The AHCA/NCAL Quality Awards criteria have their grounding in the Baldrige Excellence Framework, which assesses seven categories of performance: leadership, strategy, customers, measurement/analysis/knowledge management, workforce, operations, and results. This is a perfect match, as both the awards and the Baldrige criteria are designed to promote quality improvement, excellence, and high standards. When organizations use the Baldrige criteria in pursuit of the Quality Awards, the result is better relationships with employees and other stakeholders, higher productivity, improved resident satisfaction and outcomes, and elevated stature and reputation. 

Christopher Laxton, CAE, executive director of AMDA – The Society for Post-Acute and Long-Term Care Medicine and Baldrige alumnus examiner, explained, “Starting from the highest level, the Baldrige framework’s intent is to make organizations more sustainable, as well as competitive.” 

Looking at the seven criteria, he said, “They address areas that are exceptionally important in this setting.” For instance, leadership is clearly one area that distinguishes high-performing nursing homes from the competition. The ability to have good customer satisfaction on resident and staff surveys are another key focus, particularly coming out of a pandemic when distrust and miscommunication were sowed. 

Of course, workforce issues continue to be on everyone’s minds, and this is another area where the Baldrige criteria can help. As Laxton noted, the Centers for Medicare & Medicaid Services has started measuring facilities on staff turnover, so the ability to look at your staff situation and staffing as a key metric of success is essential. Laxton said, “Using the Baldrige framework provides a more holistic view of how staffing impacts quality of care and quality of life.” He also observed that quality assurance and performance improvement is part of Baldrige framework, and this encourages a proactive approach that employs preventive measures and identifies ways to strengthen your infrastructure.

One of the many positive attributes of the Quality Awards and the Baldrige criteria, said Laxton, is that they’re not prescriptive. “Instead, you are presented with probing questions to get you to start thinking differently about things. Particularly for a setting that is change resistant, the framework asks you in a stepwise manner to challenge that resistance and look at things openly and objectively,” he observed. 

“This is a dynamic framework that is constantly undergoing examination and updating. The Baldrige criteria have evolved over time and are at the leading edge of management disciplines. People should have confidence when they engage in the process that it is up-to-date, relevant, and designed to give them maximum results.”

While it’s true that there are many positives associated with the Baldrige framework and the Quality Awards, they do take significant time and effort. This can feel prohibitive for providers who are coming out of a pandemic and still facing staffing crises and financial strains. Laxton said, “I’ve heard this many times, and concerns about the time investment are valid. However, my response is that if you have time to keep doing things incorrectly, why don’t you have time to change and become more efficient and effective? Every hour you invest in organizational improvement has a tenfold return on investment in terms of efficiency and lean processes.”​