The setting is the Quest for Excellence Conference XXI held at the Hilton Hotel in Washington DC.  There is a stage at the end of the ballroom with a podium, plants, and a big projection screen.  An audience of about 550 conference attendees is seated about the ballroom.

Dean Smith:  Good morning, Iām Dean Smith, Director of Publications for the American Society for Training and Development.  AST is proud to be a sponsor of the Quest for Excellence and itās my pleasure to be with you this morning to moderate our next session on journey to excellence.  The American Society for Training and Development is the worldās largest association dedicated to work place learning and performance professionals.  Our members come from more than 100 countries and connect locally in more than 130 US Chapters and with more than 30 international partners.  We work in thousands of organizations as independent consultants and suppliers to create a world that works better.  During this morningās session leaders from each of the award recipients will describe the organizationās journey to performance excellence, how it transformed their organization and their lessons learned.  Later this morning we will have a panel discussion where representatives from the award recipients will answer your questions.  Just as in Mondayās plenary session, if you have a question for any or all of the presenters, please fill out a question and answer card and pass it to your conference staff.  Our first presenter during this session is Rulon Stacey, President and CEO of Poudre Valley Health System.  We heard from Rulon on Monday morning; please join me in welcoming Rulon back to the stage.
Rulon Stacey:  Good morning again, I was thrilled to hear Simon talk this morning, Ritz Carlton has played a big part in our journey in this organization and the organization I was at prior to this, we would go and look at many different Baldrige recipients and try and learn what we could from them as I suspect you have too.  So we went to Ritz Carlton and learned that their motto was ladies and gentlemen serving ladies and gentlemen and it felt like that was so important to us we went back to our organization and thought that itās important for us to get involved, model the behavior of a Baldrige winner.  We were in our obstetrical unit talking about this and our obstetrical unit said ćWell we want something like that, we want a mantra that we can live byä and after talking for a little bit the obstetrics said ćWell weāve come up with something are you okay with this?ä  ćWhat is it?ä ćWe think we should be people pulling people out of people.ä  I said ćLetās file that for a minute and weāll come back to that.ä  On Monday afternoon we had an interesting time with our organization, we quick huddled on Monday afternoon as a team and I think youād have to agree with me, the team that we brought here from the Poudre Valley Health System leadership team is amazing.  Itās fun to work with people who are fun to work with and but Monday afternoon we got together and I said ćOh I think weāve got a problem, these people at this conference think we know what weāre doing, so weāve quick gotta learn, letās put something together fast, letās make it look good and try and see what we can do to show you that we know what weāre doing.ä  The reason I say that is because we are like you, weāre the same thing.  Weāre a hospital thatās grown into a small health system in the middle of Colorado, might as well have been in the middle of Nebraska or Pennsylvania or anywhere, itās just us, itās the same thing and our journey is the same as you and if you look up here and see well one day weāll be on one of these cool, big screens, it is kinda cool by the way.  Itās you and the journey and the decisions that we went through were the exact same as you.  Weāre a small community hospital, Fort Collins, Coloradoās where we started out, 1500 employees, nearly a quarter of our employees were leaving every darn year and we had to figure out a way to stop that.  A lot of turnover from the executive ranks.  We were in a changing healthcare environment and we had to find a way to engage our physicians, to engage our employees and to get the entire organization set in the same direction.  So the trick to that was figuring out what tool were we gonna use to get our organization set in that same direction.  We evaluated a lot of different opportunities, one of them was Baldrige, we had looked at others as well and after a thorough evaluation we decided that we were going to stay with the Baldrige program and weāre gonna work forward and engage that into our organization because we believed that the processes as outlined with the criteria in the Baldrige program best allowed us the opportunity to move forward as an organization.  So we thought weāre an organization that wins awards, we had won a number of awards as we had moved through this process.  We were thinking pretty good about our self, so in the year 2000 we submitted our first application and we had developed categories, each of the different categories was run by a separate category team and we would have everybody do their normal job and then come together as categories and write category one, category two, category three and put together the application and so we did that and we submitted our application in the year 2000, fully expecting to win because we were pretty hot and who would not want to give me an award, I mean really, look at this smiley face on the big screen.  Well we didnāt and in fact we scored in band two, which was frustrating to us and we thought maybe what the trick is in 2001, letās take a year off and weāll work on our improvements and weāll apply again in 2002 and we did apply again in 2002 and scored worse.  I know, you donāt have to groan about it, it was bad enough, donāt need you making fun, no it was bad, it really was, it was hard to realize that the process that we had set up had proven to be ineffective at best.  So we decided that we were gonna do something different, we were going to make Baldrige part of our business.  What we had been doing was running Baldrige on parallel to our organization we were running a hospital over here and we were trying to be a Baldrige applicant over here, we would do the Baldrige information, we would fill out the application, each team would write their own, weād throw it together, send it in, weāre not gonna do that.  Weāre gonna make this how we do business, weāre gonna transform our business into a Baldrige business and so we started to coordinate the performance excellence teams across the organization, we hired somebody, we hired Priscilla and Sonia specifically who youāve met this week to coordinate that.  They would be at every performance excellence team and they would then come with the senior managers who were chair of each of those teams and provide the coordination that we needed to make it affective across the organization.  We would train out teams on the criteria, we would identify and address any issues that were found through state award feedback that we got and the state was wonderful to come and give site visits every year if we were interested and then we would use the feedback to drive our improvement.  So this was in 2004 and our 2005 application we received a site visit and it turned out to be the first of four consecutive site visits which is agonizing by the way.  What we decided was weāre going to run no more parallel tracks as our organization, weāre going to merge our organization into the Baldrige criteria, weāre gonna have criteria based steering committees and weāre gonna drive improvements across the organization, weāre gonna have senior leadership participation, weāre going to represent in our teams, all different aspects of our organization, weāre gonna make sure that we donāt just further the silos in our organization, weāre going to break down those silos, put different people in different teams and each team had discussion on who should be on that team based on their personality profile from the Thomas concept, based on where they worked, what they did and so that we could have teams different and coordinated throughout and then it would be coordinated by our quality improvement department Priscilla as the Director of Process Improvement and Sonia as the Manager of Performance Excellence.  So the process that we set up was we would get everything hinged on our getting feedback thatās how our organization was focused, we wanted to make sure that we had the feedback necessary to make changes as an organization.  That feedback would come to our senior management team who were the chairs of each of the categories and so we would get that, we would discuss it, weāve talked a little bit before about our organization, part of our process is the senior management team goes away at the beginning of the year and spends days talking about what are goals are gonna be based on the feedback that weāve received from our site visits or other external verification.  We then divide those up into the seven categories based on where the information falls out, we create action plans from that information, we devise improvements based on the action plans, we assess whether or not thatās happened again, we go through another site visit or another round of soliciting data and we get feedback and start the process all over again.  With teams that now talk to each other and have a coordination from across the board with the process improvement, our quality department helping us to find where they unique parts lie and how if we make one change in category one, it might also impact category 4.2 which actually happens and weāve gotta be careful that we donāt make one decision that has an unintended consequence on another.  So where did we end up with this, in our journey we started to create integrated action plans based on the key themes for our opportunities for improvement and our goal was when we made the changes to integrate the changes in with our strategic plan we wanted to make sure that when we got the feedback and we made the changes that it helped our organization move forward according to the strategic plan that had been established by our board of directors, thatās what guides the process is the strategic plan.  So we get feedback, we make changes, changes that will support the strategic plan, an example of this is Dr. Neff, last year Dr. Neff was a regular doctor, a real doctor, this isnāt really coming out the way that I had intended.  This is the last picture we have of him when he looked clinical, but we wanted to bring on a physician who could help us, one of the-- some of the feedback we got from our site survey last year was a recommendation to increase our affiliation and our interaction with our physicians and as a result of that we hired Dr. Neff and as soon as we hired him, we won the award; isnāt that amazing.  So we were able to make those changes as based by the feedback, we communicate these changes through our quarterly meetings, weāve now got quarterly meetings where all of our performance excellence people get together to enhance the communication for the whole group and then we report this to the board of directors because in the end this process belongs to the board of directors, it does not belong to us; we work at their behest.  So some of the things that we-- some of the changes that weāve made in each of the categories over the past several years include the following.  The category one, leadership team worked hard to deploy our vision, mission and values and then to measure through our organization how well people in our organization understood our vision, mission and values.  Created the leadership system that youāve seen in every one of the concurrent sessions this week.  The balance scorecard action plan process was developed by the leadership team and it was crucial to them that we have a process that is replicable in every single category as to how we deal with action plans that come up.  And our leadership priorities was also important too, leadership priorities was we got together and found out, we had received feedback from our directors that sometimes they felt like one director was getting different messages than another director and we wanted to be consistent for all of our directors.  So we developed actually we didnāt, Craig Luzinski, the Easter Bunny who youāve met this week, the bunny man Iām told developed a process that we all adopted.  We internally looked, found out that he had a best practice, we now all adopt how we pass information and record information with our direct reports.  Our strategy team did our strategy timeline, our board used to meet in the fall and based on our strategy timeline they needed to meet, they needed to have the retreat in the spring so that we could have the strategic plan done by the fall in time to create the budget according to the strategic plan, our strategy team did that.  They developed the personal goal cards and involved the physician in our strategic planning process.  Our customer service team put together the-- aggregated all of our voice with the customer data so that we could get one feedback from our customers.  They consolidated our compliment and concerns that came into the organization and they even figured out a way to quantify those and developed a top box scoring measure that allowed us to compare ourselves, not only with those in the healthcare industry but across industries to even give us better data to help us improve as we move forward.  Knowledge management developed our balanced scorecard, moved it into an electronic balance scorecard process, found national database for severity, adjusted clinical outcomes and made these actions so that we could make sure that we were comparing out data with the right organizations.  Our workforce team developed our behavior standards, our stay interviews which I think is a wonderful program to figure out ways to as to why people are staying as opposed to just why did you leave?  Developed a performance review for our volunteer program and one of our most innovative I think ideas is our peer to peer coupons and where our employees are able to individually recognize other employees at a momentās notice with no permission and extend that to our volunteers and our physicians to make them feel more like a part of the workforce again an opportunity for improvement listed by a site visit team a year or two ago.  Our process improvement team developed a decision support process so that we knew when we were evaluating things or programs for our organization that we could quantify how well that met into strategic plan and the financial viability of what weāre trying to accomplish.  We even did a PDCA on PDCA which seems a little anal if you think about but it work, to find out our we using the right process to decide our process and for us it was important.  We trained and retrained on PDCA and even did a PDCA prioritization so that we knew that when we were selecting our processes to review that we were doing the ones that would make the most impact to our organization.  In our category seven team, identified the best way to present the measures so that we could have a consistent display so that when we were transparent, people knew what that meant.  These are just things that each of the categories did, each of these teams led by senior managers, talking to each other regularly, comparing feedback reports and getting the information back out, this is some, just a small number of the changes we made as an organization.  Over the years weāve made many changes based on this process.  If you look across the bottom, those are years and each column is a different year and each list is a new program or process that we put in place based on feedback that we got as we went on a continual process improvement journey.  That was our goal, so 2008 was 2007 and 2008 was an important time for us because we had been working for so long to get the criteria in and somewhere in that process the focus had become too much on receiving the award and for that I plead guilty.  I think had I personally had a different attitude and not talked so much about the award, our organization wouldnāt have been so focused on the award and so for the CEOās out there, I personally think we can play a difference in that by keeping your big mouth shut.  I just think thereās a way to make a difference there and that was an opportunity for us.  We had shifted to winning the award, we made a specific effort to de-emphasize receiving the award, we changed the names of our teams to performance excellence instead of Baldrige teams and by the time we got to our fourth site visit as we just started to integrate this into our organization it became our or organization, we didnāt have to cram, we didnāt have to have all of the weeks before the site visit came, we didnāt have to have the hours and hours of prompting tests, of testing employees to see if they knew everything, it was who we were, it was our business and interestingly enough we also received the state award last year and when we were at the ceremony to receive the state award, we had already had our site visit for the Baldrige award and in that meeting when we were there receiving this state award, somebody came up to me and they said ćSo when do you find out about Baldrige?ä and I said ćI donāt know, I have no idea when that is, weāll have to askä and it wasnāt until that minute that maybe I had personally and organizationally moved past this being about the award.  I knew when the feedback report was coming, I knew when we were expecting the feedback report in the middle of December and in fact when the feedback report came a day or two later than when we had anticipated the award, you would like to think that the world was coming to an end.  Whereās the feedback report, where is it, weād already been announced as the winner, you would think everybody would say ćWill you just chill, you won the award.ä  No we are looking for the feedback report and when it didnāt come when we thought it was gonna come there was panic in the organization and I thought maybe this is a sign.  We didnāt know when the announcement was gonna be made, I didnāt know when the call would be made, I really didnāt know and I donāt think the organization knew for us, we had crossed over to a point where it was not about the award.  Some of the results for this are evident, weāve gone through a number of these during the past couple of days but weāll go through it again because you have to listen and I won the award, so there.  Received the award sorry.  Top ten percent in patient mortality, top ten percent patient satisfaction, employee satisfaction, physician loyalty, we are pleased mostly that weāve been able to show performance improvement in so many different areas.  A magnet hospital, we just received our third-- Poudre Valley Hospital just received their third designation for magnet, one of only eight hospitals in the country to have done that three times.  Best competitively priced organization in Colorado.  So what I would suggest as youāre going through this program, youāve gotta have the senior leaders support on this and if the senior team isnāt supportive, this is a tough row to hoe and if you canāt get your senior team to support this and see the benefit in continually improving; to be honest you need another senior team and I donāt know how you get that done either, have 'em call me and Iāll tell 'em to leave.  Youāve gotta have that level of commitment because you can be successful moving it through the organization without them but they can stop it at any point and itās a challenge.  Donāt ever give up, keep moving forward, we got to a point when you get a feedback report, when you have a site visit and your goal is to win the award it can be a de-motivator.  When your goal is to get the feedback itās not a de-motivator but donāt give up, wait til-- make sure you get your organization into a place where you are focused on the award and thatās where you wanna be.  Focused on feedback, not on the award and thatāll get you where you need to be.  Our state program, I donāt know if Tom Morrow is still here, you oughta track down Tom Morrow and just ask him how Colorado does it, I think they run the best state program, it is just unbelievable how supportive they are in a way that the Baldrige program itself just canāt be, they just donāt physically have the staff to be that supportive but the state program can and they can recognize you at different levels as you move through the process; for us it was unbelievable.  Donāt cram for the test, one of the questions I get more than anything else is ćHow do you fit Baldrige into your budget?ä or ćIs this productive time, the Baldrige time, do you count it as productive time?ä  You know what, thatās the wrong question and if you ask that question, you donāt understand the process.  Baldrige is your business and to ask how much does it cost to run Baldrige I would say ćHow much does it cost to run your business?ä thatās Baldrige, if itās not your business, if itās a parallel program and  youāre trying to figure out a separate budget for it then youāre not as effective as you might be.  The answer to how much does it cost to run Baldrige, well take however much it cost to run your business, subtract eight or ten percent, thatās how much and it costs thatās the attitude that youāve gotta be, it has to be how you do your business, it has to be the way of your business and when you get to a point where you donāt have to cram for when the site visit comes then you know itās part of your business.  So whatās next for us, weāre gonna keep going and weāre gonna keep moving ahead; we received the Baldrige Award this year and we had 32 OFIās we are like seriously mediocre and so when I say weāre just like folks, weāve got 32 OFIās weāre working on desperately this year and if any of you think that somehow weāre so much better, weāre just you, we are you and next year you could be here and youāre gonna have 32 OFIās and youāre gonna keep working hard at it too.  Weāve got action plans, weāre gonna work harder to engage the physicians and we wanna help other Baldrige organizations along the journey have regular people like us also have an extraordinary experience in receiving the Baldrige Award, it has been an unbelievable week, we are honored to be here.  I think I do work with the best team ever in the universe and itās an honor for me to be here with them and to have let you take just a minute to see them.  Thank you very much for being so nice to us this week.
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