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By Christine Schaefer
April 18, 2017
In July 2013, Greg Adams became chief operating officer of Tennessee, a new position in the state’s government. From the start, Adams said recently, “We had a big focus on the transformation of government.”
From his previous career at IBM, Adams was familiar with the Baldrige Excellence Framework, produced by a federal program within the Commerce Department’s National Institute of Standards and Technology. IBM’s Rochester plant had earned a Baldrige Award in 1990. Adams recognized the framework as “a potential tool to use to improve government performance,” he said.
Among key concepts of the Baldrige framework reflected in the state’s focus on high-quality government in recent years is “customer-focused excellence.” Governor Bill Haslam implemented an initiative called CFG (for customer-focused government) “to drive a new mindset across Tennessee government,” said Adams. CFG has five objectives:
1. Improve customer service;
2. Lower operating costs;
3. Increase flexibility and promote the pooling of skills, tools and information;
4. Streamline and integrate organizations and processes; and,
5. Improve data usage for better decision-making and investment resources.
“The Baldrige framework reinforces what we’re doing as one of our key toolsets,” said Adams, pointing out that it’s the center of the state’s strategic framework (depicted below). “We also use Lean and Covey’s Four Disciplines of Execution.”
Viewing State Government as an Enterprise
Adams described how the Baldrige framework’s systems perspective has been adopted within the state’s executive branch of 23 departments. “One example: We had 176 logos for state agencies; we found it confusing for our citizens and costly,” he said. “Two years ago we… went to one common logo, and departments could put their name on it. That has helped us implement the CFG initiatives, as employees see they’re part of one enterprise.”
As part of a yearly planning process, each department now submits a CFG plan with goals that align with state government objectives. Under the banner “Transparent TN,” Adams added, “a subset of our milestones and metrics are posted on our website.” Among results the government is proud to have earned is a “Triple A” bond rating from all three rating agencies (achieved by only 11 states).
A Strong Foundation for Baldrige
Adams credits the Tennessee Center for Performance Excellence (TNCPE) with supporting use of the Baldrige framework in the state. The nonprofit is among state and regional partners of the Federal Baldrige Performance Excellence Program.
“We had a strong foundation with the TNCPE,” Adams said. He pointed out that two state commissioners on TNCPE’s board of directors have pioneered adoption of the Baldrige framework within their departments. “Having Commissioners [Rebecca] Hunter [Department of Human Resources] and [John] Dreyzehner [Department of Health] on the TNCPE board made it easier to deploy the Baldrige framework [more widely],” said Adams.
In 2016 alone, the Tennessee Department of Health earned an advanced level Achievement Award through TNCPE’s assessment and recognition program, and the Tennessee Department of Human Resources earned an intermediate-level Commitment Award. In addition, two county health departments earned Commitment Awards, and 24 other county health departments or districts earned beginner level Interest Recognition in 2016.
“I’m really proud that our department has journeyed to a level 3 Achievement Award through the TNCPE,” said Dreyzehner. “Our examiner corps is critical to the success of our top-down and bottom-up approach, with most of our counties achieving at least a level one award.”
Dreyzehner noted that the Baldrige framework is complementary to other improvement methodologies his department uses, including Lean and Plan-Do-Check-Act. “For me, the Baldrige framework is like that plastic thingy that holds [a six-pack] together,” he said, repeating a metaphor he shared in a 2014 blog. “There are lots of different tools in your toolbox when you use the framework.”
As an example, Dreyzehner described the work of Micky Roberts, who led a county health department to earn a TNCPE Achievement Award for making its operations more efficient and effective using Lean and the Baldrige framework. Today, Roberts serves as deputy assistant commissioner for policy, planning and assessment for the state health department, where he continues facilitating performance improvement.
Highlighting results of his department’s Baldrige-based approaches, Dreyzehner described outcomes from improving a program to reduce smoking by pregnant women. “We looked at our results and discovered one barrier to success for women in the program was being around other household members who smoked,” he said.
“[After] adding a component focused on encouraging smoking cessation for other household members… we improved an initiative that went on to reduce pregnancy smoking by 11 percent and the number of low-birthweight babies by 50 percent, and we estimate a net savings so far of more than $5 million in the costs of treating low-birthweight babies.”
Dreyzehner also described a statewide reduction in the overprescribing of opioids through his department’s use of a cross-functional team to address the problem—an approach he linked to use of the Baldrige systems perspective and measurement imperative. In 2016, Tennessee demonstrated best-in-class performance on reducing morphine milligram equivalents, and the National Safety Council identified it as one of only four states making progress in relation to six indicators of opioid abuse prevention.
Author: Christine Schaefer is a staff member of the Baldrige Performance Excellence Program. She currently leads the team that manages publications, communications, the Baldrige Award process and other assessments, and training. She has a bachelor’s degree from the University of Virginia in political and social thought and a master’s degree from Georgetown University, where her studies focused on public policy issues.