2011 AHCA/NCAL National Quality Award Program - Bronze Award –

1. 2011 AHCA/NCAL National Quality Award Program- Bronze Award – Tim Case, AHCA/NCAL National Quality Award Administrator

2. 2011 Quality Award Schedule • Intent to Apply Submission Process Opens November 15, 2010 • Intent to Apply Deadline: January 18, 2011 at 8:00pm EST • Applications Accepted Online: February 1, 2011 • Bronze Application Deadline: February 28, 2011 at 8:00pm EST • Bronze Applicant Notification and Feedback Distribution June 30, 2011 • AHCA/NCAL Annual Convention & Expo (Las Vegas, NV) September 18 - 21, 2011

3. AHCA/NCAL National Quality Award3 Steps to Baldrige Baldrige Performance Excellence Program • Bronze – Organizational Profile • Silver – Core Values and Concepts • Gold – Health Care Criteria for Performance Excellence

4. Bronze Requirements Responses to 2.0 criteria in two areas: • Organizational Description • Organizational Environment • Organizational Relationships • Organizational Situations • Competitive Environment • Strategic Context • Performance Improvement System.

5. Bronze: Keys to Success • There are no trick questions. • Labeling sections as directed is required. • Address all areas of each criteria. • Adhere to the technical requirements.

6. Eligibility Requirements (Bronze) Member of AHCA/NCAL. No substandard quality of care or immediate jeopardy on any surveys within the last three years. Applicants with multi-levels of care may elect to apply for the entire organization or may apply for a distinct part of the organization, but make sure you are consistent throughout the application. Applicants must participate in a Quality Award educational program (by participating in this seminar, you have met the requirement). 6

7. Technical Requirements • 5 page limit, plus 1 page for acronyms only - 8 ½ by 11” page size, 12-pt Times New Roman font, 1” margins. • Pages must be numbered. • Must complete all sections of the application and label responses appropriately. • Applications should be written in prose style using complete sentences. • Graphs, charts and tables are encouraged. Text within tables – 10pt, within graphs – 8pt. • Refer to page 7 for complete technical requirements.

8. Submitting Your Application • Bronze applications are submitted electronically via AHCA/NCAL website (www.ahcancal.org). • Deadline to submit is February 28, 2011; 8:00pmEST. Late applications will not be accepted! • Submit one Microsoft Word document that includes responses to criteria (5-page limit). • All successful submissions will generate a confirmation email.

9. Remember! • You are responsible for what you submit. • Draft versions • Incomplete versions • Incorrectly formatted versions • Late submissions • The first application you submit will be reviewed.

10. Ethical Requirements When you submit an application you are personally certifying that; • The application is an accurate and true reflection of the application of the AHCA/NCAL award criteria to this facility. • The content of this application is original to this facility and was not supplied by others, including the corporate office, parent company, or external consultants (mission statement exempt). • You understand that if the application is deemed by AHCA/NCAL not to meet these requirements, it will be disqualified and the application fee will be forfeited. • Applications will be compared against other current and previous applications to screen for originality.

11. Multi-Facility Coordination Tips • Read, understand and disseminate the appropriate resources from the AHCA/NCAL website: at http://www.ahcancal.org/quality_improvement/quality_award/Pages/ApplicantResources.aspx • Require that every facility applying view the two Bronze webinars posted on the website.

12. Multi-Facility Coordination Tips • You can not supply any text to be used verbatim in a facilities application. • Warn facilities against copying text verbatim from corporate materials. • Coordinators (including consultants) can function as application reviewers, but not as application writers.

13. The Bronze Criteria • Let’s break down the criteria.

14. P.1: Organizational Description • What are your key organizational characteristics? Describe your organization’s operating environments and your key relationships with residents, stakeholders, suppliers and partners.

15. P.1:Organizational Description a. Organizational Environment b. Organizational Relationships

16. a. Organizational Environment (1) What is the organization’s environment: urban, suburban, rural, etc.? (2) What are the applicant’s major health care services (e.g., skilled nursing, subacute, assisted living, etc.)?

17. a. Organizational Environment (3) What is the organization’s mission/vision statement (verbatim) and the specific methods used to communicate it across the organization? (4) What is the organization’s workforce profile? Identify your key workforce groups by position (e.g., professional nurse, nursing assistant, cook, dietary aide, housekeeper), the desired number in each position, and a general description of the education level and/or professional requirements for each position. Consider using a table to provide your response.

18. a. Organizational Environment (5) What are the organization’s major equipment and technologies (e.g. computers, transfer equipment, automated dispensers, alarm devices, etc.)? (6) What is the regulatory environment under which the organization operates? What are the applicable health care delivery, occupational health and safety, physical plant, payment and reimbursement regulations?

19. b. Organizational Relationships (1) What are the organization’s principal stakeholders groups? Include customers and other groups most affected by the organization's services, actions, and success. What are the differences in requirements and expectations among stakeholder groups? In addition to residents, identify three other principal stakeholders in the first column of the table below. In the second column, identify the important requirements that each of these principal stakeholder groups has of the organization. In the third column, identify the processes that your organization uses to learn of these important stakeholder requirements. Your responses should be complete and clear.

20. b. Organizational Relationships (2) What are the key types of suppliers of goods and services, including other health care providers? (3) From the above, what are the most important types of suppliers of goods and services?

21. b. Organizational Relationships (4) What are the limitations, special business relationships, or special requirements that may exist with some or all suppliers and partners? (5) What are the organizational structure and key management links to the parent company if the applicant organization is owned by a parent organization? Respond “NA” if the applicant is not owned by a parent organization.

22. P.2 Organizational Situation What is your organization’s strategic situation? Describe your organization’s competitive environment, key strategic challenges and advantages, and your system for performance improvement.

23. P.2 Organizational Situation a. Competitive Environment b. Strategic Context c. Performance Improvement System

24. a. Competitive Environment (1) What is the organization’s position (relative size) within the local market environment? Include numbers and types of competitors. (2) What are the principal factors that determine competitive success in the local market?

25. a. Competitive Environment (3) What are your key available sources of comparative and competitive data from within the long term care profession? What limitations, if any, are there in your ability to obtain this data? (Consider your access to comparative data provided by national surveys, published research on turnover rates, the federal nursing home compare website, state health care associations, your multi-facility organization, state data bases for cost reports and census data, "secret shopper " initiatives, etc. Some organizations may not have access to much comparative data because of the category of long term care organization, location, or ownership, While a specific number of sources is not required, applicants should show some initiative in finding something that will help them assess their position in their competitive environment.)

26. b. Strategic Context (1) What are at least two major strategic challenges or advantages for the organization (e.g., entry into new markets or segments, human resource recruitment and retention, new alliances with suppliers, physicians, or other partners, introduction of new technologies, changes in the health care environment that impact the organization’s delivery of services, changes in strategy, or other challenges or advantages)?

27. b. Strategic Context (2) What is the reason(s) why it is important that the organization address these challenges or advantages?

28. c. Performance Improvement System (1) What are the key elements of your performance improvement system? In your response, describe the key steps and/or tools that you typically use for process improvement or innovation. To qualify for the Bronze award level, you must be able to articulate the approach you generally use to improve a performance outcome. At the Silver award level, applicants should be able to describe a specific methodology that they systematically use throughout the organization for process improvement and innovation. This may be a methodology such as FOCUS-PDSA, Six Sigma's DMAIC, or another approach that has been developed or adopted by the organization from other resources such as Advancing Excellence.

29. c. Performance Improvement System (2) What one clinical quality indicator did the organization improve by applying the key elements of your performance improvement system? The indicator should be clearly clinical in nature, not merely a process measure that impacts a clinical indicator. Using the key steps and/or tools of your performance improvement system, describe the process by which this indicator was improved, including what specific changes were made. Include data illustrating the improvement. IFC/MR facilities only: Given the largely non-clinical nature of IFC/MR services, these facilities may report on improvement of a non-clinical indicator in response to this criteria.

30. c. Performance Improvement System (3) Assisted Living Facilities (ALFs) and Developmental Disability (DD) residential services providers only: Because you are unable to report survey data, please report briefly on a second quality improvement effort. This effort need not necessarily be clinical in nature. Describe the process by which improvement was attained, including what specific changes were made. Include data illustrating the improvement.

31. c. Performance Improvement System (4) What are the organization’s key organizational performance measures?

32. The difference between a good application and a great one? Integration!

33. For more information... For more information about the AHCA/NCAL National Quality Award Program, please contact either Tim Case at tcase3362@charter.net or Courtney Krier at ckrier@ahca.org