Implementing Malcolm Baldrige Excellence Framework to improve Hospital Services Quality : Lessons Learned From PELNI Hospital

Why Baldrige Execellence Framework (BEF) it could be so necessary? We will know for at least these three reason:

1. It needed for performance measures hospital as a company and public service at once
2. It comparing whether our company was better than another, which means in same industry that could be competitor or a feeder
3. It has comprehensive approach to view healthcare service as a business unit toward different company in different field

BEF does need as complementary tools in organization in order to get higher level of their performance. Instead of in hospital industry, especially in Indonesia, there are two organizations whose rules and constitutes about what hospital industry must fit in. First, KARS accreditation, which has “five star paripurna” as top goal within their 14 standards. And second, Joint Commission International, which has “gold seal” as top goal within their 15 standards. It depends on what level you want to be acknowledged, national? or international? However it has a same approaches, such as: identifies, measures, and shares best practices in quality and patient safety with delivering evidence-based advisory services.

Those are necessity both to be a world class hospital. But it only told us to meet their standards for the sake of patient safety. But it doesn’t measure how the hospital must achieve their best performance to get it done. BEF is useful tools as complementary and supplement for corporate vitality. It makes company healthier by increasing organization agility. But the most important thing is, that BEF could bring you captured images of where your company level are now, and what your company condition beneath the circumstances.

The circumstances means internal and external challenges which emerge in national health coverage era. For some hospital company, it could be a threat. But, with strong leadership and choose a right approach, methodology, and tools in run a business it could be an opportunities.

Leadership should taking part of: Hospital by laws, Medical staff by laws, Organization learning, and Organization culture. Leadership also bring philosophy and conventional wisdom to a company. On PELNI Hospital case, it noted on : Focus on growth, Pursue functional excellence, Reorganize to drive change, Go lean, Become agile and resilient.

One of approach we use in disruptive innovations, which means how industries transform to provide increasingly affordable and conveniently accessible products and services to customers. If we want a more affordable and convenient healthcare system, we must demmand it and embrace disruptive innovation. The transference of skills from highly trained but also expensive personnel to more affordable providers, including technology based care.

 Leadership not just influences other people, but it also connecting between now and the future. That’s a vision, to get strategic goal which could be measured by other tools such Balance Score Card.

We take four perspective of BSC as point of view to measures corporate performance. Lean Management as methodology offer several concepts that very useful to bring “before vs  after” matrix in comparing between indicators. Improvement in strategic plan makes improving in financial capabilities through lean management as a tools  to achieve in Baldridge excellent criteria. When BEF capturing corporate condition, so does the JCI standards do in capturing how we give high quality service with patient safety oriented. Moreover Lean and BSC applied to make strategic goals  to achieve highet score with 6 perspective of BEF

When those implemented in JKN-era, we facing a very different cost structure that called as a prospective payment system. So, business model must change revolutionary. In PELNI hospital use Kaizen as changing tools that influenced by several concept in manufacture industry, which must be more faster, more cheaper. But, lean management give a break to makes this business must never compromise to: quality of service, patient safety, and employee satisfaction. Therefore, Lean is methodology to build people (employee, patient, and their families) and drive them to make improvement, through : mindset and culture.

Generally, lean management very helpful to makes people, process, and efficiency more beneficially better than before. As the results, cost structure would adapted by itself.

However, many programs which lead to make improvement must disseminated to whole employee. So that, every single unit in PELNI hospital will implements lean management with a big idea of “value creation” concept.

Lean not just change a business process, but also quality of service by several standards which established by KARS and JCI, start from : medical unit, supporting services, and general affairs. Furthermore, it resulting a beneficially change in patient satisfaction aspects, and it bring positive and increasing financial performances, such as: Ebitda, ROI, and every finance numerical ratios.