Posted by Dawn Bailey In 1987, when the development of a national quality award was assigned to scientists at the National Bureau of Standards (NBS), first Baldrige Program director Curt Reimann had a dilemma. How do you recruit quality experts from a broad spectrum of industries and ask them to contribute volunteer hours and expertise? And then how do you keep these volunteer experts engaged and willing to share with peers? In the late 1980s, for a technical organization like NBS, such cross-sector teamwork was new-scientists in different disciplines rarely worked across fields with other scientists. However, the cross-sector sharing was a success. Driven by patriotism and a spirit of continuous improvement and innovation, individual members of the Malcolm Baldrige National Quality Award Board of Examiners have worked together, sharing insights, expertise, and best practices from all sectors of the U.S. economy and abroad for more than 26 years. This elite group of professionals excelling at performance excellence and continuous improvement recently shared the benefits they have derived by serving as a Baldrige examiner; for example, "Best post-grad-education and professional development" Understanding of an organization at both the big-picture and detail levels Knowledge of the core values at the foundation of all high-performing organizations Skills to build consensus, balancing varied viewpoints Knowledge of when to use ELMO (Enough, Let’s Move On) Application of a systematic framework to processes that are often driven by the "seat-of-the-pants" Best practices across industries and sectors/benchmarking opportunities Evaluation of processes using approach-deployment-learning-integration "Continuous refining clarity and focus about performance" An extensive network of other examiners for mentoring and sharing Resources to create an organizational strategic plan Knowledge of ways to improve measurements and deployment This list continues and continues. Just ask a Baldrige examiner what he or she has personal gained as a professional development and what his or her organization has gained from having a Baldrige examiner among its ranks. What could you gain as a Baldrige examiner? Interested in finding out? The 2015 Baldrige Examiner Application opens on November 25, 2014. Special thanks to Rebecca Anderson and all of the Baldrige Examiners who participated in the LinkedIn discussion "The Benefits of Baldrige Program Examiner Participation." And thanks to all who have ever served as an examiner; your contributions continue to help U.S. organizations and the economy, as well as your peers, your companies, the Baldrige Program, and hopefully yourselves.

Posted by Christine Schaefer In late October, longtime Baldrige examiner Miriam Kmetzo traveled to Suzhou, China, to attend and speak at the 6th Quality Forum for Academics and Innovation. Kmetzo gave a presentation at a session that featured four quality award programs in the international arena: the Malcolm Baldrige National Quality Award, the Deming Prize, the EFQM (formerly called the European Foundation for Quality Management) Excellence Award, and the China Quality Award (CQA). The latter, according to Kmetzo, is fashioned after the Baldrige Award and administered by the China Association for Quality. I recently caught up with Kmetzo to learn about her experience at the forum. Following is the interview. 1. What information did you share, and what did you learn from others, during the session where you presented? I spoke on impacts of the Baldrige [Performance Excellence] Program and how the program has helped our nation’s award recipients improve their performance and the U.S. economy as a whole. Miriam Kmetzo, speaking at 6th Quality Forum in Suzhou, China, October 2014 I also spoke about eligibility rules for the Baldrige Award, the role of Baldrige examiners and judges, as well as the timeline and other details of the award process. [Audience members] were interested in the steps and how long the process takes. What they do [in the Chinese award program] is slightly different. All the examiners finish the Independent Review and Consensus Review phases of their award process in two weeks. They’re all housed in a hotel to do the work. For the site visit stage, they don’t use the same team of examiners. Instead, they use a team that is specifically trained to do a site visit. So that team gets the report that the Consensus Review team has prepared and takes it from there. 2. Did you learn anything that surprised you about use of the Baldrige-based excellence framework or related quality initiatives in China today? To have this type of forum with a focus on quality shows there is a lot of interest in quality in China. I was pleasantly surprised. They used to only hold the forum every two years, but starting next year they will have it every year. And they want to tailor it to be more like the Baldrige Program’s Quest for Excellence® Conference [where award recipients share best practices]. The forum was geared for both those involved in academics (largely engineering universities) and business (specifically manufacturing). Awards were handed out for best papers written on quality in academics, and companies were being awarded for their quality performance and innovation. In addition, there was a team competition focused on the use of quality tools such as Six Sigma and Lean. So the forum was both academic and business-oriented. I thought it was good that there was this interface between businesses and universities from around the country. 3. What questions did forum attendees ask you about the Baldrige Award and program? After my session, I was asked the question—two or three times—about the President of the United States traditionally presenting the Baldrige Award. I believe they were impressed by this and how much more prestigious this made the award. I was also asked about how Baldrige examiners are selected and what is the typical size of the board of Baldrige examiners [the answer: traditionally about 400-500 members strong]. I explained that every year whether you are a new or returning examiner, you have to submit an application to be a Baldrige examiner. And the Baldrige Program uses criteria for examiner selection to ensure that there is a balance of sectors and experience represented. And I was asked about judging for the Baldrige Award; some [audience members at the forum] wondered whether the Baldrige examiners themselves recommend the award recipients. So I explained the role of the panel of judges and how they base site visit decisions on scores [from the Consensus Review phase]. 4. Do you have other insights to share? I know there’s been this push to move away from the word quality, for example, when the name of the program changed [from the Baldrige National Quality Program to the Baldrige Performance Excellence Program]. But a focus on quality is what’s current in China now. Many of their organizations are now using the Total Quality Management model or the European quality model. And they are now open to what we’re doing in terms of a focus on quality not just in the product, but in how the organization is run. Also, the commonalities of the different excellence frameworks really jumped out at me. After my presentation, I was asked which of the four international programs described at the session I would recommend for China; I said that I couldn’t choose from the programs, that what is important is the commonalities, namely, the focus on leadership, customers and human resources, process management, and results. With any quality or performance excellence program, leadership is key; buy-in begins with the organization’s leaders. But you can’t achieve any of your objectives without a focus on customers and human resources. The process management focus is key because making sure that processes are efficient will lead to good results. So, while the criteria of the different international excellence programs are different, I found that the key elements of excellence are the same in any language.

Posted by Mark Shapiro As many of you know, I will be retiring in January 2015, after 40 years of federal service. In reflecting on these years, it is clear to me that the 15 years I’ve spent with the Baldrige Performance Excellence Program are, by far, the years that I look back on most fondly and the work I feel most proud of. Working for the Baldrige Program has truly been the highlight of my federal career. It has been a real pleasure, in fact an honor, to support everyone associated with the Baldrige community. This includes the examiners, applicants, recipients, Panels of Judges, the Foundation, the Boards of Overseers, the Alliance members, and, of course, my wonderful colleagues here at NIST. The integrity and high standards that the Baldrige community exhibits are truly inspirational for me personally. The Baldrige Program is an example of how a federal program can have a powerful impact on so many different parts of our community. By promoting performance excellence and providing global leadership in the learning and sharing of successful strategies and performance practices, principles, and methodologies, the Baldrige Program is a customer-focused federal change agent. All of us contribute to this! Some of Mark’s work involved managing evaluation teams for the Baldrige Award process. Our country can learn so much from how the Baldrige community interacts-always cognizant of the mission and acting with the highest degree of integrity, selflessness, and grace. With a culture of openness and a willingness to share our knowledge and best practices, we all contribute to enhancing and improving each other’s organizations, which in turn improves our local communities, our states, and ultimately our country. Our work at and with Baldrige has a major impact on the lives of all Americans, whether they are customers, employees, suppliers, partners, or other stakeholders. What you do, what we do, is powerful. As far as what the future holds, as an ex-military guy, I’d like to do some gratis work for the VA, continue to help my sister and brother-in-law with their Baldrige journey, work-out a lot, and maybe even transition to being an examiner (if selected).  I also might work part-time as a life guard and/or in a bicycle store, paint a few rooms, make my wife’s life easier as she approaches her own retirement, visit the city at least once every two weeks, and spend more time with my parents and family on the Eastern shore. I’d like to thank each of you for being the best colleagues, mentors, and friends, and for allowing me to serve you as you work tirelessly to help improve our country. You’ve made this humble public servant proud of his federal service and for that I thank each of you.

Posted by Dawn Marie Bailey In the 1980s, Dr. Joseph Juran, one of the Baldrige Program’s first overseers, coined the term "Big Q" to serve as a quality "umbrella": little q would encompass goods and those processes directly related to the manufacture of goods, while Big Q would encompass all of an organization’s products, goods, and services, as well as all of its processes. In alignment with Juran’s notion of encompassing all of the organization with quality practices, the Baldrige Criteria for Performance Excellence today take a systems perspective; in other words, the Criteria provide a guide to managing all the components of an organization as a unified whole-Big Q. (In the early days of the Criteria, the focus was much more that of little q-focused on process and quality tools.) A recent IndustryWeek article that quotes ASQ’s Laurel Nelson-Rowe traces the evolution of quality from compliance, to control, to a broader definition that includes the customers’ perspectives on quality. "ASQ research promotes the idea that deeper integration with the customer is a driver of improved quality," writes the IndustryWeek author Jill Jusko. "And by deeper engagement, the quality association means throughout the life cycle of the product or service." Again, the Baldrige Criteria are in alignment, weaving customers and their satisfaction, dissatisfaction, engagement, and voice into all organizational operations. The Criteria also call out the core value "customer-focused excellence" as a behavior embedded in all high-performing organizations. The Criteria even include both a current and future focus on customers: "understanding today’s customer desires and anticipating future customer desires and marketplace potential." Today’s Baldrige approach to quality is relevant to all workforce members who are interested in continuous improvement but in particular to leaders; without senior leadership’s commitment to quality, an organization can easily lose its overall focus. In his last interview with IndustryWeek in 1994, Dr. W. Edwards Deming shared his insights on quality, focusing on management’s role: "Quality is the responsibility of the top people. Its origin is in the boardroom. . . . Management today does not know what its job is. In other words, [managers] don’t understand their responsibilities. They don’t know the potential of their positions." This thinking is in line with the Baldrige Criteria, which contains the core value "visionary leadership"; one focus of the upcoming 2015-2016 Criteria (available December 2014) is on "validated leadership and performance practices." Senior leaders should set a vision for the organization, create a customer focus, demonstrate clear and visible organizational values and ethics, and set high expectations for the workforce. Of course, in addition to customers and leadership, the Big Q of quality continues to evolve. Every few years, ASQ conducts a Future of Quality study; the last one being in 2011. The study identified and prioritized eight forces of change. Then Baldrige Director Dr. Harry Hertz wrote about those concepts in an Insights column "The Future of Organizational Quality," adding three overarching factors that he felt impacted quality: complexity, agility, and ethics/social responsibility. A more recent 2013 Insights column "For Everything There Is a Season, and a Time for Every Purpose," also by Hertz, looked at the Conference Board’s Quality Outlooks from 1994 and 2009. The reports listed critical issues for quality, including commitment by senior leadership, systems thinking, partnering, and continuous improvement. Challenges to quality included customer and employee satisfaction, accountability for results, and performance management. And now as the Baldrige Program prepares to release the next version of the Baldrige Criteria, some additional key themes have evolved based on feedback, the literature, and the competitive and strategic pressures on organizations today; the three themes woven into the next Criteria:  (1) change management, (2) big data, and (3) climate change. The quality evolution continues and the Baldrige Criteria seek to continue the Big Q, staying on the leading edge of validated practices. What do you think are the critical issues and challenges for the Big Q?

Posted by Christine Schaefer We recently shared 16 tips based on the success stories of a health care organization, a small business, and a manufacturing company featured in our 2011 book Baldrige 20/20. The advice from senior leaders of those organizations is still valuable for those of any size and sector that aim to improve their performance using the Baldrige framework for excellence. Following are two more sets of do’s and don’ts from senior leaders of Baldrige Award recipients profiled in the book—this time from a public school district as well as a small business. Tips from Terry Holliday, (former) superintendent of Iredell-Statesville Schools (PDF profile), 2008 Baldrige Award winner (education): Don’t call it Baldrige (at least at the beginning of your journey). If you are dealing with a community that mistrusts change and innovation based on its experiences, convey the favorable results rather than labeling the improvement methodology. Don’t allow school staff members to give up on children, and don’t let students continue to fail until they become dropouts. Do focus on relationships and building trust among teachers and other school stakeholders. Listen and learn. Then address negative beliefs about and blame for student learning by modeling the change you want to see: model a learning-centered approach and showcase the results it can achieve. Do create a passion for learning, reigniting this passion among adults. As a school leader, continue to fight the fight. Tips from Dale Crownover, CEO of Texas Nameplate Company, Inc. (PDF profile), 2004 and 1998 Baldrige Award winner (small business): Don’t retreat into a silo when facing resistance from employees about a Baldrige improvement plan. Rather, recognize your role as change agent within your organization. Don’t assume all organizations must strive for the same "success." Instead, determine what level of performance your organization wishes to achieve and what type of evidence you need to collect to prove to yourselves and others that you’ve achieved it. Don’t let distrust among coworkers deter organizational decision making. Patiently wait for insights and fearlessly address oversights. Do keep your responses to the Baldrige Criteria’s Organizational Profile, which asks questions about your organization and its situation, current and readily accessible in good and bad times. Do envision where you want to go and, at the least, begin questioning what you really want by going there. Do make the decision to apply for the Baldrige Award—and recognize that your decision will provide many opportunities to benefit. Do study the pros and cons of major changes (e.g., in technology), and avoid the cons as much as possible. Do stay committed to pushing forward with change. Do reach out to receive training and coaching from Baldrige practitioners. Do link the collection of organizational performance data with strategic planning. Do trust your coworkers as much as you trust yourself in preparing a Baldrige Award application. Do be ready to pursue a new improvement journey even after you receive a Baldrige Award—taking your success to the next level. We hope you have enjoyed old wine in a new bottle with this series of tips reprinted from Baldrige 20/20. If you too have learned what to do—or what not to do—in order to use the Baldrige framework to better manage your organization, please share your tips by commenting below.

Posted by Dawn Marie Bailey According to a recent IndustryWeek article, the 2015 edition of ISO 9001, the standard on quality management systems, is nearing completion with three focus areas: The process approach will strongly emphasize that the quality management system has to be woven into and fully aligned with an organization’s strategic direction. Superimposed on the system of processes is the PDCA (plan-do-check-act) methodology, which will apply both to individual processes, as well as the quality management system as a whole. An overall focus on risk-based thinking aims at "preventing undesirable outcomes," such as nonconforming products and services. At the Baldrige Program, we’ve interviewed several experts on the complementary usage of ISO and the Baldrige Criteria for Performance Excellence, including Luis Calingo ("Better Than ISO? How Baldrige Benefits Manufacturers") and Ron Schulingkamp ("Baldrige and ISO QMS: A Complementary Relationship"). To me, the 2015 ISO focus concepts are reminiscent of the Baldrige Criteria. For example, The Baldrige Criteria guide an organization to align work systems and learning initiatives, as well as core competencies, with its strategic directions as part of planning. In fact, the Criteria build alignment across the organization by making connections and reinforcing measures derived from processes and strategy. In the Criteria, PDCA is called out as a common process improvement approach within category 6. A key element of this category is improving processes to achieve better performance—better quality from customers’ perspectives and better financial and operational performance. In fact, the learning that comes from PDCA is key to how the Criteria are used to evaluate processes. The Criteria encourage organizations to choose the tools (e.g., ISO, PDCA) that are most suitable and effective for an organization in making improvements. Measuring product performance (e.g., defect levels, service errors) is part of Criteria item 7.1. Such product and operational performance results demonstrate product and service quality and value that lead to customer satisfaction and engagement. The Criteria also cover risk-based thinking—intelligent risks, a concept introduced in the 2013-2014 Criteria. "Identifying strategic opportunities and intelligent risks is part of strategy, and pursuing the intelligent risks must be embedded in managing organizational operations." Innovation can result from such pursuit; the Criteria encourage organizations to use creative, adaptive, and flexible approaches to foster incremental and breakthrough improvement through innovation. In what ways do you think that the 2015 ISO 9001 edition and the Baldrige Criteria will be complementary? Note: The 2015-2016 Baldrige Criteria for Performance Excellence will be available December 16.

Posted by Bob Fangmeyer This week, we officially released the 2015-2016 Baldrige Excellence Framework: A Systems Approach to Improving Your Organization’s Performance. This is the first time in the 27-year history of the Baldrige Program that the booklet containing the Criteria for Performance Excellence has been retitled to make clear that the framework is not just for organizations that plan to apply for the Baldrige Award. In the earliest versions, the booklets even included the award application forms. Eventually, the Application Forms and Award Criteria were split into two separate booklets, the Application Forms and Instructions and the Award Criteria. Around 1996, the Criteria booklet became the Criteria for Performance Excellence and maintained that title for the next 18 years. The new title change is more than just a change in name: It is an acknowledgment that the booklet, and Baldrige framework itself, contain far more than criteria for the national award. It also says that the Baldrige framework is something any organization can benefit from using. (For those purists who fear something precious has been lost, never fear! The criteria component is still called the "Criteria for Performance Excellence"). We also significantly streamlined the criteria and improved readability in this version. In addition, for the first time we have released a mid-level assessment tool for organizations seeking to improve their performance: Baldrige Excellence Builder. This new, freely available resource was intentionally designed to be useful for organizations that might not be ready to dive into the full criteria-which are, after all, the national standard of performance excellence, a very high bar indeed! The Baldrige Excellence Builder is simple, clear, and short and can help many organizations begin to apply a systems perspective to improving their processes and results. Because we expect very broad appeal and use, we also designed it to be useful for education and outreach. If you haven’t taken the time to read through it, I sincerely hope you will. Finally, in 2015, we will release a beginner’s guide of sorts, targeting organizations that need help just getting started with core concepts embedded within the Baldrige Excellence Framework. So much has gone into the new releases: months and months of development, design, and production; establishing the distribution and sales infrastructure; preparation for customer service support; marketing and communication efforts; partner distribution policies and systems. With so many things needing to be organized, aligned, and integrated to release two new products at the same time (and the Healthcare and Education booklets not far behind), I want to express my great appreciation for every member of the small but high-performing Baldrige staff involved in making this happen. This accomplishment once again demonstrates the power of teamwork and an engaged workforce that knows what needs to happen and takes responsibility and ownership to get it done. I cannot thank my staff enough for all that they do every day. I truly believe that we are on the cusp of dramatically expanding our brand and our reach. Although thousands of organizations have benefited from Baldrige, there is the potential for many more to do so. With the new resources and the help of the larger Baldrige community, including the network of Baldrige-based programs across the country, we hope to reach all those organizations that previously might have said, "Oh, Baldrige… we’re not good enough for that. We just want to get better." Please help us spread the news that Baldrige is about both improvement and excellence, no matter your organization’s size, sector, or current level of performance.

The Blogrige team and all of us at the Baldrige Program thank you for another great year. Blogrige will return January 6, 2015. 2014_Baldrige_Holiday_Card pdf

Posted by Dawn Marie Bailey In a recent online video, Dr. Bill Neff, interim CEO and CMO at University of Colorado Health, for which 2008 Baldrige Award recipient Poudre Valley Health System (PVHS) is now part, shared PVHS’s journey to excellence. In 1997, it was a single hospital with a 24% annual employee turnover rate and five CEOs in four years; by 2008, it was a Baldrige Award winner. What happened? The Journey Dr. Neff, who was CMO at the time of the Baldrige Award, said that PVHS engaged over a 10-12-year period with the Baldrige Health Care Criteria for Performance Excellence in an effort to "get everybody running in the same direction." In 1997, PVHS was in the midst of a changing health care market, but the largest challenge, said Neff, was the need for integration with very independent physicians. PVHS’s fifth CEO in four years had been working with several organizations using the Baldrige Health Care Criteria, and the hospital decided to give the Baldrige process a try. "If you participate in the process," Neff said, "one of the first thing you have to decide is who the heck are you and what do you want to do. . . . The [Baldrige] Organizational Profile really makes you do an internal assessment of what you are trying to do, and if you are good, what would that look like. You need to measure, analyze, deploy best practices. Everybody has to be in close alignment." Between 1996 and 2000, Neff said the hospital had really become pretty impressive, even being an early adopter of Magnet in the United States. Applying for a Malcolm Baldrige National Quality Award, PVHS thought, "was a slam dunk." But the feedback written by Baldrige examiners from PVHS’s first and second award applications let the hospital know that it might not be as good as it thought it was, he said. From 2004 to 2008, Neff said that PVHS embarked heavily in the Baldrige process, trying to figure out how to get better. This included submitting applications to the Baldrige-based state award Rocky Mountain Performance Excellence (a member of the Alliance for Performance Excellence) and receiving feedback reports. "In essence, we had to make [the Baldrige Criteria] the way we were doing our day-to-day work. It couldn’t be an application that we filled in at the end of the year. It couldn’t be about the award. It was about looking at all of those elements of the Criteria and talking about how are we really trying to be what we say we want to be and how do we ensure that is completely deployed across the entire organization," Neff said. He added that it was especially important for Baldrige as a business model to be put into context for physicians; for example, PVHS conducted a Lean event that made patient processes more efficient and thus saved physicians time. The hospital had to translate the value of Baldrige into something that was real for the physicians. "Before [Baldrige], there was a tendency to go to where it’s easiest [to improve] and look right past or right over the areas where you’re weakest and need to improve the most," he said. "The [Baldrige] process forced us to look in the mirror in those areas. Slowly, we started getting better." One improvement started the day the PVHS board decided that the hospital would start measuring itself against top deciles, not just averages. "On that day, all of our scorecards went red," Neff said. Between 2004 and 2008, PVHS received four Baldrige site visits—its applications scored high enough to send a team of Baldrige examiners to PVHS to take a closer look. During this site visit week, Neff said, "folks who really, really know performance excellence are there to look at you really hard and say this is who you say you are but this is who you look like to us. You spend a week with [Baldrige examiners] who are really sharp, pointing out where you are doing well but then asking why aren’t you doing it there, too." Neff said the examiners "look under every hood." In 2008, PVHS received the Baldrige Award, the nation’s highest honor for organizational performance excellence. "By the time we finally got to that point," Neff said, "everybody thought that was really cool but what they really wanted was the feedback report. Because you kind of become addicted to that level of interaction with folks who are trying to help you get better." Lessons Learned Treat physicians as partners, not competitors or customers. PVHS recognized that physicians needed to have input into strategic initiatives, the strategic plan,  interdisciplinary teams, etc., but attendance at meetings needed to be as needed not mandatory. Physicians were also integrated into administrative leadership teams and given leadership development opportunities. "The biggest thing about physician engagement from the administrative side of the house," Neff said, "they kept looking at physician engagement as how do we get them to see things our way, the trick is that at least 50% of the time it’s how do we get to see things their way." For physicians, build a culture of engagement one step at a time, he said; show them the results, do what you said you would do, and follow up to show you did it. Encourage engaged physician leaders to engage other physicians. Constantly evaluate; performance excellence is not an instant fix. "We have a tendency to think that if we fix just one, two, three things then we’ll be close to perfect, and then we can move on to a different project. That was not our experience with performance excellence," Neff said. "With performance excellence, it becomes your culture and . . . you are going to slowly get better. It might not be at lightning speed on some elements, but you’re better today that you were yesterday, and you’re going to be better tomorrow. You’ll get there. . . . Once you’ve hardwired your systems, you just continue to get better." Look for partnerships. Once PVHS received the Baldrige Award, Neff said that finding partners was much easier, as Baldrige winners are proven to be high performing. In 2012, a joint operating agreement was signed between PVHS and the University of Colorado Hospital. "This is a testament to what you can accomplish with performance excellence," Neff said. "Remember we were that single, little bitty hospital up in Ft. Collins. To be able to come to the table with an academic system and be able to talk about an equal partnership was something that we would not have imagined in the mid-1990s." Other hospitals also have been added into the system under management agreements. Neff advises starting small and building trust with these new partners. Next Steps Neff said the next steps at University of Colorado Health are to build the whole system by integrating each category of the Criteria—implementing the performance improvement program across the entire system. He said this implementation is being done incrementally; for example, first excel at customer focus, then workforce focus, then a focus on quality metrics, etc. Neff said, "when [staff] tell me, I don’t know if we can do Baldrige, I can say, actually you’ve been doing it for a couple of years." The 2015-2016 Baldrige Health Care Criteria for Performance Excellence will be available in January 2o15.

Posted by Dawn Marie Bailey In January 2015, the 2015-2016 Baldrige Excellence Framework (Health Care)—which contains the Health Care Criteria for Performance Excellence, core values and concepts, and scoring guidelines—will be released. The Baldrige Program is grateful that there has already been much written about the value of using this Criteria for improvement. "Baldrige hospitals are . . .  more likely to be cited for marked performance improvement over a five-year span," writes Deborah Bowen, president and CEO of the American College of Healthcare Executives and Baldrige Fellow. In "Using Baldrige Criteria as a Tool for Hospitals’ Performance Improvement," Bowen writes that thousands of hospitals, clinics, and health care systems have turned to the Health Care Criteria "with its established framework for improvement and innovation that builds on core values and concepts, including: patient-focused excellence; organizational and personal learning; agility; and focus on results and creating value. . . . It is clear the Baldrige framework can be useful in enhancing systemic performance and achieving better results. . . . A key component is the importance of sharing best practices and learning from those who have achieved systematic results." Bowen adds, "Boards also can encourage their organizations to learn from others and adopt performance improvement processes using such resources as the Baldrige Health Care Criteria for Performance Excellence, because there is still much work to be done to improve the outcomes of health care for patients, families, and our communities." In "What About Lousy Hospitals?," John Griffith, professor emeritus, Department of Health Management and Policy, School of Public Health, The University of Michigan, writes, "Hospitals seeking excellence are pursuing various paths, but the best documented and most comprehensive is the ‘Baldrige journey.’ . . . Baldrige recipients and Magnet hospitals claim that they are ‘great places to get care’ because they are ‘great places to give care.’ Both document low workforce turnover and vacancy rates. . . . Hospitals such as AtlantiCare in Atlantic City, Henry Ford in Detroit, Sharp in San Diego, and North Mississippi in Tupelo all work in challenging economic environments. They are all Baldrige winners. Maybe the ‘lousy’ hospitals should study the public responses and start the Baldrige journey? It takes as little as three years to move from lousy to respectable or better." In "Correlation Between Baldrige Award Recipients and 100 Top Hospitals Winners," Truven Health’s Jean Chenoweth, senior vice president, Performance Improvement and 100 Top Hospitals, writes, "Once again, the selection of St. David’s HealthCare and Hill Country Memorial as 2014 Malcolm Baldrige Award winners and performance on the 100 Top Hospitals® National Balanced Scorecard overlap . . . a significant statistical association between use of Baldrige best management practices and highly balanced performance excellence. . . .  This is all very good news for measurement of the impact of leadership in hard data." As for any organization, its best testimonials come from its customers. Thankfully, the two 2014 Baldrige Award winners in health care have embraced the Baldrige spirit of improvement and sharing. In "Baldrige Awards are Just the Icing on the Cake for 2014 Winners," both Hill Country Memorial and St. David’s HealthCare write that participating in the Baldrige Award process brought them improvement: "We never got on this journey to win—though that’s amazing and we’re super-excited—it was to improve," says Debbye Dooley, executive director of business intelligence for Hill Country Memorial. C. David Huffstutler, president and CEO for St. David’s HealthCare, adds, "Obviously, our organization, our employees, our physicians are delighted. It’s something we’ve been working toward for a long time. . . . Though we have said from the beginning, while it would be nice to win the award, it really has been about the Baldrige process, and using it as a performance improvement tool."