Healthcare Performance Excellence: A Comparison of Baldrige Award Recipients and Competitors

Abstract

Hospitals today face pressures from a variety of stakeholders to improve performance across a comprehensive scorecard, which has become the basis for value-based purchasing and reimbursement. This study investigates relationships between the effective application of the Malcolm Baldrige Health Care version of the Criteria for Performance Excellence (HCPE) and healthcare organizational performance. There have been many studies on the value of implementing the Criteria for Performance Excellence, but due to the lack of comparable contexts and common performance measures, analysis of the differences in performance between Baldrige Award recipients and nonrecipients has been limited. This study focuses on the common context of healthcare organizations in the same geographic region along with common metrics to analyze the impact of effective HCPE application. This study 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 to determine if there is a relationship between the effective use of the HCPE as an organizational excellence framework and the performance of healthcare organizations. Three categories of performance were explored including the process of care (23 measures), patient experience using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey (10 measures), and outcome of care (six measures). Process of care and patient experience data included performance from October 2009 through September 2010, and the outcomes of care measures covered performance from July 2007 through June 2010. While there was no significant difference in process of care results or outcomes between Baldrige recipients and their competitors, there was a significant difference in patient experience results. The most important finding in this study was that Baldrige recipients provided care equal to or better than competitors while at the same time providing a better patient experience. These results add to the growing evidence that the HCPE are a valid framework to align organizational design, strategy, systems, and human capital to create long-term effectiveness in an institutionalized high-performance culture.