Deck 10: The Baldrige Framework for Performance Excellence

Question 1

Refer to the example of how K N Management addressed some of the questions in the Senior Leadership category of the Baldrige Criteria in this chapter. Explain what practices address each of the specific questions:
a. How do senior leaders set your organization's vision and values?
b. How do senior leaders deploy your organization's vision and values through your leadership system, to the workforce, to key suppliers and partners, and to customers and other stakeholders, as appropriate?
c. How do senior leaders' actions reflect a commitment to the organization's values?

Answer 1

"Senior leaders in setting up of organization's vision and values"
In K N management, senior leaders establish organization's "mission, vision and values" as a result of benchmarking visit to PS service in 2002.
Vision reflects the passion for guest delight.
Mission statement defines the role of each member in achieving vision.
And the core values were set by senior leaders with input from the feeling of team members about organization's culture.
Senior leaders deploy organization's vision and values:
Senior leaders arrange organization's vision and values through foundations, sessions and reinforcing through training, shift meeting communication and performance appraisals. It communicates key elements of culture to team members.
"Actions of senior leaders' reflect as an obligation to firm's values"
Senior leaders' actions exhibit obligation to support core values of organization through personal action. They top grade the selection process and act as role model for team members. They give out excellent benefit package.

Question 2

What is the role of national culture in adapting the Baldrige framework to a particular country?

Answer 2

Role of national culture in adapting Baldrige framework to a particular country:
Many countries substantially adopt Baldrige criteria. They use the components of Baldrige criteria but customize them according to their own business environment. These differences can be understood much better when investigation about international cultural differences are done.
Receptiveness to change differs largely among cultures; suggesting the need for countries to adapt their quality award programs to local conditions to ensure implementing them effectively.
Baldrige framework is a better fit to national culture of country J than to country U.S. This is due to a few reasons that favor country J. This stands as a better lesson for managing the global environment.

Question 3

Does your state have a quality award program? If so, obtain some current information about the program and report on it. If not, try to find a neighboring state with an award program and report on it.

Answer 3

not answer

Question 4

What are the similarities and differences among Six Sigma, ISO 9000, and the Baldrige approaches?

Question 5

List the Baldrige Core Values and Concepts. Why do you think they are important for any organization to pursue?

Question 6

Why can Baldrige, ISO 9000, and Six Sigma be used together in an organization?

Question 7

Note: This Quality in Practice feature provides some good insights into the nature of feedback that Baldrige examiners provide as part of the formal Award assessment process. Normally , such feedback is not publicly disseminated; however , the feedback was provided by Mr. David Branch to one of the authors for a research study cited in the endnote.
Located in Fort Worth, Texas, Branch-Smith Printing Division (BSPD)-one of two divisions of Branch-Smith, Inc.-is a fourth-generation, family-owned business founded in 1910 by Aaron Smith. Employing under 100 full-time employees, Branch-Smith Printing specializes in providing a wide range of turnkey services to its customers-including designing, printing, binding and mailing-related to sheet-fed printing of multipage bound materials. Products include publications, magazines, catalogues, directories and books.
BSPD?s Baldrige journey began in 1992 as David Branch, President and CEO, recognized the need to move the business forward from a typical small company paternalistic culture that was characterized by activities rather than processes, and reacting to problems, to a more ?professionalized? business built around documented procedures, repeatable operations, regular evaluation and improvement, and a fully integrated management system. Part of this motivation was to capitalize on the manufacturing industry focus on quality that was prevalent during the early 1990s. BSPD became involved with a consortium of businesses that were organized by Marlow Industries (a previous Baldrige recipient) and a consultant, Warren Hogan. They developed a two-year training curriculum on performance excellence topics, such as customer satisfaction, strategic planning, measurement-essentially the key elements of the Baldrige Criteria.
In 1994, BSPD developed a quality plan and began an internal Baldrige assessment process. The most significant opportunity for improvement they recognized was to improve in the process management area. As a result BSPD embarked on achieving ISO 9000 certification. In January of 1996, they became the first American independent printing company to be certified. Around the same time, Quality Texas, the state equivalent of the Baldrige program, was gaining momentum. Like many state programs, Quality Texas created multiple award levels that are designed to assess the degree to which an organization has developed and deployed sound, balanced approaches resulting in improved performance levels and trends. These differ by the size of the application required, whether a site visit is made to the organization, and whether scoring is performed by the examiners. In all cases, however, a feedback report is provided to the applicant. BSPD applied for a Level 2 award in 1995; the next year, David Branch became an examiner. Using the Quality Texas feedback as well as the experience of participating in site visits, David gained considerable insight into how to apply the Baldrige Criteria to his company. Among these insights were the importance of aligned goals and a solid quality information database with cascaded metrics from the top down to work groups. The database became the foundation on which strategic planning, leadership accountability, and management review activities drove the business. This led to the beginnings of an integrated performance excellence model called Innovating Excellence™ that was fully deployed in 2001.
BSPD applied again for developmental feedback from the Texas Quality Award program in 1998. BSPD then applied for the top-level award in 1999 and received the Texas Quality Award (now called the Texas Award for Performance Excellence). The feedback at that time noted that
[The scoring] range is indicative of organizations that have effective approaches and good results in most categories , but deployment in some key areas is still too new to demonstrate results. Further deployment measures and results are needed to demonstrate integration , continuity, and maturity.
Thus, while further refinements were identified at the state level, BSPD's overall approaches merited a high level of recognition of achievement.
Over the next three years, BSPD applied for the Baldrige Award. In 2000, the company did not receive a site visit. Although the examiners recognized that the company had some key strengths and outstanding practices, for example:
Branch-Smith Printing Division uses a fact-based systematic planning process throughout the organization, from setting its overall organization direction to details such as determining its recognition and reward system. Branch-Smith Printing Division collects inputs, either directly or indirectly, from customers, employees, suppliers, peer groups within the industry, professional organizations, and benchmark organizations outside of the industry. Senior leaders use that information to set short-range and longer-range objectives that align with each of its four major goals. Employee teams create action plans to meet those goals and objectives. Branch-Smith Printing Division has an extensive system for collecting performance data in its Quality Improvement Database (QID) for daily monitoring of performance, for monthly analysis and review, for creating new action plans to address processes falling short of performance goals, and for annual strategic planning. This systematic approach is a key factor in the division's success in meeting the requirements of its customers.
They also pointed to some weaknesses (opportunities for improvement), such as:
Branch-Smith Printing Division does not provide results information about several areas that seem important to its success. These areas include market share, the level of errors and the level of errors that reach customers, the effectiveness of its education and training programs, customer loyalty and referral, results measuring responsibility to the public other than VOC emissions, the effectiveness of its work system , the impact of supplier performance on Branch-Smith Printing Division's performance, and indicators that it is reaching its goal of continuously improving its quality systems. It also does not segment results by product , service , or employee groups.
and
Development of Branch-Smith Printing Division's design and delivery processes appears to focus on the availability of new technology to a greater degree than on changes in the marketplace. Branch-Smith Printing Division does not supply evidence that it keeps abreast of changes in the marketplace with the same thoroughness that it keeps abreast of technological changes in the industry.
The examiner?s feedback noted that
Branch-Smith Printing Division scored in band 3 ( 351 - 450 ) in the consensus review of written applications for the Malcolm Baldrige National Quality Award. Branch-Smith Printing Division demonstrates a systematic approach that is responsive to the basic purposes of most Items, but deployment in some key Areas to Address is still too early to demonstrate results. Early improvement trends in areas of importance to key organizational requirements are evident.
A significant reason why BSPD's results were lagging its approaches can be explained from a strategic perspective. As Mr. Branch explained, "we were using the Criteria to improve how we run the business, but we also had to make fundamental changes regarding what businesses we were in." In the late 1990s, BSPD recognized the need to change to digital printing technology in order to survive in the evolutionary and highly competitive printing industry. The high capital cost of this technology necessitated a new growth model to justify the investment. This led to changes in the products and services offered: an increased sales force; a new emphasis on customer service; and a better information system to manage complexity. As a result, it took several years before improved results-especially in the financial and customer areas-began to occur. During this transition, BSPD continued to use the Baldrige Criteria as a basis for refining its management systems.
In 2001, the company received a site visit but was not selected as an award recipient. The 2001 feedback stated:
Branch-Smith Printing Division scored in band 5 ( 551 - 650 ) in the consensus review of written applications for the Malcolm Baldrige National Quality Award. Although no rescoring is done at the site visit , the site visit findings would have resulted in a scoring increase in Category 6 and no change in Categories 1 , 2 , 3 , 4 , 5 and 7. An organization with this scoring profile typically demonstrates an effective, systematic approach responsive to many of the Areas to Address and to key organizational needs, with a fact-based evaluation and improvement process in place in key Areas. There are no major gaps in deployment, and a commitment exists to organizational learning and sharing. Improvement trends and/or good performance are reported for most areas of importance. Results address most key customer/stakeholder and process requirements and demonstrate areas of strength.
Finally in 2002, BSPD received another site visit and was selected as a recipient of the Baldrige Award. The company made substantial progress in improving its approaches and results. For example, the weakness cited above in 2000 regarding the lack of staying abreast of changes in the marketplace was now cited as a strength:
Changes in customer requirements are incorporated into Branch-Smith Printing Division's design and production processes through the use of the PSI software, which uses estimate request forms to create job tickets. For the design phase, the Art and Electronic Prepress departments use proofing processes for this purpose as well. CSRs and sales personnel are responsible for ensuring that changes are incorporated into a customer's job ticket. The INC process is used to monitor and track the costs associated with failing to keep customer requirements up to date when such errors occur.
In summary, the feedback noted:
The Site Visit Team found the descriptor for scoring band 6 ( 650 - 750 ) to be the most accurate overall for Branch-Smith Printing Division. An organization in this band typically demonstrates refined approaches, including key measures, good deployment, and very good results in most Areas. Organizational alignment, learning, and sharing are key management tools. Some outstanding activities and results address customer/stakeholder, process, and action plan requirements. The organization is an industry leader in some Areas.
BSPD clearly made substantial progress in its journey toward performance excellence, culminating in being recognized as a national role model.
Identify what Baldrige Core Values and Concepts are reflected in the strength and opportunity for improvement comments cited in this case.

Question 8

Discuss how the Baldrige Core Values and Concepts define a high performance culture. How might they be used as a starting point for self-assessment, without actually answering the formal questions in the Baldrige Criteria?

Question 9

Do you believe that eliminating federal funding for the Baldrige Program was appropriate, given that it was originally established by an act of Congress? Critics have suggested that the loss of interest by manufacturing companies and the surge in health care applications has taken the program away from its roots. Do you agree or not?

Question 10

What is organizational sustainability? Why is it vital to business success?

Question 11

New Jersey-based health care provider AtlantiCare was one of five Baldrige award recipients for 2009. Although the organization didn't implement the Baldrige Criteria until the new millennium, its culture was rooted in quality well before that. In the 1990s, it built its operations around the concept that patients are the center of everything, and it also employed a total quality management philosophy that gave it the necessary tools to create sustainable improvements in customer service and adopted the plan-do-check-act cycle. Then, in 2000, it began implementing the Baldrige Criteria to push its performance levels to new heights.
In 2006, AtlantiCare crafted its first Baldrige application but failed to receive a site visit. The next year, however, resulted in a site visit, providing a measure of encouragement and an expectation of disappointment. ?You don't know how much work you have to do, but we knew we were not Baldrige worthy when we had our first site visit,? said AtlantiCare President and CEO David Tilton. ?We knew we could be a lot better.? Another site visit in 2008 further drove home the fact the organization was making progress, a feeling borne out by its triumph a year later.
At orientation, new employees get a crash course in AtlantiCare's improvement methods, as well as a performance excellence framework it calls the 5Bs-a program with the aim of making the organization the best in five areas: quality, customer service, people and workplace, growth and financial performance. As employees ascend the organization's ranks, the emphasis on improvement follows. At the managerial level, AtlantiCare requires attendance at an educational program outlining how to use the Baldrige framework to enhance performance and foster innovation. That gives managers the tools they need to operate within a leadership environment referred to by the organization as the tight-loose-tight process (TLT). The strategy refers to the level of autonomy and authority given to those below the top management level. By loosening the reins, AtlantiCare empowers its employees in individual business units to customize the means by which they meet high-level goals, thus creating a more agile organization.
Along with setting targets, the business units establish annual action plans and identify key measurements to help them identify when they've met their targets. Each action plan set by the business units relates to the nine strategic challenges AtlantiCare identified as keys to organizational success:
Health care delivery
• Engaging physicians in new models of collaboration and partnership.
• Creating sustainable growth outside of the primary service area.
• Identifying and prioritizing health care service opportunities for investment and recruitment.
Health engagement
• Developing new business and care models to support and grow primary care.
• Identifying and improving critical success factors for community health and wellness.
Health information
• Increasing quality of care through clinical communication and transparency.
• Using technology to improve patient safety and clinical quality.
Operational
• Recruiting, training and retaining a highly skilled workforce.
• Succeeding in an environment of decreasing reimbursement and access to capital, and a growing uninsured population.
In another effort to overcome those challenges, AtlantiCare rolls several voice of the customer activities into its planning processes. By collecting web-user data, analyzing call center trends, and conducting focus groups, the organization evaluates and improves customer access. The most visible example of the benefits of this focus is the Access Center, which AtlantiCare established in 2006 after focus group research revealed a customer base frustrated with its access to and navigation of an often-convoluted health care system. The toll-free physician and event scheduling line tracks customers' requests and needs. These efforts resulted in increased customer satisfaction, higher market share, and increased revenues. The organization is in the top 10 percent for CMS patient-care measurements related to congestive heart failure, acute myocardial infarction and pneumonia. The Home Health Division was awarded HomeCare Elite status by OCS Inc., which delivers performance improvement benchmarking measures to home health and hospice providers. The title,-based on quality outcomes, quality improvement, and financial performance,-puts AtlantiCare in the top 100 of 8,222 organizations in the United States. Results for effectiveness of treatment in behavioral health consistently surpass the Mental Health Corp. of America?s benchmark and include a 2009 result that is 16 percent above the benchmark.
The numbers back up AtlantiCare's wholehearted embrace of the Baldrige Criteria, but its belief in the program goes beyond measurables and the award that followed. Despite competing in the highly competitive health care industry, AtlantiCare established a series of Baldrige Sharing Days for any organization that wants to travel the same road to improvement. ?We believe a commitment to quality and continuous improvement is imperative in the health care field. Part of our responsibility as a recipient of the Baldrige award is to share our performance excellence strategies and practices with other organizations. We humbly look forward to serving as mentors and role models for those who wish to join us on our quality journey.?
How might the different categories of the Baldrige Criteria relate to the strategic challenges that AtlantiCare faced? Specifically, clearly explain how effective approaches to the questions in the Criteria will help address these challenges.

Question 12

Create a matrix diagram in which each row is a category of the Baldrige Award criteria and four columns correspond to a level of organizational maturity with respect to quality:
• Traditional management practices
• Growing awareness of the importance of quality
• Development of a solid quality management system
• Outstanding, world-class management practice In each cell of the matrix, list two to five characteristics that you would expect to see for a company in each of the four situations for that criteria category. How might this matrix be used as a self-assessment tool to provide directions for improvement?

Question 13

Visit the Baldrige Program website (http://www.nist.gov/baldrige) and write a report on the information that can be found there.

Question 14

Describe the Baldrige Award process. How does it ensure that organizations are truly worthy of receiving the Award?

Question 15

Summarize the purposes of the Baldrige Award.

Question 16

Examine the questions in the Baldrige Criteria and discuss which ones relate to the concept of organizational sustainability as defined in this chapter? Why is sustainability an important issue in business?

Question 17

Note: This Quality in Practice feature provides some good insights into the nature of feedback that Baldrige examiners provide as part of the formal Award assessment process. Normally , such feedback is not publicly disseminated; however , the feedback was provided by Mr. David Branch to one of the authors for a research study cited in the endnote.
Located in Fort Worth, Texas, Branch-Smith Printing Division (BSPD)-one of two divisions of Branch-Smith, Inc.-is a fourth-generation, family-owned business founded in 1910 by Aaron Smith. Employing under 100 full-time employees, Branch-Smith Printing specializes in providing a wide range of turnkey services to its customers-including designing, printing, binding and mailing-related to sheet-fed printing of multipage bound materials. Products include publications, magazines, catalogues, directories and books.
BSPD?s Baldrige journey began in 1992 as David Branch, President and CEO, recognized the need to move the business forward from a typical small company paternalistic culture that was characterized by activities rather than processes, and reacting to problems, to a more ?professionalized? business built around documented procedures, repeatable operations, regular evaluation and improvement, and a fully integrated management system. Part of this motivation was to capitalize on the manufacturing industry focus on quality that was prevalent during the early 1990s. BSPD became involved with a consortium of businesses that were organized by Marlow Industries (a previous Baldrige recipient) and a consultant, Warren Hogan. They developed a two-year training curriculum on performance excellence topics, such as customer satisfaction, strategic planning, measurement-essentially the key elements of the Baldrige Criteria.
In 1994, BSPD developed a quality plan and began an internal Baldrige assessment process. The most significant opportunity for improvement they recognized was to improve in the process management area. As a result BSPD embarked on achieving ISO 9000 certification. In January of 1996, they became the first American independent printing company to be certified. Around the same time, Quality Texas, the state equivalent of the Baldrige program, was gaining momentum. Like many state programs, Quality Texas created multiple award levels that are designed to assess the degree to which an organization has developed and deployed sound, balanced approaches resulting in improved performance levels and trends. These differ by the size of the application required, whether a site visit is made to the organization, and whether scoring is performed by the examiners. In all cases, however, a feedback report is provided to the applicant. BSPD applied for a Level 2 award in 1995; the next year, David Branch became an examiner. Using the Quality Texas feedback as well as the experience of participating in site visits, David gained considerable insight into how to apply the Baldrige Criteria to his company. Among these insights were the importance of aligned goals and a solid quality information database with cascaded metrics from the top down to work groups. The database became the foundation on which strategic planning, leadership accountability, and management review activities drove the business. This led to the beginnings of an integrated performance excellence model called Innovating Excellence™ that was fully deployed in 2001.
BSPD applied again for developmental feedback from the Texas Quality Award program in 1998. BSPD then applied for the top-level award in 1999 and received the Texas Quality Award (now called the Texas Award for Performance Excellence). The feedback at that time noted that
[The scoring] range is indicative of organizations that have effective approaches and good results in most categories , but deployment in some key areas is still too new to demonstrate results. Further deployment measures and results are needed to demonstrate integration , continuity, and maturity.
Thus, while further refinements were identified at the state level, BSPD's overall approaches merited a high level of recognition of achievement.
Over the next three years, BSPD applied for the Baldrige Award. In 2000, the company did not receive a site visit. Although the examiners recognized that the company had some key strengths and outstanding practices, for example:
Branch-Smith Printing Division uses a fact-based systematic planning process throughout the organization, from setting its overall organization direction to details such as determining its recognition and reward system. Branch-Smith Printing Division collects inputs, either directly or indirectly, from customers, employees, suppliers, peer groups within the industry, professional organizations, and benchmark organizations outside of the industry. Senior leaders use that information to set short-range and longer-range objectives that align with each of its four major goals. Employee teams create action plans to meet those goals and objectives. Branch-Smith Printing Division has an extensive system for collecting performance data in its Quality Improvement Database (QID) for daily monitoring of performance, for monthly analysis and review, for creating new action plans to address processes falling short of performance goals, and for annual strategic planning. This systematic approach is a key factor in the division's success in meeting the requirements of its customers.
They also pointed to some weaknesses (opportunities for improvement), such as:
Branch-Smith Printing Division does not provide results information about several areas that seem important to its success. These areas include market share, the level of errors and the level of errors that reach customers, the effectiveness of its education and training programs, customer loyalty and referral, results measuring responsibility to the public other than VOC emissions, the effectiveness of its work system , the impact of supplier performance on Branch-Smith Printing Division's performance, and indicators that it is reaching its goal of continuously improving its quality systems. It also does not segment results by product , service , or employee groups.
and
Development of Branch-Smith Printing Division's design and delivery processes appears to focus on the availability of new technology to a greater degree than on changes in the marketplace. Branch-Smith Printing Division does not supply evidence that it keeps abreast of changes in the marketplace with the same thoroughness that it keeps abreast of technological changes in the industry.
The examiner?s feedback noted that
Branch-Smith Printing Division scored in band 3 ( 351 - 450 ) in the consensus review of written applications for the Malcolm Baldrige National Quality Award. Branch-Smith Printing Division demonstrates a systematic approach that is responsive to the basic purposes of most Items, but deployment in some key Areas to Address is still too early to demonstrate results. Early improvement trends in areas of importance to key organizational requirements are evident.
A significant reason why BSPD's results were lagging its approaches can be explained from a strategic perspective. As Mr. Branch explained, "we were using the Criteria to improve how we run the business, but we also had to make fundamental changes regarding what businesses we were in." In the late 1990s, BSPD recognized the need to change to digital printing technology in order to survive in the evolutionary and highly competitive printing industry. The high capital cost of this technology necessitated a new growth model to justify the investment. This led to changes in the products and services offered: an increased sales force; a new emphasis on customer service; and a better information system to manage complexity. As a result, it took several years before improved results-especially in the financial and customer areas-began to occur. During this transition, BSPD continued to use the Baldrige Criteria as a basis for refining its management systems.
In 2001, the company received a site visit but was not selected as an award recipient. The 2001 feedback stated:
Branch-Smith Printing Division scored in band 5 ( 551 - 650 ) in the consensus review of written applications for the Malcolm Baldrige National Quality Award. Although no rescoring is done at the site visit , the site visit findings would have resulted in a scoring increase in Category 6 and no change in Categories 1 , 2 , 3 , 4 , 5 and 7. An organization with this scoring profile typically demonstrates an effective, systematic approach responsive to many of the Areas to Address and to key organizational needs, with a fact-based evaluation and improvement process in place in key Areas. There are no major gaps in deployment, and a commitment exists to organizational learning and sharing. Improvement trends and/or good performance are reported for most areas of importance. Results address most key customer/stakeholder and process requirements and demonstrate areas of strength.
Finally in 2002, BSPD received another site visit and was selected as a recipient of the Baldrige Award. The company made substantial progress in improving its approaches and results. For example, the weakness cited above in 2000 regarding the lack of staying abreast of changes in the marketplace was now cited as a strength:
Changes in customer requirements are incorporated into Branch-Smith Printing Division's design and production processes through the use of the PSI software, which uses estimate request forms to create job tickets. For the design phase, the Art and Electronic Prepress departments use proofing processes for this purpose as well. CSRs and sales personnel are responsible for ensuring that changes are incorporated into a customer's job ticket. The INC process is used to monitor and track the costs associated with failing to keep customer requirements up to date when such errors occur.
In summary, the feedback noted:
The Site Visit Team found the descriptor for scoring band 6 ( 650 - 750 ) to be the most accurate overall for Branch-Smith Printing Division. An organization in this band typically demonstrates refined approaches, including key measures, good deployment, and very good results in most Areas. Organizational alignment, learning, and sharing are key management tools. Some outstanding activities and results address customer/stakeholder, process, and action plan requirements. The organization is an industry leader in some Areas.
BSPD clearly made substantial progress in its journey toward performance excellence, culminating in being recognized as a national role model.
What value can you see in David Branch, the CEO, becoming an award examiner?

Question 18

Explain the concepts of approach, deployment, learning, and integration in Baldrige assessment.

Question 19

Study the questions asked in the Baldrige Criteria. Select what you believe are the "top 10" most difficult questions for an organization to answer and justify your reasoning.

Question 20

Discuss the implications of the Baldrige Criteria for e-commerce. What are the specific challenges that e-commerce companies face within each category of the criteria?

Question 21

New Jersey-based health care provider AtlantiCare was one of five Baldrige award recipients for 2009. Although the organization didn't implement the Baldrige Criteria until the new millennium, its culture was rooted in quality well before that. In the 1990s, it built its operations around the concept that patients are the center of everything, and it also employed a total quality management philosophy that gave it the necessary tools to create sustainable improvements in customer service and adopted the plan-do-check-act cycle. Then, in 2000, it began implementing the Baldrige Criteria to push its performance levels to new heights.
In 2006, AtlantiCare crafted its first Baldrige application but failed to receive a site visit. The next year, however, resulted in a site visit, providing a measure of encouragement and an expectation of disappointment. ?You don't know how much work you have to do, but we knew we were not Baldrige worthy when we had our first site visit,? said AtlantiCare President and CEO David Tilton. ?We knew we could be a lot better.? Another site visit in 2008 further drove home the fact the organization was making progress, a feeling borne out by its triumph a year later.
At orientation, new employees get a crash course in AtlantiCare's improvement methods, as well as a performance excellence framework it calls the 5Bs-a program with the aim of making the organization the best in five areas: quality, customer service, people and workplace, growth and financial performance. As employees ascend the organization's ranks, the emphasis on improvement follows. At the managerial level, AtlantiCare requires attendance at an educational program outlining how to use the Baldrige framework to enhance performance and foster innovation. That gives managers the tools they need to operate within a leadership environment referred to by the organization as the tight-loose-tight process (TLT). The strategy refers to the level of autonomy and authority given to those below the top management level. By loosening the reins, AtlantiCare empowers its employees in individual business units to customize the means by which they meet high-level goals, thus creating a more agile organization.
Along with setting targets, the business units establish annual action plans and identify key measurements to help them identify when they've met their targets. Each action plan set by the business units relates to the nine strategic challenges AtlantiCare identified as keys to organizational success:
Health care delivery
• Engaging physicians in new models of collaboration and partnership.
• Creating sustainable growth outside of the primary service area.
• Identifying and prioritizing health care service opportunities for investment and recruitment.
Health engagement
• Developing new business and care models to support and grow primary care.
• Identifying and improving critical success factors for community health and wellness.
Health information
• Increasing quality of care through clinical communication and transparency.
• Using technology to improve patient safety and clinical quality.
Operational
• Recruiting, training and retaining a highly skilled workforce.
• Succeeding in an environment of decreasing reimbursement and access to capital, and a growing uninsured population.
In another effort to overcome those challenges, AtlantiCare rolls several voice of the customer activities into its planning processes. By collecting web-user data, analyzing call center trends, and conducting focus groups, the organization evaluates and improves customer access. The most visible example of the benefits of this focus is the Access Center, which AtlantiCare established in 2006 after focus group research revealed a customer base frustrated with its access to and navigation of an often-convoluted health care system. The toll-free physician and event scheduling line tracks customers' requests and needs. These efforts resulted in increased customer satisfaction, higher market share, and increased revenues. The organization is in the top 10 percent for CMS patient-care measurements related to congestive heart failure, acute myocardial infarction and pneumonia. The Home Health Division was awarded HomeCare Elite status by OCS Inc., which delivers performance improvement benchmarking measures to home health and hospice providers. The title,-based on quality outcomes, quality improvement, and financial performance,-puts AtlantiCare in the top 100 of 8,222 organizations in the United States. Results for effectiveness of treatment in behavioral health consistently surpass the Mental Health Corp. of America?s benchmark and include a 2009 result that is 16 percent above the benchmark.
The numbers back up AtlantiCare's wholehearted embrace of the Baldrige Criteria, but its belief in the program goes beyond measurables and the award that followed. Despite competing in the highly competitive health care industry, AtlantiCare established a series of Baldrige Sharing Days for any organization that wants to travel the same road to improvement. ?We believe a commitment to quality and continuous improvement is imperative in the health care field. Part of our responsibility as a recipient of the Baldrige award is to share our performance excellence strategies and practices with other organizations. We humbly look forward to serving as mentors and role models for those who wish to join us on our quality journey.?
What lessons can other organizations learn from AtlantiCare?s experience?

Question 22

What are the characteristics that distinguish Baldrige Award recipients from other organizations?

Question 23

Find the application summary for a recent Baldrige recipient on the Baldrige website, and identify at least three "role-model" practices among the first six categories. Justify why you consider them "role-model" practices.

Question 24

As we noted in the chapter, process items in the Baldrige Criteria are assessed on four dimensions: approach, deployment, learning, and integration. The following are opportunities for improvement that an examiner team identified in the Leadership Category for a Baldrige applicant. Discuss which of the four dimensions are implied in these comments (some may address more than one dimension).
a. The applicant presents limited evidence of systematic evaluation and refinement of several key leadership approaches that may support operational excellence and enhance sustainability. These include approaches for innovation, performance leadership, creation of a workforce culture that delivers a consistently positive customer experience, and enhancement of leadership skills. Other examples are the Leadership Development Series, legal and ethical approaches, methods used to create a focus on action, and Legendary Service standards.
b. A systematic process is not evident to create and balance value for the applicant's customers and stakeholders (regulators, shareholders, and the community). For example, the applicant does not describe the activities, people, and steps involved in the Leadership System and in aligning associates to customers through the Performance Management and Development Process.
c. Several key leadership approaches do not appear to be fully deployed. For example, it is unclear how the Mission/Vision/Values (MVV) are deployed to key suppliers and partners; how development opportunities are deployed to all workforce members; and whether the MVV, service standard training, and legal and ethical requirements are deployed to support center employees (nearly 20 percent of the workforce).
d. It is not evident that the applicant deploys its approaches to ethical behavior to interactions with customers, partners, suppliers, and other stakeholders. For example, the applicant describes only one approach focused on nonworkforce stakeholders, and no enabling/monitoring processes appear to include them. This gap may be significant in light of the applicant's numerous supplier and partner relationships.

Question 25

Describe the key issues addressed in each of the seven categories of the Criteria for Performance Excellence.

Question 26

Describe some approaches that organizations use to conduct Baldrige self-assessments.

Question 27

We introduced the Baldrige Core Values and Concepts in this chapter. Look back at Deming's 14 Points and System of Profound Knowledge in Chapter 2, and discuss how Deming's philosophy is reflected in the Core Values and Concepts.

Question 28

What are some of the impacts that the Baldrige program has provided, both in the United States and around the world?

Question 29

Download the current Baldrige Excellence Framework document for business and nonprofit organizations from the Baldrige website (it will cost you $10).
For each numbered set of questions in Categories 1-6 of the Baldrige Criteria, determine whether each of the core values and concepts are reflected (a) strongly, (b) moderately, or (c) little to not at all. Summarize your results in a matrix (rows represent core values and columns represent the item questions).

Question 30

How does Baldrige support Deming's 14 Points?

Question 31

Explain the logic of the Baldrige Criteria framework and why each element is important in any organization.

Question 32

Explain the differences between the Baldrige framework and the EFQM framework.