Abstract

Effective Quality Management Systems (QMS) aim to ensure that organizations are continuously searching to achieve excellence and to satisfy demands from all stake holders. This study attempts to assess the feasibility of using the Baldrige Excellence Framework for designing Quality Management Systems ad hoc to the needs of a specific organization and for providing guidelines for their continuous improvement. The Baldrige Excellence Framework for Health Care was used to assess the current status of the QMS of a Brazilian philanthropic hospital. The information was collected through semi-structured interviews using the questionnaire proposed by said framework. Theoretical sampling was used to select a sample of employees from the hospital to be interviewed. Administrative data was also collected. Grounded Theory was used to analyze the data. The complete assessment of the QMS of the selected hospital is presented. Additionally, we provide a list of steps to replicate this procedure for other hospitals based on our findings, as well as a prioritization model to rank improvement projects required to gradually advance towards excellence, according to certain critical variables, such as impact and implementation cost of the proposed projects. Finally, we also propose a set of indicators to monitor the effectiveness of the QMS over time. Identifying strengths, opportunities for improvement and recommendations according to the structure proposed by the Baldrige Excellence Framework enabled us to design the QMS for the selected hospital and to propose improvement projects that are relevant to the hospital's situation. The use of both the prioritization model for improvement projects and the proposed set of indicators to monitor the effectiveness of the QMS maximizes the likelihood of persistently improving the quality provided by hospitals.