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Using the Baldridge Criteria to Improve Organizational Performance

Healthcare leaders have been hearing a lot about the Malcolm Baldrige National Quality Award over the last fifteen years, and for good reason.  Baldrige has become an increasingly common framework used by top performing hospitals, and has become one of the dominant industries represented in the national annual quality award competition administered by the U.S. Department of Commerce’s National Institute of Standards and Technology (NIST).  On May 16, NIST announced that 34 businesses across 5 business sectors are vying for the prestigious award in 2016.  Of those, a whopping 62% (21 of the 34) were healthcare organizations (16 of 26 applicants were in healthcare in 2015, also 62%).  Every year since 2002, there have been at least 10 healthcare applicants and at least one healthcare Baldrige Award winner.

Hospital leaders not currently using the Baldrige framework often worry that adopting Baldrige means jettisoning their current strategic plan, performance improvement methodology, and/or balanced scorecard.  In fact, none of these is the case.  Baldrige provides a framework within which to structure and align strategies, methodologies, and measurement, not a replacement for them.  The Baldrige criteria don’t specify how to operate your business; they encourage you to define and evaluate your business within an internationally-recognized and proven framework.  According to NIST, the Baldrige Excellence Framework “helps you evaluate performance, assess where improvements or innovation are most needed, and get results.”

The Baldrige framework is composed of seven parts within a 1,000-point structure:

  1. Leadership (120 points)
  2. Strategy (85 points)
  3. Customers (85 points)
  4. Measurement, Analysis, and Knowledge Management (90 points)
  5. Workforce (85 points)
  6. Operations (85 points)
  7. Results (450 points)

For healthcare leaders, the first thing to notice about the structure is its focus primarily on results and secondarily on leadership.  Today’s leaders know that in this fast-paced and ever-changing healthcare landscape, nothing is more important than achieving results.  Our communities and our stakeholders demand and deserve great healthcare outcomes.  Baldrige places nearly half of the framework’s focus on achieving and maintaining superior results.  And, of the six remaining framework areas, notice what plays the biggest role in achieving results: leadership.  Baldrige focuses on important leadership factors like vision, values, and mission; communication and organizational performance; governance; and legal and ethical behavior.

A common question among leaders new to Baldrige is: Is it really an accurate gauge of performance excellence?  The answer is overwhelming “yes.”  A 2011 Thomson Reuters study compared Baldrige hospitals (award winners and applicants receiving site visits) to 100 Top Hospitals award winners and found:

  • Baldrige award recipients are significantly more likely to win a 100 Top Hospitals national award.
  • Baldrige hospitals were significantly more likely to display a faster pace of performance improvement over a five-year period.
  • Baldrige hospitals were 83% more likely to win a 100 Top Hospitals national award for excellence in balanced organization-wide performance.
  • Baldrige hospitals outperformed non-Baldrige hospitals in practically all individual performance measures used in the 100 Top Hospitals composite score.

Finally, healthcare leaders are often concerned that Baldrige won’t fit with other performance improvement initiatives like achieving Magnet status, maintaining accreditation with The Joint Commission, or participating in Institute for Healthcare Improvement (IHI) initiatives.  The good news is that Baldrige’s non-prescriptive approach is 100% compatible and congruent with these approaches.  The Baldrige framework allows leaders to organize and integrate multiple approaches to improve patient outcomes and achieve and sustain performance excellence.

If your organization is looking for a proven way to guide operations, improve performance, and achieve sustainable results, consider integrating the Baldrige framework into your organization’s DNA.  According to Eric Fletcher, Senior Vice President of Strategy, Marketing, and Business Development and an Alumni Baldrige Examiner, “One of the undersold benefits of the use of the Baldrige framework is its impact on organizational alignment and integration.  Devoted use of the framework leads to the tearing down of silos, and a true harmony among the processes and systems which propel an organization forward.  It’s not an easy journey, but world-class results await those who successfully implement the framework.”

If you need a little help starting your Baldrige journey, try beginning with some of the great (and free) resources offered by NIST at  In particular, if you’d like to learn more about the criteria and how it improves organizational performance, a great place to start is Baldrige 20/20: An Executive’s Guide to the Criteria for Performance Excellence (available for free download at  If you think you’re ready to take a crack at assessing where your organization stands today using a simplified version of the Baldrige framework, try the quick and easy Are We Making Progress? tool (available for free download at ).  And, when you’re ready to progress in your performance excellence journey and don’t want to go it alone, we can recommend some outstanding partners to jump-start your efforts.

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