Health Care Criteria for Performance Excellence

1. Health Care Criteria for Performance Excellence Business Health Care Education A disciplined approach to addressing key patient/customer and stakeholder requirements and key operational requirements…built around cycles of learning.

2. Malcolm Baldrige National Quality Program • Established in 1988 • To restore vitality and competitiveness to products and services of U.S. Companies • Works through a public/private partnership • Demonstrated effectiveness • On average, publicly traded recipients outperform the S&P 500 by 4 to 1

3. Baldrige Health Care Criteria FrameworkA Systems Perspective

4. To help organizations enhance their performance through focus on: Delivery of ever-improving value to customers, contributing to marketplace success Improvement of overall organizational effectiveness and capabilities Organizational and personal learning Basic Goals of the Criteria

5. 1999 Award Recipients • STMicroelectronics, Inc.—Region Americas • BI • The Ritz-Carlton Hotel Company, LLC • Sunny Fresh Foods

6. 3M Dental Products Division (1997) ADAC Laboratories (1996) Armstrong Building Products Operations (1995) AT&T Transmissions Systems Business Unit (1992) Boeing Airlift and Tanker Programs (1998) Cadillac Motor Car Company (1990) Corning Telecommunications Products Division (1995) Eastman Chemical Company (1993) Manufacturing Award Recipients

7. IBM Rochester (1990) Milliken and Company (1989) Motorola, Inc. (1988) Solar Turbines, Inc. (1998) Solectron Corporation (1991 and 1997) STMicroelectronics—Region Americas (1999) Texas Instruments Defense Systems and Electronics Group (1992) Westinghouse Commercial Nuclear Fuel Division (1988) Xerox Business Products and Systems (1989) Zytec Corporation (1991) Manufacturing Award Recipients

8. AT&T Consumer Communications Services (1994) AT&T Universal Card Services (1992) BI (1999) Dana Commercial Credit Corporation (1996) Federal Express Corporation (1990) GTE Directories Corporation (1994) Merrill Lynch Credit Corporation (1997) The Ritz-Carlton Hotel Company, LLC (1992 and 1999) Xerox Business Services (1997) Service Award Recipients

9. Ames Rubber Corporation (1993) Custom Research, Inc. (1996) Globe Metallurgical, Inc. (1988) Granite Rock Company (1992) Marlow Industries, Inc. (1991) Sunny Fresh Foods (1999) Texas Nameplate Company (1998) Trident Precision Manufacturing, Inc. (1996) Wainwright Industries (1994) Wallace Company, Inc. (1990) Small Business Award Recipients

10. Baldrige Outperforms S&P 500 • The “Baldrige Index” • Hypothetical Investment • Whole company recipients by 4.4 to 1 • All recipients by 4.2 to 1

11. Baldrige Winners’ Stock Value

12. Project Aim • Baldrige Award Recipients are world-class business organizations that secure exceptional performance by addressing workforce process, safety, morale, recruitment, retention and development • Studying their practices will provide learning, guidance and direction that can be applied to improve health care organizations

13. Past Recipients STMicroelectronics Ritz-Carlton Hotel Co. Boeing Airlift & Tanker Programs Merrill Lynch Credit Corp. Solectron Corp. 3M Dental Products Division 2000 Award Recipients Dana-Spicer Driveshaft Karlee Co. Operations Management International Los Alamos National Bank Companies Researched

14. Baldrige Health Care Criteria FrameworkA Systems Perspective

15. Staff Focus

16. Category 5: Staff Focus • Three broad areas of staff management and improvement • Work systems • Staff education, training and development • Staff well-being and satisfaction

17. Staff Focus

18. Summary of Findings • These organizations are intentional • Leaders recognize HR practices are fundamental source of bottom-line success • Nothing is left to chance • Leaders love their employees

19. Summary of Findings • The role of HR is to Deliver skilled and empowered employees operating in an exceptional environment of pride and joy.

20. Findings, cont. • These organizations believe in their people • Employee satisfaction  customer satisfaction • Communicate clear expectations linking daily work to company strategies and goals • Staff closest to the action makes decisions • Ask “What do you think?” and pay attention

21. 5 Things Employees Want(assuming competitive compensation) • Open communication • Consideration of how work affects personal and family life • Knowledge that “I” make a difference • Quality leadership • Quality direct supervision

22. Findings, cont. • These companies measure performance, use the information for decisions and empower staff to monitor and correct its own actions • They share information • They share authority

23. Findings, cont. • These organizations use teams as their fundamental approach to work and design • Improvement is the work of the organization

24. Findings, cont. • Leaders delineate leadership roles and responsibilities that • Model attributes and behaviors (“live the life”) • Commit their own energy • Grow and develop staff • Empower staff through education • Coach people at all levels • Keep promises they make • Set expectations of alignment and demand they be met

25. More Findings • You can’t fake it • Working under these principles wills that every leader will have to change something • Delegate authority along with responsibility • Put real money where your mouth is

26. Work Design • Supervisors need to know how to coach • Employees must be honestly represented • Communicate both the positive and the negative • Flatten the organization • But remember that some mid-management will be needed

27. Education and Development • Link targets for training hours to organizational goals with learning objectives • Devise means to learn from improvement within the organization • Learning must be actionable to have value

28. Well-Being and the Environment • Respond to the real issues faced by employees • Quality of life matters to everyone at all levels • Engage employees in real improvement • Respond to bad news • Treat employees with the respect they deserve—and make sure everyone follows suit

29. Conclusions • See HR as an investment, not an expense • The HR ROI is a function of how employees are selected, oriented, trained, certified, reinforced and managed.

30. It is So Easy… It is so easy—it is frighteningly easy—to forget why we are troubling ourselves in the very first place. It is so easy—it is frighteningly easy—to become trapped in a sterile thesis that our institutions must survive simply because they must survive or that our true deep purpose is to gain and preserve market share in a vacant terrain of others whose purpose is precisely the same. It is easy to believe that our habits of work are somehow valid and worth defending in isolation from the reason for that work to exist in the first place. The work is not there in the first place. In the first place, there is the patient...

31. The Patient Who Says… • Tell me what you know right away • Answer me • Comfort me • Don’t make me wait • Don’t waste my time • Don’t frighten me

32. The Patient Who Says… Help me live Donald M. Berwick, M.D.