Why Not an Engaged, Family-Based Workforce to offer Exceptional Health Care?

Posted by Dawn Marie Bailey

“Why not me . . . to be extraordinary?” asked Kendra LaCour-Ramey, director of medical staff services at Baldrige Award recipient Memorial Hermann Sugar Land Hospital, during a recent Baldrige Quest for Excellence© Conference session. “Why not us to become the preeminent community hospital in the nation? Why not us to create a remarkable and engaging experience for the entire workforce?”

Qiara Suggs and Kendra LaCour-Ramey of Memorial Hermann Sugar Land Hospital

Echoing these aspirations, Qiara Suggs, senior human resources business partner at Memorial Hermann Sugar Land Hospital, said “Why Not Us or Me? is a framework developed to elevate our organization in its thinking while setting high performance targets.” It not only challenges the organization to be successful but for the workforce to be personally successful, too, she said.

In fiscal year 2016, Memorial Hermann Sugar Land Hospital, part of the Memorial Hermann Health System, was honored with the 2016 Malcolm Baldrige National Quality Award. Its workforce retention results were at 90 percent for employee partners, 100 percent for physician partners, and 90 percent for volunteer partners–all results comparable to or exceeding national benchmarks. Additionally, the first-year retention rate for all partners was nearly 75 percent, exceeding the national level.

People are the cornerstone of the framework, said LaCour-Ramey; “But gone are the days of just happy employees; it isn’t enough. . . . They must be happy and engaged. . . . Regardless of your title, . . . our goal is to make sure we connect and engage all of our workforce in various ways.”

LaCour-Ramey and Suggs shared tips with the Quest conference audience on how to connect and engage your workforce using the Why not us? mindset, the hospital’s family caring for family culture, and its cycle of workforce engagement to promote advocacy and loyalty.

While many organizations struggle with workforce engagement, LaCour-Ramey said, Memorial Hermann Sugar Land has “bucked this trend,” with engagement results in the top decile nationally (96th percentile). These results have even been attained in Houston, a very competitive health care market—largest in Texas, fourth largest in the United States, in one of the most affluent U.S. counties, and with four major hospitals in that county, which is also one of the most diverse in the nation.

“We place great emphasis on workforce engagement to drive our family caring for family culture at a level of high performance and innovation,” said LaCour-Ramey. Engagement is attained through the hospital’s Advance strategies, with their emphasis on valuing employees, engagement, inclusiveness, and learning opportunities. Forums, an open-door policy, and the People Excellence Council support the strategies.

“Our employees know that we listen and we act on feedback,” she said.

LaCour-Ramey said one key to success is including physicians and volunteers as part of the workforce; “Our volunteers are likely the first you will see when you walk into our hospital . . . and our physicians are at the bedside. . . . This is why [treating them like family] is so important.” She added that the hospital once considered physicians to be customers but quickly realized that that thinking did not align with the culture.

Suggs echoed the importance of physicians and volunteers within the family culture, especially in an extremely competitive health care industry; “When we talk about our workforce, not only are our employees being picked off by our competitors, but so are our physicians and volunteers, and they all play a huge role in how we execute on our strategies.”

The hospital’s cycle of workforce engagement includes multiple phases:

  • Discover and recruit
  • Welcome and connect
  • Energize and enrich
  • Recognize and refuel
  • Grow

To discover and recruit, the hospital has developed a workforce plan using local market analytics, national staffing guidelines, capacity metrics, and performance reviews.

According to Suggs, the interview process incorporates multiple layers. Recruiters and leaders look for skills, competencies, and knowledge, especially for identified, critical positions. In addition, a recent cycle of improvement added front-line staff to culture panel interviews to specifically assess a candidate’s potential fit in the organization. This panel looks at aligning individuals with organizational values by asking behavior-based and unconventional questions that look for a person’s emotional intelligence as well as competencies.

“At Memorial Hermann, we’re purely focused on fit,” said Suggs. “Have you ever hired someone who has the perfect skill set, but [he/she] just didn’t fit in with your organization? . . . Our recruiting process is set to focus on individuals who will complement our culture. . . . It’s those innate characteristics that are unteachable.”

To welcome and connect, expectations are communicated and candidates are offered the opportunity for a few hours to job shadow and observe the work environment. During the onboarding process, leaders send personalized notes to employees’ homes and stop in at new employee orientation. All new hires have a training preceptor who is equipped to orient them to the department and facility. In addition, pit stop conversations are a one-on-one, personalized check that onboarding and training are effective, and if they’re not, the conversations allow trainers to course-correct early on.

“Keep in mind that onboarding begins an employee’s journey, career throughout the organization,” said Suggs. “So it’s important for us to outline a systematic process to make sure that everyone has a pleasant and equal experience.”

When it comes to recognizing and refueling, “We celebrate [the frontline],” she said, adding that monthly and annually recognitions are personalized with the goal to make them meaningful and motivational.

Growth is intertwined in all of the phases, she said. “As an organization that thrives on learning and development, we offer adequate, timely, and meaningful learning opportunities for all of our employees, including our leadership team. . . . We encourage our workforce to growth through an innovative mindset,” said Suggs, adding that tuition assistance is offered to employees pursuing higher education, and Memorial Hermann Sugar Land is one of the few organizations to help with student loan repayment, with the “expectation that you bring knowledge back to your organization.”

Is your staff (or you) engaged enough to wonder why not your organization (or yourself) to be exceptional?

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How Long-Term Care Center Grows Its Own Engagement

Posted by Dawn Marie Bailey

By 2022, the Bureau of Labor Statistics predicts that in the United States 19.4 percent more registered nurses (RNs) will be needed to fill vacancies to care for our population, including an increasingly aging population. In addition, our health care organizations will need 21.1 percent more nursing assistants, 48.5 percent more home health aides, and 24.8 percent more licensed practical nurses (LPNs) and vocational nurses.

But at Baldrige Award recipient Kindred Nursing and Rehabilitation – Mountain Valley, some registered nurses drive as far as 40 miles to work there—even though it is not the highest paying health care center in the area, and a “grow-your-own” philosophy has resulted in LPNs training to be RNs, nursing aides training to be LPNs, and even some housekeepers training to be nursing aides.

What’s the secret? According to Jodi Hagaman, director of nursing service, speaking to a Baldrige Quest for Excellence© Conference audience, the nursing and rehabilitation center truly values its workforce and creates a culture of safety, empowerment, innovation, excellence, and no fear. It also uses the Baldrige Excellence Framework and the feedback reports received from applying for the Baldrige Award and American Health Care Association (AHCA)/National Center for Assisted Living (NCAL) National Quality Award Program (based on Baldrige) to validate its strengths, and reveal and prioritize its opportunities for improvement.

The 68-bed, skilled nursing facility, located in Kellogg, Idaho, has 90 employees and 33 key volunteers. According to Hagaman, “We are not the highest paying center [in the area] by far, but [nurses] want to work with us because they have researched our culture and our reputation.”

Like the entire health care industry, Hagaman said that Kindred Nursing and Rehabilitation – Mountain Valley is challenged with the retirement of many of its staff members and with recruiting new staff and nurses that want to work in its rural environment in a formerly bustling silver mine town.

She said that the center has been more successful than most in “growing our own through our culture of excellence.” Growing this culture has meant using the Baldrige framework to guide a determination of the drivers of workforce engagement and then to develop strategies with action plans and goals to promote that engagement.

“Our employees want to feel safe. They do not want to work in an environment of blame [where] they would potentially end up spending most of their energy protecting themselves, not doing what is in the best interest of our organization,” she said. “In our center, staff are willing to speak up, to be honest, and have a positive approach.” Communication is our strength; we give our workforce the freedom and responsibility to be efficient, she added.

To accomplish its core competencies of a highly engaged workforce, resident/patient-centered care, and excellent customer service, Kindred Nursing and Rehabilitation – Mountain Valley has developed a Workforce Capability and Capacity System with seven steps. The system is also aligned with its mission, vision, and values and considers succession planning. “When you see things go bad in health care, it’s usually because of turnover,” said Hagaman.

Senior leaders at the center remain intimately involved in operations. Hagaman said that each morning during stand-up meetings, all senior leaders and nursing staff review data and any staffing concerns that may be felt in the next three–five days. Stand-up meetings are also used to discuss referrals and discharges and to ensure the center has appropriately trained staff for patients per day and prior to admission.

The management of changing needs occurs through a Learning and Development System, as well as through a Service Excellence Program, which was created after reading Baldrige opportunity for improvement feedback. Successes are celebrated at any opportunity, Hagaman said; for example, the center recently celebrated its 100 percent deficiency-free survey from the Idaho Department of Health, which requires each nursing and rehabilitation facility in the state to be thoroughly inspected and evaluated in areas such as safety, quality of care, patient rights, food service, nursing care, and administration.

In addition, Hagaman said frank, two-way communication with senior leaders has created an environment of credibility and openness, opening up a “code of trust within the workforce”; such a favorable environment is evident in employee engagement results. “How we create our culture of excellence is through a highly engaged workforce. . . . [We have a] culture of innovation that encourages workforce empowerment with no fear of retaliation,” she added.


Posted in Baldrige Award Process, Baldrige Award Recipients, Baldrige Criteria, Health Care, Uncategorized, Workforce Focus | 5 Comments

How a Small Textile Distributor Became a Leading Innovator in Its Industry

Posted by Christine Schaefer

During the Baldrige Program’s recent Quest for Excellence® Conference, Momentum Group, a 2016 Baldrige Award recipient, described key practices that have helped it become a leading innovator in its industry. Momentum Group Design Director Shantel McGowan led a panel highlighting the customer-focused processes and practices (category 3 of the Baldrige Excellence Framework) of the California-based textile distributor.

McGowan first explained that Momentum Group has three customer groups—business, health care, and hospitality organizations—for which it designs and sells fabrics to be used in gathering spaces such as offices, lobbies, and waiting rooms.

The company identifies its customer requirements (or needs) for new products in part by looking at trends and customer/market-specific considerations. Design considerations include workforce demographic factors such as the increasing number of young workers, who have relatively short tenures of about two years, and the higher number of 65-year-olds in the U.S. workforce today than in past decades, said McGowan.

Other design considerations include business practices that impact work environments, such as the creation of more collaborative work environments by innovative technology businesses. In contrast, product design considerations for Momentum Group’s health care customers include infection control and the need to create a soothing environment for patients and families.

In considering the needs of ill patients, Momentum Group designed a product called “naked nylon” that avoids chemicals traditionally used on the back of fabric to adhere to office furniture, said McGowan. Another innovative fabric the company introduced for health care environments is Silica, which is naturally anti-microbial and highly resistant to staining (thus easily cleanable). Silica was launched as an alternative to vinyl, according to McGowan.Momentum Group values and industry awards listed

Momentum’s innovative fabrics also include recycled nylon, which “has changed the entire industry,” said McGowan. As an environment-friendly fabric, recycled nylon is aligned with the company’s focus on creating sustainable products. McGowan noted several industry awards Momentum Group has received for such innovations.

Following are some key practices that have enabled Momentum Group to create innovative products for its customers, as presented by McGowan.

  1. Momentum Group ensures that the Design Team is composed of people who bring different perspectives. An example is a collaboration with an Italian designer who has a unique perspective on colors, which resulted in a product line that sold extremely well, said McGowan.
  2. Momentum Group takes advantage of computer-aided design. Whereas most competitors use off-the-shelf design software, McGowan said, her company uses high-end software that allows for more control of the process, such as the capacity to send an email file to any mill in the world to create a new textile.
  3. Momentum Group makes use of data analysis.
  4. Momentum Group stresses innovation.
  5. Momentum Group uses Design Thinking and Benchmarking. This is a process for solving problems (see graphic below); McGowan said her Design Team received training on it, though it is not just for designers.Design Thinking and Benchmarking Process depicted
  6. Momentum Group evaluates its supplier capabilities.
  7. Momentum Group lives its core value of “bettering the world around us”—defined by McGowan as designing products that will change things for the better for the customer, which makes “your brand bigger,” she said.

Momentum Group also does “quite a bit of testing” on products to ensure that they do what we say they can do, said McGowan. For example, she cited the infection-control fabrics the company designed for its health care market. Further, Momentum Group has created a systematic process for investigating product failures (in regard to claims) in order to improve products if need be, McGowan said. Such cases usually result from environmental abuse, such as use of an improper cleaner, she added.

As a proactive approach to obtaining input from customers, the Design Team also visits at least 60 customers per year to get face-to-face feedback on company products, according to McGowan. Those interactions go beyond customer visits by sales employees from the company.

How does your organization listen to your customers? Please share your best practices or other thoughts on the topic.

A previous blog about Momentum Group highlighted its leadership practices, as presented by CEO Roger Arciniega. 


Posted in Baldrige Award Recipients, Baldrige Criteria, Baldrige Events, Customer Focus, Small Business | Tagged , | Leave a comment

Two Inspirational Leaders Honored for Commitment to Excellence

Posted by Dawn Marie Bailey

For their leadership that has inspired performance excellence in their organizations and benefited their workforces, customers, and students, Mary Searcy Bixby and E. David Spong were recently honored at the 29th Annual Baldrige Quest for Excellence© Conference.

Mary Searcy Bixby

In recognizing Bixby as this year’s Harry S. Hertz Leadership Award winner, Baldrige Foundation Chair P. George Benson said, “While no one person in the organization can be credited with that organization’s performance excellence, this award recognizes all of the leader’s behaviors that inspire . . . are courageous, challenge, and empower others to achieve performance excellence.” Benson added that Bixby is a “transformational leader,” an “educational reformer,” an “innovator and pioneer in successfully addressing the needs of at-risk students,” and a “role model for educators everywhere.”

Accepting the honor, Bixby, the founder, president, and CEO of Baldrige Award recipient Charter School of San Diego, acknowledged her team and said, “Leadership is not a singular. It’s a plural.”

Bixby encouraged leaders and “organizations that wish to be futuristic” to invest in research that supports people and finds systems that can help them improve. She suggested that all leaders at every level deserve mentorship, support, and coaching.

“I do believe that our work is not just supporting our organizations and moving them into the future, but also inspiring others,” said Bixby. “There is change in the wind . . . for better or for worse. . . . Our clients, our patients, our students have discovered a voice, and I think that’s a good thing. Because guess what, they want the best. They want quality.”

Bixby said it’s important for all of us to look critically at how to improve. When we get data or information, “we need to be sure that it’s timely. It’s actionable. And it’s accurate. We can use it to make meritorious decisions. That’s what we did at our school. When we work with our workforce . . . our issue is to help prepare them in the best way we can so that they can touch the hearts of our students.”

The Charter School of San Diego, said Benson, has achieved phenomenal results, including continued overall student and parent satisfaction levels at close to 100 percent, reduced drop-out rates, and equalized or exceeded county-wide graduation rates. In addition, the school has maintained teacher and staff satisfaction levels and teacher and staff retention rates; “thereby creating the stability that ultimately brings benefits to students,” he said.

Bixby said her team has traveled across the country in this last year visiting school systems that “are eager to open that door to the Baldrige experience.”

“[Baldrige] was never work that was on top of our own work,” she said. “It was integrated from the beginning. This is our lives. Baldrige has opened doors to us, and we will be eternally grateful. We are willing to give back. . . . We are teachers. We transform lives. And we are Baldrige.”

David Spong

“To receive the E. David Spong Lifetime Achievement  Award, an individual must have a sustained, exceptional, and far-reaching contribution to the Baldrige enterprise,” said Benson of the new award. “Lifetime achievement award recipients change their worlds and inspire others to do the same. It is fitting then that the award should be named after and its first recipient should be David Spong.”

Benson added that through Spong’s 54-year career and well into his retirement, he has held multiple leadership roles including president of ASQ, chairman of the Baldrige Foundation Board of Directors, chairman of the Baldrige Board of Overseers, and chair of the National Institute of Standards and Technology’s Visiting Committee of Advanced Technology.

Spong, who said he was attending his nineteenth Baldrige Quest conference, said his life-long journey towards excellence started with a feeling of “maybe I’ll get there” but has come to believing fervently in the “Big Q.”

He grew up the youngest of five children in England, with a singular goal in mind. “There was no doubt where I was heading. I was going to be an engineer working on airplanes,” he said.

In 1956, Spong became an apprentice in the United Kingdom Ministry of Supplies Facility (also known at various times as the Balloon Factory and Royal Aircraft Establishment). He said he received his first lesson in the importance of quality working on a replica of a 1917 airplane. His assignment was to work on a steel plate that had to be hacksawed and filed, flat and square; no machines allowed. “At some point, I realized I made a mistake with the angle,” he said. “I continued to work on it hoping that no one would notice. At some point, the apprentice master . . . said there’s something funny about that. He measured it . . . and he said, ‘Start over, lad.’ I spent many hard-working hours . . . but it didn’t conform to the drawings.” This first very important lesson, Spong said, he calls “Little Q”–conformance to requirements or specifications.

Some 40 years later, after emigrating to America, Spong joined the aerospace industry to work on the “then beleaguered C-17 program.” About the same time, he said, his chairman and CEO, Sandy McDonnell, of the McDonnell Douglas Corporation, put out a memo that the company would use the Baldrige Criteria in its business.

“It was a long-term, total quality management system and internal evaluation,” Spong said. “I remember thinking at the time, who has time for this soft stuff. We have airplanes to build. However, we dutifully wrote our internal [Baldrige] application and performed a self-assessment. . . . Over time, our scores got better, and wonder of wonder, I noticed our performance was getting better, too.”

Spong said that after Boeing Airlift and Tanker Programs (McDonnell Douglas merged with Boeing in 1997) received the Baldrige Award in 1999, “I was a full fledged believer in what I call Big Q.”

At Boeing, Spong said the company kept applying for the Baldrige Award, receiving feedback, and learning. Boeing Aerospace Support, which Spong led to a Baldrige Award in 2003, made him the only leader to guide his organizations to Baldrige Awards in two different sectors: manufacturing and service.

At the close of his remarks, Spong thanked his family and told the story of his granddaughter being nicknamed “Baby Baldrige” because she attended her first Quest conference at just two months old.

He added, “It took me 40 years to come back to where I was in the beginning: inspect my work and make sure it conforms. . . . Go forth and live the Big Q!”

Posted in Baldrige Award Process, Baldrige Award Recipients, Baldrige Criteria, Baldrige Events, Business, Education, Leadership, Performance Results, Workforce Focus | 1 Comment

To Invent Your Organization’s Future, Experiment, Question, Sometimes Fail     

Posted by Dawn Marie Bailey

Create an innovation advantage for your organization by letting go of industrial-age principles, embracing imagination, and experimenting even if you might fail, said Polly LaBarre, co-founder and director of Management Lab (MLab) and co-founder of MIX (Management Innovation eXchange). LaBarre, who delivered the 29th Annual Quest for Excellence© Conference keynote presentation, said, “You cannot have some big opportunities without having some big misses. . . . Mistakes should be shared and picked apart for every last tidbit of insight.”

LaBarre asked the conference audience, “How do you build the capacity for innovation and the adaptability that keeps your organization growing and thriving?” and “Are you capable of changing as fast as the world is changing? . . . The next game changer probably will come out of nowhere. Your customers, patients, stakeholders have more information, more choice, higher expectations than ever before. . . . In that context, are you constitutionally adaptable?”

The modern industrial-age organization was not built for adaptability and innovation, she said. Instead, the assembly-line plants from years ago were designed “to maximize standardization, specialization, predictability, and control,” said LaBarre, adding that the business model was to “get flesh and blood human beings to become widget-producing robots.”

“All of the practices and systems that we have built and embedded in our organizations [including] budgeting, performance review, ROI calculations, inventory. . . . All of those things were invented over a century ago to routinize the nonroutine,” said LaBarre; “When [today’s] challenge is for every organization to become ever-more adaptable, ever-more innovative, ever-more inspiring and engaging, those principles don’t serve us well. There’s no competitive advantage left. . . . We can’t solve the new problems with the old principles.”


LaBarre said that innovation in today’s organizations tends to get compartmentalized if it is not embedded in every activity, every function. “As a result, the 90% of people who do not have a formal innovation role, think of innovation as someone else’s job. And those companies then end up commercializing and capturing just a tiny potential of their people and their organizations,” she said.

The efficiency principles of the industrial age are still critical and necessary, LaBarre said, but to “transcend the inevitable tradeoffs of discipline without the cost and the drag on agility . . . and the crushing of human initiatives,” organizations should also consider pro-innovation principles such as aspiration, experimentation, diversity, freedom, and openness. She illustrated several real organizations who have embedded such principles and asked the audience to consider, “What kind of sustaining advantage can innovation bring?”

The first tip for our organizations, LaBarre said, is to expand autonomy. “Control [of people, information, deviation from the norm] is the wrong design when you want to unleash people’s best imagination, initiative, passion–the human gifts that are in so much demand today but which cannot be commanded or controlled into existence.”


LaBarre pointed out that we’ve all experience a huge expansion of freedom in our personal lives, especially with our ability to connect with anyone, anywhere in the world. “We can challenge, speak up, have a voice in the world, but the workplace lags so far behind,” she said, adding that in their personal lives, people can buy houses, cars, etc., but in the workplace, they may not have the authority to purchase a desk chair.

She asked the audience to consider, in their organizations, “Who does the thinking and who does the doing?” She described freedom as giving employees more opportunities and more channels to have meaningful roles.

She shared with the audience that she has traveled around the world looking for organizations that have reinvented their management models,swapping out industrial bureaucratic DNA for pro-innovation and pro-adaptability.” In some of these companies, LaBarre said she found employees with total autonomy, which is balanced by extensive accountability, especially by coworkers who, for example, conduct each other’s performance reviews. These organizations are growing their leadership capacity, she said.

LaBarre spoke of the “latent creative potential” of employees and cultures of collaboration. Invite everyone to be part of the strategic and creative realm, she suggested. In one organization she visited, LaBarre said she found hundreds of “communities of passion” that work on strategic priorities and local problems, and resolve issues must faster than they could under a standard corporate model.

“Design systems and practices for more headroom and elbow room,” she said, “so people can operate outside of their spheres. . . . People can find natural collaborators, pursue their passions, [find] the slack [they] need for trying new things, for experimenting, and for taking risks.”


“If you want to build innovative, adaptive capacity, there is no more powerful leverage than experimentation,” said LaBarre.

How life itself has flourished is a perfect example of experimentation, according to LaBarre. “Life has become ever more capable and complex in the process without a CEO, SVP, or strategic plan at the helm,” she said. “Evolutionary progress . . . is a product of rampant experimentation. Mutations are mistakes. Let me put it another way, if life was run by Six Sigma, we would all still be slime.”

LaBarre said experimentation is about cycling through ideas, testing assumptions, getting feedback, discarding what isn’t working, and building on what is. “It’s a strategy for measuring your insights,” she said.

Organizations should develop the facility to fail in order to learn, because in the words of Pixar Animation Studios, according to LaBarre, “Pain is temporary. Suck is forever.” Or, in other words, she said, Pixar understands that “if you are going to try new things, you’re going to have errors” and that’s how you learn.


To truly build an innovation capability at your organization, “Ask more questions than you give answers,” she said. “If you’re open, curious, you can surface more possibilities. As a leader, craft stretch questions. . . . Invest as much in what could be as what is. . . . Walk in stupid. . . . Practice the innocence of children to gain fresh eyes to innovation.”

She encouraged the audience to question every orthodoxy in their industries and to hack every process to imbue it with innovation principles. “Questions that no one has asked before spawn innovative answers that no one has sought before,” LaBarre said, adding “invite the subversive in.”

Innovation Panel

To further explore innovation, senior leaders from the four 2016 Baldrige Award recipients joined LaBarre on stage. They talked about how they define innovation and how they equip people to handle it.

Roger Arciniega, CEO of Momentum, said, “Culture is most important. You need a structure for innovations to break through. A big barrier is employees not wanting to be associated with failure,” adding the importance of not having a “gotcha” mentality.

The health care senior leaders on stage, Maryruth Butler, executive director of Kindred Nursing and Rehabilitation Center – Mountain Valley, and Malisha Patel, vice president of operations at Memorial Hermann Sugar Land, discussed how to stimulate innovation and still ensure patient safety.

Don Chalmers Ford’s Andy Strebe, director of fixed operations, said innovation sometimes means being open to ideas that make you uncomfortable. The leaders also talked about getting out of the way of employees’ ideas, integrating work processes with action plans, looking for innovation in the supply chain, simplifying innovation, trusting employees, and putting down your “pivot foot” (i.e., practicing values-based innovation).

Posted in Baldrige Award Process, Baldrige Award Recipients, Baldrige Events, Business, Customer Focus, Health Care, Leadership, Operations Focus, Performance Results, Uncategorized | 2 Comments