Cascading Goals for Better Outcomes

Posted by Dawn Marie Bailey

Most organizations have goals. And people who work there have goals, too. But the magic, experts say, is when organizational goals align with department goals that are in alignment with the workforce’s goals. Such goal alignment can improve outcomes and operations; increase employee morale and retention, creating ownership in the organization’s success; and lead to more satisfied patients and customers who benefit from smoothly running processes and motivated workforce members.

But if you work for a large system (or even a small organization), where do you begin in aligning goals–and sustaining that alignment–across your entire organization?

At the upcoming 29th annual Quest for Excellence Conference, Brenda Grant, chief strategy officer, and Dr. Glenn Crotty, chief operating officer, at Charleston Area Medical Center (CAMC), will be sharing Baldrige Award recipient’s CAMC Health System’s Goal Cascade Process, which is used to align the organization’s annual goals throughout the entire system to every department.

Grant explained the process, “The goal cascade has been key to improvement in overall organizational results by ensuring our focus on key improvement areas. For example, a BIG DOT [key measure] under our quality pillar is Value-Based Purchasing–Hospital-Acquired Infections. This is cascaded to applicable nursing departments as CAUTI (Catheter-Associated Urinary Tract Infections). The nursing departments have CAUTI as a Top-5 Board improvement project and monitor the implementation of ‘bundles of care’ that need to take place every day to prevent these infections. As a result of this focus, CAMC’s CAUTI rate for 2016 was 0.30, better than the Centers for Medicare and Medicaid (CMS) top-quartile performance of 0.90.”

She added that Top-5 Boards are 4×6-foot boards in each department with five columns that address the Define, Measure, Analyze, and Improve components of DMAIC, the system’s problem-solving methodology. The boards are in visible areas so that the performance improvement work is very transparent to the workforce, patients, and visitors. Each column lists an improvement team addressing an issue cascaded from the corporate goals.

In addition to improving outcomes, the Goal Cascade Process has helped CAMC engage everyone in performance improvement.

“As a cycle of learning, to continue our focus on sharing best practices and knowledge management, we now have Top 5 Board report outs from each of our hospitals and corporate areas,” said Grant. “Not only are clinical results improved, our Top 5 Boards have the added value of engaging employees in their daily work to achieve corporate goals.”

Grant also shares some words of wisdom for using Baldrige resources to improve Quest participants’ own organizations. For example,

  • The Baldrige Criteria align with and support required accreditation processes.  Show the connections!
  • Transparency supports engagement. Through the Goal Cascade Process, CAMC Health System shares its strategic direction and the “why” behind its plans.
  • Comparisons and benchmarks are critical to knowing how you perform. Ask the question, “How do you know?”
  • Having systematic processes in place (including CAMC Health System’s Organizational Sustainability Framework) helps prepare health care organizations to work through the challenges and instability of delivering health care in today’s environment.

Grant said the Baldrige Award-winning system continues to improve. “We are using the Baldrige Cybersecurity Excellence Builder to better understand the effectiveness of our cybersecurity risk management efforts and to identify opportunities for improvement, and we are participating in the Communities of Excellence work to ensure we can be even more effective in our work with our community.”   

To learn more, register now for the 29th Annual Quest for Excellence Conference, which will feature the 2016 Baldrige Award recipients and many more national role models sharing their best practices.

Posted in Baldrige Award Process, Baldrige Award Recipients, Baldrige Criteria, Health Care, Operations Focus, Performance Results, Uncategorized, Workforce Focus | 3 Comments

The Impact of the Baldrige Award … 15+ Years Later

By Christine Schaefer

Earlier this month, 2001 Baldrige Award-winning University of Wisconsin–Stout hosted a lively campus engagement session. (See for yourself via this video of the livestreamed event, which kicked off with dancing.) The university holds the so-called “You Said… We Did” sessions each January to demonstrate its responsiveness to the input of its employees and students.

The same week, UW–Stout released news highlighting the ongoing impact of the Baldrige Award and excellence framework on its values and practices.

Following is a recent conversation on that impact with Meridith Drzakowski, a senior Baldrige examiner and the assistant chancellor at UW–Stout who oversees the university’s office of Planning, Assessment, Research and Quality.

Baldrige Examiner and UW-Stout Asst. Chancellor Meridith Drzakowski

Baldrige Examiner and UW-Stout Asst. Chancellor Meridith Drzakowski

  1. Tell us about your university’s ongoing use of the Baldrige Excellence Framework (which includes the Education Criteria for Performance Excellence)?

Since the 2001 Baldrige Award, nearly all of the people who were part of the team that led us through that process have left UW–Stout. However, within the past several years, we’ve started an informal Baldrige team. Membership is open to the entire campus, and we meet several times throughout the year to discuss ways in which we are following the Baldrige Criteria and addressing our opportunities for improvement. The focus isn’t about writing a new Baldrige Award application; instead, it’s about how we can continue to grow and learn using the Baldrige Criteria.

We also send teams to various Baldrige professional development offerings through the state-level Baldrige programs in Wisconsin and Minnesota, as well as to the Baldrige regional conferences and occasionally to the Quest for Excellence® Conference. And we encourage them to become examiners through the state-level Baldrige programs.

In addition, we use a Baldrige-based approach to meet our regional accreditation requirements through the Higher Learning Commission (HLC). At the HLC’s 2017 conference, I’ll be co-presenting with Jan Garfield, another Baldrige examiner and HLC peer reviewer, about how to integrate HLC requirements into daily operations. We’ll be talking about how understanding and using ADLI (i.e., Approach/Deployment/
Learning/Integration, which are process evaluation factors in the Baldrige Criteria) can reduce the burden associated with preparing for comprehensive visits, quality initiatives, and required reports associated with meeting HLC requirements.

Incidentally, UW–Stout had its comprehensive review in March 2016. The review team leader said it was the best portfolio he had ever seen.

 

  1. Would you please describe a few examples of how Baldrige-based practices have contributed to your organization’s success?

One of the most significant processes that has been impacted by the Baldrige Criteria is our planning process. The planning process aligns feedback we receive from the campus with data we collect on key performance indicators and with our budget. Our student jobs program and “You Said…We Did” events are great examples of initiatives/actions implemented through this process.

UW-Stout leaders and other employees participate at January 2017 "You Said ... We Did" event.

UW-Stout leaders and other employees participate in January 2017 “You Said … We Did” event.

Participants in UW-Stout’s 2017 campus engagement event celebrate ideas.

To encourage innovation, one principle that is important to us in planning is starting with the idea first, and identifying resource needs second. It’s easy to start by saying, “We only have $X dollars,” and then let that limit your thinking. However, starting by thinking big has helped us to implement new initiatives in innovative ways.

One example is our e-Stout (laptop) program. Students pay a per-credit fee to receive a laptop that is refreshed every two years and that they keep after graduation. The fee also provides for a number of support services, software programs, etc. This idea would never have come forward if we started by looking at the amount of money we had available.

Other examples of innovative ways we have funded initiatives include partnerships with our foundation office, forming grant-writing teams to apply for external funding, and increasing efforts for fundraising. (We have a university priority on fundraising and are starting the process of implementing a comprehensive campaign.)

Baldrige has also helped us to focus on a smaller number of metrics that are most important to us. Every five years, we update the list of our key performance indicators that we use to assess the success of our strategic plan. Although we collect data on hundreds of metrics campus-wide, the Baldrige framework helps us prioritize to focus on those metrics that are most important to our success and that align with our strategic plan—which keeps them to a small number.

 

  1. What are your top tips for using the Baldrige framework to support improvement and innovation?
  • Trust the process. When new faculty and staff members are hired at UW–Stout, it’s common for them to look at our planning process and say that it’s too time-intensive or complex or impossible to reach consensus with so many stakeholders. We tell them to trust the process, to give it a year and then decide whether they think it works or not. After the year is over, most people understand and buy in to the importance of the process.
  • You can start small. You don’t have to begin by deciding to write an entire Baldrige Award application or implementing all of the Baldrige Criteria. Start with the Organizational Profile, and then pick a specific item or core value to start with. The way we engage people in the process is by involving them in aspects of the Criteria that impact them directly or that they are interested in learning more about, or about which they have ideas or concerns. It’s not about receiving the award; it’s about learning and growing as an organization.

 

  1. Would you please outline what participants may learn at your university’s session, “From Crisis to Confidence,” at the Baldrige Program’s Quest for Excellence® Conference in Baltimore in early April?

During difficult budget times, the easy thing to do is to stop or cut back on new, innovative ideas that emerge through the strategic planning process or to administer across-the-board cuts.

However, despite the significant and ongoing budget cuts that UW–Stout has experienced over many years—including the most significant cuts we’ve ever received within the last biennium—we have always continued to focus on what’s important and never stopped planning, listening, and making decisions based on the data. We’ve had to cut back and be more selective about what is funded, but we’ve never stopped putting our time and resources into these processes.

Our presenters, Maria Alm and David Ding, will also discuss how visionary leadership at UW–Stout has helped support our focus on what’s important. And we will discuss the critical role that the leadership has in building and maintaining trust, as well as some of the processes we use to build trust.

[Added Alm, “Participants will learn how UW-Stout’s commitment to the Baldrige Criteria helped us navigate the most recent round of state budget cuts. While the cuts were significant, we never lost sight of the importance of (and our values related to) planning, innovation, and people. For that reason, after what was a very difficult year, we were still able to celebrate our accomplishments and to dance!”]

 

  1. What are a few key reasons that organizations in your sector can benefit from using the Baldrige framework?

The framework can help [universities] meet regional accreditation requirements. We have one process for planning, one process for accountability, one process for assessment, etc., and requirements for the HLC are integrated within those processes.

At the same time, Baldrige helps us put our primary focus on taking action because it will benefit the organization. In other words, the framework can help organizations focus on taking action not because an external organization told them they had to do something but because it’s important to them. When an organization is trying to encourage buy-in on processes related to planning and assessment, the last thing that people want to hear is, “We are doing this because it’s required by our accrediting body.”

Also, the Baldrige framework provides guidance in making resource decisions—in good times and in bad.

 

To learn more, register now for the 29th Annual Quest for Excellence Conference, which will feature the 2016 Baldrige Award recipients and many more national role models sharing their best practices.

Posted in Baldrige Award Recipients, Baldrige Events, Baldrige Examiners, Education, Strategic Planning, Workforce Focus | Tagged , | 5 Comments

One Data Breach Each Day in 2016—Another Reason Experts Say Focus on Cyber Risk Now

Posted by Dawn Marie Bailey

The year 2016 averaged one health care data breach per day, affecting more than 27 million patient records, according to Protenus, Inc., which recently collaborated with DataBreaches.net on the “Breach Barometer Report: Year in Review.”

Additional findings from analysis of that report, which pertains to health care, follow:

  • There were 450 total breach incidents in 2016.
  • Insiders caused 43 percent of the data breach incidents.
  • Hacking and ransomware were responsible for 26.8 percent of the breaches.
  • It took the average entity 607 days to discover breaches caused by insider wrongdoing.
  • Breach incidents affected 47 states.

“There’s no such thing as total security anymore. You must make every effort to strengthen security as much as possible,” said Michael Dowling, president and CEO of Northwell Health, in a recent article in Becker’s Hospital Review. “Hacking and data breaches are realistic and stubborn dangers we face each day. No [leader] has the luxury of dismissing these threats or viewing the work to prevent them as optional.”

Of course, breaches related to cybersecurity are not reserved for the health care industry.

Jon Boyens of the National Institute for Standards and Technology (NIST), in a paper titled “Integrating Cybersecurity into Supply Chain Risk Management,” pointed out that trends, including the Internet of Things (where everything is smart and interconnected), IT-enabled supply chain management, and 3-D printing, present cyber risks that can result in the delivery of poor quality, compromised or counterfeit products that diminish brand reputation, loss of intellectual property, and compromised customer information and operational control systems.

Paul Myerson, professor of practice in supply chain management at Lehigh University, highlights in a recent Industry Week article incidents such as hackers gaining access to owner data on 600 million Samsung Galaxy phones and poor information security by service suppliers leading to recent data breaches at Target, Home Depot, Goodwill, and many other companies and organizations.

In light of the increasing volume and sophistication of cyber threats, organizations need a systems approach to improve their cybersecurity performance. The Baldrige Program has been working hard, in collaboration with the Applied Cybersecurity Division at NIST and industry experts, to develop the Baldrige Cybersecurity Excellence Builder, a voluntary self-assessment tool that enables organizations to better understand and improve the effectiveness of their cybersecurity risk management efforts. It helps leaders of organizations to identify opportunities for improvement based on their cybersecurity risks, needs, and objectives, as well as their larger organizational environment, relationships, and outcomes.

To help organizations use this tool and improve their cybersecurity performance, the Baldrige Program is hosting a Baldrige Cybersecurity Excellence Builder Workshop and panel session in conjunction with the 29th Annual Quest for Excellence Conference at the Baltimore Marriott Waterfront Hotel in Maryland on April 2 (workshop) and 3 (panel).

The program invites you and anyone concerned with and responsible for mission-driven, cybersecurity-related policy and operations in your organization to attend this interactive workshop. Attendees will learn how to use the Baldrige Cybersecurity Excellence Builder to better understand where their cybersecurity efforts are today and what they can look like in the future, as well as how to conduct a self-assessment of their cybersecurity programs.

Baldrige Director Robert Fangmeyer has written, “In our increasingly connected data-driven world, protecting data, information, and systems has become a basic necessity for organizations of all kinds and a critical national priority.” Baldrige Cybersecurity Excellence Builder and this workshop are designed to help organizations of all kinds start assessing their cyber risk now.

The Baldrige Cybersecurity Excellence Builder Workshop is available on a first-come, first-serve basis. Registration is now open with limited seating.

Registration is also now open for the 29th Annual Quest for Excellence Conference, which will feature the 2016 Baldrige Award recipients and many more national role models sharing their best practices.

Posted in Baldrige Criteria, Business, Health Care, Leadership, Operations Focus, Uncategorized | Leave a comment

All Organizations Are Imperfect in Their Own Way

Posted by Harry Hertz, the Baldrige Cheermudgeon

Even the best organizations are imperfect. High-performing organizations strive for six sigma performance, but that is striving for 3.4 defects per million opportunities. So even this holy grail still admits to and even strives for achieving a degree of imperfection.

In this blog post, I would like to address imperfection at a different level, the level of organizational imperfection. Let me start with a simple illustration of the existence of these imperfections on a broad scale. Consider the Baldrige survey tool, Are We Making Progress?, a 40-statement employee (and leadership) perception survey based on the Baldrige Excellence Framework. The statement, “My organization removes things that get in the way of progress” generally has one of the lowest levels of agreement among the 40 statements for both employees and leaders. Frequently, some of the barriers can be easily identified through dialog and some “imperfections” can be fairly easily removed. The interesting point is that both employees and leaders are aware of these imperfections, yet only after a simple survey do they see the benefit to dialog and to addressing the imperfections.

But what about big picture “imperfections” or “opportunities” that organizations frequently miss. In the book, Creative Confidence, IDEO’s David and Tom Kelly recount the story of the GE MRI that was great for doctors and hospitals, but when the design engineer went to see pediatric imaging  in a hospital he discovered the machine was so scary to kids that they frequently had to be sedated. With that ultimate customer knowledge, it was easy to redesign the casing to look like a pirate ship or space adventure (and even create a script to go with it for machine operators).

The problem for organizations is that they are often blind to opportunities or even simple fixes on an operational base, and agile too late or at a minimum later than they should be on a strategic base. We are stuck in an old paradigm of plan, execute for a fixed period of time, and only then evaluate and improve.

A Baldrige core value is organizational learning and agility. Agility requires a capacity for rapid change in strategy and for flexibility in operations. Organizational learning requires both continuous improvement of existing approaches and innovation creating new and different approaches. These concepts are embedded in the Baldrige Criteria for Performance Excellence and many of the criteria questions aid you in achieving agility in strategy and operations.

So, what are some of the practices that organizations can embed in their planning and operations to identify “opportunities” and “imperfections” and become more agile? Here are a few for you to consider:

  • a mechanism for continuously scanning the external environment for new technologies, and potential changes in regulation and the external business environment
  • continuously looking for strategic opportunities that could lead to innovation on an ongoing basis
  • having a defined process for seeking blind spots as part of strategy development
  • constantly listening to customers through visits, observation, surveys, social media, and lost customer analysis
  • engaging in two-way conversation and empowering employees
  • benchmarking organizations that can offer you opportunities to learn
  • building agility steps into planning and operations processes
  • managing your organizational knowledge for purposes of learning and cross-functional integration

In a Forbes blog several years ago, Greg Satell stated that businesses are run much like an orchestra, with a conductor leading a pre-arranged program. Yet today, organizations need to be more like a jazz band with a sense of direction, empowerment (improvisation), and an expectation of failures along the way.

One final thought, enterprise risk management is all about managing imperfections and opportunities. The term is well chosen. It is risk management, not risk avoidance. All successful organizations must take intelligent risks to manage their imperfections and opportunities and build long-term sustainability.

May your year be characterized and rewarded by intelligent risks!

Posted in Baldrige Criteria, Business, Operations Focus, Strategic Planning, Uncategorized | Tagged , , , | 5 Comments

Spotlight on a Baldrige Examiner: Bill Craddock

Posted by Dawn Marie Bailey

While the annual online application for the 2017 Board of Examiners has now closed, we are always looking for ways to celebrate Baldrige Examiners. Competitively selected, these volunteers hail from many states, sectors, and professions. Following is an interview of William (Bill) Craddock from Arkansas. President of Craddock & Associates, Inc., Bill has served on the Board of Examiners for the past six years.

Baldrige examiner William (Bill) Craddock

Tell us how you first became interested in becoming a Baldrige examiner?

In my second year of participation in the Arkansas Governor’s Quality Award Program [a member of the Alliance for Performance Excellence, a network of Baldrige-based state and sector programs], I volunteered to be on the training committee. I soon recognized that examiner experience at the national level could help improve our training at the state level. The value began with the knowledge gained from the formal training and discussions with other examiners about how they approached different scenarios, and continued through mentoring by my team leader during the evaluation process. I believe I am a better trainer for our state program because of my participation as a national examiner.

What were your impressions or highlights of your first training to be an examiner? What have been highlights for you of annual examiner training in subsequent years?

I was very impressed with the caliber of the Baldrige examiners in my first training class and felt honored to be included in the room. Everyone (examiners and Baldrige staff) both shared experiences and provided specific feedback on how to improve. In subsequent years, I have enjoyed visiting with colleagues with whom I have served on teams or worked on projects. I have also appreciated the opportunities to help facilitate the training.

Would you please share some memorable learning experiences you’ve had as an examiner on Consensus Review teams?

It’s a difficult balance to stay on schedule for the consensus calls and make sure all team members are both heard and will support the consensus decision. Occasionally, there is a team member who voices an alternate viewpoint in a way that convinces the other team members. Regardless of how passionate some of the consensus discussions are, it always feels great when the team leader declares “we have reached consensus”—especially at the end of the last consensus review call.

How have you applied learning from your service as a Baldrige examiner to your work with various organizations?

There are multiple ways Baldrige participation has helped me. I listen more carefully and try to better understand the other person’s perspective. I recruit organizations to get involved—both as applicants and as sources of potential examiners. I tell them how amazing it is to see truly outstanding organizations up close and personal during a site visit.

My focus is on helping organizations improve. The Baldrige phrase “successful now and in the future” really resonates with me.

Because the 2015 revision of ISO 9001 created greater alignment with the Baldrige Criteria, I am now actively involved with organizations who are working to upgrade to the revised standard. And yes, I still recruit them to get involved as Baldrige applicants!

Posted in Baldrige Award Process, Baldrige Award Recipients, Baldrige Criteria, Baldrige Examiners, Baldrige State & Local Programs, Uncategorized | 2 Comments