Health Care Performance Excellence: A Comparison of Baldrige Award Recipients and Competitors The 28 th Annual Quest for Excellence Conference Marriott Baltimore Waterfront April 3 6, 2016 Baltimore, MD USA Ron Schulingkamp, Sc.D. Loyola University New Orleans
Authors Ron Schulingkamp Sc.D. Baldrige Award Recipient Consortium (BAR) formally DM Petroleum Operations Company, a prime contractor to the U.S. Department of Energy; 2005 Baldrige Award recipient and the 2006 Robber W. Campbell International Environmental, Health & Safety Award. John R Latham Ph.D. Founder, Organization Design Studio, Ltd. www.organizationdesignstudio.com 2
Why Was the Study Conducted? Many studies on the value of implementing the Criteria for Performance Excellence Lack of comparable contexts and common performance measures Analysis of the differences in performance between Baldrige Award recipients and nonrecipients has been limited 3
The Challenge Hospitals today face pressures from a variety of stakeholders to improve performance across a comprehensive scorecard, which has become the basis for Centers for Medicare & Medicaid Services (CMS) Value-Based Purchasing (VBP) program. The VBP program goal is to transform Medicare from a passive payer of claims based on volume of care to an active purchaser of care based on the quality of services its beneficiaries receive 4
The Purpose of the Study Investigates the relationships between the effective application of the Malcolm Baldrige Health Care version of the Criteria for Performance Excellence (HCPE) and healthcare organizational performance. Compares 34 Malcolm Baldrige National Quality Award Health Care recipients (2002-2011) to 153 competitors in their geographic markets using standard Centers for Medicare & Medicaid Services (CMS) performance measures 5
The Questions HCPE Baldrige Award Recipients Process of Care Patient Experience Outcomes of Care H1 H2 H3 Traditional (non-hcpe) Competitors Process of Care Patient Experience Outcomes of Care 6
The Measures Study includes 39 measures in Table 1, three VPP program categories of performance including the: 1. Process of care (23 measures), Heart attack, heart failure, pneumonia, and surgical results 2. Patient experience using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey (10 measures), 3. Outcome of care (6 measures) 7
Table 1 Value-based Purchasing Value-Based Purchasing Federal Fiscal Year 2013 2014 2015 2016 2017 % Program contribution 1.00 1.25 1.5 1.75 2.0 Included in study 1 Process of care 0.70 0.45 0.20 0.10 0.05 2 Patient experience (HCAHPS survey) 0.30 0.30 0.30 0.25 0.25 3 Outcome 0.25 0.30 0.40 0.25 Not included in study 4 Efficiency: Medicare spending per beneficiary 0.20 0.25 0.25 5 Safety 0.20 8
Results Directly Related to Valuebased Purchasing The study results identifies Baldrige Award recipient hospitals Higher mean values for (1) Process of Care and (2) HCAHPS patient survey measures, while lower mean values for (3) Outcomes of Care representing higher performance than the non-baldrige Award recipient hospitals In 37 of the 39 (95 percent) study measures. 9
HCAHPS Hospital Experience Patient Survey 1. Nurses always communicated well. 2. Doctor always communicated well 3. Patients always received help soon as they wanted. 4. Patients pain was always well controlled. 5. Patients staff always explained about medicines. 6. Room and bathroom were always clean. 7. Room was always quiet at night. 8. Patients were given information about recovery at home. 9. Hospital rating of 9 or 10. 10. Patients would definitely recommend the hospital. 10
Significant Findings The HCAHPS patient survey measures results were the most significant findings in this study. All 10 HCAHPS hospital experience measures using the HCPE had higher means values and eight of the 10 measures had lower standard deviations than the non-hcpe hospitals. All differences were statistically significantly at α < 0.05, but after applying the Bonferroni correction of α*< 0.001, the HCAHPS hospital experience measures were significant except for Doctor always communicated well. 11
Significant Findings The final HCAHPS patient survey question, Patients would definitely recommend the hospital, was perhaps the most critical performance measure in the study and is considered a critical question relating to customer loyalty, which is an important aspect of the profitability and sustainability of any organization. 12
Conceptual Framework of the Research Results for HCPE and Non-HCPE Hospitals 13
Discussion Ron Schulingkamp Sc.D. RonSchulingkamp@gmail.com (504) 390-3888 We cannot solve the problems that we have created with the same thinking that created them. - Albert Einstein Download Paper Schulingkamp, R. C. & Latham, J. R. 2015 Healthcare Performance Excellence: A Comparison of Baldrige Award Recipients and Competitors Quality Management Journal Vol 22 Issue 3 http://johnlatham.me/wp-content/uploads/2015/07/schulingkamp_and_latham_2015.pdf 14