Baldrige criteria spur ongoing change
Baldrige criteria spur ongoing change
For Saint Luke’s-Shawnee Mission Health System in Kansas City, MO, the Malcolm Baldrige self-assessment tool has led to nearly seven years of continuous change and improvement. (The tool is available from the Baldrige National Quality Program in Gaithersburg, MD.)
"One of the big turning points was in 1995, when the CEO came to my medical director and me with the Missouri quality award criteria," recalls Sherry Toigo, RN, CPHQ, vice president of quality for Saint Luke’s Hospital, part of the Saint Luke’s — Shawnee Mission system. "He wanted to know what we thought, and to us it seemed like an excellent idea." (For a copy of the Baldrige criteria, go to www.quality.nist.gov/.)
The timing, however, could have been better; Saint Luke’s staff were unfamiliar with the criteria, and they had just come off a large patient-focused work redesign initiative.
Investing sweat equity
"A lot of sweat equity had gone into the process, and we had a three-year Joint Commission [on Accreditation of Healthcare Organizations] survey coming up, so there was not a lot of enthusiasm; people were spent," Toigo says.
How was this reticence overcome and staff successfully enlisted in yet another change process? "Your leader has to champion it," she says. "Had he not done that, we would not be on the path we are on today. We moved from looking at ourselves from the Joint Commission standards to really assessing ourselves by a set of objective criteria. We were fortunate enough to go far enough to get a whole group of quality experts in here; you can’t buy that kind of advice." Toigo says she has never participated in any initiative quite as broad-ranging or in such a short amount of time. The applications were 75 pages long, and we had 2½ weeks to complete them," she says.
The second key to success is that Toigo’s team was given very specific expectations by the CEO, and it was assigned accountability. "This was really critical," she observes. "We were quickly organized, we had our category leaders, and everything else was dropped and we ran with it. People knew who was doing what. Our CEO constantly and publicly promoted the process; he kept the vision in front of us at all times — in department head meetings, in medical staff meetings."
Saint Luke’s won the regional award (health care institutions have yet to register their first Baldrige national award winner), but that was only the beginning of change at Heartland Health. "Now, with our latest initiative, the whole Saint Luke’s-Shawnee Mission Health System is being committed to the Baldrige management philosophy," Toigo reports. "Once we won the Missouri quality award, it has been deployed across the entire system. We now have our own internal assessment system, Commitment to Excellence.’ From that point, we decided we would reapply in 1999 to do a reality check and see where we fell."
Taking the next step
Saint Luke’s wrote an application, won again, and then moved on to Phase II. "From that process, we got a feedback report from the Baldrige people, as well as internal feedback; basically, it presented us with the opportunity for improvement with our metrics architecture. While we had a wide variety in place, we did not always see a clear alignment to our overall strategy. We’ve now decided we will be the first facility to completely revise our entire metrics architecture."
Again, says Toigo, there are very clear expectations, an explained rationale, and a built-in accountability piece. "I haven’t heard any [staff] complaints," she notes. "It has to do with trust. They trust this leader, and we all have been very successful. People are really embracing the core Baldrige value of managing by fact."
Need more information?
For more information, contact:
• Sherry Toigo, RN, CPHQ, Vice President of Quality, Saint Luke’s-Shawnee Mission Health System, 10920 Elm Ave., Kansas City, MO 63134. Telephone: (816) 460-4080.
• Baldrige National Quality Program, 100 Bureau Dr. Stop 1020, Gaithersburg, MD 20899-1020. Telephone: (301) 975-2036.
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