After years of waiting, health care finally has a Baldrige winner!

Quality journey’ at SSM Health Care has taken years, hard work

Until this year, no health care organization has captured the coveted Malcolm Baldrige National Quality Award (MBNQA), the top honor a U.S. company can receive for quality management and quality achievement.

Now, however, all that has changed. SSM Health Care (SSMHC), a St. Louis-based not-for-profit health system, has become the first health care organization in the country to be named an MBNQA winner.

The award is presented each year to as many as three organizations by the U.S. Department of Commerce, and is administered by the Baldrige National Quality Program, National Institute of Standards and Technology in Gaithersburg, MD.

"The reality is that this is probably the most gratifying experience of my life, and that has become more and more clear with the tremendous response we have had [for being the first health care winner]," says Sr. Mary Jean Ryan, FSM, president/CEO of SSM. "The expectations for us as an organization have been raised, and the task for us now is to live up to that."

Baldrige award winners are considered role models, she notes, "and in my weaker moments that has scary dimensions to it."

"Certainly, the judges have been cognizant of the fact that the education and health care sectors have been eligible, and that last year we selected three education recipients," notes Joe Muzikowski, chair of the Baldrige panel of judges and a judge for the past three years.

"A judge has to balance his objectivity along with this kind of hope of eventually getting a [health care] winner, but you can’t go into the process rooting for one," he says.

Why not sooner?

Why has it taken so long for a health care organization to emerge as a Baldrige winner?

"This is the fourth year for eligibility," notes Muzikowski. "In the late 1980s, when Baldrige was first implemented, it took a few years for service firms to get a winner, while manufacturing’s primary driver was losing competitiveness to foreign manufacturers." (The first winners were manufacturers.)

"I think there’s a parallel here. Just as it took until 1990 to get the first service winner, it has taken longer for health care to understand the need to develop these standards. Manufacturing, which was in a crisis, saw the need. During the last few years, a lot of external light has been put on health care processes and improving outcomes," he points out.

"We’ve talked about [there being no health care winners] a lot as an organization, and I think there are several reasons," Ryan adds. "First, we do not have the luxury of making widgets. So, when we talk about processes, how many processes can we possibly have in health care?"

Also, she adds, health care has an unusual element no other profession has: physicians.

"This is a group with whom we work very closely, and with whom we want to continue to work closely, but they have no financial responsibility for our organization," Ryan observes. "I can’t articulate all the reasons for that, but it’s like having an outside group work with you that brings you customers, makes demands on you, but has no financial responsibility."

Add to that the realities of health care financing today, she says, and "those complexities cannot be mirrored in any other industry."

The long quality journey

SSM’s journey to the Baldrige Award began in 1990, when it first began pursuing continuous quality improvement. "About 18 months later, the [Institute for Healthcare Improvement] asked me to be a keynoter at their ’91 forum," Ryan recalls.

"From that point on, we have given probably hundreds of presentations around QI, and people have come in to talk with us about the things we do. We put ourselves out there and have always wanted to share what we learned — even if it was not complimentary," she adds.

SSM began to formally pursue the Baldrige four years ago, and was the first health care organization to receive a site visit. Ryan says SSM has used the Baldrige model over the past seven years to help achieve its mission.

"First of all, we looked at the criteria you had to meet before you could apply," she recalls. "We had a pilot program we used as a self-assessment. One of the things we did early on was to put teams around categories, in areas where we thought there were major gaps."

One of the things the teams discovered was that the system didn’t have a single mission statement. "So, it came to us in one of those very defining moments that we needed a single mission statement," Ryan recalls. "We spent a year and a half with 3,000 employees working on it."

The end result was the following: "Through our exceptional health care services, we reveal the healing presence of God."

"We were very proud of it," she says. "But Baldrige replied, OK, how do you define exceptional? Your comparative data are about averages; you have to compare yourself to the best.’ In other words, we had to find data to demonstrate exceptional clinical outcomes; exceptional patient, physician, and employee satisfaction; exceptional financial results."

To this day, she looks back on that challenge as one of the defining moments in SSM’s history. "If you don’t have a place to start, you never know how far you’ll be able to go," she asserts.

A rigorous process

To actually win the award, SSM had to go through a rigorous process. First, all applicants had to submit a 50-page application.

"The lead judge and most of the panel go through this in excruciating detail," Muzikowski says. "You have a phone call with the team leader to clarify any issues."

He says four major questions are asked:

  • What is different about this organization in person than what we saw on paper?
  • What are the significant strengths that would be role model practices?
  • What were the key vulnerabilities?
  • What were the key strengths in results, or areas for improvement?

"Results are critical, as they count for 45% of the total points," Muzikowski says. "We look at systems and the demonstration of synergy. That’s the difference between a very good company and a winner."

He adds, however, that the process is about more than just naming winners; it’s about sharing best practices as well.

"Last year, one comment I heard was from a manufacturing professional who said, Yes, we can learn from health care and vice versa.’ Now that there’s a health care winner, I hope we see the same thing now, with health care looking to share best practices," Muzikowski says.

Need More Information?

For more information, contact:

  • Sr. Mary Jean Ryan, FSM, President/CEO, SSM Health Care, 477 N. Lindbergh, St. Louis, MO 63141. Telephone: (314) 994-7800. Fax: (314) 994-7900. Web site:
  • Joe Muzikowski, Vice President, Business Processes and Strategic Supply, Solvay America, Houston. Telephone: (713) 525- 6050. E-mail: