Discussion/Assignment

User Generated

zvffybiryl85

Business Finance

JWI 533

Description

Please answer the discussion question for Week 9 & 10... I have attached the completed assignment 1 for reference.

Secondly please complete the assignment 3 for power point slides. Please let me know if you have any questions.

Unformatted Attachment Preview

Week 9 Discussion Key Performance Indicators In the Organizational Snapshot you created for Assignment 1, your identified Key Performance Indicators your organizations measures itself against. After exploring the topics we have covered in this course, and reviewing the Baldrige Excellence Framework, how do you feel about these performance metrics? Are they the right ones? Would you make any changes or additions? Explain. Week 10 Your Big Idea • • • You have been invited to speak at the upcoming National Leadership in Healthcare Innovation Conference. The committee members have asked you to give a presentation on innovative ideas that will transform your organization and explain how these ideas could be applicable in other organizations. What is the main innovation (AKA “Big Idea”) you would build your presentation around and why? What recent stories from the Wall Street Journal or other reputable publication would you use as illustrations to support the main themes of your presentation? What are the costs and benefits of your Big Idea? Organizational Snapshot Identification of the Organization Baylor Scott & White Holdings- BSW Holdings is a nonprofit organization that is situated in Texas, which was created as a merger of two healthcare systems in the county. The affiliates are the Scotts & White Healthcare (S & W) and Baylor Health Care System (BHCS). The corporation controls important aspects and reserved powers over the material affiliates of S & W and BHCS. It involves two flagship hospitals, the Scott & White Memorial Hospital and the Baylor University Medical Center in combination with other twenty hospitals that are situated in central Texas (Baylor Health Care System, n.d). The system also comprises a research institute and five foundations. It has the Baylor Scott & White Quality Alliance (BSWQA), which is a care organization that is accountable for performing the clinical operations, integrating the health network of employees, hospital, physicians that are independent and other providers that aim at delivering value-based cost-effective and high-quality care. The organization has a strategy of changing the healthcare system for the better, which it aims at achieving through creating a road map for the future. The strategy is aligned with the vision, mission, and values and of the organization. Its mission is based on its foundation as a Christian ministry of healing, where it works towards promoting the well- being of the communities, families, and individuals. Its vision is to become a trusted innovator and educator in the value- based care delivery, affordability and customer experience (Baylor Health Care System, n.d). The strategy of BSW Holding is health experience, affordability and alignment growth. Revenue and Expense The operating margin of BSW Holding for the first half of the fiscal year 2018 amounted to 383.4 million dollars, which was equivalent to 8 % of the total operating revenue. In comparison to the fiscal year 2017, during the same time, the income had increased from $ 212.5 million which was 4.7 %. The adjusted EBITDA for the first half of the fiscal year 2018 was 25.2 percent of the total operating revenue amounting to $ 730.5 million in comparison to the 10.9 % that represented $ 490.0 million for the same period in the fiscal year 2017 (Baylor Health Care System, n.d). The net operating revenue of the organization for the first half of the fiscal year 2018 increased by $324.5 million representing 7.2%, from $ 44891 in 2017 to $ 4813.6 million. The net care revenue for the patient and the expenses related to bad debts of the patients increased by $ 301.0 million representing 7.8 per cent from to $4140 million in the first half of the the fiscal year 2018 from $ 3839.4 million in the first half of the fiscal year of 2017 (Baylor Health Care System, n.d). These statistics reflect the higher volumes for the fiscal year 2018. The value of premium revenue decreased from $ 476.9 million in the first half of the fiscal year 2017 to $412.3million in the first half of the fiscal year of the fiscal year 2018, which represented -13.5 percent. The decline in the premium revenue is explained by the decision to leave the public exchange market, Individual ACA, which led to the organization losing about 42, 500 members that have subscribed to this product in the first six months of the fiscal year 2017. The combined operating expenses of BSW Holding for the first six months of the fiscal year 2018 increased by 3.6% amounting to $ 153. 7 million compared to $4276.5 million that was recorded in the first half of the fiscal year 2017 (Baylor Health Care System, n.d). Expenses on wages, salaries, and employee benefits increased to $2222.2 million which was by 4.1% amounting to $.5 million in the first half of the fiscal year 2018, from $ 21337 million for the first six months of the fiscal year 2017. The rise was estimated as 46.2 % and 47.5% of the total operating revenue for the first half of the fiscal year 2018 and 2017 respectively. Wages, salaries and employees’ benefits represented 49.9% and 50.2% of the expenditure of the organization for the first six months of 2017 and 2018 respectively. The expenditure on other operating expenses and supplies rose by 6.9% or $ 118.1 from $1700.6 in the first six months of the fiscal year 2017 to $1818.7 in the first six months of the fiscal year 2018, which represented 27.9 % and 37.8 % for the first half of the fiscal year 2017 and 2018 respectively (Baylor Health Care System, n.d). The supplies and operating expenses for the first half of the fiscal year 2017 and 2018 represented 39.8% and 41.1% of the total expenses respectively. Current Metrics to Assess Financial Performance The liquidity of BSW Holding includes unrestricted investment and cash that increased to $ 4.5 billion as at 30 June 2017 to $ 4.7 billion as at 31 December 2017 after net gains in trading and investment of $ 187.6 million and capital expenditure of $ 218.6 million. Unrestricted day cash at hand increased from 194.2 days as at 30 June 2017 to 204. 7 days as at 31 December 2017. Days cash on hand totaled 241.5 days at 31 December 2017 in comparison to 22.7 days at 30 June 2017 (Baylor Health Care System, n.d). The capitalization to debt ration reduced from 40.0 % at 30 June 2017 to 38.4% at 31 December 2017. The total assets for the organization increased from $11.1 billion at 30 June 2017 to $11.9 billion at 31 December 2017. The BSW Holding System runs five foundations that include the Irving Healthcare Foundation, Scott & White Healthcare Foundation Brenham, Baylor Health Care System Foundation, and All Saint Health Foundation. The total assets of the foundations have increased to $ 7.1 billion at 31 December 2017 from $ 6.7 billion at 30 June 2017. Financial Issues of the Greatest Concern Among the main financial issues of BSW Holding is revenue. This issue represents the amount that the organization receives from all its operations and it is among the basic points in determining the profitability, viability, and sustainability of the organization in the market. The issue is important in determining the growth patterns of the organization and gives information to the investors on the viability to invest in the company. For example, flat or declining revenues have implications of limited opportunities for the growth of the company and its possibility to dissolve. Possible Areas of Financial Performance Improvement BSW Holdings needs to improve the management of its operating expenses. The Salaries, wage, and employees benefits account 46.2% of the total operating expenses, and the expenditure has been rising, which reduces the revenue for the organization. The company can hire more independent contractors to work on a temporary basis instead of hiring long-term employees. This strategy can be effective in reducing the employee's benefit and overall expenditure on operating expenses. The company can also implement a non- monetary compensation programs to reduce the turnover on employees while maintaining their motivation to work. References Baylor Health Care System. (n.d). Quarterly Disclosure Report for the Six Months Ended December 31, 2017 (Unaudited) On ly Examiner Version Includes Criteria Commentary Us e BALDRIGE EXCELLENCE FRAMEWORK am health care in er A systems approach to improving your organization’s performance LEADERSHIP Ex STRATEGY CUSTOMERS MEASUREMENT, ANALYSIS, AND KNOWLEDGE MANAGEMENT WORKFORCE 2017 2018 OPERATIONS RESULTS #Baldrige www.nist.gov/baldrige Baldrige Performance Excellence Program National Institute of Standards and Technology (NIST) • United States Department of Commerce January 2017 To order copies of this publication or obtain other Baldrige Program products and services, contact Baldrige Performance Excellence Program Administration Building, Room A600 100 Bureau Drive, Stop 1020 Gaithersburg, MD 20899-1020 On ly Telephone: (301) 975-2036 Fax: (301) 948-3716 E-mail: baldrige@nist.gov Web: https://www.nist.gov/baldrige The Baldrige Program welcomes your comments on the Baldrige Excellence Framework and other Baldrige products and services. Please direct your comments to the address above. e The Baldrige Excellence Framework (Health Care)TM is an official publication of NIST under the authority of the Malcolm Baldrige National Quality Improvement Act of 1987 (Public Law 100-107; codified at 15 U.S.C. § 3711a). This publication is a work of the U.S. Government and is not subject to copyright protection in the United States under Section 105 of Title 17 of the United States Code. The U.S. Department of Commerce, as represented by NIST, holds copyright to the publication in all countries outside of the United States. Us BALDRIGE CRITERIA FOR PERFORMANCE EXCELLENCE® and Design, BALDRIGE PERFORMANCE EXCELLENCE PROGRAM®, CRITERIA FOR PERFORMANCE EXCELLENCE®, EDUCATION CRITERIA FOR PERFORMANCE EXCELLENCE®, HEALTH CARE CRITERIA FOR PERFORMANCE EXCELLENCE®, MALCOLM BALDRIGE NATIONAL QUALITY AWARD® and Design, PERFORMANCE EXCELLENCE®, THE QUEST FOR EXCELLENCE®, and the MALCOLM BALDRIGE NATIONAL QUALITY AWARD medal and depictions or representations thereof are federally registered trademarks and service marks of the U.S. Department of Commerce, National Institute of Standards and Technology. The unauthorized use of these trademarks and service marks is prohibited. in er NIST, an agency of the U.S. Department of Commerce, manages the Baldrige Program. NIST has a 100-plus-year track record of serving U.S. industry, science, and the public with the mission to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology in ways that enhance economic security and improve our quality of life. NIST carries out its mission in three cooperative programs, including the Baldrige Program. The other two are the NIST laboratories, conducting research that advances the nation’s technology infrastructure and is needed by U.S. industry to continually improve products and services; and the Hollings Manufacturing Extension Partnership, a nationwide network of local centers offering technical and business assistance to small manufacturers. am Suggested citation: Baldrige Performance Excellence Program. 2017. 2017–2018 Baldrige Excellence Framework (Health Care): A Systems Approach to Improving Your Organization’s Performance. Gaithersburg, MD: U.S. Department of Commerce, National Institute of Standards and Technology. https://www.nist.gov/baldrige. Ex The Baldrige Program and the Baldrige Foundation thank the American Hospital Association as the lead sponsor for the Health Care Criteria for Performance Excellence. We also thank the following organizations for supporting the publication of this booklet. Contents ii About the Baldrige Excellence Framework The Baldrige framework empowers your organization to reach its goals, improve results, and become more competitive. The framework consists of the Criteria, the core values and concepts, and the scoring guidelines. v How to Use the Baldrige Excellence Framework You can use this booklet as a reference, for self-assessment, or as the basis of an external assessment. Health Care Criteria for Performance Excellence Overview and Structure ly 1 On The Health Care Criteria include the Organizational Profile and seven interconnected categories. The categories are subdivided into items and areas to address. 3 Health Care Criteria for Performance Excellence Items and Point Values 4 Health Care Criteria for Performance Excellence Organizational Profile 7 1 Leadership 10 2 Strategy 13 3 Customers 16 4 Measurement, Analysis, and Knowledge Management 19 5 Workforce 23 6 Operations 26 7 Results in er 31 Us e 4 Scoring System Performance against Health Care Criteria items is scored on two evaluation dimensions: process and results. 34 Process Scoring Guidelines 35 Results Scoring Guidelines How to Respond to the Health Care Criteria am 37 This section explains how to respond most effectively to the Health Care Criteria item requirements. 40 Core Values and Concepts These embedded beliefs and behaviors form the foundation of the Health Care Criteria. Changes from the 2015–2016 Baldrige Excellence Framework 47 Glossary of Key Terms Ex 45 The glossary includes definitions of terms in small caps in the Health Care Criteria and scoring guidelines. 55 Index of Key Terms 58 List of Contributors On the Web Health Care Criteria Commentary (https://www.nist.gov/baldrige/baldrige-criteria-commentary-health-care) This commentary provides the “why” behind the Health Care Criteria, as well as additional examples and guidance. i About the Baldrige Excellence Framework The Baldrige Excellence Framework empowers your organization to reach its goals, improve results, and become more competitive. ly Thousands of organizations around the world use the Baldrige Excellence Framework to improve and get sustainable results. Those recognized as national role models receive the Malcolm Baldrige National Quality Award, a Presidential award. More than 100 recipients have broadly shared their best practices with others. Through that sharing, many thousands of organizations have improved their operations and results, and thus their contributions to the U.S. and global economy. On Baldrige has a simple purpose. The purpose of the Baldrige framework is simply to help your organization—no matter its size or the types of health care services it offers—answer three questions: Is your organization doing as well as it could? How do you know? What and how should your organization improve or change? Us e By challenging yourself with the questions that make up the Health Care Criteria for Performance Excellence (pages 4–30), you explore how you are accomplishing what is important to your organization. The questions (divided into six interrelated process categories and a results category) represent seven critical aspects of managing and performing as an organization: Leadership 2. Strategy 3. Customers 4. Measurement, analysis, and knowledge management 5. Workforce 6. Operations 7. Results in er 1. Baldrige promotes a systems perspective. Ex am A systems perspective means managing all the components of your organization as a unified whole to achieve ongoing success. The system’s building blocks and integrating mechanism are the core values and concepts (pages 40–44), the seven interrelated Health Care Criteria categories (pages 4–30), and the scoring guidelines (pages 34–35). I see the Baldrige process as a powerful set of mechanisms for disciplined people engaged in disciplined thought and taking disciplined action to create great organizations that produce exceptional results. —Jim Collins, author of Good to Great: Why Some Companies Make the Leap . . . and Others Don’t ii 2017–2018 Baldrige Excellence Framework (Health Care) Systems perspective • 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 • Delivering value and results On • ly A focus on core values and concepts. Baldrige is based on a set of beliefs and behaviors (see pages 40–44). These core values and concepts are the foundation for integrating key performance and operational requirements within a results-oriented framework that creates a basis for action, feedback, and ongoing success: A focus on processes. Processes are the methods your organization uses to accomplish its work. The Baldrige framework helps you assess and improve your processes along four dimensions: Approach: How do you accomplish your organization’s work? How effective are your key approaches? 2. Deployment: How consistently are your key approaches used in relevant parts of your organization? 3. Learning: How well have you evaluated and improved your key approaches? How well have improvements been shared within your organization? Has new knowledge led to innovation? 4. Integration: How well do your approaches align with your current and future organizational needs? How well do your measures, information, and improvement systems complement each other across processes and work units? How well are processes and operations harmonized across your organization to achieve key organization-wide goals? in er Us e 1. A focus on results. The Baldrige framework leads you to examine your results from three viewpoints: the external view (How do your patients, other customers, and other stakeholders view you?), the internal view (How efficient and effective are your operations?), and the future view (Is your organization learning and growing?). am In Baldrige, results include all areas of importance to your organization. This composite of measures ensures that your strategies are balanced—that they do not inappropriately trade off among important stakeholders, objectives, or shortand longer-term goals. The Baldrige framework helps you evaluate your results along four dimensions: Levels: What is your current performance on a meaningful measurement scale? 2. Trends: Are the results improving, staying the same, or getting worse? 3. Comparisons: How does your performance compare with that of other organizations and competitors, or with benchmarks or industry leaders? 4. Integration: Are you tracking results that are important to your organization and that consider the expectations and needs of your key stakeholders? Are you using the results in decision making? Ex 1. A focus on linkages. The linkages among the Health Care Criteria categories are an essential element of the systems perspective provided by the Baldrige framework. Some examples of these linkages are • the connections between your processes and the results you achieve; • the need for data in the strategic planning process and for improving operations; • the connection between workforce planning and strategic planning; • the need for patient, other customer, and market knowledge in establishing your strategy and action plans; and • the connection between your action plans and any changes needed in your work systems. About the Baldrige Excellence Framework iii A focus on improvement. The Baldrige framework helps you understand and assess how well you are accomplishing what is important to your organization: how mature and how well deployed your processes are, how good your results are, whether your organization is learning and improving, and how well your approaches address your organization’s needs. The Baldrige scoring guidelines (pages 34–35) are based on the process and results dimensions described above. As you respond to the Health Care Criteria questions and gauge your responses against the scoring guidelines, you will begin to identify strengths and gaps—first within the Health Care Criteria categories and then among them. The coordination of key processes, and feedback between your processes and your results, will lead to cycles of improvement. As you continue to use the framework, you will learn more and more about your organization and begin to define the best ways to build on your strengths, close gaps, and innovate. Baldrige is adaptable. Baldrige has national and global impact. On ly The Health Care Criteria do not prescribe how you should structure your organization or its operations. In the Organizational Profile (pages 4–6), you describe what is important to your organization (its operating environment, key relationships, competitive environment, and strategic context). The Health Care Criteria encourage you to use creative, adaptive, and flexible approaches, which will foster incremental and breakthrough improvement through innovation. The Health Care Criteria encourage you to choose the tools (e.g., Lean, Six Sigma, the International Organization for Standardization [ISO] 9000 series, a balanced scorecard, Plan-Do-Check-Act [PDCA]) that are most suitable and effective for your organization in making improvements and achieving excellence. Us e The Baldrige framework and Criteria play three roles in strengthening U.S. competitiveness: • They help improve organizational processes, capabilities, and results. • They facilitate the communication and sharing of best practices among U.S. organizations through the Baldrige Award, the Quest for Excellence® Conference, and other educational offerings. • They serve as a working tool for understanding and managing organizational performance, guiding your strategic thinking, and providing opportunities to learn. in er Baldrige works with public and private sector partners to address critical national needs related to long-term success and sustainability, including cybersecurity risk management (see https://www.nist.gov/baldrige/products-services /baldrige-cybersecurity-initiative) and excellence in U.S. communities (see Communities of Excellence 2026, http://www.communitiesofexcellence2026.org). am Within the United States, state, regional, sector, and organizational performance excellence programs use the Baldrige framework to help organizations improve their competitiveness and results. Globally, about 100 performance or business excellence programs exist; most use the Baldrige framework or a derivative as their organizational excellence model. Baldrige is here for your organization. Ex According to one health care leader, “It was the use of the Baldrige framework that boosted our ability to deliver better care to our patients. And, in the end, that is the most important thing: delivering better care to our patients—and ­having a greater and more positive impact on the lives of all of our customers” (Nancy Schlichting, CEO, Baldrige Award recipient Henry Ford Health System). Why not take advantage of that opportunity? Your patients, other customers, workforce, community, and other stakeholders—and the nation—will be better off. I honestly in my heart believe that because we participated in the Baldrige Program and because it gave us that consistent feedback, there are people who are alive today who wouldn’t have been had we not been so committed to the Baldrige process. —Rulon Stacey, former president/CEO, Baldrige Award recipient Poudre Valley Health System iv 2017–2018 Baldrige Excellence Framework (Health Care) How to Use the Baldrige Excellence Framework Whether your organization is large or small, you can use the Baldrige Excellence Framework for improvement. Your experience with Baldrige will help you decide where to begin. If your organization is in the business/nonprofit or education sector, you should use the business/nonprofit or education version of this booklet, respectively. See https://www.nist.gov/baldrige/publications/baldrige-excellence -framework to obtain a copy. ly If you are just learning about the Baldrige framework . . . Here are some ways to begin using the Baldrige framework to improve your organization. On Scan the questions in the Organizational Profile (pages 4–6). Discerning and discussing the answers to these questions with your senior leadership team might be your first Baldrige self-assessment. Study the 11 Baldrige core values and concepts (pages 40–44). Consider how your organization measures up in relation to the core values. Are there any improvements you should be making? Us e Answer the questions in the titles of the 17 Health Care Criteria for Performance Excellence items to reach a basic understanding of the Criteria and your organization’s performance. See a simple outline of a holistic performance management system by reading the headings in purple in the Health Care Criteria section of this booklet (pages 4–30). See if you are considering all of these dimensions in establishing your leadership system and measuring performance. Use the Baldrige framework and its supporting material as a general resource on organizational performance improvement. This booklet and the materials online (https://www.nist.gov/baldrige/publications/baldrige-excellence -framework) may help you think in a different way or give you a fresh frame of reference. in er Attend the Quest for Excellence® or a state or regional Baldrige conference. These events highlight the rolemodel approaches of Baldrige Award recipients. These organizations have used the Baldrige framework to improve performance, innovate, and achieve world-class results. Workshops on Baldrige self-assessment are often offered in conjunction with these conferences. Become an examiner, or attend the Baldrige Examiner Training Experience (https://www.nist.gov/baldrige /products-services/baldrige-examiner-training-experience). Examiners receive valuable training, evaluate award applications, and learn to apply the Criteria to their organizations. am Become a Baldrige Executive Fellow. Baldrige Fellows (C-suite and rising executives) participate in an executive development program (see https://www.nist.gov/baldrige/products-services/baldrige-executive-fellows-program), learning from each other and from Baldrige Award recipients. If you are ready to assess your organization using Baldrige . . . Ex To assess your organization with the Baldrige framework, follow one or more of the suggestions below. Check your progress on achieving organizational excellence and improve communication among your workforce members and leadership team with two simple questionnaires: Are We Making Progress? (https://www.nist.gov /baldrige/self-assessing/improvement-tools/are-we-making-progress) and Are We Making Progress as Leaders? (https://www.nist.gov/baldrige/self-assessing/improvement-tools/are-we-making-progress-leaders). Identify gaps in your understanding of your organization and compare your organization with others with ­easyInsight: Take a First Step toward a Baldrige Self-Assessment (https://www.nist.gov/baldrige/self-assessing /improvement-tools/easyinsight-take-first-step-toward-baldrige-self). This assessment is based on the Organizational Profile. Complete the Organizational Profile (pages 4–6). Have your leadership team answer the questions. If you identify topics for which you have conflicting, little, or no information, use these topics for action planning. For many organizations, this approach serves as a first Baldrige self-assessment. How to Use the Baldrige Excellence Framework v Answer the questions in the Baldrige Excellence Builder (https://www.nist.gov/baldrige/publications/baldrige -excellence-builder). This assessment tool includes key questions for improving your organization’s performance. They are the questions in black boldface in the Criteria section of this booklet. Use the full set of Health Care Criteria questions as a personal guide to everything that is important in leading your organization. You may discover blind spots or areas where you should place additional emphasis. Review the scoring guidelines (pages 34–35). They help you assess your organizational maturity, especially when used in conjunction with “Steps toward Mature Processes” (page 36) and “From Fighting Fires to Innovation: An ­Analogy for Learning” (page 32). ly Answer the questions in one Health Care Criteria category in which you know you need improvement, either yourself or with leadership team colleagues, referring to the item notes and Health Care Criteria Commentary (https:// www.nist.gov/baldrige/baldrige-criteria-commentary-health-care). Then assess your strengths and opportunities for improvement, and develop action plans. Be aware, though, that this kind of assessment limits the benefits of the systems perspective embodied in the Baldrige framework. On Have your leadership team assess your organization. At a retreat, have your leadership team develop responses to the Organizational Profile and the seven Health Care Criteria categories, using the Baldrige Excellence Builder (https:// www.nist.gov/baldrige/publications/baldrige-excellence-builder), and record the responses. Then assess your strengths and opportunities for improvement, and develop action plans. Us e Conduct a full Baldrige self-assessment. Set up teams within your organization to develop responses to the ­Organizational Profile and Health Care Criteria categories. For details, see https://www.nist.gov/baldrige/self-assessing and the slide presentation “Self-Assessing Your Organization with the Baldrige Excellence Framework” (https://www .nist.gov/baldrige/community/baldrige-ambassadors). Contact your state, local, or sector-specific Baldrige-based program (see the Alliance for Performance Excellence, http://www.baldrigepe.org/alliance). Many programs provide networking opportunities, training, coaching, and selfassessment services in addition to an award program. in er Contact a Baldrige Award recipient. Organizations that receive the Baldrige Award advocate for performance improvement, share their strategies, and serve as role models. Many undertake ongoing self-assessments of their organizations and can share their experiences with you. See http://patapsco.nist.gov/Award_Recipients/index.cfm for award recipients and their contact information. If you are ready for external feedback . . . Here are some resources for receiving external feedback on your organization’s strengths and opportunities for improvement. am Apply to your state, local, or sector-specific Baldrige-based award program (see the Alliance for Performance Excellence, http://www.baldrigepe.org/alliance). A team of experts will examine your organization objectively and identify your organization’s strengths and its opportunities to improve. Arrange for a Baldrige Collaborative Assessment (https://www.nist.gov/baldrige/products-services/baldrige -collaborative-assessment). In this on-site assessment, a team of Baldrige examiners works with your leaders and staff to give your organization immediate, actionable feedback. Ex Apply for the Malcolm Baldrige National Quality Award. Once you meet eligibility requirements, apply for the highest level of national recognition for performance excellence that a U.S. organization can receive: the Malcolm Baldrige National Quality Award. Award applicants say that the Baldrige evaluation process is one of the best, most cost-effective, most comprehensive performance assessments you can find, whether or not they receive the Baldrige Award. See https://www.nist.gov /baldrige/baldrige-award for more information. In the Baldrige process, everyone is a learner. vi 2017–2018 Baldrige Excellence Framework (Health Care) Health Care Criteria for Performance Excellence Overview and Structure Health Care Criteria for Performance Excellence Overview: A Systems Perspective ly The performance system consists of the six categories in the center of the figure. These categories define your processes and the results you achieve. Performance excellence requires strong Leadership and is demonstrated through outstanding Results. Those categories are highlighted in the figure. On The word “integration” at the center of the figure shows that all the elements of the system are interrelated. The center horizontal arrowheads show the critical linkage between the leadership triad (categories 1, 2, and 3) and the results triad (categories 5, 6, and 7) and the central relationship between the Leadership and Results categories. Us e The center vertical arrowheads point to the Organizational Profile and the system foundation, which provide information on and feedback to key processes and the organizational environment. The Organizational Profile sets the context for your organization. It serves as the background for all you do. The leadership triad (Leadership, Strategy, and Customers) emphasizes the importance of a leadership focus on strategy and customers. in er Organizational Profile Strategy Ex am Leadership The system foundation (Measurement, Analysis, and Knowledge Management) is critical to effective management and to a fact-based, knowledgedriven, agile system for improving performance and competitiveness. The results triad (Workforce, Operations, and Results) includes your workforce-focused processes, your key operational processes, and the performance results they yield. Workforce RESULTS Integration Customers Operations Measurement, Analysis, and Knowledge Management s Core Values and Concept The basis of the Health Care Criteria is a set of Core Values and Concepts that are embedded in high-performing organizations (see pages 40–44). Health Care Criteria for Performance Excellence Overview and Structure      All actions     lead to    Results—a composite of health care and process, customer, workforce, leadership and governance, and financial and market results. 1 Health Care Criteria for Performance Excellence Structure The seven Baldrige Health Care Criteria for Performance Excellence categories are subdivided into items and areas to address. Items Requirements There are 17 Health Care Criteria items (plus 2 in the Organizational Profile), each with a particular focus. These items are divided into three groups according to the kinds of information they ask for: Item requirements are expressed as questions or statements on three levels: • Basic requirements are expressed in the title question. ly • Overall requirements are expressed in the questions in boldface in the shaded box. These leading questions are the starting point for responding to the requirements. • The Organizational Profile asks you to define your organizational environment. On • Process items (categories 1–6) ask you to define your organization’s processes. • Multiple requirements are the individual questions under each area to address, including the question in boldface. That first question expresses the most important one in that group. • Results items (category 7) ask you to report results for your organization’s processes. See page 3 for a list of item titles and point values. Key Terms Us e Item Notes Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Item notes (1) clarify terms or requirements, (2) give instructions and examples for responding, and (3) indicate key linkages to other items. Areas to Address in er Each item includes one or more areas to address (labeled a, b, c, and so on). Key term in small caps Item number address (1) Financial PeRfoRmance What are your financial PeRfoRmance Results? What are your current levels and trends in key measures or indicators of financial performance, including aggregate measures of financial return, financial viability, and budgetary performance, as appropriate? How do these results differ by market segments and patient and other customer groups, as appropriate? (2) Marketplace PeRfoRmance What are your marketplace PeRfoRmance Results? What are your current levels and trends in key measures or indicators of marketplace performance, including market share or position, market and market share growth, and new markets entered, as appropriate? How do these results differ by market segments and patient and other customer groups, as appropriate? Ex Headings a. Financial and Market Results summarizing ­multiple requirements Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Note Item notes 2 7.5a(1). Measures should relate to the financial measures you report in 4.1a(1) and the financial management approaches you report in item 2.2. Aggregate measures of financial return might include those for return on investment (ROI), operating margins, profitability, or profitability by market segment or patient or other customer group. Measures of financial viability might include those for liquidity, debt-to-equity ratio, days cash on hand, asset utilization, cash flow, bond ratings, accountable care organization or shared savings programs, and value-based purchasing financial results, as appropriate. For nonprofit RE SU LT S Area to to provide in response to this item 7.5 Financial and Market Results: What are your results for financial viability? (90 pts.) am Item title and basic requirements Type of information Item point value Overall requirements health care organizations, measures of performance to budget might include additions to or subtractions from reserve funds, cost avoidance or savings, responses to budget decreases, lowering of costs to patients or other customers or return of funds as a result of increased efficiency, administrative expenditures as a percentage of budget, and the cost of fundraising versus funds raised. Multiple For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). Link to Health Care Criteria Commentary requirements 2017–2018 Baldrige Excellence Framework (Health Care) Health Care Criteria for Performance Excellence Items and Point Values See pages 31–36 for the scoring system used with the Health Care Criteria items in a Baldrige assessment. Organizational Profile P.1 Organizational Description P.2 Organizational Situation 3 4 Strategy 85 1.1 Senior Leadership 1.2 Governance and Societal Responsibilities 2.1 Strategy Development 2.2 Strategy Implementation 3.1 Voice of the Customer 3.2 Customer Engagement 40 45 45 Information and Knowledge Management 45 am Workforce 5.1 Workforce Environment 40 5.2 Workforce Engagement 45 Operations 6.1 Work Processes 45 6.2 Operational Effectiveness 40 Results 7.1 Health Care and Process Results 7.2 Customer Results 80 7.3 Workforce Results 80 7.4 Leadership and Governance Results 80 7.5 Financial and Market Results 90 90 85 85 450 120 TOTAL POINTS Health Care Criteria for Performance Excellence Items and Point Values 85 40 Measurement, Analysis, and Improvement of Organizational Performance Ex 7 45 Measurement, Analysis, and Knowledge Management 4.2 6 50 Customers 4.1 5 70 Us e 2 120 Leadership in er 1 Point Values On Categories and Items ly P 1,000 3 Health Care Criteria for Performance Excellence Begin with the Organizational Profile The Organizational Profile is the most appropriate starting point for self-assessment and for writing an application. It is critically important for the following reasons: • It helps you identify gaps in key information and focus on key performance requirements and results. • You can use it as an initial self-assessment. If you identify topics for which conflicting, little, or no information is available, use these topics for action planning. ly • It sets the context for and allows you to address unique aspects of your organization in your responses to the Health Care Criteria requirements in categories 1–7. On P Organizational Profile The Organizational Profile is a snapshot of your organization, the key influences on how it operates, and your competitive environment. a. Organizational Environment Us e P.1 Organizational Description: What are your key organizational characteristics? (1) Health Care Service Offerings What are your main health care service offerings (see the note on the next page)? What is the relative importance of each to your success? What mechanisms do you use to deliver your health care services? (2) Mission, Vision, and Values What are your stated mission, vision, and values? What are your organization’s core competencies, and what is their relationship to your mission? in er (3) Workforce Profile What is your workforce profile? What recent changes have you experienced in workforce composition or in your needs with regard to your workforce? What are • your workforce or employee groups and segments, • the educational requirements for different employee groups and segments, and • the key drivers that engage them in achieving your mission and vision? am What are your organized bargaining units (union representation)? What are your organization’s special health and safety requirements? (4) Assets What are your major facilities, technologies, and equipment? (5) Regulatory Requirements What is the regulatory environment under which you operate? What are the key applicable occupational health and safety regulations; accreditation, certification, or registration requirements; industry standards; and environmental, financial, and health care service delivery regulations? Ex b. Organizational Relationships (1) Organizational Structure What are your organizational leadership structure and governance system? What are the reporting relationships among your governance board, senior leaders, and parent organization, as appropriate? (2) Patients, Other Customers, and Stakeholders What are your key market segments, patient and other customer groups, and stakeholder groups, as appropriate? What are their key requirements and expectations for your health care services, patient and other customer support services, and operations? What are the differences in these requirements and expectations among market segments, patient and other customer groups, and stakeholder groups? (Continued on the next page) 4 2017–2018 Health Care Criteria for Performance Excellence (3) Suppliers and Partners they play What are your key types of suppliers, partners, and collaborators? What role do • in your work systems, especially in producing and delivering your key health care services and patient and other customer support services; and • in enhancing your competitiveness? What are your key mechanisms for two-way communication with suppliers, partners, and collaborators? What role, if any, do these organizations play in contributing and implementing innovations in your organization? What are your key supply-chain requirements? ly Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Notes On might cover greenhouse gas emissions, carbon regulations and trading, and energy efficiency. P.1b(2). Customers include the direct users and potential users of your health care services (patients), as well as referring health care providers and users who pay for your services, such as patients’ families, insurers, and other thirdparty payors. Us e P. Your responses to the Organizational Profile questions are very important. They set the context for understanding your organization and how it operates. Your responses to all other questions in the Baldrige Health Care Criteria should relate to the organizational context you describe in this profile. Your responses to the Organizational Profile questions thus allow you to tailor your responses to all other questions to your organization’s uniqueness. P.1a(1). Health care service offerings are the services you offer in the marketplace. Mechanisms for delivering services to your patients or other customers might be direct or might be indirect, through contractors, collaborators, or partners. P.1b(2). The requirements of your patient and other customer groups and your market segments might include patient safety; security, including cybersecurity; quality of care; affordability; care planning and continuity of care; provider choice; electronic communication and access to personal health information; easy transferability of health information; billing requirements; socially responsible behavior; cultural inclusion; and multilingual services. in er P.1a(2). If your organization has a stated purpose as well as a mission, you should include it in your response. Some organizations define a mission and a purpose, and some use the terms interchangeably. In some organizations, purpose refers to the fundamental reason that the organization exists. Its role is to inspire the organization and guide its setting of values. P.1b(2). Patient and other customer groups might be based on common expectations, behaviors, preferences, or profiles. Within a group, there may be customer segments based on differences, commonalities, or both. You might subdivide your market into segments based on health care service lines or features, service delivery modes, payors, volume, geography, or other defining factors. am P.1a(2). Core competencies are your organization’s areas of greatest expertise. They are those strategically important, possibly specialized capabilities that are central to fulfilling your mission or provide an advantage in your marketplace or service environment. Core competencies are frequently challenging for competitors or suppliers and partners to imitate and frequently preserve your competitive advantage. Ex P.1a(3). Workforce or employee groups and segments (including organized bargaining units) might be based on type of employment or contract-reporting relationship, location (including telework), tour of duty, work environment, use of certain family-friendly policies, or other factors. P.1a(3). Organizations that also rely on volunteers and unpaid staff to accomplish their work should include these groups as part of their workforce. P.1a(5). Industry standards might include industrywide codes of conduct and policy guidance. Depending on the regions in which you operate, environmental regulations Organizational Profile P.1b(2), P.1b(3). Patient, other customer, stakeholder, and operational requirements and expectations will drive your organization’s sensitivity to the risk of service, support, and supply-chain interruptions, including those due to natural disasters and other emergencies. P.1b(3). Communication mechanisms should use understandable language, and they might involve in-person contact; email, social media, or other electronic means; or the telephone. For many organizations, these mechanisms may change as marketplace, patient, other customer, or stakeholder requirements change. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). 5 P.2 Organizational Situation: What is your organization’s strategic situation? a. Competitive Environment (1) Competitive Position What is your competitive position? What are your relative size and growth in the health care industry or the markets you serve? How many and what types of competitors and key collaborators do you have? (2) Competitiveness Changes What key changes, if any, are affecting your competitive situation, including changes that create opportunities for innovation and collaboration, as appropriate? (3) Comparative Data What key sources of comparative and competitive data are available from within the health care industry? What key sources of comparative data are available from outside the health care industry? What limitations, if any, affect your ability to obtain or use these data? ly b. Strategic Context On What are your key strategic challenges and advantages in the areas of health care services, operations, societal responsibilities, and workforce? c. Performance Improvement System What are the key elements of your performance improvement system, including your processes for evaluation and improvement of key organizational projects and processes? Us e Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Notes approaches and their deployment. This question is intended to set an overall context for your approach to performance improvement. The approach you use should be related to your organization’s needs. Approaches that are compatible with the overarching systems approach provided by the Baldrige framework might include implementing a Lean Enterprise System, applying Six Sigma methodology, using PDCA methodology, using standards from ISO (e.g., the 9000 or 14000 series), using decision science, or employing other improvement tools. P.2c. The Baldrige Scoring System (pages 31–36) uses performance improvement through learning and integration as a dimension in assessing the maturity of organizational For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). Ex am in er P.2b. Strategic challenges and advantages might relate to technology; health care services; finances; operations (including data and information security); organizational structure and culture; your parent organization’s capabilities; patients, other customers, and markets; brand recognition and reputation; the health care industry; and people. Strategic advantages might include differentiators such as technology leadership, innovation rate, geographic proximity, accessibility, health care and administrative support services, cost, reputation for service delivery, and wait times for service. 6 2017–2018 Health Care Criteria for Performance Excellence 1 Leadership (120 pts.) The Leadership category asks how senior leaders’ personal actions guide and sustain your organization. It also asks about your organization’s governance system and how your organization fulfills its legal, ethical, and societal responsibilities. 1.1 Senior Leadership: How do your senior leaders lead the organization? (70 pts.) a. Vision and Values ly P R O C ESS (1) Setting Vision and Values How do senior leaders set your organization’s vision and values? How do senior leaders deploy the vision and values through your leadership system; to the workforce; to key suppliers and partners; and to patients, other customers, and other stakeholders, as appropriate? How do senior leaders’ personal actions reflect a commitment to those values? (2) Promoting Legal and Ethical Behavior How do senior leaders’ actions demonstrate their commitment to legal and ethical behavior? How do senior leaders promote an organizational environment that requires it? On b. Communication How do senior leaders communicate with and engage the entire workforce, patients, and other key customers? How do they • encourage frank, two-way communication, including use of social media, when appropriate; • communicate key decisions and needs for organizational change; and c. Mission and Organizational Performance (1) Creating an Environment for Success the future? How do they Us e • take a direct role in motivating the workforce toward high performance and a patient, other customer, and health care focus, including by participating in reward and recognition programs? How do senior leaders create an environment for success now and in • create an environment for the achievement of your mission and for organizational agility; in er • cultivate organizational learning, learning for people in the workforce, innovation, and intelligent risk taking; • create a workforce culture that fosters patient and other customer engagement; • participate in succession planning and the development of future organizational leaders; and • create and promote a culture of patient safety? (2) Creating a Focus on Action How do senior leaders create a focus on action that will achieve the organization’s mission? How do senior leaders am • create a focus on action that will improve the organization’s performance; • identify needed actions; • in setting expectations for organizational performance, include a focus on creating and balancing value for patients, other customers, and other stakeholders; and Ex • demonstrate personal accountability for the organization’s actions? Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Notes 1.1. In health care organizations with separate ­administrative/operational and health care provider leaders, the term “senior leaders” refers to both sets of leaders and the relationship between them. 1.1. Your organizational performance results should be reported in items 7.1–7.5. Results related to the effectiveness of leadership and the leadership system should be reported in item 7.4. 1 Leadership 1.1a(1). Your organization’s vision should set the context for the strategic objectives and action plans you describe in items 2.1 and 2.2. 1.1b. Use of social media may include delivering periodic messages through internal and external websites; tweets; blogging; and electronic forums for patients, other customers, and the workforce, as well as monitoring external social media outlets and responding, when appropriate. 7 ly 1.1c(2). Senior leaders’ focus on action considers your strategy, workforce, work systems, and assets. It includes taking intelligent risks and implementing innovations and ongoing improvements in performance and productivity. Senior leaders’ focus on action also includes the actions needed to achieve your strategic objectives (see 2.2a[1]), and may involve establishing change management plans for major organizational change or responding rapidly to significant information from social media or other input. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). Us e 1.1c(1). A successful organization understands that some risk is always present, and determines and oversees its risk appetite and risk tolerance. A successful organization is capable of addressing current business needs and, through agility and strategic management, is capable of preparing for its future business, market, and operating environment. In creating an environment for success now and in the future, leaders should consider both external and internal factors. Factors might include workforce capability and capacity, resource availability, technology, knowledge, core competencies, work systems, facilities, and equipment. Achieving future success may require leading transformational changes in the organization’s structure and culture. Success now and in the future might be affected by changes in the marketplace, in patient and other customer preferences, in the financial markets, and in the legal and regulatory environment. In the context of ongoing success, the concept of innovation and taking intelligent risks includes both technological and organizational innovation to help the organization succeed in the future. A successful organization also ensures a safe and secure environment for its workforce and other key stakeholders. A successful organization is capable of addressing risks and opportunities arising from data and information security and from environmental considerations and climate change. On 1.1b. Organizations that rely heavily on volunteers to accomplish their work should also discuss efforts to communicate with and engage the volunteer workforce. 1.2 Governance and Societal Responsibilities: How do you govern your organization and fulfill your societal responsibilities? (50 pts.) a. Organizational Governance in er • Accountability for senior leaders’ actions • Accountability for strategic plans • Fiscal accountability • Transparency in operations • Selection of governance board members and disclosure policies for them, as appropriate • Independence and effectiveness of internal and external audits am • Protection of stakeholder and stockholder interests, as appropriate • Succession planning for senior leaders Ex (2) Performance Evaluation How do you evaluate the performance of your senior leaders and your governance board? How do you use performance evaluations in determining executive compensation? How do your senior leaders and governance board use these performance evaluations to advance their development and improve both their own effectiveness as leaders and that of your board and leadership system, as appropriate? b. Legal and Ethical Behavior (1) Legal, Regulatory, and Accreditation Compliance How do you address and anticipate legal, regulatory, and community concerns with your health care services and operations? How do you • address any adverse societal impacts of your health care services and operations; • anticipate public concerns with your future health care services and operations; and • prepare for these impacts and concerns proactively, including through conservation of natural resources and effective supply-chain management processes, as appropriate? What are your key compliance processes, measures, and goals for meeting and surpassing regulatory, legal, and accreditation requirements, as appropriate? What are your key processes, measures, and goals for addressing risks associated with your health care services and operations? (Continued on the next page) 8 2017–2018 Health Care Criteria for Performance Excellence PROC ESS (1) Governance System How does your organization ensure responsible governance? How does your governance system review and achieve the following? (2) Ethical Behavior How do you promote and ensure ethical behavior in all interactions? What are your key processes and measures or indicators for enabling and monitoring ethical behavior in your governance structure; throughout your organization; and in interactions with your workforce, patients, other c ­ ustomers, partners, suppliers, and other stakeholders? How do you monitor and respond to breaches of ethical behavior? c. Societal Responsibilities (1) Societal Well-Being How do you consider societal well-being and benefit as part of your strategy and daily operations? How do you contribute to the well-being of your environmental, social, and economic systems? ly (2) Community Support How do you actively support and strengthen your key communities? What are your key communities? How do you identify them and determine areas for organizational involvement, including areas that leverage your core competencies? How do your senior leaders, in concert with your workforce, contribute to improving these communities and building community health? On Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Notes responses to them, survey results showing workforce perceptions of organizational ethics, ethics hotline use, and results of ethics reviews and audits. Measures or indicators of ethical behavior might also include evidence that policies, workforce training, and monitoring systems are in place for conflicts of interest; protection and use of sensitive data, information, and knowledge generated through synthesizing and correlating these data; and proper use of funds. Us e 1.2. Societal responsibilities in areas critical to your ongoing marketplace success should also be addressed in Strategy Development (item 2.1) and Operations (category 6). Key results should be reported as Leadership and Governance Results (item 7.4). 1.2. The health and safety of your workforce are not addressed in this item; you should address these workforce factors in items 5.1 and 6.2, respectively. 1.2c. Areas of societal contributions might include your efforts to improve the environment (e.g., collaboration to conserve the environment or natural resources); strengthen local community services, education, health, and emergency preparedness; and improve the practices of trade, business, or professional associations. in er 1.2a(1). The governance board’s review of organizational performance and progress, if appropriate, is addressed in 4.1(b). 1.2a(1). Transparency in the operations of your governance system should include your internal controls on governance processes. am 1.2a(1). In protecting stakeholder interests, the governance system should consider and sanction appropriate levels of risk for the organization, recognizing the need to accept risk as part of running a successful organization. 1.2a(2). The evaluation of leaders’ performance might be supported by peer reviews, formal performance management reviews, reviews by external advisory boards, and formal or informal feedback from and surveys of the workforce and other stakeholders. Ex 1.2b(2). Measures or indicators of ethical behavior might include the percentage of independent board members, instances of ethical conduct or compliance breaches and 1 Leadership 1.2c(2). Actions to build community health are populationbased services that support the general health of the communities in which you operate. Such services will likely draw on your core competencies and might include the identification of community health needs, health education programs, immunization programs, health screenings, wellness and prevention programs, indigent care, and programs to eliminate health disparities. You should report the results of these services in item 7.4. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). 9 2 Strategy (85 pts.) The Strategy category asks how your organization develops strategic objectives and action plans, implements them, changes them if circumstances require, and measures progress. 2.1 Strategy Development: How do you develop your strategy? (45 pts.) a. Strategy Development Process • organizational agility, including operational flexibility? ly • transformational change and prioritization of change initiatives; and On (2) Innovation How does your strategy development process stimulate and incorporate innovation? How do you identify strategic opportunities? How do you decide which strategic opportunities are intelligent risks to pursue? What are your key strategic opportunities? (3) Strategy Considerations How do you collect and analyze relevant data and develop information for your strategic planning process? In this collection and analysis, how do you include these key elements of risk? • Your strategic challenges and strategic advantages Us e • Potential changes in your regulatory and external business environment • Potential blind spots in your strategic planning process and information • Your ability to execute the strategic plan b. Strategic Objectives in er (4) Work Systems and Core Competencies How do you decide which key processes will be accomplished by your workforce and which by external suppliers and partners? How do those decisions consider your core competencies and the core competencies of potential suppliers and partners? What are your key work systems? How do you make work system decisions that facilitate the accomplishment of your strategic objectives? How do you determine what future organizational core competencies and work systems you will need? (1) Key Strategic Objectives What are your organization’s key strategic objectives and timetable for achieving them? What are your most important goals for these strategic objectives? What key changes, if any, are planned in your health care services, customers and markets, suppliers and partners, and operations? (2) Strategic Objective Considerations How do your strategic objectives achieve appropriate balance among varying and potentially competing organizational needs? How do your strategic objectives am • address your strategic challenges and leverage your core competencies, strategic advantages, and strategic opportunities; • balance short- and longer-term planning horizons; and Ex • consider and balance the needs of all key stakeholders? Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Notes 2.1. This item deals with your overall organizational strategy, which might include changes in health care service offerings and processes for patient and other customer engagement. However, you should describe the service design and patient and other customer engagement strategies, respectively, in items 6.1 and 3.2, as appropriate. might use various types of forecasts, projections, options, scenarios, knowledge (see 4.2b for relevant organizational knowledge), analyses, or other approaches to envisioning the future in order to make decisions and allocate resources. Strategy development might involve key suppliers, partners, patients, and other customers. 2.1. Strategy development refers to your organization’s approach to preparing for the future. In developing your strategy, you should consider your level of acceptable enterprise risk. To make decisions and allocate resources, you 2.1. The term “strategy” should be interpreted broadly. Strategy might be built around or lead to any or all of the ­following: new health care services; redefinition of key patient and other customer groups or market segments; 10 2017–2018 Health Care Criteria for Performance Excellence P R O C ESS (1) Strategic Planning Process How do you conduct your strategic planning? What are the key process steps? Who are the key participants? What are your short- and longer-term planning horizons? How are they addressed in the planning process? How does your strategic planning process address the potential need for 2.1a(3). Your strategic planning should address your ability to mobilize the necessary resources and knowledge to execute the strategic plan. It should also address your ability to execute contingency plans or, if circumstances require, a shift in strategy and rapid execution of new or changed strategic plans. 2.1a(4). Work systems refer to how your organization’s work is accomplished, consisting of the internal work processes and external resources you need to develop and produce health care services, deliver them to your patients and other customers, and succeed in your marketplace. Decisions about work systems are strategic. These decisions involve protecting intellectual property, capitalizing on core competencies, and mitigating risk. Decisions about your work systems affect organizational design and structure, size, locations, financial viability, and ongoing success. In a generic view of an organization, for example, the organization might define three work systems: one that addresses the clinical delivery of health care services, one that engages patients and other customers, and one that comprises systems that support service delivery and patient and other customer engagement. Us e 2.1a(2). Strategic opportunities are prospects for new or changed services, processes, business models (including strategic alliances), or markets. They arise from outside-thebox thinking, brainstorming, capitalizing on serendipity, research and innovation processes, nonlinear extrapolation of current conditions, and other approaches to imagining a different future. The generation of ideas that lead to strategic opportunities benefits from an environment that encourages nondirected, free thought. Choosing which strategic opportunities to pursue involves considering relative risk, financial and otherwise, and then making intelligent choices (“intelligent risks”). 2.1a(3). Blind spots arise from incorrect, incomplete, obsolete, or biased assumptions or conclusions that cause gaps, vulnerabilities, risks, or weaknesses in your understanding of the competitive and collaborative environment and strategic challenges your organization faces. Blind spots may arise from new or replacement offerings or business models coming from inside or outside your industry. ly 2.1a(1). Organizational agility refers to the capacity for rapid change in strategy. Operational flexibility refers to the ability to adjust your operations as opportunities or needs arise, including as a result of strategic changes. 2.1a(3). Your decisions about addressing strategic challenges, changes in your regulatory and external business environment, blind spots in your strategic planning, and gaps in your ability to execute the strategic plan may give rise to organizational risk. Analysis of these factors is the basis for managing strategic risk in your organization. On differentiation of your brand; new core competencies; entry into retail or telemedicine; new partnerships, alliances, or acquisitions to improve access, grow revenue, or reduce costs; and new staff or volunteer relationships. Strategy might be directed toward becoming a high-reliability organization, a preferred provider, a center for clinical and service excellence, a research leader, a low-cost provider, a market innovator, a provider of a high-end or customized service, an integrated service provider, or an employer of choice. It might also be directed toward meeting a community or public health care need. in er 2.1a(3). Data and information may come from a variety of internal and external sources and in a variety of forms. Data are available in increasingly greater volumes and at greater speeds. The ability to capitalize on data and information, including large datasets (“big data”), is based on the ability to analyze the data, draw conclusions, and pursue actions, including intelligent risks. Ex am 2.1a(3). Data and information might relate to patient, other customer, and market requirements, expectations, and opportunities; your culture, policies, and procedures to ensure patient safety and avoid medical errors; your policies and procedures for access to and equity of care; your core competencies; the competitive and collaborative environment and your performance now and in the future relative to competitors and comparable organizations; technological and other key innovations or changes that might affect your services and the way you operate, as well as the rate of innovation; workforce and other resource needs; your ability to capitalize on diversity; opportunities to redirect resources to higher-priority health care services or areas; financial, societal, ethical, regulatory, technological, security and cybersecurity, and other potential risks and opportunities; your ability to prevent and respond to emergencies, including natural or other disasters; changes in the local, national, or global economy; requirements for and strengths and weaknesses of your partners and supply chain; changes in your parent organization; and other factors unique to your organization. 2 Strategy 2.1b(1). Strategic objectives might address access and locations; rapid response; customization; co-location with major partners; workforce capability and capacity; specific joint ventures; rapid or market-changing innovation; societal responsibility actions or leadership; social media and web-based management of relationships with suppliers, providers, patients, and other customers; implementation of electronic health records and electronic care processes (e.g., order entry and e-prescribing); and enhancements in health care service quality. Responses should focus on your specific challenges, advantages, and opportunities—those most important to your ongoing success and to strengthening your overall performance. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). 11 2.2 Strategy Implementation: How do you implement your strategy? (40 pts.) a. Action Plan Development and Deployment (2) Action Plan Implementation How do you deploy your action plans? How do you deploy your action plans to your workforce and to key suppliers, partners, and collaborators, as appropriate, to ensure that you achieve your key strategic objectives? How do you ensure that you can sustain the key outcomes of your action plans? ly (3) Resource Allocation How do you ensure that financial and other resources are available to support the achievement of your action plans while you meet current obligations? How do you allocate these resources to support the plans? How do you manage the risks associated with the plans to ensure your financial viability? On (4) Workforce Plans What are your key workforce plans to support your short- and longer-term strategic objectives and action plans? How do the plans address potential impacts on your workforce members and any potential changes in workforce capability and capacity needs? (5) Performance Measures What key performance measures or indicators do you use to track the achievement and effectiveness of your action plans? How does your overall action plan measurement system reinforce organizational alignment? b. Action Plan Modification Us e (6) Performance Projections For these key performance measures or indicators, what are your performance projections for your short- and longer-term planning horizons? What is your projected performance on these action plan measures or indicators compared with your projections of the performance of your competitors or organizations offering similar health care services and with key benchmarks, as appropriate? If there are gaps in performance against your competitors or comparable organizations, how do you address them in your action plans? How do you establish and implement modified action plans if circumstances require a shift in plans and rapid execution of new plans? Notes in er Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). am 2.2. The development and deployment of your strategy and action plans are closely linked to other Health Care Criteria items. The following are examples of key linkages: • Item 1.1: how your senior leaders set and communicate organizational direction Ex • Category 3: how you gather patient, other customer, and market knowledge as input to your strategy and action plans and to use in deploying action plans • Category 4: how you measure and analyze data and manage knowledge to support key information needs, support strategy development, provide an effective basis for performance measurements, and track progress on achieving strategic objectives and action plans • Category 5: how you meet workforce capability and capacity needs, determine needs and design your workforce development and learning system, and implement workforce-related changes resulting from action plans 12 • Category 6: how you address changes to your work processes resulting from action plans • Item 7.1: specific accomplishments relative to your organizational strategy and action plans 2.2a(2). Action plan implementation and deployment may require modifications in organizational structures and operating modes. The success of action plans benefits from visible short-term wins as well as long-term actions. 2.2a(6). Measures and indicators of projected performance might consider new ventures; organizational acquisitions or mergers; new value creation; market entry and shifts; new legislative mandates, legal requirements, industry standards, or accreditation standards; and significant anticipated innovations in health care services and technology. 2.2b. Organizational agility requires the ability to adapt to changing circumstances, both internal and external. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). 2017–2018 Health Care Criteria for Performance Excellence PR O C ESS (1) Action Plans What are your key short- and longer-term action plans? What is their relationship to your strategic objectives? How do you develop your action plans? 3 Customers (85 pts.) The Customers category asks how your organization engages its patients and other customers for long-term marketplace success, including how your organization listens to the voice of the customer, serves and exceeds patients’ and other customers’ expectations, and builds relationships with patients and other customers. 3.1 Voice of the Customer: How do you obtain information from your patients and other customers? (40 pts.) a. Listening to Patients and Other Customers On ly P R O C ESS (1) Current Patients and Other Customers How do you listen to, interact with, and observe patients and other customers to obtain actionable information? How do your listening methods vary for different patient groups, other customer groups, or market segments? How do you use social media and web-based technologies to listen to patients and other customers, as appropriate? How do your listening methods vary across the stages of patients’ and other customers’ relationships with you? How do you seek immediate and actionable feedback from patients and other customers on the quality of health care services, patient and other customer support, and transactions? Us e (2) Potential Patients and Other Customers How do you listen to potential patients and other customers to obtain actionable information? How do you listen to former, potential, and competitors’ patients and other customers to obtain actionable information on your health care services, patient and other customer support, and transactions, as appropriate? b. Determination of Patient and Other Customer Satisfaction and Engagement (1) Satisfaction, Dissatisfaction, and Engagement How do you determine patient and other customer satisfaction, dissatisfaction, and engagement? How do your determination methods differ among your patient and other customer groups and market segments, as appropriate? How do your measurements capture actionable information to use in exceeding your patients’ and other customers’ expectations and securing your patients’ and other customers’ engagement for the long term? in er (2) Satisfaction Relative to Competitors How do you obtain information on your patients’ and other customers’ satisfaction with your organization relative to other organizations? How do you obtain information on your patients’ and other customers’ satisfaction • relative to their satisfaction with your competitors; and • relative to the satisfaction of patients and other customers of other organizations that provide similar health care services or to health care industry benchmarks, as appropriate? Notes am Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Ex 3.1. The voice of the customer refers to your process for capturing patient- and other customer-related information. Voice-of-the-customer processes are intended to be proactive and continuously innovative to capture patients’ and other customers’ stated, unstated, and anticipated requirements, expectations, and desires. The goal is customer engagement. In listening to the voice of the customer, you might gather and integrate various types of patient and other customer data, such as survey data, focus group findings, social media data and commentary, marketing information, and complaint data that affect patients’ and other customers’ purchasing and engagement decisions. 3.1a(1). Social media and web-based technologies are a growing mode of gaining insight into how patients and other customers perceive all aspects of your involvement with them. Listening through social media may include 3 Customers monitoring comments on social media outlets you moderate and on those you do not control. 3.1a(1). Your listening methods should include all stages of your involvement with patients and other customers. These stages might include relationship building, the active relationship, and a follow-up strategy, as appropriate. 3.1b. You might use any or all of the following to determine patient and other customer satisfaction and dissatisfaction: surveys, including third-party surveys or surveys endorsed or required by payors, such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS); formal and informal feedback; health care service utilization data; ­complaints; win/loss analysis; patient and other customer referral rates; and transaction completion rates. You might gather information on the web, through personal contact or a third party, or by mail. Determining patient and other 13 customer dissatisfaction should be seen as more than reviewing low satisfaction scores. Dissatisfaction should be independently determined to identify root causes and enable a systematic remedy to avoid future dissatisfaction. 3.1b(2). Dimensions of patient satisfaction might include, for example, satisfaction with provider interactions, long-term health outcomes, ancillary services, quality of care, cost, and ease of access. Information you obtain on relative patient and other customer satisfaction may include comparisons with competitors, comparisons with other organizations that deliver similar health care services in your market or a noncompetitive market, or comparisons obtained through health care industry or other organizations. Information obtained on relative satisfaction may also include information on why patients and other customers choose your competitors over you. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). ly 3.2 Customer Engagement: How do you engage patients and other customers by serving their needs and building relationships? (45 pts.) How do you determine health care service offerings? How do you • determine patient, other customer, and market needs and requirements for health care service offerings; • identify and adapt service offerings to meet the requirements and exceed the expectations of your patient and other customer groups and market segments; and Us e • identify and adapt service offerings to enter new markets, to attract new patients and other customers, and to create opportunities to expand relationships with current patients and other customers, as appropriate? (2) Patient and Other Customer Support How do you enable patients and other customers to seek information and support? How do you enable them to obtain health care services from you? What are your key means of patient and other customer support, including your key communication mechanisms? How do they vary for different patient and other customer groups or market segments? How do you • determine your patients’ and other customers’ key support requirements, and in er • deploy these requirements to all people and processes involved in patient and other customer support? (3) Patient and Other Customer Segmentation groups and market segments? How do you How do you determine your patient and other customer • use information on patients, other customers, markets, and health care service offerings to identify current and anticipate future patient and other customer groups and market segments; • consider competitors’ patients and other customers, as well as other potential patients, customers, and markets in this segmentation; and am • determine which patient and other customer groups and market segments to emphasize and pursue for business growth? b. Patient and Other Customer Relationships (1) Relationship Management How do you build and manage relationships with patients and other customers? How do you market, build, and manage relationships with patients and other customers to Ex • acquire patients and other customers and build market share; • manage and enhance your brand image; • retain patients and other customers, meet their requirements, and exceed their expectations in each stage of their relationship with you; and • increase their engagement with you? How do you leverage social media to manage and enhance your brand, and to enhance patient and other ­ ustomer engagement and relationships, as appropriate? c (2) Complaint Management How do you manage patient and other customer complaints? How do you resolve complaints promptly and effectively? How does your management of those complaints enable you to recover your patients’ and other customers’ confidence, enhance their satisfaction and engagement, and avoid similar complaints in the future? Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). 14 2017–2018 Health Care Criteria for Performance Excellence P RO C ESS (1) Service Offerings On a. Service Offerings and Patient and Other Customer Support Notes 3.2a(2). The goal of patient and other customer support is to make your organization easy to obtain health care services from and responsive to your patients’ and other customers’ expectations. ly 3.2b. Building relationships with patients and other customers might include developing partnerships or alliances with them. 3.2b(1). Brand management is generally associated with marketing to improve the perceived value of your health care services or brand. Successful brand management builds loyalty and positive associations on the part of patients and other customers, and it protects your brand and intellectual property. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). Ex am in er Us e 3.2a(1). Health care service offerings are the services that you offer in the marketplace. In identifying health care service offerings, you should consider all the important characteristics of services that patients and other customers receive in each stage of their relationship with you. The focus should be on features that affect patients’ and other customers’ preference for and loyalty to you and your brand—for example, features that affect their view of clinical and service quality and that differentiate your offerings from those of competing or other organizations. Those features might include extended hours, family support services, ease of access to and use of your services, timeliness, cost, and assistance with billing/paperwork processes and transportation. Key service features might also take into account how transactions occur and factors such as the privacy and security of patient and other customer data. Your results on performance relative to key service features should be reported in item 7.1, and those for patients’ and other customers’ perceptions and actions (outcomes) should be reported in item 7.2. On 3.2. Customer engagement refers to your patients’ and other customers’ investment in or commitment to your brand and health care service offerings. Characteristics of engaged patients and other customers include retention, brand loyalty, willingness to make an effort to obtain—and to continue to obtain—health care services from you, and willingness to actively advocate for and recommend your brand and health care service offerings. 3 Customers 15 4 Measurement, Analysis, and Knowledge Management (90 pts.) The Measurement, Analysis, and Knowledge Management category asks how your organization selects, gathers, analyzes, manages, and improves its data, information, and knowledge assets; how it uses review findings to improve its performance; and how it learns. 4.1 Measurement, Analysis, and Improvement of Organizational Performance: How do you measure, analyze, and then improve organizational performance? (45 pts.) a. Performance Measurement ly • select, collect, align, and integrate data and information to use in tracking daily operations and overall organizational performance; and On • track progress on achieving strategic objectives and action plans? What are your key organizational performance measures, including key short- and longer-term financial ­ easures? How frequently do you track these measures? m (2) Comparative Data making? How do you select comparative data and information to support fact-based decision Us e (3) Patient and Other Customer Data How do you select voice-of-the-customer and market data and information? How do you select voice-of-the-customer and market data and information (including aggregated data on complaints and, as appropriate, data and information from social media) to build a more patient-focused culture and to support fact-based decision making? (4) Measurement Agility How do you ensure that your performance measurement system can respond to rapid or unexpected organizational or external changes? b. Performance Analysis and Review in er How do you review your organization’s performance and capabilities? How do you use your key organizational performance measures, as well as comparative and customer data, in these reviews? What analyses do you perform to support these reviews and ensure that conclusions are valid? How do your organization and its senior leaders use these reviews to • assess organizational success, competitive performance, financial health, and progress on achieving your strategic objectives and action plans; and am • respond rapidly to changing organizational needs and challenges in your operating environment, including any need for transformational change in organizational structure and work systems? How does your governance board review the organization’s performance and its progress on strategic objectives and action plans, if appropriate? c. Performance Improvement Ex (1) Future Performance How do you project your organization’s future performance? How do you use findings from performance reviews (addressed in 4.1b) and key comparative and competitive data in your projections? How do you reconcile any differences between these projections and those developed for your key action plans (addressed in 2.2a[6])? (2) Continuous Improvement and Innovation How do you use findings from performance reviews (addressed in 4.1b) to develop priorities for continuous improvement and opportunities for innovation? How do you deploy these priorities and opportunities • to work group and functional-level operations; and • when appropriate, to your suppliers, partners, and collaborators to ensure organizational alignment? Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). 16 2017–2018 Health Care Criteria for Performance Excellence P R O C ESS (1) Performance Measures How do you track data and information on daily operations and overall organizational performance? How do you Notes 4.1a. Data and information from performance measurement should be used to support fact-based decisions that set and align organizational directions and resource use at the work unit, key process, department, and organization levels. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). Ex am in er Us e 4.1a(2), 4.1a(3). The comparative and customer data and information you select should be used to support operational decision making and the overall performance reviews addressed in 4.1b. Comparative data and information are obtained by benchmarking and by seeking competitive comparisons. Benchmarking is identifying processes and results that represent best practices and performance for similar activities, inside or outside the health care industry. Competitive comparisons relate your performance to that of competitors and other organizations providing similar health care services. One source of this information might be social media or the web. 4.1b. Performance analysis includes examining performance trends; organizational, health care industry, and technology projections; and comparisons, cause-effect relationships, and correlations. This analysis should support your performance reviews, help determine root causes, and help set priorities for resource use. Accordingly, such analysis draws on all types of data: health care outcome, patient- and other customer-related, financial and market, operational, and competitive/comparative. The analysis should also draw on publicly mandated measures, when appropriate. ly 4.1. Your organizational performance results should be reported in items 7.1–7.5. 4.1b. Organizational performance reviews should be informed by organizational performance measurement (4.1a) and by performance measures reported throughout your Health Care Criteria item responses, and they should be guided by the strategic objectives and action plans you identify in category 2. The reviews might also be informed by internal or external Baldrige assessments. On 4.1. The results of organizational performance analysis and review should inform the strategy development and implementation you describe in category 2. 4 Measurement, Analysis, and Knowledge Management 17 4.2 Information and Knowledge Management: How do you manage your information and your organizational knowledge assets? (45 pts.) a. Data and Information (2) Availability How do you ensure the availability of organizational data and information? How do you make needed data and information available in a user-friendly format and timely manner to your workforce, suppliers, partners, collaborators, patients, and other customers, as appropriate? How do you ensure that your information technology systems are user-friendly? (1) Knowledge Management ly b. Organizational Knowledge How do you build and manage organizational knowledge? How do you On • collect and transfer workforce knowledge; • blend and correlate data from different sources to build new knowledge; • transfer relevant knowledge from and to patients, other customers, suppliers, partners, and collaborators; and • assemble and transfer relevant knowledge for use in your innovation and strategic planning processes? (3) Organizational Learning organization operates? Us e (2) Best Practices How do you share best practices in your organization? How do you identify organizational units or operations that are high performing? How do you identify their best practices for sharing and implement them across the organization, as appropriate? How do you use your knowledge and resources to embed learning in the way your Notes in er Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). am 4.2a(2). Information technology systems include, for example, physical devices and systems (hardware); software platforms and applications; externally based information systems, such as those stored in the cloud or outside your organization’s control; and the data and information stored within them. Your response might include information related to electronic health records within your organization. For additional guidance on this item, see the Health Care Criteria Commentary (https://www.nist.gov/baldrige /baldrige-criteria-commentary-health-care). Ex 4.2b(1). Blending and correlating data from different sources may involve handling big data sets and disparate types of data and information, such as data tables, video, and text. Furthermore, organizational knowledge constructed from these data may be speculative and may reveal sensitive information about organizations or individuals that must be protected from use for any other purposes. 4.2b(3). Embedding learning in the way your organization operates means that learning (1) is a part of everyday work; (2) results in solving problems at their source; (3) is focused on building and sharing knowledge throughout your organization; and (4) is driven by opportunities to bring about significant, meaningful change and to innovate. 18 2017–2018 Health Care Criteria for Performance Excellence PR O C ESS (1) Quality How do you verify and ensure the quality of organizational data and information? How do you manage electronic and other data and information to ensure their accuracy and validity, integrity and reliability, and currency? 5 Workforce (85 pts.) The Workforce category asks how your organization assesses workforce capability and capacity needs and builds a workforce environment conducive to high performance. The category also asks how your organization engages, manages, and develops your workforce to utilize its full potential in alignment with your organization’s overall needs. 5.1 Workforce Environment: How do you build an effective and supportive workforce environment? (40 pts.) a. Workforce Capability and Capacity ly (3) Workforce Change Management capacity needs? How do you On (2) New Workforce Members How do you recruit, hire, place, and retain new workforce members? How do you ensure that your workforce represents the diverse ideas, cultures, and thinking of your hiring and patient community? How do you ensure the fit of new workforce members with your organizational culture? How do you prepare your workforce for changing capability and • manage your workforce, its needs, and your organization’s needs to ensure continuity, prevent workforce reductions, and minimize the impact of such reductions, if they become necessary; Us e • prepare for and manage any periods of workforce growth; and • prepare your workforce for changes in organizational structure and work systems, when needed? (4) Work Accomplishment How do you organize and manage your workforce? How do you organize and ­manage your workforce to • accomplish your organization’s work; • capitalize on your organization’s core competencies; • reinforce a focus on patients, other customers, and health care; and in er • exceed performance expectations? b. Workforce Climate (1) Workplace Environment How do you ensure workplace health, security, and accessibility for the ­workforce? What are your performance measures and improvement goals for your workplace environmental factors? For your different workplace environments, what significant differences are there in these factors and their performance measures or targets? Ex am (2) Workforce Benefits and Policies How do you support your workforce via services, benefits, and policies? How do you tailor these to the needs of a diverse workforce and different workforce groups and segments? What key benefits do you offer your workforce? Terms in small caps are defined in the Glossary of Key Terms (pages 47–54). Notes 5.1. Workforce refers to the people actively involved in accomplishing your organization’s work. It includes permanent, temporary, and part-time personnel, as well as any contract staff you supervise, independent practitioners (e.g., physicians, physician assistants, nurse practitioners, acupuncturists, and nutritionists not paid by your organization), and health profession students (e.g., medical, nursing, and ancillary). It includes team leaders, supervisors, and managers at all levels. People supervised by a contractor should be addressed in categories 2 and 6 as part of your larger work system strategy and your internal work processes. For organizations that also rely on volunteers, workforce includes these volunteers. 5 Workforce 5.1a. Workforce capability refers to your organization’s ability to carry out its work processes through its people’s kn...
Purchase answer to see full attachment
User generated content is uploaded by users for the purposes of learning and should be used following Studypool's honor code & terms of service.

Explanation & Answer

here we go lemm...


Anonymous
Goes above and beyond expectations!

Studypool
4.7
Trustpilot
4.5
Sitejabber
4.4

Related Tags