Why Baldrige as a Quality Platform?

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Why Baldrige as a Quality Platform?
Presented to The Quality Colloquium On the
Campus of Harvard University August 25, 2004

• Robert J. Harriman, PhD L. Craig Miller, M.D.,
  FCCP
• V.P., Quality Improvement Sr. V.P., Medical
  Affairs
• and Patient Safety Baptist Health Care
• Baptist Hospital, Inc. Pensacola, Florida
• rharriman_at_bhcpns.org cmiller_at_bhcpns.org

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Seven Categories of the Health Care Criteria

• 1. Leadership
• 2. Strategic Planning
• 3. Focus on Patients, Other Customers, and
  Markets
• 4. Measurement, Analysis, and Knowledge
  Management
• 5. Staff Focus
• 6. Process Management
• 7. Organizational Performance Results

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Journey to Performance Excellence Began in 1995

• No Secrets
• Commitment to Performance Excellence
• Benchmark Best Practices
• Customer Satisfaction Teams

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Journey to Performance Excellence

• Real Time Accountability
• Non-Negotiable Results
• Leadership Development
• Never Stop Learning

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1. Leadership

• Senior Leadership Direction
• Empowerment, Innovation and Agility
• Key Performance Measures Improving Leadership
  System Effectiveness
• Support of Key Communities and Community Health

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Pillars of Operational Excellence
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2. Strategic Planning

• Strategic Planning Process
• Process Considerations
• Action Plan Development/Deployment
• Short and Longer Term Action Plans

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Methods Used in Alignment of Strategic Planning
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3. Focus on Patients, Other Customers and
Markets

• Patient/Customer and Health Care Market Knowledge
• Patient/Other Customer/Market Segments
• Listening/Learning and Using Patient/Customer
  Requirements
• Patient and Other Customer Relationships and
  Satisfaction

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Listening Learning
Customer Snapshot
LL Activities
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Listening and Learning Activities
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Customer Snapshot
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4. Measurement, Analysis and Knowledge Management

• Data Gathering/Alignment to Support Operations
  and Decision Making
• Information and Knowledge Management

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BHIS SYSTEMATIC APPROACH
DATA
INFORMATION (Alignment)
KNOWLEDGE (Deployment)
Traditions (Employee Orientation) Physician
Orientation Serv-U (90 days following
Traditions) Daily Line-Up (aka Baptist
Daily) Daily Rounds Communication Boards Employee
Forums Inside Baptist (Intranet) Standard of the
Month Firestarter Meetings Department Head
Meetings Baptist University Colleges of
Performance Excellence College of Clinical
Excellence College of Leadership
Development Physician Leadership
Development Medical Staff Meetings/Retreat Board
of Directors Meetings/Retreat Informal,
Intentional Deployment
Solucient Action Solucient Explore Benchmarking
Visits Bright Ideas CaduCIS Direct Feedback
Staff and Partners EIS (Executive Information
System) Employee Exit Interview Employee Forum
Evaluation Form Employee Surveys Florida Cancer
Data System HealthSource (24 hour call
program) HIS (Hospital Information System) MIDAS
(Medical Information Data Access
System) Physician Action Line Press, Ganey and
Associates Sperduto Teams TrendStar VHA Southeast
Leader Performance Evaluation (y) 90-Day Action
Plan (q) StopLight Report (q) BAR (Financial/H.R.
Indicators) (m) CARE Report (Clinical Indicators)
(m) Nursing Report Card (m) Responsibility Report
(m) Productivity Report (bi-w) 3600 Feedback
Survey (bi-y) Patient Satisfaction Reports
(w) HPAR (q) Physician Satisfaction Reports
(y) Financial Statements (m) Board Reports
(m) Financial Focus Packets (m)
ACTION (Review/Refine)
DASHBOARD
This systematic approach reflects how, through
fact-based management and extensive
organizational learning and sharing, we align and
integrate our performance with our organizational
needs. This provides a strong foundation for use
in refining and continually improving our
performance.
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5. Staff Focus

• Organization and Management of Work
• Effective Communication and Skill Sharing
• Staff Performance Management System
• Recruiting, Hiring Retaining Staff
• Staff Education, Training and Development
• Staff Well-Being and Satisfaction

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6. Process Management

• Key Health Care Services and Processes
• Process Performance Improvement
• Key Support and Business Practices

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Service Design Process
Step 1 Step 2 Step 3 Step 4 Step 5 Step 6
Conception Feasibility Approval Plan for Implementation Implementation Evaluation
Idea Generation / Screening Concept Development Financial Productivity Cycle Tune Volume Regulatory Capital Sourcing Senior Leaders and, if necessary, Board Create a Team Develop Strategies and Goals Develop Action Steps Develop Monitoring and Evaluation Targets Develop Exit or Decline Strategy Execute Plan Evaluate and Monitor Actual Performance to Goals Develop Corrective Action Plans if necessary
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EBCI Process
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7. Organizational Performance Results

• Health Care Results
• Patient/Other Customer-Focused Results
• Financial and Market Results
• Staff and Work System Results
• Organizational Effectiveness Results
• Governance and Social Responsibility Results

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High Employee Morale
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Low Employee Turnover
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Patient Satisfaction Correlated to Employee
Morale
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Baptist Hospital, Inc., ResultsClinical Quality
Pillar
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Infection Prevention Results SINUVentilator
Related Pneumonia
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IHI Critical Care CollaborativeCost Results
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Physician Satisfaction Survey
Active Physicians (n139) Top 2 Ratings
Overall 2001 2003
Satisfaction with Primary Hospital 80 90
Quality of Emergency Department 67 93
Quality of Medical Records 78 79
Quality of Laboratory Services 82 92
Quality of Radiology Services 80 96
Quality of Nursing Staff 75 93
Quality of Pharmacy 82 96
Ratings of 4 or 5 (Completely Satisfied or
Very Satisfied)
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Outcome Profile at Baptist Hospital
Standardize Variation Diff from Predicted
3 2 1 0 -1 -2 -3
Yr. 1999-2000 12,253 IP Case Case Mix Index
1.62 Yr. 2002-2003 13,124 IP Case Case Mix
Index 1.72 Significant at 90 confidence
level
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Baptist Hospital, Inc., ResultsFinancial
Performance Pillar
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Baptist Hospital, Inc.Results Growth Pillar
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Summary

• Make Patient-Defined Quality and Value the
  Strategy
• Convey the Vision
• Measure Performance at the Whole- System Level
• Assure Cooperation across the Continuum

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Conclusion

• In times of change the learner will inherit the
  earth while the learned find themselves
  wonderfully equipped to live in a world that no
  longer exists.
• Eric Hoffer (1902-83)