Unlike other federal programs, the Baldrige Performance Excellence Program is overseen by an advisory committee whose members are appointed by a cabinet member of the Presidential administration; in our case, the U.S. Secretary of Commerce. By charter, the Baldrige Board of Overseers is tasked with reviewing the work of the program and recommending improvements.
In this Board of Overseers blog series, we will be interviewing members of the Board of Overseers. In the interviews, they share their insights and perspectives on their experiences, on the Baldrige Program and its products and services, and on the Baldrige approach to organizational improvement.
Following is an interview of Jack Lynch who has served as president and CEO of Main Line Health in Philadelphia, Pennsylvania, since 2015. During his tenure, Lynch and his leadership team have been credited with strengthening the organization’s commitment to quality and safety, enhancing technology, fostering a period of expansion, and cultivating a recognized employee work environment.
What’s your experience with the Baldrige Excellence Framework in health care?
We kicked off our Baldrige effort almost accidentally. We were working on a cost-quality-safety-equity improvement initiative prompted by some fairly significant financial erosion. When talking to different consulting groups, everybody except for one brought us the traditional cost-savings exercises. Then we met Rulon Stacey [Stacey served two terms as chair of the Board of Overseers and was the CEO of 2008 Baldrige Award Recipient Poudre Valley Health System] who suggested a different approach: performance excellence. It was an effort to impact safety, to eliminate harm; impact quality, to drive top-decile performance across all of our quality metrics; impact equity, to eliminate disparities of care; and lastly attempt to break even on Medicare or what we call affordability.
We’re now 2.5 years into using the Baldrige framework in this performance excellence pursuit, and we’ve had great success. The Baldrige framework is a very process-oriented, results-driven, proven framework, and it hardwires things. As Rulon shared with us, so often many of these cost-saving initiatives result in savings over the first couple of years, but savings erode as people go back to the old ways of doing things. We overlaid the framework with our traditional quality improvement and cost-reduction efforts, believing that that would allow us to sustain those improvements over the long haul. We have saved about $120 million. That’s a big deal.
Our hospital system is really trying to move from separate siloes of organizations—five hospitals, a home care company, a physician-owned company, a drug and alcohol treatment facility, and a research institute—to operate more like a system. We believe that laying the Baldrige framework on top of our efforts to be more system-like or system-ness would result in better performance and sustained performance. System-ness would mean that I don’t have one hospital doing something one way and another hospital doing something another way. Last year, we applied for the Mid-Atlantic Alliance for Performance Excellence (MAPE) award and were very excited to win, which made us eligible to go for the Baldrige Award.
What experiences led you to the role of Baldrige overseer?
I was not one of the Kool-Aid-drinking, Baldrige-is-the-best-thing-in-the-world person. My chief nursing executive became a Baldrige Executive Fellow and came back convinced that using this framework would really make a difference. I went to the Baldrige Quest conference and looked for Baldrige Award-winning organizations that were our size or bigger. I learned that the framework fits for a mom-and-pop shop, a mid-size company, and a large regional company. I suspect national, and potentially global, companies can use the framework, too. That was the bug that bit me. Then having the opportunity to participate on the Board of Overseers to better understand where we were trying to head as a Baldrige organization was very valuable, in addition to better understanding the importance of communicating the value of Baldrige participation.
You can call me a Baldrige overseer. I would say I’m a Baldrige ambassador, an advocate. I’m excited to participate in the next Health Care Criteria revision, bringing my 30 years of health care experience to the table. When someone picks up a Baldrige application, I want him/her to see that it is easily relatable to health care and to his/her own organization.
How do you apply Baldrige principles/concepts to your current work?
In health care, we have to simultaneously drive down cost and improve quality. Revenue declines are moving at greater speed than expense reductions; probably more fairly said, the revenue increases are much smaller than the traditional expense increases year over year. Even very profitable health systems are going to face challenges if they don’t find a way to flatten their expense curves. And when you start to flatten your expense curve, if you are not careful, you can take out important quality initiatives. You can take out important safety initiatives, and you can lose sight of the importance of equity.
So the Baldrige framework, in my estimation, allows us to not just focus on one of those things but in fact understand that all four of them (cost-quality-safety-equity) are really, really important, and in fact, they are inextricably linked.
The framework gives us a way to address issues long-term. It helps us to hardwire a process to sustain and continue to make improvements over time. It’s not, “Let’s fix the stuff we fixed two years ago”; that stuff is sticking.
The charter of the Board of Overseers says the overseers shall make suggestions for the improvement of Baldrige and act as an advisory committee for the program. As an overseer, what would you like the community/stakeholders to know about the Baldrige Program and its award and other products? What improvements/changes at the Baldrige Program are you most excited about?
Often the only opportunities for organizations to get outside feedback are through processes where the consequences of the feedback could be severe (e.g., a health care inspection). The Baldrige process, starting at the state level, allowed us to stick our foot in the water and understand the value of getting feedback, which is both insightful and rewarding. For me as an overseer, being able to advocate for that level of outside review done by industry peers and other experts, a review that brings a completely objective set of eyes to what you’re doing and how you’re doing it, is invaluable.
When organizations are mature and their teams have been together for a long time, there’s a lot of value that comes out of that, but there’s also a lot of risk that you won’t try new things. But when you submit yourself to a Baldrige application, you’re exposing where your strengths and weaknesses potentially could be. Just the fact that an organization files a Baldrige application, to me, demonstrates commitment to improving performance.
As an overseer, one of the things that I think is most important is that we help organizations understand the value of the framework and increase people’s awareness. We’re not doing Baldrige for the award. Awards are things you go home and tell your parents about. We do it for the process, which is proven to result in sustained performance improvement. So if we don’t get the award but continue to get feedback that leads to sustained performance improvement, you can argue that it will drive high performance in the organization.
I think in the health care industry in this country, we are ripe for needing that level of framework and that level of feedback because we’re changing peoples’ lives every day. As an overseer, helping the Baldrige Program to understand how we might engage more health care organizations in the pursuit is a real value, too.
What encouragement/advice would you give U.S. organizations thinking about applying for the Baldrige Award or using another one of the Baldrige Program’s products or services?
The Baldrige Excellence Framework has empowered organizations to accomplish their missions, improve results, and become more competitive. It includes the Criteria for Performance Excellence, core values and concepts, and guidelines for evaluating your processes and results.