Robert Wood Johnson University Hospital Hamilton Transformed


Vice President Dick Cheney and Secretary of Commerce Carlos Gutierrez congratulate RWJ Hamilton CEO Christy Stephenson and then COO Debbie Cardello on RWJ Hamilton’s 2004 Baldrige win.

It was a monumental moment when President and CEO Christy Stephenson and I accepted the 2004 Malcolm Baldrige National Quality Award on behalf of all employees from Vice President Dick Cheney in Washington, D.C. But it didn't even come close to seeing the joy and pride on the faces of our employees and physicians when they learned we had won the nation's highest honor for performance excellence.

And the win was really just one moment that capped an exhilarating six-year journey, where each successive Baldrige cycle fueled even more momentum, ownership, and empowerment throughout the organization. The flywheel was spinning!

Getting Started
We adopted the Baldrige model because of its comprehensive business approach. We wanted to get better faster. Our community expected and deserved the very best care and we recognized that the Baldrige model would help expedite this quality journey. Since Baldrige is a leader-driven model, we had to plan our approach, decide our team structure and define timeframes for deliverables.

Attending the Baldrige Quest for Excellence⁵ conference really set our leadership team on fire. In fact, our executive team could be found after the day's conference in a nearby lounge huddled around a laptop on the floor editing our Baldrige application. We were so inspired and in awe of what other Baldrige winning organizations achieved. Everyone remembered us because it was such an unusual sight!

"Embracing Baldrige helped us realize our mission and achieve the kind of results that many organizations dream about."
– Christy Stephenson, President and CEO Robert Wood Johnson University Hospital Hamilton, NJ

Back at home, when we began to define our Baldrige approaches, we had a pleasant surprise: A number of our approaches were already in place because we had been using prescriptive tools from Studer Group. For instance, Category 1.1 Criteria ask: "How do senior leaders communicate with, empower, and motivate staff throughout the organization?" We could describe how we used the Five Pillar framework (People, Service, Quality, Finance, Growth) and communication boards as tools to communicate results and key information to all groups. Our hardwired system to ensure all employees receive handwritten thank you notes is an example of how we recognize, motivate, and empower employees. When we were asked for our process to determine patient and other customer satisfaction and dissatisfaction (Category 3.2) we described our approach using other Studer Group tools like Rounding for Outcomes and discharge phone calls. An especially effective approach was to have our executive leaders serve as Baldrige Category leads.

Walking the Walk and Talking the Talk
The first time we read the Criteria it seemed like it was written in a foreign language. But over time, as we aligned our tools and team to the Baldrige Criteria and approaches, this lengthy set of Criteria transitioned from items on our "to do" list into the way we did business. For example, Baldrige taught us to benchmark best practices in other organizations. We always set goals in the top 10th percentile of any database. It was almost a religion.

Whenever we set out to design a new process or service, we always asked ourselves first: "Who does this well?" And we learned from them. In fact, a leader from one Baldrigewinning organization advises Baldrige applicants to "steal shamelessly." So we did. In fact, we modeled our E3 (Engage Every Employee) goal cascade after SSM Health Care's "Passport", their tool to align individual employee goals with organizational goals. (See sidebar to download a sample.) Baldrige examiners were impressed that every staff person they interviewed could explain how their goals aligned with organizational and department goals.

Another example of "stealing shamelessly" was our Food on Demand or "room service" program We recognize that patients don't come to the hospital to eat, but wanted them to have options and choices as to what they eat and when they eat it. We also knew that hotels have been offering room service for years. So we benchmarked the Ritz-Carlton. The wonderful thing about Baldrige—much like Studer Group's national learning lab—is that there is this huge formal network of organizations you can reach out to for help. It's sort of an unwritten expectation that all organizations on the Baldrige journey (again, like Studer Group partner organizations) agree to share information freely. In the end, the goal is for all organizations to get better.

RWJ Hamilton was a good organization pre-Baldrige, and cared for its community, employees, and physicians. But the Baldrige framework helped our key results soar tobenchmark bests…truly creating an organizational transformation.

With over 20 years experience in health care, Debbie Cardello, RN, MSN and former COO at Robert Wood Johnson University Hospital Hamilton Hospital Hamilton recently joined Studer Group as a coach and Baldrige expert.

5 The Quest for Excellence® Conference is the official conference of the Malcolm Baldrige National Quality Award. To learn more, visit the National Institute of Standards and Technology website at www.quality.nist.gov.