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Monday, September 3, 2012

Malcolm Baldrige National Quality Award


Paul Borawski writes in A view from the Q on the topic 25 years of the Baldrige program  (http://asq.org/blog/2012/08/25-years-of-the-baldrige-program/).  Quite justifiably  ASQ sees the Malcolm Baldrige National Quality Award as an American program worth honouring.  

I agree.  

The MBNQA program was developed in 1987 during Ronald Reagan’s second term as president.  It has been a cornerstone for American Quality ever since.  Paul speaks of the legion of Baldrige zealots (not just fans and admirers, but zealots!).  I might even include myself in that group; well maybe a mini-zealot.  The Malcolm Baldrige Award is, at least in my mind, the highest level of Quality and excellence achievable in the United States, and a symbol that says that striving for the best can and will be rewarded.  

I once contacted the Baldrige organization to see if I could apply for an assessment of my combined CMPT proficiency testing program and POLQM program office.  I was told that would not be possible, because the MBNQA could only be awarded to American organizations, but perhaps I could consider contacting our Canadian counterpart, Excellence Canada.  Excellence Canada is a not-for-profit private organization that supports itself, at least in part, through a partners program.  You can read about Excellence Canada at their site www.NQI.ca.  

Excellence Canada has been active in Canada since 1992 (this is its 20 year anniversary!) and is responsible for the Canada Awards for Excellence program, which predates the organization itself, going back as far as 1984.  

In recent years, healthcare organizations have been a disproportionately large part of the applicants to both the US and Canadian programs.  From my perspective, inside healthcare, I see that as a good thing because it means the threat and danger of patient safety violations is sinking in.  

Paul asks an interesting state-of-the-nation question about why the number of organizations getting involved with the Baldrige process is low.  I feel compelled to respond.  

I suspect that behind the question lies the fact that as much as healthcare organizations are showing a very large interest, perhaps other industries are showing less.  I suspect that a large part of the answer is money, especially during a slow recession recovery.  In many industries, if the exercise is about Quality, there are a lot of options including lean, six sigma, ISO9000.  In an era when cash flow is slow, Quality  can be done in pieces and with relatively controllable cost and some incremental improvement.   

On the other hand, in healthcare, cash flow is usually not a problem and the costs of poor quality are massive when you take into consideration the impacts of liability including malpractice litigation.  The argument for a substantial move to quality is substantial and compelling.

When it comes to winning awards, private sector industries need to see that the gains from the award outweigh the cost of earning it.  Their view can be relatively short sighted, looking forward on a quarter-by-quarter basis.  
In healthcare the dynamic may be different.  Winning awards can have long term benefits in patient referrals.  It is easier to see the appeal and benefit.


 But I think the question undervalues the degree of change that we have seen in the Quality arena between where we were before the Malcolm Baldrige award program and where we are now.  It would be fair to call the change a major international game changer.


The Malcolm Baldrige National Quality Award began in 1987.  Since then:

ISO9000 first published in 1987, 
In the United States, the Clinical Laboratory Improvement Act was passed in 1988 setting legislated Quality thresholds for all US medical laboratories.  
ISO 17025 followed in 1999, 
ISO 15189 in 2003 

This growth in volunteer standards changed the face of Quality through clarity of expectation and as a foundation for external assessment of a huge number of testing and calibration and medical laboratories, reducing error and improving confidence in test results around the world.  

These standards lead to accreditation of laboratories critical to health (food, water, medical) becoming the norm throughout North America, Europe, Australia and New Zealand, Japan, and is rapidly establishing its place in Brazil, Argentina, China, India, South and East Africa.  

And most notably, similar programs for Quality and Excellence have sprouted up around the world.
Would all this have happened without the impetus of Malcolm Baldrige?; maybe, but unlikely at the same timetable or pace.  I personally would go further.  The development of the Malcolm Baldrige National Quality Award is an example of US innovation having impact on quality around the world.


PS: To date, I have not yet contacted Excellence Canada to find out more about eligibility and requirements for applying for assessment of CMPT and POLQM and pursuing a Canadian Award for Excellence.  But I have included it in my CMPT Quality Plan for 2012-2013. 

PPS: I wrote last year critically about the ASQ  [see http://www.medicallaboratoryquality.com/2011/07/quality-and-excellence.html ] when there was concerns that congressional funding for the awards program might be lost.  I was critical of ASQ going public because the amount of funding that was being discussed was small,   When a government is in massive debt, some cutbacks are inevitably going to happen, and the better Quality response is to look to innovation for the solution.  I have scoured the web to find a follow-up on the issue of funding, and found nothing, which suggests to me that the issue has met some level of negotiated compromise, or have sought a new solution.

1 comment:

  1. Michael, thanks for the blog. Re. follow-up on funding, the Baldrige Program is providing information on its transition to a sustainable Enterprise at http://www.nist.gov/baldrige/transition/index.cfm.

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