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 90^th percentile of the Healthcare Effectiveness Data and Information set.
• SFC manages key performance data through DataMall where it is collected, aggregated, trended, segmented, and available to managers, clinicians, customer-owners, and employees.
• SCF’s overall customer satisfaction rating in 2010 was 91%. Its overall satisfaction rating on Consumer Assessment of Healthcare Providers and Systems (CAHPS) was 73.3%, significantly higher than the CAHPS TopBox benchmark of 46%.
• Staff turnover decreased from 37% in 2008 to 17% in 2011.
• SCF’s per capita expenditures percentage change has been lower than the MGA benchmark since 2005 despite its phenomenal growth.

Notice the exceptional results across all critical areas: operations, patient care, patient satisfaction, workforce, and financial. Organizations must be good at everything and great at a few things to win a Baldrige Award, as SCF has demonstrated.

Health care organizations that want to replicate its success can start with the Nuka System of Care, which is based on four principles: (1) customers drive everything; (2) customers must know and trust the health care team; (3) customers should face no barriers in seeking care; and (4) employees and supporting facilities are vital to success. If it works for SCF in remote areas of Alaska, it can work for any health system in the country.

You can read more about SCF and its world-class results here.

To learn more about other Baldrige health care leaders, click on these articles:

• Henry Ford Health System
• Heartland Health
• AtlantiCare
• Poudre Valley Health System
• St. Luke’s Health System

I remember helping a manufacturer early in its Baldrige application process. It was its industry’s worldwide leader and had been for several years. It worked closely with its distributors and had ongoing customer contact. It assumed it knew what each customer group required even though it had never formally determined those requirements or tested them with customers to make sure the lists were right.

When I presented my evaluation of its application to senior leadership, my first point was that it did not have a rock-solid understanding of customer requirements. I thought they were going to tear my throat out until the president interrupted and said he thought I had a point. As a result, the company hired a market research firm to close this gap. Two years later, it received the Baldrige Award.

The Baldrige model is a process model. The starting point for any effective process is knowing what the customers of that process require. That’s true at the macro level — profound knowledge of what your customers require of your organization — and at the micro level — profound knowledge of what customers require of each process. Plunging ahead on the assumption that you know these requirements puts your organization on shaky footing.

To read more about understanding customer requirements, click on these articles:

• Smart Question #3: Who Are Our Customers and What Do They Require?
• Kano Satisfaction Model
• Be Careful How You Measure Customer Satisfaction
• Walk in Your Customer’s Body Armor
• KEYSTONE: Customer Knowledge