Charleston Area Medical Center Creates Culture of Quality in Winning Baldrige Award

This year’s winner of the National Institute of Standards and Technology’s Malcolm Baldrige National Quality Award in the health care category, Charleston (W.Va.) Area Medical Center Health System is the largest nongovernmental employer in its region, and is an important regional provider of Level I trauma care, neonatal and pediatric intensive care, kidney transplants and a host of other services

“We are key to the community, the economy, the business climate, the workforce, and more,” says David Ramsey, president and CEO. “We just feel an absolute responsibility to be the best we can be.” The system operates four hospitals, a foundation, a health and education research institute, and physician clinics.

The system has been focused on quality for a long time and has used a number of different methods to attain and maintain high quality, says Dale Wood, vice president and chief quality officer. “Back around 2000, we invested in the Six Sigma improvement methodology,” he says. The organization also turned to a local Toyota plant in West Virginia to teach it the fundamentals of the company’s Lean production processes. That initiative became CAMCHS’ Transforming Care Together campaign, which broadened involvement in the quality initiatives to every employee in the quality initiatives.

All of this helps to drive the process-oriented strategy that starts at the board level and works its way throughout the organization, says Brenda Grant, chief strategy officer. The strategy starts with a four-year plan, with the board and management identifying five key quality improvement initiatives to concentrate on each year, Grant explains. “Then the units use those five overarching initiatives to figure out for themselves their own five goals,” she says. “If you go to a physicians’ practice, you’ll see their top five; it’s shorthand for the overall improvement process.” — Jon Asplund

Baldrige: A Framework for Quality

Professional awards often are seen as a way to inspire others in a given field and to enable them to learn from the winners’ success. The Malcolm Baldrige National Quality Awards, on the other hand, are designed so applicants can learn from themselves as they go through the process, according to Robert Fangmeyer, director of the Baldrige Performance Excellence Program..

“It’s very common for organizations to use the Baldrige Excellence Framework to help guide their quality efforts,” he says. “It’s really as much a leadership and management guide as an awards program.”

This year’s health care recipients couldn’t agree more.

The Baldrige process gave Charleston Area Medical Center Health System “an overarching framework for the system, not just quality measurements,” says system CEO Dave Ramsey. “Having clinical outcome quality was a given, but Baldrige added ways to achieve quality in our support of the community, our working relationship with vendors, our relationship with the medical staff, medical researchers and the workforce, pretty much everything.”

Chief Quality Officer Dale Wood says he’s never seen a process in which he’s learned so much about building quality excellence. “It’s remarkable,” he says. “The award itself will drive your quality program.”

Building for the Future

What’s next for Charleston Area Medical Center Health System? An information technology revamp that will further integrate the entire system, Grant says.

“Before, we used a ‘best in breed’ system in which one area of the health care system would research and get the best system for its area of expertise, then we’d figure out how to get everyone to talk to each other,” she says. The Baldrige Award, on the other hand, “really does make you think differently. Is it enterprisewide? That’s part of the way you’ve got to work.”

So, IT will be rethought to communicate and share information in the same way for everyone. “We’re going to use what we’ve learned with Baldrige to handle the change management challenge to do this the right way — across the entire enterprise,” Grant says.

Why It Won

Among the accomplishments NIST pointed to in selecting CAMCHS are:

  • A systemwide commitment to superior care, including being among the top 10 percent of the nation’s hospitals in patient safety for 2013 and 2014, according to the Agency for Healthcare Research and Quality.
  • When surveyed about which area hospital “provides the highest-quality care,” local residents chose CAMCHS by a tenfold margin over its closest competitor.
  • The national Consumer Assessment of Healthcare Providers and Systems survey ranks the system in the top 10 percent nationally for overall outpatient satisfaction in all areas.
  • Since 2010, CAMCHS’ employee turnover rate has been better than the U.S. benchmark set by Nursing Solutions Inc., a national hospital staffing service. “CAMCHS has maintained a superior workforce by committing to a “growing our own” environment,” the Baldrige Awards committee said in citing the system.
  • And even though it has above-average uncompensated care, the system has maintained an average operating margin of 5.2 percent since 2011.