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The Official Baldrige Blog

Cascading Goals for Better Outcomes


Most organizations have goals. And people who work there have goals, too. But the magic, experts say, is when organizational goals align with department goals that are in alignment with the workforce’s goals. Such goal alignment can improve outcomes and operations; increase employee morale and retention, creating ownership in the organization’s success; and lead to more satisfied patients and customers who benefit from smoothly running processes and motivated workforce members.

But if you work for a large system (or even a small organization), where do you begin in aligning goals--and sustaining that alignment--across your entire organization?

At the upcoming 29th annual Quest for Excellence Conference, Brenda Grant, chief strategy officer, and Dr. Glenn Crotty, chief operating officer, at Charleston Area Medical Center (CAMC), will be sharing Baldrige Award recipient’s CAMC Health System’s Goal Cascade Process, which is used to align the organization’s annual goals throughout the entire system to every department.

Grant explained the process, “The goal cascade has been key to improvement in overall organizational results by ensuring our focus on key improvement areas. For example, a BIG DOT [key measure] under our quality pillar is Value-Based Purchasing–Hospital-Acquired Infections. This is cascaded to applicable nursing departments as CAUTI (Catheter-Associated Urinary Tract Infections). The nursing departments have CAUTI as a Top-5 Board improvement project and monitor the implementation of 'bundles of care' that need to take place every day to prevent these infections. As a result of this focus, CAMC’s CAUTI rate for 2016 was 0.30, better than the Centers for Medicare and Medicaid (CMS) top-quartile performance of 0.90.”

She added that Top-5 Boards are 4x6-foot boards in each department with five columns that address the Define, Measure, Analyze, and Improve components of DMAIC, the system's problem-solving methodology. The boards are in visible areas so that the performance improvement work is very transparent to the workforce, patients, and visitors. Each column lists an improvement team addressing an issue cascaded from the corporate goals.

In addition to improving outcomes, the Goal Cascade Process has helped CAMC engage everyone in performance improvement.

"As a cycle of learning, to continue our focus on sharing best practices and knowledge management, we now have Top 5 Board report outs from each of our hospitals and corporate areas," said Grant. "Not only are clinical results improved, our Top 5 Boards have the added value of engaging employees in their daily work to achieve corporate goals."

Grant also shares some words of wisdom for using Baldrige resources to improve Quest participants' own organizations. For example,

  • The Baldrige Criteria align with and support required accreditation processes.  Show the connections!
  • Transparency supports engagement. Through the Goal Cascade Process, CAMC Health System shares its strategic direction and the “why” behind its plans.
  • Comparisons and benchmarks are critical to knowing how you perform. Ask the question, “How do you know?”
  • Having systematic processes in place (including CAMC Health System's Organizational Sustainability Framework) helps prepare health care organizations to work through the challenges and instability of delivering health care in today’s environment.

Grant said the Baldrige Award-winning system continues to improve. "We are using the Baldrige Cybersecurity Excellence Builder to better understand the effectiveness of our cybersecurity risk management efforts and to identify opportunities for improvement, and we are participating in the Communities of Excellence work to ensure we can be even more effective in our work with our community."   

To learn more, register now for the 29th Annual Quest for Excellence Conference, which will feature the 2016 Baldrige Award recipients and many more national role models sharing their best practices.

About the author

Dawn Bailey

Dawn Bailey is a writer/editor for the Baldrige Program and involved in all aspects of communications, from leading the Baldrige Executive Fellows program to managing the direction of case studies, social media efforts, and assessment teams. She has more than 25 years of experience, 18 years at the Baldrige Program. Her background is in English and journalism, with degrees from the University of Connecticut and an advanced degree from George Mason University.

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This is a very good article and the diagram is excellent.
Love It
Visual displays suffice many purposes when it comes to shop-floor improvements.

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