By Sarah Blakelock
There are many different factors that influence an organization’s success. While each of these factors is worthy of careful study and thought, the ones that I’m most driven to understand, and I think need to be prioritized in any organization, are centered around human psychology.
Because every human being seeks happiness and fulfillment. Of course, we often go about achieving these aims in a variety of ways, and with varying levels of success. However, through understanding human psychology, we can more effectively achieve our goals and help others to do the same.
Through my Industrial-Organizational Psychology program, I’ve learned that:
Of course, organizational effectiveness can be increased through multiple pathways, and aiming to understand and improve the psychology of people within an organization is only one of them. However, it’s one that is often overlooked, and I hope that through this post I have been able to spark in you some interest in this topic.
As a new intern at IQC, I am lucky to work for an organization that strives for excellence and understands the importance of getting the psychology right. I’m also grateful to have the opportunity through this internship to learn more about the psychology of organizational excellence.
By Scott Burgmeyer
Having spent my career dedicated to helping organizations achieve excellence and implement process improvement, many people ask me about the Baldrige Performance Excellence Program and want to learn more. The number one thing about Baldrige is you’re always learning. The goal is to bring Baldrige principles to life as you reflect on where you started and where you’re headed.
This is how we do our process (e.g. strategy, hiring, operations, etc.).
Here is the evidence that the process is being done as we believe it is being done.
Our processes are performing at this level (compared to your competitors or best in class).
We use the data about our process to make our process better.
Understand the criteria. Ask yourself, “What are the requirements?” Whether a request from a customer, the Baldrige criteria, a regulatory mandate, employees, your CEO or other imperative, it’s important to understand what you are aiming for.
Identify 4-6 key factors. Synthesize the criteria or information into what is most critical for you, the leadership team, the workforce, and the strategy to deliver results that are important to the customer.
Analyze the application. Examine what is actually going on vs what you think is going on. This is where you begin to see where there might be misalignment between what is intended to the reality in your strategy, operations and/or the Baldrige criteria.
Determine areas of strength and opportunity. Ideally, you should focus on the top 3-4 items that are going well AND where you can improve. The improvement opportunities are the most valuable and allow you to hold a mirror up and answer honestly – Can we do better? If we do better, will it move us forward toward excellence? This attention to being purposeful in your journey begins to separate the average from the excellent.
Write comments and actions. Based on what you found in #4, summarize the strengths and opportunities and use this in your strategy, operations, etc. to propel you forward. These are the core elements that will really create an excellent organization.
Determine the score. As you look back, if you submit a Baldrige application, you will get a score. If you don’t, you can assign points and determine a score on your own. How are you moving forward on your journey of excellence? How well are your processes performing? Are you comparing them to benchmarks?
At a high level, Baldrige is about applying the following four steps to EVERY process in your organization:
If we dive a little deeper, the following six key items detail how the Baldrige framework supports an organization’s journey to excellence. The beautiful part is, you can do this yourself or submit an application and have a group of trained examiners provide you 3rd-party feedback to support your journey.
Whether you apply formally or are working independently to build a journey of excellence, these six steps can be integrated into your organization. Baldrige is about learning, growth and the pursuit of excellence – join the journey with us.
By Roger Wolkoff
"All hands on deck" is the mantra for you and your team. Everyone is available and ready to help - front desk clerks, facilities, sales, marketing, even the hotel manager. Everyone is on hand to put chairs in place, set up end tables, stock bathrooms, and hang pictures. That's what you do when you're on the team to open a new property.
You walk into the nearly completed grand ballroom. In one corner, you see a massive stack of yellow and orange pillows for the new guest rooms. Next to the pillows are the sleek glass and steel work desks you selected for the business center. You make your way over to the corner window opening where yet another forklift of furniture and carpeting makes its way into the building.
Your role doesn't matter. Just ask Kathleen who recently helped open a property in Wisconsin. "We all pitched in. Everyone had a part in getting our hotel and restaurant ready for our guests and events." Kathleen is the Event Sales Executive, and she rolled up her sleeves like everyone else. "Opening a new property gave us the chance to make it ours," she says.
While Kathleen didn't necessarily get to drive a forklift, she and her colleagues set the tone for how they operate as a team. Think about the fun and opportunities you can have while opening a new space or refurbishing an old one. You get to make it yours. You and your team have a chance to listen to customers and deliver precisely the experiences they desire.
That's what makes teamwork exciting. Consider what you want to deliver with the outcome or endgame in mind. What do you want your customers to feel when they walk into your lobby? What's the first thing that should capture their eye when they walk into their hotel room? What aromas do you want emanating from your kitchen to entice them into your restaurant?
The phrase "teamwork makes the dream work" gets thrown around a lot these days. However, stop and consider where you would be without a team around you, especially an engaged, collaborative group of people on whom you can rely. When you find yourself stuck or needing a fresh perspective, involve the people around you. You build relationships, and you build trust.
You may be adept at figuring things out on your own; but together, you're stronger, smarter, and savvier. The excitement of working on something new gets the adrenaline flowing. It heightens your senses and awareness. That's what builds creativity and success.
You've likely seen variations on the theme of breaking out "team" into an acronym and someone getting creative about what the letters stand for. Here are my thoughts. Let me know what you think.
Trust - Trust is the foundation on which all else is built. Teams go through many stages of trust and gain it at differing speeds. Be open to forming new relationships and creating new bonds.
Energy - Be aware of the energy that you and your teammates bring to a project or activity. Are you high energy or low energy? How do others on your team feel about your goals and outcome? Take the pulse early and often.
Appreciation - We like gratitude for our ideas and efforts. We can never say or hear "thank you" enough.
Mindset - Have a positive mindset when you embark on a new opening. Put yourself in the place of the customer and think about the experiences they want.
Together you are stronger. What actions will you take on your next opening or grand re-opening to have fun and come together as a team? Who knows, if you ask nicely, they may even let you drive the forklift!
© Roger Wolkoff, Wolkoff, LLC. All rights reserved.
Learning is all around us formally and informally. The Baldrige framework defines learning as “new knowledge or skills acquired through evaluation, study, experience, and innovation.” Learning includes both individual and organizational learning. We will focus on individual learning.
As an individual, learning and brain science is clear.
We need to build capacity in ourselves and others by:
Building a philosophy of learning – one example is 10:20:70 – the amount of learning applied to a topic:
For example, if you attend a two-hour class to learn a specific skill, to really build fluency in that topic, you should spend four hours thinking about and discussing the learning and fourteen hours practicing or applying the learning.
How do you learn best to become a master of that skill?
DMAIC (pronounced duh-MAY-ick) is the five-step process of Six Sigma that stands for Define, Measure, Analyze, Improve and Control. There are many variations of the Six Sigma platform that include Six Sigma, Lean Sigma, and blends of other continuous improvement methodologies. While the traditional Six Sigma practitioners have emphasized reducing variation, some recent focus has been to improve processes and be a central foundation of an organization’s continuous improvement journey.
As you peel back the layers of DMAIC, we focus on:
IQC has multiple belt levels (Yellow, Green and Black) where individuals and teams can learn the five steps for improvement. Committing to the key elements of DMAIC is how you internalize the thinking process of improvement through the five steps.
By Jessica Clark
In Spring 2019, the organization of which I was a part was only beginning to apply the notion of performance excellence as a strategic consideration, so when I was introduced to the Baldrige examiner experience at that time, I anticipated that I was unqualified to take part in evaluation of performance excellence at any level. I’m a little embarrassed to admit to my naivete in thinking Baldrige an elitist practice or label that could never apply to organizations like mine or growing professionals like me. I certainly did not understand how it could impact my learning and professional development. I now, without reservation, admit just how wrong I was in those early assessments.
I attended a day-long class at last Spring’s iPEX where we simulated the months-long examination process over the course of one day. I was struck by the diversity of industry represented in the room that day--from manufacturing and insurance to education, health care, and government to financial services and human services. The simulation and accompanying Q&A and discussion provided context for each step in the evaluation process and a roadmap for the months ahead.
Over the next several months, I enjoyed the process and came to understand that the Baldrige framework for performance excellence is not only about organizations already on the path to organizational health or with expressed and very public commitments to performance excellence; it is also a framework for implementation of such a commitment. When stumbling over how to codify a commitment to performance excellence where it had not previously existed, going through the examiner experience and seeing the application of the Baldrige framework provided a “how to get started” toolkit when getting started seemed overwhelming.
The examination process is designed for success and for learning. At the start, I was assigned to a team for application review--that actually amounted to the opportunity to work with others committed to performance excellence in varied industries, which I found a rare and awesome experience. Our initial meeting was spent on in-depth review of the applicant’s Organizational Profile and identification of Key Themes that we used as guideposts through the examination process.
The initial months were devoted to independent review, during which we independently read and provided comments on the sections of the application that demonstrated the applicant’s implementation of each of the principles.
In early Fall, the teams reconvened for Consensus Week, during which we reviewed comments and questions and learned from one another in discussions, formulated structured comments, and planned for site visit. Learning from seasoned examiners on the team and learning from team members from other applicant organizations enhanced my experience as an examiner and a critical thinking professional.
The deep-dive during site visit was the culmination of the examiner experience. The opportunity to see in practice what we’d read and talked about for months by that point, talking with leaders and staff throughout all tiers of the organization and validating descriptions throughout the application affirmed that performance excellence really is a commitment and discipline and does not just happen.
One of my favorite, most important takeaways was the engagement with many other dedicated professionals and how those engagements verified for me the universality of the principles of Baldrige and performance excellence -- regardless of industry, the application of the principles results in better organizational health; employee engagement, attraction and retention; operational excellence; and results.
In my previous work, the Baldrige framework and my experience as an examiner provided a way to organize strategic thinking around performance excellence and to help the organization start on the Baldrige journey. As I looked to shift my career, I used the principles and tenets identified in my own Baldrige journey to clarify the qualities of an organization I aspired to move into. Experience showed me that I wanted to be part of a value-driven organization with committed leadership, as evidenced by strategic attention to customers, workforce development, operational excellence, and a drive toward results, culminating in organizational health and growth. I’ve since joined such an organization, and still my examiner experience is reminding me that Baldrige is a journey. Knowing the framework enables me to see in my current organization what is working well and why; illuminates opportunities for improvement; and reinforces how the integration of those principles is essential for success.
Now that I have familiarity with the framework and examination process and have experience in different industries and in different places on the spectrum of organizational health and commitment to performance excellence, I look forward to a new year and a new team and applicant.
2020 has been a year of change and disruption we haven’t likely seen in our lifetime. This anxiety, stress, and forced innovation comes with learning. Looking back at 2020, the key learnings we have walked away with so far include:
Innovation and Change: Through the great disruption, we have been forced to change and work in ways we haven’t before. The question is, how do we support our organizations and employees to continue to be ready for change AND manage the anxiety that comes with it? The research supports the premise that the more change ready an organization is, the more sustainable and successful it will be.
We are bigger than just ourselves: Many events remind us of the unfairness and need for change and respect. The learning is that each of us can make a difference. Respect each other, look for opportunities to learn about organizations, people, and cultures that are different, and apply that learning to grow.
Time to Focus: We all have had more time working by ourselves, assessing how we work, and completing projects that were on the back burner. This attention raises a question: how do we remain this focused on execution while still maintaining relationships?
Your learnings may be different. My challenge to you is to take the time to reflect, gather what you have learned--the good, the bad and the ugly--and determine how you can move forward on the journey. This reflection is what makes the journey worth it.
By Angie Bowen
Being a Baldrige Examiner for the Iowa Recognition for Performance Excellence was a lot of hard work, but extremely rewarding. It has often been mentioned that being an Examiner is like getting an MBA in four months due to the range and amount of knowledge being processed. I know my brain was mush after I completed my independent review of the application. I can only imagine the mindset of those applicants who have implemented all the processes to achieve performance excellence, crafted and polished their application, and sent it off for review.
While going through the 55-page application (and not one page more) and comparing it to the Baldrige criteria during Independent Review, I not only gained a much better appreciation of quality, but also what it takes to achieve performance excellence. The application I reviewed was in a field with which I was not familiar, something I could not say by the time I was done with the Independent Review. For each item, I had to note 4-6 of the most relevant strengths or opportunities for improvement (OFI), (including at least one strength and one OFI). Sometimes it was necessary to drill down into the item notes to find something in the criteria to reference, then write the feedback-ready comment noting the nugget (criteria), then an example of the nugget in the application, and why the example was relevant. Only then could I move on to the next item. Repeat this over 70 times, writing over 280 feedback-ready comments in under four weeks, and one has Independent Review down pat. By the end of Independent Review, I felt I knew the applicant well and had a good feel for who they were as an organization.
After each member on my team independently reviewed the application and wrote their comments, we came together for Consensus Week. During Consensus, the members of each team gathered to compare what everyone noted during Independent Review, came into agreement on how we viewed each item as a team, then either prepared for the on-site visit or generated the final report of the review of the application.
It was interesting to see not only what each of us wrote up during Independent Review, but also where we agreed and disagreed. At this point (where the week gets its name from), we were tasked to come to consensus on each of the items. This meant going through all the feedback-ready comments we individually wrote, deciding which ones best captured what we felt as a team about the application, then either tweaking or rewriting comments noting strengths and OFIs. It was interesting to see where someone captured a key factor that others didn’t necessarily see during Independent Review, only to have it become a key point. This also emphasized why Independent Review must remain independent, guided by our team lead. Despite hearing stories of previous years where there have been knock-down-drag-out fights over a point of view on a comment, this was not the case with our group. As our applicant was not eligible for a site visit, we spent the second half of Consensus Week crafting our final report, walking the wall of the feedback comments to be included, noting grammar, word usage and the like.
At the end of Consensus, we realized what our little group of three newbies and a team lead had accomplished. I say “little” as there are usually twice as many people on a team than what we had. This didn’t mean the application was easy, but it allowed those overseeing the iPEX program to see what could be accomplished.
Being an Examiner was an outstanding experience. I had a great team, even if we were all first-time Examiners. It allowed us to journey together the very steep learning curve of being an Examiner. We were fortunate to have help from an experienced team lead who helped guide us through the process. Independent Review of the application made me use my brain in ways it had not been used for many, many months. The process gave me not only an appreciation for all the work these applicants do when writing up the 55-page application to determine if they have met performance excellence, but also a better appreciation for quality. While I did not get my MBA diploma, I did receive a certificate of recognition of my hard work and dedication, and as a result I am looking forward to the next opportunity to become an Examiner.
Examiner Training starts in September! Details here.
By Katie Freeman, IQC
Many people assume that you can only benefit from implementing a management system if you are (or become) ISO certified. GOOD NEWS!! Any organization in any industry can benefit from implementing a management system.
A management system is a set of policies, processes, and procedures used by an organization to ensure fulfillment of the needs and expectations of the customer. This is a key part of our Audit Fundamentals course!!
Want to take the next step? If you take time to plan, implement, and sustain a management system within your organization – here are some considerations for you:
The best outcome of a well implemented management system is happy customers because their needs are always met. One of the most important key elements is the review and improvement of the processes and the overall system. Perhaps the best way to achieve this review and improvement is through auditing.
Auditing may sound daunting, but it is really quite simple, and fun! When you are auditing, you simply are comparing what you are observing to what is “supposed” to be happening and finding the gaps. Once the gaps are identified, then you can work to close the gaps and improve the process.
By Karen Kiel Rosser, Mary Greeley Medical Center
In 2008, Mary Greeley Medical Center began looking for a system of evidence-based quality principles. Every accountant knows the Generally Accepted Accounting Principles, or GAAP, as the evidence-based best practices for finance. We knew we needed something like that for Quality and Performance Excellence at Mary Greeley. It was during a presentation on the Baldrige program at an ACHE conference in 2008 that we realized we had found what we were looking for.
From the start, we decided our process to document performance improvement would be a long-term priority and not simply an annual goal. Our decade-long journey began not in a single moment, but as a culmination of several. In the over ten years that ensued, this focus on quality has resulted in Mary Greeley Medical Center becoming the first organization in Iowa to receive the prestigious Malcolm Baldrige National Quality Award. It also helped us earn Magnet Designation, the nation’s top recognition of nursing quality. We are one of only 12 hospitals in the country to have both honors.
Here are some of the lessons we’ve learned along this journey.
Early on, we made the decision not to house our Baldrige efforts in a single department, but rather to expose as many departments as possible to the framework and criteria. We enrolled staff as examiners in the Iowa Recognition for Performance Excellence (IRPE) program. Becoming examiners exposed our staff to the criteria as well as gave them firsthand experience to other organizations striving to radically improve.
Learning from other Baldrige organizations as well as using the IHI’s improvement philosophy, we developed what we call our Big Dot goals. There are four of them: reducing patient harm; improving patient experience; improving workforce engagement; and achieving a positive operating margin. These goals are on wallet-size cards on which employees can describe how they contribute to these goals. Each goal has a measurement that is tracked both organization-wide and in individual departments.
We track our progress on our Big Dot Goals on huddle boards displayed in every department across the hospital. Daily huddles are routinely held near these boards during which we stress operations issues, process improvement, and current performance. Using the vernacular of 4DX, a formula for executing on important strategic goals laid out in the book, “The 4 Disciplines of Execution,” departments create lead measures that align with the Big Dot Goals so each staff member understands how their individual work contributes to the organization’s goals.
CREATE ONGOING IMPROVEMENT AND INNOVATION MECHANISMS
Our improvement philosophy is that everyone at Mary Greeley has two roles: Do Our Work and Improve Our Work. To support this, we encourage staff to present improvement ideas through an online system. Additionally, we challenge our leaders to think of innovative ways to reduce costs or generate revenue through the 100-day workout concept.
We created a quality improvement unit which, among other things, oversees rapid improvement projects designed to literally break down our processes, develops ideas to improve them, and then executes these ideas. Each of these projects involves cross-sections of staff, which further hardwires a culture of improvement throughout the organization.
LISTEN TO YOUR CUSTOMERS … AND ACT ON WHAT YOU HEAR
We get feedback from our customers in a variety of ways, including hourly rounding, patient surveys, a patient and family advisory council, social media, letters, unsolicited phone calls, and through informal interactions with patients and families. We collect and track these comments through a customer listening system and complaint management process, which enables us to address problems in an efficient and timely manner. It also enables us to monitor trends that indicate larger opportunities for improvement.
SUSTAIN THE FOCUS
During our IRPE journey, we received Gold-level recognition in 2014 and 2017. We remain the only Iowa organization to reach this top level twice. We have continued to submit our application to the IRPE program even when we are not award-eligible because we receive valuable feedback that helps us remain focused on the process. We also continue to recruit staff to be IRPE examiners. To date we have over 80 years of combined examiner experience!
While we take pride in the honors received for our quality, the real impact of our efforts can be seen in the measurable quality of our care and the opinions of our patients and employees.
Our key measurements are in the Centers for Medicare and Medicaid Services (CMS) top decile, including 30-day readmissions, 30-day mortality, incidence of preventable blood clots, and compliance with sepsis practices, influenza vaccinations, stroke bundle, and outpatient imaging measures.
Inpatient satisfaction, as measured by HCAHPS, has been at or above top-decile performance since 2016. More than 75 percent of inpatients and outpatients would recommend Mary Greeley to others, representing top-decile or near-top-decile levels.
Close to the National Research Corporation top decile, 75 percent of employees “talk up” the organization as a great place to work. Meanwhile, physician engagement ranks in the 82nd percentile.
Our ten-year journey has had a significant impact on our patients and families and staff, and it does not end. The Baldrige framework has become the standard practice for how we do our work – and improve our work. It has allowed us to document, standardize, and improve some of the most complex and seemingly impossible-to-document processes in our healthcare system. Most importantly, it has enabled us to provide continually improving care to our patients.
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