Knowing What Is Important For Your Business
Use of Baldrige Framework
With increasing pressure to transform the healthcare delivery system, organizations face enormous challenges and opportunities to improve quality and decrease costs. The rapidity of change has been accelerated by the regulatory changes, reducing profit margins & changing customer expectations and it is imperative that hospitals and health care providers develop more effective and efficient ways of delivering care.
This makes us think -What are the frameworks or process improvement approaches that are being used by hospitals and health systems to transform their organizations and maximize positive outcomes? The Baldrige Performance Excellence Program provides healthcare organizations with one such framework to identify improvement opportunities, develop best practices, and attain and sustain top performance. Baldrige is a proven improvement and innovation framework to assess the functioning and operations in the following key areas: leadership; strategic planning; customer focus; measurement, analysis & knowledge management; workforce focus; operations focus; and results by applying this framework in daily operations. In addition to these benefits, the organizations can also apply for the Prestigious Baldrige award by CII /RBNQA /Malcolm Baldrige USA and be recognized in the industry for the best practices. Research has proven that the adoption of Baldrige practices leads to higher organizational performance.
The impact of using the Baldrige Criteria for Performance Excellence can be significant in improving quality, reducing costs, and becoming the market leader. As the Baldrige framework propagates, Differentiation through demonstration of top performance is essential for survivability and sustainability. Today’s healthcare environment is one of constant change. Healthcare leaders are still finding a footing in the quest to achieve long-term sustainability in this new environment. They need to constantly ask themselves, “How can we achieve the level of performance that is needed to be successful in the future?”
This is a case study of a Tertiary care hospital that was struggling with the challenge of shrinking market size and reducing community confidence. Decided to do something path-breaking, the organization decided to implement the Baldrige framework.
The framework requires asking a lot of questions that helps the organization in channelizing the already scarce resources in the right direction. It mandates that the organization needs to define its key stakeholders and their requirements. And as a part of this exercise, two main healthcare segments were identified. As an outcome of this activity ‘Affordability’ and ‘Transparency’ was identified as the key requirements by both the key stakeholders – Patients and the Community
Key customer / stakeholder requirements and expectations
|Competent Clinical Care||✓|
|Access to carey||✓||✓|
This became the two key Strategic Objective of the organization
|Strategic Objective||Key Measure|
|Improve the Affordability & Efficiency of the organization||Improving the discharge Percentage|
|Improve the Transparency with the patients||No of Multidisciplinary team meetings done|
It was then aligned with the Strategic Planning process and short term and long term goals and process changes were identified.
|Strategic Objective||Relevant Strategic challenge & Strategic Advantage||Short (S) & Long (L)term goals||Key Short (S) & Long (L)term HR goals|
|Improve the Affordability & Efficiency of the organization||1. Well-deployed
interdisciplinary care teams
2. Strategic partnership with the neighbourhood smaller healthcare providers
3. Integration of Clinicians and staff on process improvement and innovation
4. Collaboration with insurance companies
5. Technological advantage to aid in streamlining the process
1. Maintain affordable prices in environment of Regulatory changes and Demanding Customers
2. High Attrition Rates
1. Collaborate with Clinicians, Nursing staff, Administrators to enhance the process efficiency
2. Including the MDT compliance & E-HR Compliance as a part of clinicians appraisals
1) Develop and pilot a model of Collaboration with Insurance companies
1. Recruit and hire one Discharge Manager and five Discharge coordinators
1. Recruit one executive in the Medical quality team to coordinate & monitor the MDT meetings
2. Plan for communication workshops for Clinician & Nursing staff to improve the quality of communication & establish its importance
The organization made sure that the changed Stakeholder requirements were made a part of the strategic planning process and made as the key strategic objectives of the organization. The critical link between the strategic objective & the core competency (Leveraging on technology to aid in process improvement) was established to meet the customer and stakeholder requirements, and deliver customer and stakeholder value. This was achieved by identifying process owners at each levels, integrating it with the performance management system and continuous and rigorous monitoring of DASHBOARD results.
This structured approached helped in first identifying what is of value to the customer & achieving the desired results and regular course correction when needed. The figure below describes the Strategic planning process & the strategy deployment process.
The following steps were taken to improve the discharge percentage & improve the compliance to Multi-disciplinary team Meetings. :
- Daily Billing report to the patients (Communication) – Daily information sharing with the patient to help them keeping updated on the financial obligations & explaining the rationale of treatment & investigations.
- Discharge Planning & Summary preparation – The approach for preparation of discharge Summary using the Electronic Health record was established, improved communication
between medical, nursing & other team members. Evaluating patients’ requirement for home care & collaborating for it.
- Scheduled Multi- Disciplinary team meetings- Defining the MDT trigger & requirements based on the length of stay & clinical condition of the patient. Defining the triggers in the electronic
health records to alert the clinicians about the timing of MDT.
- Integrating the discharge score & MDT scores with the Physicians Performance appraisal – The
transparency & efficiency related parameters were included in the annual appraisal of clinicians.