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Assess Your EMS Organization with the Baldrige Criteria

By William H. Dunwoody, MBA, CQM, CQIA, EMTP

September 2003, MERGINET - In 1987, the Malcolm Baldrige National Quality Program was created within the National Bureau of Standards with “the objective of encouraging American business and other organizations to practice effective quality control in the provision of their goods and services.” This model of excellence was to be used as the basis for the recognition of businesses that had been evaluated and considered worthy of this award.

Since its inception, most states and some industries have adopted a form of the Baldrige Criteria in developing their own measures of performance excellence and quality recognition awards. Versions of the criteria have been created for general business, education and healthcare. The National EMS Management Association (NEMSMA) is planning to create a set of criteria specifically for the EMS industry based on the Baldrige Criteria for Healthcare Excellence.

The Baldrige Criteria for Healthcare Excellence includes seven interrelated categories of performance measurement:

* Leadership;
* Strategic Planning;
* Focus on Patients, Other Customers and Markets;
* Measurement, Analysis and Knowledge Management;
* Staff Focus;
* Process Management; and
* Organizational Performance Results

An organization that uses the Baldrige Criteria to evaluate its operations or to apply for an external feedback report through the Baldrige Award process must demonstrate, in its own style, how well the organization meets the individual criteria items in each one of these seven categories.

The Baldrige Criteria are very different from accreditation standards of organizations such as the Commission on Accreditation of Ambulance Services (CAAS) and the Commission on Accreditation of Medical Transport Services (CAMTS). CAAS and CAMTS identify very specific attributes, policies, procedures, tools and structures that a provider organization must have to meet their accreditation standards.

In contrast, the Baldrige Criteria are nonprescriptive and adaptable. The Criteria recognize that each organization is different and may have its own unique ways of working toward performance excellence in an ever-changing healthcare and business environment. With CAAS or CAMTS, you pass or fail to meet the accreditation criteria. With Baldrige, you get a detailed numerical performance score in each of the seven categories and their respective subcategories. Those results can be used to plan for performance improvements in the coming year. The assessment process can be repeated periodically to measure progress over time. Does this mean that Baldrige is better than CAAS or CAMTS? Certainly not. They simply serve different purposes. For most EMS organizations, CAAS and CAMTS are great places to start a formal performance improvement effort. Once accreditation is achieved, the organization can then continue its efforts using the Baldrige Criteria.

In very simple terms, the Baldrige Criteria provide a framework in which an EMS organization asks questions about its performance and objectively demonstrates its capability with regard to these questions. Some of these questions include:

* Do the organization and its members understand its purpose?
* Are the organization and its members aware of its position in the market?
* Are the organization and its members aware of the environmental factors that influence its performance?
* Do the organization and its members plan for its future and initiate change within the organization based upon this plan?
* Do the organization and its members understand who its “customers” are?
* Do the organization and its members listen to and act upon its “customer’s” needs?
* Do the organization and its members learn from their experiences?
* Do the organization and its members evaluate their performance?
* Do the organization and its members make changes within the organization according to the results of their evaluations of performance?

For further information regarding the Baldrige National Quality Program, please view the National Institute of Standards and Testing Web site (http://www.quality.nist.gov/) or contact the National EMS Management Association (www.nemsma.org).

William H. Dunwoody, MBA, CQM, CQIA, EMTP, is the Director of Operations for Delta Ambulance in Waterville, Maine, winner of the 2000 Maine State Quality Award, Level 1. He also serves as Chairperson of the Maine State Board of EMS Quality Improvement Committee and Treasurer of the National EMS Management Association.