How Baldrige Encouraged a People to Be Innovative, Community Focused

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“Baldrige is the reason why I didn’t quit my job in 2003,” said Dr. Katherine Gottlieb, president/CEO of Baldrige Award recipient Southcentral Foundation and recipient of the 2015 Harry S. Hertz Leadership Award.

In her leadership role in 2002, Gottlieb had more than 900 employees, a budget of $150 million, and the responsibility to provide health care services to 40,000 people spread across 110,000 square miles of southcentral Alaska.

“And I realized our organization needed systematic change in order to be sustainable and function at the highest level of quality," she said. "I believed I was not the leader to take the organization to the next step.”

But Gottlieb said, before making up her mind, she would look for examples of other successful organizations that had transformed themselves and tools that could help.

“So when I was introduced to [the Baldrige Criteria for Performance Excellence] in 2003, I looked at it with the same scrutiny that I would for anyone or anything entering our Tribal doors. . . . I found that Baldrige aligned with our values. I found that Baldrige does not dictate but asks questions. . . . I found Baldrige would assist my leadership in driving our system to best practices. I found that Baldrige focuses on systematic change. I chose to enter the Baldrige journey to excellence."

To really understand that journey, one needs to understand the history of Southcentral Foundation and its customer-owners, the Alaska Native and American Indian people.

“Imagine not having control over anything in your life, but that all of your life, someone or something else did. And this control was exercised over you and your family in a way that stripped you of your cultural and spiritual beliefs and even your language. It stripped you of your country and privileges, rights as a human being, and the result of this was your people became despondent and lost their voices," said Gottlieb, summarizing the plight of Native communities in Alaska.

According to Gottlieb, upon passing the Indian Self-Determination and Education Assistance Act of 1975, Congress said, "the federal domination of Indian programs has served to retard rather than enhance the people and their communities and denied them an effective voice in the planning and implementation of programs that respond to the needs of people." She said the federal government recognized that if the people receiving health services owned their own health care, health statistics would improve.

Alaska Native and American Indian people chose to exercise this law throughout the entire state of Alaska and are now operating and managing their our own health care systems.

In 1991, as the new CEO of Southcentral Foundation, Gottlieb said the health care system chose to create vision statements, goals/shared responsibilities, and operational principles based on relationships. Outcome measures, population-based services that recognized the community's culture and strength, infrastructure, culturally appropriate buildings, and listening mechanisms had to be established as the customer-owners, the Alaska American Indian people themselves, took over their own health care.

In 2004, Southcentral Foundation started using the Baldrige model.

“The Baldrige Criteria for Performance Excellence has played a tremendous role in providing a systems framework to transform a slow, medical, bureaucracy [into an] agile, customer-driven system of care. . . . I owe Baldrige a lot," she said.

She added, "Baldrige does not control but relies on creativity and innovation for answers. Baldrige didn’t try to take away our culture but encouraged it through the inclusion of our community, our people, our customer-owners, our employees."

One of the first things the organization learned through Baldrige, she said, regarded the vision statement; "Baldrige came in and asked the question, 'How does every employee know they are achieving the vision?'" After its 2011 Baldrige site visit, Gottlieb said staff members, from receptionists, to providers, to maintenance workers, could respond to how they personally achieve the vision and mission.

“Baldrige revealed opportunities for improvement. . . . Baldrige gave us that common language. . . . It continues to encourage me as a leader." She said her most proud moment was the third-party validation of Southcentral's excellence during the 2011 Baldrige Award ceremony.

Organizations from around the nation and world now come to Southcentral Foundation to learn about its customer-focused, relationship-based "Nuka System of Care.” According to Gottlieb, communities from Oregon, the Veterans Administration, Cherokee Nation, and Canada are just some who have begun to adapt Southcentral's Nuka system.

Gottlieb can even pull the organization's updated Baldrige Award application—"the Little Baby Bible"—out of her purse; “This document lays out in detail the infrastructure of Southcentral Foundation. . . . How the succession planning works, budget approval cycles. It’s all in there. Everyone knows where we’re at. Data are kept up to speed. . . . It keeps us up to speed on where we are with health and safety measures, workforce, where we're falling behind, where are our shortages, what's happening in the global world that might affect us. . . . It’s really fun to use. It’s a format that works for us.”

Southcentral Foundation continues the Baldrige journey, she added, "because Baldrige is a tool that influences without controlling. . . . And allows a community, an individual, an organization, a group of employees to be free to be innovative. Baldrige encourages an organization to include its community and culture. . . . And thus we are renowned for these successes.”

But there is one additional success that Gottlieb proudly shares. And that is taking back the Native dance, culture, and Supiaq language of her Alaskan Native village. Not only does she share Southcentral's model to help other health care providers improve, but, she tells me, she is proud to be giving back her culture, too.