Sector
A Unique Healthcare Delivery System
For the 55,000 Alaska Native and American Indian people it serves, Southcentral Foundation (SCF) has cut costly emergency room and urgent care visits by 50% and reduced specialty care by 65%, primary care visits by 36%, and hospital admissions by 53%. Such impressive results helped SCF win the 2011 Baldrige Award.
Of those SCF serves, 45,000 live in the Anchorage, Alaska, area and 10,000 live in 55 remote villages accessible only by plane. SCF serves them through a unique health care delivery system, the Nuka System of Care, that focuses strategies and processes on wellness. The system is owned, managed, directed, designed, and driven by Alaska Native people, which SCF calls “customer-owners.”
These unique ownership and health care delivery systems are producing impressive results:
- Customer-owners can see their primary care providers on the same day if they call by 4 p.m. and arrive by 4:30. Seventy to 80% of appointment slots are open at the start of each day.
- Alaska Natives and American Indian people experience diabetes at twice the national rate. Since 2009, SCF’s performance levels for diabetes care have exceeded the 90th percentile of the Healthcare Effectiveness Data and Information set.
- SFC manages key performance data through DataMall where it is collected, aggregated, trended,…
Huge Health System Wins 2011 Baldrige Award
Kudos to the leaders at Henry Ford Health System, one of four Baldrige Award winners in 2011. It is very challenging for an organization to make the necessary systemic changes to produce repeatable world-class results. It is especially challenging when that organization has 140 sites: seven hospitals, 33 multispecialty ambulatory care centers, affiliated physician practices, a research and education component, the Health Alliance Plan (health insurance coverage for more than 467,000 members), and 91 community care operations.
Henry Ford Health System serves a three-county region encompassing Detroit and its suburbs with a workforce just shy of 30,000 employees, physicians, and volunteers. Its revenue in 2010 was $4.08 billion.
It’s hard to imagine the effort it has taken to keep this massive organization moving along the Baldrige path, but its results are a testament to its leaders’ tenacity:
- Rated #1 for member satisfaction among all health insurance plans in Michigan by J.D. Powers and Associates
- Satisfaction exceeding 90th percentile level for HFHS’s medical centers, with 80% likely to recommend
- Performance on CMS core measures at the 90th percentile for 75% of reporting areas across the system’s seven inpatient hospitals
- Evidence-based global harm campaign to improve patient safety recognized as a national best practice by the Institute for Healthcare Improvement
- Market…
My Baldrige Experience in Iowa
Two days ago I took my 88-year-old mother to Wright Medical Center in Clarion, Iowa, for a hip replacement. We arrived at 6 a.m. and were greeted warmly by a woman in Admissions. Mom signed a few forms and was whisked away for lab work. I saw her again for a few minutes before they prepared her for surgery. An hour-and-a-half later, her surgery was done. I was talking to her in her room by 10 a.m.
She was expertly pampered for the rest of the day, able to get out of bed for a light dinner in the evening, walking the hallways yesterday, likely to be released today. None of it felt rushed. The attention was timely, focused, and compassionate. As a son, I felt relieved at the quality and efficiency I witnessed and at the high level of care my Mom received.
Wright Medical Center is a quality leader. It has integrated Baldrige by applying for the Iowa Recognition for Performance Excellence award. Two years ago, the quality processes it was implementing were described in Quality Progress, the magazine of the American Society for Quality.
I found all of this out when I was wandering the halls waiting for my Mom…
6Oct2011 | Steve George | 2 comments | ContinuedEducation Needs Baldrige
Based on results, the most effective way to ensure that no child is left behind would be to mandate integrating the Baldrige model at every public school system. Increase school funding to support the initiative, say one full-time person for every 10,000 students in a district, and you would get exponentially better achievement, satisfaction, and cost control. As an example, for my city’s school district, spending $50,000 on a Baldrige leader, out of a total budget of more than $30 million, would offer a huge return on investment.
Two Baldrige Award-winning districts prove my point. Jenks Public Schools in Tulsa, Oklahoma, received the Baldrige Award in 2005. It has continued to use the Baldrige model to pursue excellence. According to the Jenks Gazette, “the 2011 graduates of Jenks High School had an average composite (ACT) score of 23.9, which is far above both state and national averages of 20.7 and 21.2, respectively. The composite ACT score for graduating students at JHS has increased every year for the past five years,” or since it won the Baldrige Award. Dr. Kirby Lehman, superintendent of Jenks Public Schools, noted that “these scores are even more impressive when considering over 80% of all graduates at…
22Sep2011 | Steve George | 0 comments | ContinuedBaldrige and Lean in Healthcare
For the last few years, nearly half of the Baldrige Award’s customers have come from healthcare, which is not surprising: Healthcare costs continue to rise without a related improvement in healthcare results.
Hospitals and medical centers embrace the Baldrige model for the systems perspective it provides. Senior leaders who have integrated Baldrige attest to the new knowledge it gives them about how their organizations operate, which means they gain greater control over the levers of success. In healthcare, where so many factors conspire to increase costs and decrease performance, understanding and controlling those factors is priceless.
One example is described here. Advocate Condell Medical Center, a 350-bed Level 1 trauma center in north Chicago, turned to Baldrige and Lean to tackle serious challenges at the hospital and its imaging business including:
- Ranking in the bottom quartile of patient satisfaction
- High percentage of denials and bad debt
- Negative growth
- 30% of calls abandoned or lost
- Report turnaround time of 16 hours
- A 6% no-show rate
- Cumbersome registration process
- Long patient wait times
- Low staff and physician morale
Baldrige provided the management framework for aligning and integrating strategies, plans, and activities. Lean improved process flow and eliminated waste by involving staff in identifying and eliminating wasteful steps and streamlining processes.
One year after launching the…
22Aug2011 | Steve George | 0 comments | ContinuedHow Would You Measure a Society’s Performance?
If you could apply the Baldrige model to a society, how would you measure its performance?
One way would be to identify key indicators of performance excellence. One indicator would be productivity, which many organizations include in their Baldrige applications. The following chart, from an article in Mother Jones, shows that productivity in the U.S. has improved by 80% since 1979. According to NationMaster.com, the U.S. ranks second in overall productivity behind only Luxembourg.
Some of that is due to automation and technology, but it’s also because Americans are working harder. Forty percent of professional men and 23% of middle-income men work more than 50 hours a week. In a healthy society, one would expect that the people responsible for improving productivity—and working longer and harder to do it—would benefit from their efforts. Not in the United States. As the blue line on the chart shows, average overall wages increased about 3% in 30 years. As Mother Jones reports, “If the median household income had kept pace with the economy since 1970, it would now be nearly $92,000, not $50,000.”
The red line on the chart shows where some of the value of our productivity increase has gone. More is going for corporate…
22Jun2011 | Steve George | 0 comments | ContinuedStop the Race to the Bottom
Ecolab CEO Doug Baker recently claimed in a StarTribune commentary that Minnesota’s tax rate is “a barrier to attracting and sometimes keeping top talent.” I think that’s baloney.
Let’s say the “top talent” is a single person who earns a taxable income of $150,000 a year, surely at the low end for really top talent. Minnesota taxes currently take $11,775 of that. The Minnesota rate is about the same rate as the states of Wisconsin, New York, and North Carolina, higher than Illinois, North Dakota, and Missouri, and lower than Iowa, California, and Maine.
Baker claims our high personal income taxes are already a barrier, but our rates are not out of line with most other states. The average state tax rate, not counting the states with no state taxes, is around 6 percent for a single earner taxable income of $150,000. One would hope the quality of life in Minnesota—not to mention the opportunity to work at companies like Ecolab, 3M, Cargill, General Mills, Medtronic, Mayo Clinic, Best Buy, and many others—would more than offset the extra couple grand in state taxes the top talent would accrue here. If that was truly a sticking point, I’m guessing Ecolab could bump their…
12Jun2011 | Steve George | 0 comments | Continued
