From time to time, headlines highlight people or organizations recognized as outliers because the outcomes of their work garner national notice. More often than not tragic, accidental outcomes rivet our attention. Occasionally, though, it is the opposite: the achievement of an outcome so unusual and inconceivably distinguished that it warrants emulation. The receipt of the 2005 Malcolm Baldrige National Quality Award by Bronson Methodist Hospital, Kalamazoo, Mich., is an example of the latter. It was no accident—this is an organization that pursues validation of its excellence assertively and enthusiastically. It is unusual because it is only the fifth healthcare organization to be counted among the ranks of Baldrige winners, and it is distinguished because the award comes from our nation’s highest elected leader.
The management team at Bronson is quick to point out that it took every employee’s involvement and enthusiasm to win this honor. Among those employees are 15 hospitalists, representing 11 full-time equivalents.
The Baldrige Award
Established in 1987 by an act of Congress, the Baldrige Award is presented annually by the President of the United States to qualifying organizations of any size in five categories: manufacturing, service, small business, education, and healthcare.
The application fee—ranging from $5,000 for large organizations to $500 for non-profit educational institutions—supports a minimum of 300 hours of review by eight or more business and quality experts, with on-site visits generating more than 1,000 hours of in-depth review. An extensive feedback report highlighting strengths and areas to improve is part of the review.
Contenders must be judged outstanding in seven areas to win. (See “Baldrige Award Criteria,” top left.) The criteria focus on two goals: delivering continuously improving value to customers and improving overall organizational performance. This helps organizations enhance their effectiveness and sustainability. Since 1999, when the Baldrige criteria for healthcare were first introduced, 116 healthcare organizations have applied.
According to, Katie Harrelson, RN, vice president of Patient Care Services and chief nurse executive, Bronson has always strived to be the best. In the late 1990s, they began looking at various quality models, and discovered the Baldrige Criteria.
“We began using the criteria because they provided a focus, or framework, to help us define who we are,” says Harrelson. “Physicians became partners, and patients are our customers. Bronson’s hospitalists are strong partners, and our relationship with them is great. It had to be in order to standardize care practices and continue our efforts to be a national leader in healthcare quality.”
She describes the organization’s three strategic objectives: clinical excellence, customer and service excellence, and corporate effectiveness. These “3 Cs” provide focus for Bronson and that are on the tip of all employees’ tongues.
As Bronson embarked on the journey to excellence, it already employed hospitalists. “Bronson started using hospitalists at a time when many of the community’s primary care physicians were older and retiring, or looking for an alternative admission method,” says Scott Larson, MD, senior vice president Medical Affairs and chief medical officer, “There were economic pressures, too. It’s less efficient for individual practitioners to conduct hospital rounds for a small number of patients than to use hospitalists, and hospitalists are more familiar with hospital protocol.”
By 2003 Bronson was continuing to integrate hospitalists into their program, and hospitalists were employing the precepts of performance improvement like other Bronson employees.