Building Performance Excellence in Health Care

James R. EvansProfessor of Quantitative Analysis and Operations ManagementCollege of BusinessUniversity of Cincinnati

What Is Performance What Is Performance Excellence?Excellence?

An integrated approach to organizational An integrated approach to organizational performance management that results inperformance management that results in Delivery of ever-improving value to patients, Delivery of ever-improving value to patients,

other customers, and stakeholders, contributing other customers, and stakeholders, contributing to improved health care qualtiy organizational to improved health care qualtiy organizational sustainability sustainability

Improvement of overall organizational Improvement of overall organizational effectiveness and capabilities as a health care effectiveness and capabilities as a health care providerprovider

Organizational and personal learningOrganizational and personal learning

Baldrige Health Care Baldrige Health Care Award Recipients Award Recipients

Bronson Methodist Hospital (2005)Bronson Methodist Hospital (2005) Robert Wood Johnson University Robert Wood Johnson University

Hospital Hamilton (2004)Hospital Hamilton (2004) Baptist Hospital, Inc. (2003)Baptist Hospital, Inc. (2003) Saint Luke’s Hospital of Kansas City Saint Luke’s Hospital of Kansas City

(2003)(2003) SSM Health Care (2002)SSM Health Care (2002)

An Example of An Example of Performance Performance ExcellenceExcellence

BMH ResultsBMH Results

99th Percentile*

* Professional Research Consultants, Inc. (Percentile calculated from a database of 19,684 physician responses across 161 hospitals)

Physician SatisfactionPhysician Satisfaction

The Criteria for Performance The Criteria for Performance ExcellenceExcellence

PurposesPurposes:: To help improve To help improve organizational performance organizational performance practices, capabilities, and practices, capabilities, and results,results, To facilitate communication To facilitate communication and sharing of best practices and sharing of best practices information among information among organizations of all types, andorganizations of all types, and To serve as a working tool for To serve as a working tool for understanding and managing understanding and managing performance and for guiding performance and for guiding organizational planning and organizational planning and opportunities for learning.opportunities for learning.

Current Baldrige Framework Current Baldrige Framework ––

A Systems PerspectiveA Systems Perspective

Summary of Summary of Categories/ItemsCategories/Items

1.1. LeadershipLeadership1.1. Senior LeadershipSenior Leadership2.2. Governance and Social Governance and Social

ResponsibilitiesResponsibilities2.2. Strategic PlanningStrategic Planning

1.1. Strategy DevelopmentStrategy Development2.2. Strategy DeploymentStrategy Deployment

3.3. Focus on Patients, Other Focus on Patients, Other Customers, and MarketsCustomers, and Markets

1.1. Patient, Other Patient, Other Customer, and Health Customer, and Health Care Market KnowledgeCare Market Knowledge

2.2. Patient and Other Patient and Other Customer Relationships Customer Relationships and Satisfactionand Satisfaction

4.4. Measurement, Analysis, Measurement, Analysis, and Knowledge and Knowledge ManagementManagement

1.1. Measurement, Analysis Measurement, Analysis and Review of and Review of Organizational Organizational PerformancePerformance

2.2. Information and Information and Knowledge ManagementKnowledge Management

5.5. Human Resource FocusHuman Resource Focus1.1. Work SystemsWork Systems2.2. Staff Learning and MotivationStaff Learning and Motivation3.3. Staff Well-Being and Staff Well-Being and

SatisfactionSatisfaction6.6. Process ManagementProcess Management

1.1. Health Care Processes Health Care Processes 2.2. Support Processes and Support Processes and

Operational PlanningOperational Planning7.7. Results Results

1.1. Health Care and Service Health Care and Service Delivery OutcomesDelivery Outcomes

2.2. Patient- and Other Customer-Patient- and Other Customer-Focused OutcomesFocused Outcomes

3.3. Financial and Market Financial and Market OutcomesOutcomes

4.4. Human Resource OutcomesHuman Resource Outcomes5.5. Organizational Effectiveness Organizational Effectiveness

OutcomesOutcomes6.6. Leadership and Social Leadership and Social

Responsibility OutcomesResponsibility Outcomes

Core ValuesCore Values Visionary leadership Visionary leadership Patient-focused excellencePatient-focused excellence Organizational and personal Organizational and personal

learninglearning Valuing staff and partnersValuing staff and partners AgilityAgility

Focus on the futureFocus on the future Managing for Managing for

innovationinnovation Management by factManagement by fact Social responsibility Social responsibility

and community and community healthhealth

Focus on results and Focus on results and creating value creating value

Systems perspectiveSystems perspective

Performance Excellence Performance Excellence Maturity ModelMaturity Model

Bronson Methodist Hospital Bronson Methodist Hospital Complaint Management ProcessComplaint Management Process

Key characteristics:Systematic and repeatable processFocused on improvement and preventionCapable of organizational learningKnowledge sharing

Satisfaction ResultsSatisfaction Results

Arbor Associates best practice benchmark since 2001 and Arbor Associates Award for Highest Overall Patient Satisfaction four years in a row.

Baldrige ResourcesBaldrige Resources www.baldrige.orgwww.baldrige.org

CriteriaCriteria““Getting Started…” guideGetting Started…” guideAward recipientsAward recipients

Contacts, profiles, application Contacts, profiles, application summariessummaries

A variety of other materials and A variety of other materials and publicationspublications

Supplementary SlidesSupplementary SlidesThe following slides provide brief The following slides provide brief

descriptions of key indicators of descriptions of key indicators of performance excellence in an performance excellence in an organizationorganization

Key Excellence Indicators: Key Excellence Indicators: LeadershipLeadership

Personal commitment to patients and Personal commitment to patients and other customersother customers

Effective setting and communication Effective setting and communication of organization’s directionof organization’s direction

Personal Involvement in developing Personal Involvement in developing future leadersfuture leaders

Key Excellence Indicators: Key Excellence Indicators: LeadershipLeadership

Communication of and role Communication of and role model for the organization’s model for the organization’s valuesvalues

Legal and ethical behavior Legal and ethical behavior Focus on learning at all levels of Focus on learning at all levels of

the organizationthe organizationGood citizenshipGood citizenship

Key Excellence Indicators: Key Excellence Indicators: Strategic Planning Strategic Planning

Balance of short- and long-term Balance of short- and long-term viewsviews

Aggressive goal setting Aggressive goal setting Strong work process alignment Strong work process alignment

with strategywith strategySystematic approach to Systematic approach to

addressing all sources of riskaddressing all sources of risk

Key Excellence Indicators: Key Excellence Indicators: Strategic Planning Strategic Planning

Critical targets and goals based on Critical targets and goals based on customer requirements and market customer requirements and market directionsdirections

Strong involvement of key Strong involvement of key suppliers, partners, and customerssuppliers, partners, and customers

A focus on plan execution and A focus on plan execution and agilityagility

Key Excellence Indicators: Key Excellence Indicators: Patient, Other Customer and Patient, Other Customer and

Market FocusMarket Focus In-depth market knowledge and forecastsIn-depth market knowledge and forecastsConsideration of needs of current and Consideration of needs of current and

potential patients and customerspotential patients and customersProactive contact Proactive contact Multiple listening posts to identify Multiple listening posts to identify

requirementsrequirements

Key Excellence Indicators: Key Excellence Indicators: Patient, Other Customer and Patient, Other Customer and

Market FocusMarket FocusFocus on enhancing patient and Focus on enhancing patient and

customer relationships and customer relationships and loyalty loyalty

Effective and prompt resolution Effective and prompt resolution of complaintsof complaints

High levels of patient and High levels of patient and customer satisfaction and loyaltycustomer satisfaction and loyalty

Key Excellence Indicators: Key Excellence Indicators: Measurement, Analysis, & Measurement, Analysis, & Knowledge ManagementKnowledge Management

Use of fact-based decision makingUse of fact-based decision makingCollection of actionable dataCollection of actionable dataUse of multiple aligned and Use of multiple aligned and

interlinking measures (internal and interlinking measures (internal and external)external)

Wide deployment and accessibility Wide deployment and accessibility of data and informationof data and information

Key Excellence Indicators: Key Excellence Indicators: Human Resource FocusHuman Resource Focus

Recognition of staff as “internal Recognition of staff as “internal customers”customers”

Strong commitment to staff satisfaction, Strong commitment to staff satisfaction, motivation, well-being, and moralemotivation, well-being, and morale

Reward system related to key Reward system related to key organizational challenges and organizational challenges and organizational performanceorganizational performance

Key Excellence Indicators: Key Excellence Indicators: Human Resource FocusHuman Resource Focus

Commitment to staff training, Commitment to staff training, education, and developmenteducation, and development

Links between individual and Links between individual and organizational learningorganizational learning

Empowered staffEmpowered staff

Key Excellence Indicators: Key Excellence Indicators: Process Management Process Management

Well-defined health care, business, and Well-defined health care, business, and support processessupport processes

Focus on processes that create value for all Focus on processes that create value for all key stakeholderskey stakeholders

Quality designed into all products, services, Quality designed into all products, services, and processesand processes

Focus on continuous improvement, cycle Focus on continuous improvement, cycle time reduction, innovation, and productivity time reduction, innovation, and productivity

Key Excellence Indicators: Key Excellence Indicators: Process Management Process Management

Strong integration of prevention, correction, Strong integration of prevention, correction, and improvement into daily operationsand improvement into daily operations

Partnering with suppliers and customersPartnering with suppliers and customersFinancial and other resources committed to Financial and other resources committed to

key processeskey processes

Key Excellence Indicators: Key Excellence Indicators: ResultsResults

Tied toTied to Patient, other customer, and stakeholder Patient, other customer, and stakeholder

requirementsrequirements Key processesKey processes Product/service performanceProduct/service performance Strategy and action plansStrategy and action plans Human resource needsHuman resource needs Financial and marketplace measuresFinancial and marketplace measures Governance and social responsibilitiesGovernance and social responsibilities

Key Excellence Indicators: Key Excellence Indicators: ResultsResults

Tracking of levels and trendsTracking of levels and trendsLinked to organization-level Linked to organization-level

information information and analysesand analyses

Use of comparisons/benchmarksUse of comparisons/benchmarksActionableActionable