to both sets of leaders and the relationship between them. Category 5, Workforce Focus, pays particular attention to recruiting and retaining clinical staff, and physicians are so important to the success of a health care organization that just about every health care Baldrige Award recipient outlines best practices for engaging physicians in their application summaries.
  • Creating a successful patient engagement strategy. According to Gene O’Dell, vice president of AHA, “Consumer-driven health care is becoming more relevant and driving new models of care delivery. Now, more than ever, consumers are looking to their own health and developing a trusted partnership with their doctors in medical decisions.” An entire section of the Criteria, 3.2, is dedicated to how to engage patients and other customers by serving their needs and building relationships. Strategy is covered in category 2 and throughout the Criteria, and again this concept is so important that best practices for patient engagement are almost always covered during Baldrige Quest for Excellence® and Regional conferences and in Baldrige Award application summaries.
  • Getting the most out of the EMR. “Optimizing an effective system that aggregates clinical, financial, and patient satisfaction data to help hospitals is fundamentally important to allow hospitals to better understand their business,” according to the white paper.  In the Criteria, considerations for electronic data and health records are laid out in 4.2, Data, Information, and Information Technology, as well as in other areas of the Criteria, including categories for Leadership and Strategy.

For an ACO to succeed, according to the white paper, organizations need to improve the patient experience of care, improve population health, reduce costs, integrate physicians, and ensure that every member of their team understands (or at least appreciates) the importance of quality data (and how they should be gathered, normalized, and made actionable).

I might add one more: implement the Baldrige framework as a roadmap to ensure that you are considering all of these elements to succeed as an ACO. Also, apply for a Baldrige Award so that you can receive objective feedback from Baldrige Examiners on how you are doing to achieve your goals.

What other elements of the Criteria do you think could help health care organizations succeed as ACOs?

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