Background: Bronson Healthcare Group, a 343-bed not-for-profit health care system serving all of south-west Michigan and northern Indiana, has as its flagship Bronson Methodist Hospital, the recipient of the 2005 Malcolm Baldrige National Quality Award. Overall Approach to Quality and Safety: The Baldrige criteria were used to formalize Bronson's approach to performance excellence. The strategic plan is condensed and communicated via a "Plan for Excellence" focused on three strategies: clinical excellence, customer and service excellence, and corporate effectiveness. Addressing the Institute of Medicine (IOM) Quality Aims: Initiatives include clinical scene investigation (a system for reporting and investigating sentinel and atypical events), a strategy for educating staff in the Situation-Background-Assessment-Recommendations (SBAR) communication technique, and mandatory influenza immunization for health care staff (safety), patient health literacy needs and a health information center (patient centeredness); methods to reduce bloodstream and ventilator-acquired pneumonia infections (effectiveness); a physician portal for access to forms, test results, and patient information (efficiency); restaurant-style pagers for patients and families while waiting (timeliness); and community outreach (equity). Challenges and Lessons Learned: Bronson's journey to excellence continues with more accountability for hand-off communication and teamwork, enhancing a non-punitive environment for patient safety reporting, and further incorporating patient and family involvement.
