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The Official Baldrige Blog

Another Reason Health Care Organizations Need the Baldrige Framework

2015-2016 Baldrige Core Values graphic

A panel of patient safety experts recently found that a “systems approach” is necessary to ensure patient safety in hospitals and other health care organizations. An article published late last year in the industry newsletter FierceHealthcare summarized findings of a new report from the National Patient Safety Foundation (NPSF).

The December 2015 report, follow-up to the NPSF’s groundbreaking 1999 report “To Err is Human: Building a Safer Health System,” publishes findings of an expert panel on patient safety convened by NPSF early in 2015 and co-led by Dr. Donald Berwick, president emeritus and senior fellow at the Institute for Healthcare Improvement. The panel’s charge was reportedly to “assess the state of the patient safety field and set the stage for the next 15 years of work.”

Summarizing the findings, FierceHealthcare Executive Editor Ilene MacDonald writes that the new NPSF report finds necessary “a total system approach and a culture of safety” to combat medical errors and adverse events. A total system approach. Surely that resonates with those of you who are already adherents of the Baldrige Excellence Framework (which includes the Health Care Criteria for Performance Excellence). Systems perspective is the first of 11 core values and concepts described in the Baldrige Program’s 2015–2016 Health Care Criteria for Performance Excellence. Those core values and concepts serve as the “foundation for integrating key performance and operational requirements within a results-oriented framework that creates a basis for action, feedback, and ongoing success” (page 39).

The Baldrige framework’s other 11 foundational and interrelated core values and concepts are visionary leadership, patient-focused excellence, valuing people, organizational learning and agility, focus on success, managing for innovation, management by fact, societal responsibility and community health, ethics and transparency, and delivering value and results.

The Baldrige Performance Excellence Program, which produces the Baldrige Excellence Framework (health care version), defines systems perspective as “managing all the components of your organization as a unified whole to achieve your mission, ongoing success, and performance excellence.” According to the full definition in the booklet’s glossary, “Successfully managing overall organizational performance requires realization of your organization as a system with interdependent operations. Organization-specific synthesis, alignment, and integration make the system successful.”

As described further in the Baldrige framework booklet, when a health care organization takes a systems perspective, its senior leaders focus on strategic directions and on patients and other customers. They monitor, respond to, and manage performance based on the organization’s results. With a systems perspective in place, a health care organization uses its measures, indicators, core competencies, and organizational knowledge to build its key strategies, link these strategies with its work systems and key processes, and align its resources to improve the organization’s overall performance and its focus on patients, other customers, and stakeholders. 

So health care organizations that have adopted the Baldrige Excellence Framework to manage their performance in and across all areas already have “a total system approach” in place. Baldrige organizations are thus in optimal position to achieve good and ever-improving patient safety results. How is your health care organization improving patient safety?

About the author

Christine Schaefer

Christine Schaefer is a longtime staff member of the Baldrige Performance Excellence Program (BPEP). Her work has focused on producing BPEP publications and communications. She also has been highly involved in the Baldrige Award process, Baldrige examiner training, and other offerings of the program.

She is a Phi Beta Kappa graduate of the University of Virginia, where she was an Echols Scholar and a double major, receiving highest distinction for her thesis in the interdisciplinary Political & Social Thought Program. She also has a master's degree from Georgetown University, where her studies and thesis focused on social and public policy issues. 

When not working, she sits in traffic in one of the most congested regions of the country, receives consolation from her rescued beagles, writes poetry, practices hot yoga, and tries to cultivate a foundation for three kids to direct their own lifelong learning (and to PLEASE STOP YELLING at each other—after all, we'll never end wars if we can't even make peace at home!).

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Over the years, I've observed that 'systems thinking" is viewed as a barrier to many and may be a learned skill and combined with a "growth" mindset present a singular challenge. Once resolved, it's delightful to see the deeper understanding and learning begin. We presented to a group of nearly 100 teacher and could feel the angst; however into an hour into day two, the cheering began. It took some teaching and learning to get the core values and concepts, organization profile, process categories, results, to not be viewed as a threat. Yes, a holistic, integrated, and system management approach.
This is hardly new news. I cannot think of much beyond the mastering of basic skills (say walking) that isn't done best through a systems approach. Education, city planning, home design (not to mention interior decorating) all benefit from a "systems approach." That does not mean that "systems thinking" is applied as much as it should be -- it isn't. As an example, the reason that the Internet of Things (IoT) is such a security threat is that the developers of the nodes in the IoT didn't bother to employ systems thinking and, therefore, left out security considerations.
Thank you for your comment -- and for helping me make the point with your observation that systems thinking is not applied as much as it could/should be. While a systems perspective (and other core features of the Baldrige framework) is not breaking news or a novel practice, its adoption is not universal (as you noted) by organizations that could benefit, such as health care organizations that could improve patient safety. This blog is merely highlighting a rather new report by a panel of experts that reached that conclusion.
Great article, and good comments from Greg and Simeon. If anyone is intimidated by the term "systems approach" (or any of the other 11 core values listed above) - fear not! Starting down the path of the Baldrige Performance Excellence Program IS a systems approach, where you learn as you go from many others who have gone before.
Was fortunate to have the opportunity earlier this year to partake in the Baldrige training program together with some of my colleagues in the group. We certainly brought back some learnings to further improve our TBEM program. What's immensely satisfying though is that our TBEM program, which is mirrored on the Baldrige program, has emerged as truly world-class; I'm proud to be part of the journey of excellence.

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