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 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…

Creating Value for Society

“It is in the enlightened self-interest of business to forge economic growth models that create larger societal value than shareholder value alone.”

I doubt if there are many on Wall Street who agree with this opinion, which was put forward in this article by S. Sivakumar, group head of the Agri & IT businesses of Indian conglomerate ITC. But then, I’m not sure anyone on Wall Street really cares about shareholder value either. Accumulating personal wealth seems to be their driving force.

The Great Recession being felt worldwide can be laid at the doorstep of corporate—and personal—greed, housed by soulless companies like Goldman Sachs, Merrill Lynch, Bank of America, and others. By wrecking the economy for the 99%, they spawned Occupy Wall Street, a movement that has become an international voice against the damage being caused by these companies.

Sivakumar’s company is a refreshing alternative to Wall Street gluttony. ITC has been “water positive” for nine years (created twice as much freshwater potential than it has consumed), “carbon positive” for six years (sequesters twice as much carbon as it emits), and “solid-waste-recycling positive” for four years (recycles all wastes from its industrial operations). “In addition, these innovative business models have led to the creation of sustainable livelihood opportunities for over 5 million people from among the most vulnerable of Indian society,” Sivakumar writes.

ITC has delivered these results without damaging financial performance: Total shareholder returns have grown at a compound…

One Step to Better Results

Consider the list of concerns that most senior leaders have:

• I must meet the goals that I and others have set for our organization.
• I need to know what is or might keep us from reaching those goals.
• I need to think long-term but I also need results now.
• I need to get everyone on the same page.
• I need to make good decisions about allocating resources, both human and financial.
• I want to minimize surprises and firefighting and make our continued success predictable.
• I want to keep my job—or get a better one.

The list can be overwhelming if a senior leader has to focus on each concern individually, but it is manageable if all concerns are addressed by a systematic approach to leadership.

The Baldrige model provides a proven, systems approach.

A leader sees his or her organization through the filter of his/her area of expertise. The CFO views the organization differently than the COO. While the CEO has broader responsibilities, he or she arrived at that position with a filter, having been a CFO or COO or leader of another function before taking the top post. This inhibits a systems perspective of how the organization does what it does, and without that systems perspective, it is very difficult for a leader to identify the right goals and strategic objectives, align every employee and activity with achieving those goals and objectives, and integrate the daily work of all employees to move the organization…

Bottom-Up Baldrige

One of the most common questions I get from managers and employees who believe Baldrige is exactly what their organizations need is: How do I get senior leaders to see the value of this?

Paige Lillard has an answer that worked.

I came across an interview on the Baldrige program’s Web site, link here, with Lillard, VP of business excellence at Turner Broadcasting System. Turner Broadcasting employs more than 9,000 people at such networks as CNN, TBS, and TNT.

Lillard has a small consulting team within Turner Broadcasting that is responsible for helping units within the organization achieve their goals. She does this through the Baldrige model.

Lillard was in the audio department in the early 1990s, an extrovert spending her days alone in an audio studio, and she wasn’t happy. She started learning about total quality management and was intrigued by the concept of leveraging employee engagement and involving them in creating and improving processes. She talked to her manager and asked to discuss it with their VP. She asked him what kept him up at night and he said he wanted to get more out of the staff. Lillard outlined her ideas and he supported them and they started building a performance excellence system.

Her interest in TQM led her to Baldrige. She was given permission to form a sub-department to implement test the Baldrige framework. In the first six to nine months, her little group increased customer…