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Ge Way and Malcolm Baldrige for Performance Excellence by ubg57935

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									Mayo Health System:
Developing 65
Points of
Excellence



                       Deb Fischer
                       Mayo Clinic
                      October 10, 2007
    Presentation Objectives

• Baldrige National Quality Program
  framework
• Mayo Health System’s journey to
  performance excellence
                Topics
• Susan
• Need for a checkup
• Baldrige National Quality framework
• Mayo Health System’s Baldrige journey
• What we learned
• Implications for you
       Meet Susan
• She is a patient at
  Franciscan Skemp
  Healthcare – Mayo Health
  System in La Crosse, WI
• She has been a patient
  there for more than 20
  years, before it became
  a Mayo Health System
  practice
    Susan’s not alone
• She’ll have at least one of our
  2.5 million system-wide
  patient visits this year
• She’ll also be one of the
  18,000 patients referred
  to Mayo Clinic this year
  for highly specialized
  care
   Susan has a choice
• She can choose to visit us or
  a competitor -we’re within
  miles of each other in
  La Crosse
• She could also seek care at
  any of our 65 locations
  throughout Minnesota,
  Iowa and Wisconsin, or
  at Mayo Clinic in
  Rochester
                                                                                   Barron         Cameron
                                                                          Prairie Farm
                                                                                                  Chetek

                                                                                                   Bloomer
                                                                  Glenwood               Colfax
                                                                     City
                                                                                  Menomonie                Chippewa Falls

                                                                   Elmwood                          Eau Claire
                                              New Prague
                                                           Cannon Falls
                                                                                   Mondovi Osseo
                                        Le Sueur                Lake City
   Lamberton             St. Peter                Northfield
                                                                      Wabasha
                                       Waterville     Faribault                      Alma       Arcadia
               Springfield    Mankato                                  Plainview
                                       Janesville
                                                      Owatonna                           Galesville
                Madelia      Lake Crystal                                                               Sparta Tomah
                                                Waseca                    Rochester
          St. James                                      Blooming                               Holmen
                               New Richland               Prairie                                  Onalaska
                Truman                                                              La Crescent         West Salem
                                   Wells        Alden   Austin Grand Meadow
               Fairmont                                                         Houston             La Crosse
MINNESOTA
                   Sherburn
                                 Kiester    Albert Lea Adams          LeRoy Mabel
                                                                                       Caledonia

     IOWA                        Lake Mills                                          Decorah                     WISCONSIN
                    Armstrong
                                                                                                  Waukon
                                                           Charles City
                                                                                                               Prairie du Chien


 CP1199837-1
                                                                                                                 CP1199837-8
  A chance encounter
• Susan often travels to
  Mankato, MN to visit her son
• During a recent visit she had a
  heart attack …
• She’s okay, but was
  surprised to learn that
  even though she was
  still in the “system”, her
  medical information
  wasn’t readily available
                                                                                     Barron       Cameron

                                                                                        Prairie   Chetek


               “Silo Thinking”                                            Glenwood
                                                                             City
                                                                                        Farm
                                                                                                   Bloomer
                                                                                              Colfax
                                                                                                      Chippewa
                                                                                                         Falls
                                                                           Menomonie
                                                                         Elmwood                      Eau Claire
                                                  New Prague
                                                            Cannon Falls                                   Osseo
                                                                       Lake City          Mondovi
                                   Le Sueur
              Lamberton                                     Northfield
                                St. Peter
                                              Waterville    Faribault         Wabasha       Alma         Arcadia
                  Springfield        Mankato                                       Plainview
                                              Janesville
                    Madelia                                 Owatonna                               Galesville
                                  Lake Crystal                                                              Sparta Tomah
                                                      Waseca                    Rochester
               St. James                                    Blooming                                    Holmen
                                      New Richland           Prairie                                     Onalaska
                    Truman                                                                  La Crescent       West Salem
                                                    Alden Austin Grand Meadow
                  Fairmont               Wells                               Houston                         La Crosse
MINNESOTA                 Sherburn                           Adams
                                                                     LeRoy
                                        Kiester  Albert Lea                        Caledonia
                  Armstrong                                                 Mabel
    IOWA                                                                           Decorah                      WISCONSIN
                                               Lake Mills
                                                                                                   Waukon
                                                               Charles City                             Prairie du Chien



CP1199837-1
                                                                                                                   CP1199837-8
A learning experience
• Susan, and others like her, are
  one reason Mayo Health
  System chose Baldrige for
  system optimization
   Mayo Health System – 15 years
Merger and acquisition
   1992 – 1997

Structure and organizational relationships
   1998 – 2003

Alignment
   2004 – 2007
        Mayo Health System

   Pride in physician leadership
   Enjoy local autonomy
   Organizations are accountable for quality
    and financial performance

      How they succeed is up to them
     A checkup is needed
• All health care
  organizations need to do
  something – quick
  – Fraught with waste
  – Quality not where it should be
  – Fierce competition
  – Medicare’s future in doubt
  – Baby boom means fewer
    workers
  – It’s the right thing to do
      A checkup is needed
• Crossing the Quality Chasm
  Institute of Medicine, 2001
  Urgent call for redesign of the
  American health care system
  – performance expectations
  – align $ and quality incentives
  – rules to guide relationships
  – evidence-based practice
  – information systems
• Fundamental change is
  necessary
  How does one
create and replicate
   Excellence in
   65 locations?
 One Option
• Wait
• Let others lead the way
• Allow others (government
  and other payers) to dictate
  your future
 Another Option:
Create excellence in
    health care
  • Know your patients
  • Align with your partners
  • Optimize all processes
  • Assess your results

    Improve every aspect
      of your business
Improve every aspect
  of your business

   A model clearly working
   in industry and now it’s
   working in health care
           What is Baldrige?
   Malcolm Baldrige National Quality Program
   Award created by public law, 1987
   Assessment and improvement framework
   Criteria based
          1.   Leadership
          2.   Strategic Planning
          3.   Customer
          4.   Information management
          5.   Workforce
          6.   Process Management
          7.   Results
        What Baldrige is not

   A way for “corporate” to take control
   Something that the “Quality” people do
   Quick
   A season
Baldrige Criteria for
Performance Excellence

               Strategic
               Planning      Workforce
                              Focus


  Leadership                                  Performance
                                                Results

                             Process
        Customer Focus      Management
          & Markets




      Measurement, Analysis & Knowledge Management
Baldrige Health Care Awards
    2002
     SSM Health Care (St. Louis, MO)


    2003
     Baptist Hospital, Inc. (Pensacola, FL)

     Saint Luke’s Hospital (Kansas City, MO)


    2004
     Robert Wood Johnson University Hospital

      (Hamilton, NJ)
    2005
     Bronson Methodist Hospital, (Kalamazoo, MI)


    2006
     North Mississippi Medical Center (Tulepo, MS)
               Minnesota Health Care
                   Recognition
                  Winona Health

               Allina Hospitals and Clinics

  Mayo Health System
              Benedictine Health System

Mayo Clinic Radiology
Mayo Clinic Cardiovascular Diseases
         Excellence is catching on
        Malcolm Baldrige Award Applicants
90
80
70                All sectors
60
50
40
                                Health care
30
20
10
 0
 1999     2000   2001   2002     2003   2004   2005   2006
Why Baldrige works for Health Care

Sr. Mary Jean Ryan - President/CEO, SSM Health Care
“Baldrige is the best way to get better faster.”

Frank Sardone - President/CEO, Bronson Methodist Hosp.
“This [Baldrige] achievement places a spotlight … on
 everyone at Bronson who has worked so hard to be the
 best, because it is the right thing to do for the patients
 and families we serve.”
Baldrige will help MHS assure:
   A uniform patient experience
   Optimized performance
   Alignment with Mayo Clinic direction
   A strategy-driven future
       Clear goals / objectives linked to strategic priorities
       Reliable performance measurement & analysis systems
       Operating strategy & infrastructure to drive results
    How do we do Baldrige?

   Baldrige Health Care Criteria for
    Performance Excellence - 2007
   Attend national / regional Baldrige conferences
   Oversight committee & seven category teams
   Research current state to address the questions
   Formulate responses
   Write & rewrite responses
How do we do Baldrige? (2)

   Combine / edit into a written application
   Submit to state award program
   Site visit
   Extensive feedback
       Strengths
       Opportunities for Improvement (OFI)
   Continuously work toward addressing OFIs
        Mayo Health System Journey
2004                         2006
   MHS Board of Directors      Prioritize opportunities,
    endorsement                  update MHS strategic plan
   Criteria training           2nd MN Quality Award
                                 application
2005
                             2007
   1st MN Quality Award
    application                 Site visit & feedback report
   Site visit & feedback       Prioritized opportunities,
    report                       update MHS strategic
                                 improvement plan
How did Mayo Health System fare?
Commitment
   Early stages of implementing systematic approaches and obtaining results
   Committed to promoting organizational excellence through self-assessment

Advancement
   Demonstrate good progress in building and deploying
    systematic approaches especially in the leadership, strategic
    planning and customer focus areas
   Many good results

Achievement
   Generally aligned and demonstrates evaluation and improvement
   Good results and trends in most areas with no major faults
Excellence
   Refined, fully deployed, systematic approaches, with positive trends in all key
    measures and results
   Well integrated and can serve as national and global role models
                                                                    MN Council for Quality
2006 Executive Summary
Strengths
• Leadership: physician leadership supports the
  Baldrige core value of patient-focused excellence
• Transparency: data transparency supports the
  Baldrige core value of management by fact
• Community focus: locally available health
  care and high quality align with the Baldrige core
  value of social responsibility and improved
  community health
2006 Executive Summary
Opportunities for Improvement
• Leverage best practices: determine and
  spread best practices across the system
• Strategic planning: lack some targets and
  performance measures making it difficult to
  achieve alignment across the system. Evaluate
  and improve the strategic planning process
• Business and support processes: need
  approach for identifying key processes, their
  requirements and measures
         System observations

   Rigor forces learning & acknowledgement of
    strengths plus opportunities
       Focus on PROCESS
       Focus on RESULTS

   Unifying experience
   External reviewers add credibility
   Valuable consulting
        Personal observations

   Hard work … but worth it
   Cannot delegate Baldrige … must lead from
    the top
   Communicate, communicate, communicate
   Journey will take many years
   Gaining momentum


  7 of 12 Mayo Health System
organizations have begun a local
 Performance Excellence effort
            What’s next?

   Concentrate on key system operations
   Consistently “Manage to Baldrige”…
    no “Baldrige Season”
   MHS Performance Report
                                                                      External drivers
                     MHS Performance
                         Report
                  Health Care         Customer
Board driven



                   Outcomes           Outcomes                          MHS Strategic
                                                                      Improvement Plan

                                                  Internal
                  Financial &         Workforce
                    Market            Outcomes     drivers
                                                  what needs
                    Process          Leadership   to get better             • Measures
                 Effectiveness       Outcomes                               • Performance targets

               • Current levels / trends                                   Creates
               • Performance targets




                                                                                          Management
                                                                                            driven
           The                                                         Action
                                                                       Plans
   Baldrige framework                              • Measures
    to manage MHS                                  • Performance targets
  Thanks to Baldrige
   We’re able to more
methodically work toward
achieving Susan’s vision of
what Mayo Health System
        should be
 How do YOU create and replicate
  excellence in your organization?
• How do you create
  dramatic change and
  increase quality?
  – Keep a focus on
    the customer
  – Create services and
    delivery based on
    customer needs
  – Manage processes
• Are your partners or
  competitors pursuing
  Baldrige?
Questions

								
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