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