Managing for Quality and Performance Excellence 10th Edition by James Evans ,William Lindsay

Exercise 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?