“We didn’t get here on our own,” said Brian Dieter, President and CEO of Baldrige Award recipient Mary Greeley Medical Center (MGMC), speaking at the 32nd Baldrige Quest for Excellence® Conference. “We think we are very much better as a result of having learned from [other Baldrige Award recipients and state and local quality award winners]. . . . At some point, we hope there is someone in the audience today who will say we learned something of significant value from Mary Greeley Medical Center, and we can stand on their shoulders in the future.”
MGMC, a 220-bed acute care, municipal hospital, located in Ames, IA, certainly has posted outcomes and processes to learn from.
MGMC, which serves a 14-county service area, has a simple vision: To be the best.
Dieter said that vision statement “almost requires” the hospital to be part of the Baldrige community “because [the vision] is bold enough to say we want to be the best. We don’t want to be the best in our service area or the best out of five or six hospitals that we have selected as a peer group. We truly want to be the best.”
“We want to make a very compelling argument to [patients and other customers] that they want to select Mary Greeley Medical Center,” he added.
Part of that compelling argument is pride that staff members have in MGMC, which comes from its legacy.
After his service in the Union Army during the Civil War, Captain Wallace Greeley headed west, settling in Ames, IA, a village of about 100 people. He used $3,200 in Army pay to purchase 200 acres of farmland. When his wife Mary died, Greeley gifted the construction of Mary Greeley Memorial Hospital to the City of Ames.
Said Dieter, “[Captain Greeley] made the decision that Ames deserved a hospital, and he was going to make it happen . . . not just for the people who need it today but for the people well after we are gone. . . . It’s a sacred trust that we carry on for Captain Greeley, for the memory of Mary, and for the communities that we serve.”
Dieter said MGMC started small in its commitment-to-excellence journey, believing that it could get better.
“We decided to utilize the Baldrige framework and therefore make application to the state [quality award program, part of the Alliance for Performance Excellence programs]. As you might imagine, it took us quite a while to get successful . . . all the way along finding methods that we could utilize to continue to get better.”
One recognition that MGMC made early on is that, like many other hospitals, it had way too many indicators. Dieter said he would present the hospital scorecard, with its green, yellow, and red indicators, at town halls and other meetings as a way to communicate with staff members and make improvement plans. “When we finally deep-sixed that scorecard, we had 33 indicators,” he said.
Dieter said the MGMC scorecard has gotten much simpler, and the hospital has adopted a big-dot goal philosophy of just four goals: eliminate serious safety events, improve overall patient engagement, improve overall workforce engagement, and meet or exceed operating margin.
“By focusing on these, I think, the picture is much clearer,” he said. “We are much more able to talk about the work that is directly ahead of us, as well as how we are doing and where we might need to pivot to make improvements.”
Dieter added that of the four goals, “margin” is intentionally last because it’s important, but it’s not the lead measure; “if we are doing the other things right. If we are providing great, high-quality, safe patient care that patients actually appreciate and feel that they are engaged in, and our staff members have that same opportunity, the margin won’t matter.”
According to Dieter, one of the questions that he is frequently asked is, “Why Baldrige?” MGMC started the Baldrige process because “we were interested in getting better,” he said. After a decade of improvement with the help of the IA Baldrige-based program (The Iowa Quality Center) and Baldrige feedback reports, as well as Baldrige sharing events, MGMC received the national award in 2019, posting role-model outcomes. But the COVID-19 pandemic grinded everything to a halt, he said, and “We recognized that . . . we have more work to do . . . . 2019 is the year we were awarded the national Baldrige quality award. This doesn’t mean we’re done.”
“The Baldrige framework works for us,” Dieter added. “In particular, we love the fact that it’s a systematic approach. We love the fact that it regards process. We could have created our own scorecard and said we’ve moved forward on a number of indicators, but the fact that Baldrige is a rigorous, nationally recognized process. That makes it worth the effort.”
Dieter, who began his career in public accounting, described what he called “GAAP vs. crap.” GAAP stands for generally accepted accounting principles, which is the standard adopted by the U.S. Securities and Exchange Commission (SEC). He said,
We truly believe [from] a quality measurement standpoint that generally accepted principles are the Baldrige framework. To utilize [any other type of quality tool] that we would have put together would have run the risk of following the pathway to cleverly rigged accounting practices. That’s why we selected Baldrige.
Learning from other Baldrige Award recipients, as well as national and state feedback reports, has supported MGMC’s focus on consistency and commitment to excellence, Dieter said.
For example, during the COVID-19 pandemic, “our communications platform was so robust, so built out, that we had other hospitals participate in our calls. . . . If we had tried to construct [such a communication platform during the pandemic], we would not have been able to get our message out, and the message was so important and changing rapidly.”
Getting information directly, quickly, and consistently to staff members increased their confidence that MGMC would survive this pandemic, he said.
Dieter ended his presentation by highlighting the importance of sharing and learning among Baldrige Award recipients, as well as across the Baldrige community. “[Such learning] we think [is the reason we have] benefited from utilizing the Baldrige national quality approach. As I mentioned, we’re here standing on the shoulders of others [Baldrige Award recipients]. . . . We’re very serious in saying we are here to help, as well.”
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.