All the models for business excellence have a similar structure. The prime focus of business excellence includes:

• leadership.
• continuous improvement of key performance measures.
• customer satisfaction.
• effective use of information.
• good people management.
• quality processes.

The message of business excellence has not changed over the years. Yet the “real world” in many businesses, including healthcare organizations, continues to struggle to achieve high performance. A lot of energy is expended as people pursue the strenuous task of becoming higher performers with efforts such as team building, process improvement activities, elimination of waste in processes, and participative problemsolving. Even though patient care operations may seem comfortable, they, in no way, approach high performance.

One of the key attributes of high performing healthcare organizations is alignment. Alignment refers to the degree of congruence or consistency within the organization, i.e., how well the various systems, structures, messages (both spoken and unspoken), and styles support and reinforce each other on an everyday basis. A leader who preaches the importance of a non-punitive environment and then disciplines the next person who makes a mistake is not creating alignment. An organization that advocates teamwork, but continues to hire, promote, evaluate, and reward staff based solely on individual performance is not creating alignment.

To advance organizational alignment, senior leaders must ensure that all elements of the business are integrated and aligned with the organization’s mission, vision, and strategic objectives. In addition, leaders must promote a high degree of coherence between the individual elements of the organization’s performance management system.

After completing this activity, the participant should be able to:

• identify opportunities for improving organizational alignment by using the Baldrige criteria.
• discuss a common vision for deployment throughout all levels of the organization.
• discuss how to move the organization from isolated pockets of excellence to system-wide improvements that advance strategic goals.
• explain how to establish mechanisms for improving accountability and ownership for performance excellence.
• discuss improvements for interdepartmental teamwork and employee morale.