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Steve George

Health Care

Baldrige and the Impact of the Affordable Care Act

When you need to increase capacity, Baldrige addresses the entire system

Published: Wednesday, March 12, 2014 - 16:45

The implementation of the Affordable Care Act (ACA) will stress a healthcare system that is already under the strain of an aging baby boomer population. New patients are expected to flood the system starting in early 2014, part of the 25 million uninsured Americans projected to get health coverage by 2016, according to the Congressional Budget Office.

In “The Waiting Room Is About to Get Crowded” (Bloomberg Businessweek, Dec. 5, 2013), John Tozzi looks to Massachusetts, which passed a law similar to the ACA in 2006, for an idea of what to expect. Massachusetts has more doctors per capita than any other state, yet according to a recent survey, Boston has the longest wait times of 15 U.S. cities: almost double the next-longest wait time, which is in Denver. The article suggests that some medical practices are preparing for the onslaught of new patients by adding capacity, but there are only so many doctors and nurses to go around.

To help manage the rapidly approaching “new normal,” high-performing hospitals and medical centers across the country are integrating the Baldrige model.

The Baldrige Program helps leaders develop robust strategic plans that reveal an organization’s key challenges and advantages, core competencies, risks to sustainability, and blind spots. It helps guide the deployment of strategic plans throughout the organization to make sure everyone is focused on what must happen for the organization to succeed.

When physicians and staff incorporate Baldrige concepts, they’ve found that focusing on patients increases, and they feel like developing ways to provide better care and achieve the organization’s action plans. The Baldrige program helps leaders identify and address the critical factors that affect workforce engagement, including learning and development as well as career progression, that can help physicians and staff provide quality healthcare despite growing demands.

The Baldrige model helps make processes more efficient and effective, which is essential for increasing capacity. For example, Southcentral Foundation, a 2011 Baldrige Award recipient, used the Baldrige model to significantly improve same-day access to care. This helped cut emergency room and urgent care visits by 50 percent, specialty care by about 65 percent, primary care visits by 36 percent, and hospital admissions by 53 percent.

Organizations that seek proven options for strengthening their management systems, especially at a time when those systems face growing pressure, turn to Baldrige because it addresses the entire system. It helps leaders identify the most critical areas to improve and take immediate actions to enhance performance. As the Baldrige model becomes integrated into the way organizations do business, leaders gain control over all the elements that contribute to performance excellence.

First appeared Jan. 2, 2014, on the Core Values Partners blog.


About The Author

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Steve George

Steve George provides Baldrige assessment and application support to Core Values Partners’ clients that range from facilitation to complete assessment and application development and refinement. Twenty-one of the organizations he has worked with have applied for quality awards and received site visits and eleven have won awards, including five Baldrige Award recipients. Mr. George has written ten books, four of which explore the Baldrige management model, including Total Quality Management: Strategies and Techniques Proven at Today’s Most Successful Companies, which has sold more than 32,000 copies.


Instrumentation and IT can help ACA overloads

Doctors offices are terrible, but not as bad as hospitals, for waiting times and except for ER's there is little instrumentation to provide useful inputs for the doctor at time patients arrive and few remote monitoring tools to cut down on visits.  I think newer medical instruments (gages) could help deal with the overloads better than simply "more doctors." 

Cardio specialists use EKG during signin, for example, but GP's could augment the paperwork with real data if they had better med records and appropriate instrumentation to speed up the process while the patient is waiting for doctor.  I suspect most doctor visits could be handled by technicians and nurses given med history and instrumentation for updates to med history.  

Home devices such as oxygen-in-blood monitors as well as better BP and Glucose monitors are coming at lower costs now.  

Note: I have no financial interest in instrumentation...just hate waiting so long before the techs get around to measurements and hate filling out med history for each doctor in referral chain when they could share med records. Why all the paper in 21st century?

Luckily I only have to do that once a year.  Others are not so lucky.