How the U.S. Dept. of Veterans Affairs Promotes Excellence

Posted by Christine Schaefer

What’s behind the 94% customer satisfaction rating of a Veterans Affairs (VA) organization—the highest rating ever recorded by the University of Michigan’s American Customer Satisfaction Index?

The short answer is the Baldrige Criteria. Specifically, the Baldrige-based program that promotes and recognizes excellence in organizations across the VA. Known as the Robert W. Carey Performance Excellence Award (or simply, the Carey Award), the program uses the Baldrige Criteria for Performance Excellence as a basis for evaluating and helping VA organizations achieve high performance.

To find out more, I recently interviewed Scott Holliday, director of the Management Systems Improvement Service in the Enterprise Program Management Office of the VA’s Office of Policy and Planning.

He explained that starting in 1991, the VA got involved with the President’s Quality Award, a program that continues to be managed by the Office of Personnel Management (OPM). After a few years of participating in the OPM program, the VA decided to set up its own award program aligned with the Baldrige Criteria. Holliday explained the transition as follows:

Our then VA Secretary Anthony Principi advised our Director for Quality Improvement Services that he wanted a more robust quality award program. We had used the OPM quality program for two to three years, but each of the three administrations, along with our program office (Quality Improvement Services), determined that they wanted to change over to a program that offered a higher level of performance metrics and a more significant award program. At that point, they moved to the Baldrige Criteria.

How does the Carey Award program support high performance across the VA today? Holliday detailed these four concrete objectives of the program:

  1. Provide best practices and systems management training and development by certified Baldrige instructors to teach the participants how to use the Criteria to continuously improve service to veterans.
  2. Provide a model(s) and standard(s) against which organizations can measure and compare their performance to that of other public- and private-sector organizations.
  3. Provide a clearinghouse with which organizations can seek and obtain information related to best practices in systems management.
  4. Inspire organizations and individuals to seek opportunities for continuously improving the benefits and services they provide to America’s veterans and their beneficiaries.

The “Carey Team” today is composed of Gwen Young (who has been with the program for 18 years); Diane Burton (with the program for six years); and Jo Brabson, the new program manager. Organizations eligible to participate include the administrations and field offices of the Veterans Benefits, Veterans Health, and National Cemetery Administrations, as well as VA staff offices.

Here are some of the transformational results the organizations have achieved, as described by Holliday:

  • At the highest level, the Veterans Health Administration (VHA) has used the Baldrige Criteria enterprise-wide and participated in the Carey program since its inception. That, coupled with the adoption of other enterprise-wide quality engineering and management best practices, has been responsible for the transformation of VHA over the years from a health care system with widespread quality issues, to arguably the best public health care system in the world today, as evidenced by being the benchmark for many key health care metrics espoused by the Center for Medicare and Medicaid Services, says Holliday.
  • Similarly, VA’s National Cemetery Administration (NCA) has integrated the Baldrige Criteria into its “Organizational Assessment and Improvement Program,” which it uses to evaluate all VA national cemeteries. As a result of building the Baldrige Criteria best practices and other quality improvement practices into the NCA management system, it has achieved the highest customer satisfaction rating ever recorded by the University of Michigan’s American Customer Satisfaction Index of 94%, according to Holliday.
  • The Veterans Affairs Cooperative Studies Program Clinical Research Pharmacy Coordinating Center (known as the Center), which benefited from its participation in the Carey Award program, also became, in 2009, one of the four nonprofit organizations to date to receive a Baldrige Award. Among the results the national program highlighted were the Center’s outstanding financial and marketplace performance levels and trends, with new pharmaceutical clinical trials growing 143% from 2002 to 2008, compared to 58% for the VA over the same period. In addition, the Center’s productivity rate of $221,000 of revenue per full-time employee in the year before it won the Baldrige Award compared favorably to the rates of eight top competitors, with the highest competitor’s performance at approximately $195,000 of revenue per employee.

What future role might Holliday envision for the Baldrige Criteria in improving the performance of military, government, and other nonprofit organizations? The “adoption [of Baldrige] is not widespread in the federal government sector,” he responds candidly, adding that it is “not uncommon for Baldrige to be viewed as too hard, without a tangible defined ROI.” Yet given the results VA organizations have achieved, Holliday would like to see more help for other federal government departments and agencies to get started using the Criteria.

For those organizations that would like to get started, Holliday provides this guidance:

Find a way to start slow, i.e., perform assessments at the item level, and identify opportunities for improvement, knowing that being able to address the Criteria at a high level of maturity takes many years for most organizations. Be patient. Most great organizations begin using the Criteria four to five years prior to attempting to apply for any recognition.

If you would like more information on the VA program, see the Carey Award Web site here. If your organization is outside the VA, you can find other sector-specific or regional, state, and local Baldrige-based programs on the Web site of the Alliance for Performance Excellence here. And if you have an inspirational story or practical guidance to share with organizations that have just begun or are considering a Baldrige journey, please leave a comment here.

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4 Responses to How the U.S. Dept. of Veterans Affairs Promotes Excellence

  1. Michael Mayo-Smith MD says:

    As a long time VA employee, I was introduced to Baldrige through the in house VA programs such as Carey. I find the Baldrige criteria an extremely effective approach to improving organizational performance. We are using it widely now within VA New England Health Care System, with very positive benefits. I hope its use becomes even more embedded in the VA.

  2. Kristi Groves says:

    I too, was introduced the Baldrige Criteria through the VA’s Carey program. Thank you for showcasing the VA’s efforts!

  3. MICHAEL C PINCHOT says:

    I AM VERY IMPRESSED THAT THE VA HOLDS THIS PRESTIGOUS AWARD FOR EXCELLENCE. IT IS AN HONOR OF THE UTMOST HIGH TO RECEIVE IT.LIKE THE MEDAL OF HONOR,OR THE AWARD OF HONOR IN ULTIMATE DEGREE. THERE IS NO GREATER ACHIEVMENT IT CAN RECIEVE,WITH EVERYONE INVOLVED. THE REASON I AM WRITING ABOUT THE CAREY AWARD,IS THAT ONE OF MY BEST FRIENDS GROWING UP IN A SMALL TOWN OF GIRARDVILLE PA. WAS ROBERT W CAREY,BOBBY AS WE CALLED HIM. THERE ARE SOME PEOPLE IN THIS WORLD THAT WE WOULD LIKE TO CONTINUE IN LIFE WITH AND TO KEEP IN TOUCH WITH A PHONE CALL ONCE IN A WHILE, WAS BOBBY CAREY. HE WAS A GREAT IRISHMAN AND LOVE THE SING ALONGS,WITH HIS FRIENDS AND FAMILY. YOU FELT PROUD TO BE HIS FRIEND AS WELL AS HIS BROTHER .LEO.I HAVE MISSED THE OPERTUNITY TO CALL HIM AND TO SAY HOW PROUD I AM OF HIS ACHIEVMENT. HE WAS THE THE BEST FRIEND TO MANY,AND THE AWARD IS NAMED AFTER A TRUE GENTLEMAN AND A GREAT PERSON TO HAVE KNOWN IN MY LIFE. MICHAEL C PINCHOT. MADEIRA BEACH FL.

  4. Greg MAZZOTTA says:

    I concur with Mr. Holiday’s suggestion to begin slowly, no great accomplishments have ever been easy. In Delaware, the Governor, now Senator (and Captain) Tom Carper, began the state-level program and we stressed the importance of the initial assessment, core values and concepts, and overview of the six process categories
    and one results category and developing a few annual cycles of improvement, any
    organization would be ready for more. Thank-you Scott Holiday for your leadership.

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