The objective of this research was to determine whether there is a relationship between the level of maturity of an organization's business processes as measured by the Malcolm Baldrige National Quality Award's Criteria for Performance Excellence (BCPE) and the level of employee engagement. Two organizations were selected for the study based on their overall level of maturity measured by the BCPE scoring guide representing firms with high and low levels of maturity. The first hypothesis tested indicates a negative statistically significant relationship between the level of maturity of an organization and the level of employee engagement. Next, the level of employee engagement between males and females was significantly different as the level for men was higher than the level for women participating in the study. Finally, no support was found for the third hypothesis exploring differences in the levels of employee engagement between military and civilian employees. This study was limited to predominantly full-time personnel assigned to two of twenty-eight state Army National Guard (ARNG) organizations that participated in the ARNG Army Communities of Excellence (ACOE) award process during the award years of 2009-2010. The absence of support for the BCPE's effect on the level of employee engagement within organizations could be an indicator of other factors affecting employee engagement that are needed to be researched further before any conclusions can be reached.

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The purpose of this study was to determine the core competencies needed by state Baldrige examiners, to identify best practices in examiner training programs provided by state Baldrige organizations, and to identify best practices for teaching core competencies. A Delphi panel ranked core competencies, best practices, and best practices for teaching core competencies using a Likert-style survey. Descriptive statistics and a formula for determining consensus quantified the results. The key findings of this study were that the Baldrige Criteria for Performance Excellence continue to provide the core competencies for which examiners need to be trained to effectively evaluate and score applications and provide meaningful feedback to applicants. The best practices for teaching core competencies, however, vary according to the needs of each state organization and the expertise and teaching styles of the trainers in the various state organizations. Coaching was the one best practice upon which the panel agreed as being applicable to teaching most of the core competencies. A template for training examiners using the best practices for teaching core competencies was the outcome of this study. Recommendations include using this template to train examiners and using the actual teams, of which the examiners will be a part, for evaluating and scoring the applications from receipt of the application through the life of the application. It is recommended that the individual review of applications be eliminated. As examiners will work with the actual applications from the beginning of the process, it is recommended that the case study be eliminated as pre-work. It is also recommended that coaches work with the actual teams from the training session until the feedback report is written.

The purpose of this single case study was to explore the strategies that leaders of a nonprofit organization used to build long-term donor relationships through social media. Participants included a purposeful sample of 3 senior leaders of a small nonprofit organization in Southern California who demonstrated successful approaches to using social media to manage donor relations. The conceptual framework for this study was Hon and Grunig’s concept for measuring long-term organization–public relationships. Data were collected through semistructured interviews with organization leaders, review of publicly available organizational documents, and information including financial statements, strategic planning documents, organizational budgets, employee handbooks, and board manuals. Member checking and methodological triangulation were used to validate the findings. Data from organizational documents and interviews were manually coded, and themes were identified using content analysis. Five themes emerged related to process strengths and opportunities including leadership succession and performance evaluation, workforce capacity, revenue diversification, performance measurements and data collection, and the expansion of relationship management via social media. The findings from this study might contribute to positive social change by providing strategies for building long-term relationships with donors through social media and the supporting processes that nonprofit leaders can use to increase financial resources through a loyal donor community and enhance organizational sustainability.

School systems nationwide confront declines in the number of principal applicants while facing increasing student accountability concerns. The idiosyncrasies of adolescent development and the social nature of the educational environment reflect the declines in applicants and impact student accountability. Using a three-tiered case study, the present research inquiry identified perspectives of superintendents, middle school principals, and middle school teachers regarding Baldrige-based practices in the four Malcolm Baldrige National Quality Award-winning school districts in the United States. This study's data illuminated how a non-prescriptive framework such as the Baldrige National Quality Program (BNQP) combined with Baldrige Education Criteria for Performance Excellence (BECPE) assessment instrument, were utilized by the superintendents and middle school principals in the award-winning schools to address the issues of both instructional leadership and student achievement. Perspectives from targeted superintendents, middle school (grades 6-8) principals, and middle school teachers regarding Baldrige-based practices as they relate to instructional leadership in middle level education were investigated. Research participants from Chugach School District in Anchorage, Alaska; Pearl River School District in Pearl River, New York; Community Consolidated School District 15 in Palatine, Illinois; and Jenks Public Schools in Jenks, Oklahoma discussed the adoption, implementation, and maintenance of the Baldrige National Quality Program, combined with the ongoing utilization of BECPE, in their middle schools. Respondents disclosed instructional leadership beliefs and practices utilized within their school and/or district. Utilizing information from the three interview protocols created for superintendents, middle school principals, and middle school teachers in the targeted districts, an analysis of themes emerged from the transcribed interviews and interview correspondences, providing insight about the gaps in research literature pertaining to the application of Baldrige-based practices in middle level education. These gaps substantiated the need for continued research that examines the role of instructional leadership in creating Baldrige environments in the middle school arena. Overall, the qualitative results of this exploratory study promoted understanding and informed efforts to build instructional leadership in other middle level educational institutions across the nation.

This dissertation study presents a conceptual framework for implementing and assessing patient safety systems in healthcare institutions. The conceptual framework consists of critical processes and performance measures identified in the context of the 2003 Malcolm Baldrige National Quality Award (MBNQA) Health Care Criteria for Performance Excellence. Methodology: The Delphi technique for gaining consensus from a group of experts and forecasting significant issues in the field of the Delphi panel expertise was used. Data collection included a series of questionnaires where the first round questionnaire was based on literature review and the MBNQA criteria for excellence in healthcare, and tested by an instrument review panel of experts. Twenty-three experts (MBNQA healthcare reviewers and senior healthcare administrators from quality award winning institutions) representing 18 states participated in the survey rounds. The study answered three research questions: (1) What are the critical processes that should be included in healthcare patient safety systems? (2) What are the performance measures that can serve as indicators of quality for the processes critical for ensuring patient safety? (3) What processes will be critical for patient safety in the future? The identified patient safety framework was further transformed into a patient safety tool with three levels: basic, intermediate, and advanced. Additionally, the panel of experts identified the major barriers to the implementation of patient safety systems in healthcare institutions. The identified "top seven" barriers were directly related to critical processes and performance measures identified as "important" or "very important" for patient safety systems in the present and in the future. This dissertation study is significant because the results are expected to assist healthcare institutions seeking to develop high quality patient safety programs, processes and services. The identified critical processes and performance measures can serve as a means of evaluating existing patient safety initiatives and guiding the strategic planning of new safety processes. The framework for patient safety systems utilizes a systems approach and will support healthcare senior administrators in achieving and sustaining improvement results. The identified patient safety framework will also assist healthcare institutions in using the MBNQA Health Care Criteria for Performance Excellence for self-assessment and quality improvement.

This study examined the process of third-party scoring of organizational self-assessments. An experiment was conducted to illustrate the magnitude of score consistency and accuracy among evaluators, estimate the impact of frame-of-reference (FOR) training on score consistency and accuracy, and explore the relationship between evaluator characteristics and score accuracy. The organizational self-assessment used was the 1995 Malcolm Baldrige National Quality Award Colony Fasteners Case Study. The subjects were 81 graduate students enrolled in two televised graduate engineering courses with considerable quality management content. Subjects were randomly assigned to groups and randomly assigned to four of the seven categories of the Baldrige Award. Each subject evaluated the case study against two categories prior to the treatment. Subjects in the control group evaluated two additional categories and then a two and one-half hour FOR training intervention was provided to all subjects. Next, subjects in the treatment group evaluated their two additional categories. Finally, a questionnaire was administered regarding evaluator characteristics related to previous experience and education. Accuracy was assessed by comparing subjects’ scores to experts’ scores and calculating indices (elevation and dimensional accuracy) for each subject’s scores on each category. Prior to training, no statistical differences were found between groups, but a leniency effect was observed for all subjects. Category 6.0, Business Results, and Category 7.0, Customer Focus and Satisfaction, had statistically smaller score variances than the other five categories. After training, group x time ANOVAs found evidence of an interaction. Examination of simple effects found significant differences between the group mean scores for all three items from Category 6.0 and two of the four items from Category 5.0. Significant simple time effects were found for all three items from Category 6.0 for the treatment group. No meaningful differences were found between group score variances. A significant difference in category score variance was seen across categories for the untrained group. Training improved elevation accuracy, but no evidence was seen of effects on DA. Exploratory regression produced a prediction equation for DA with an adjusted R-square of 0.538. Predictors included work experience, QA/QC experience, employer’s industry and employer’s size. / Ph. D.

This research examines the relationship between quality management (QM) practices and performance in the healthcare industry via the conduct of three studies. The results of this research contribute both to advancing QM theory as well as in developing a unique text mining method that is illustrated by examining QM in the healthcare industry. Essay 1 explains the relationship between operational performance and QM practices in the healthcare industry. This study analyzed the findings from the literature using meta-analysis. We applied confirmatory semantic analysis (CSA) to examine the Baldrige winners' applications. Essay 2 examines the benefits associated with an effective QM program in the healthcare industry. This study addressed the research question about how effective QM practice results in improved hospital performance. This study compares the performance of Baldrige Award-winning hospitals with matching hospitals, state average, and national average. The results show that the Baldrige Award can lead to an increase in patient satisfaction in certain periods. Essay 3 discusses the contribution of an online clinic appointment system (OCAS) to QM practices. An enhanced trust model was built on understanding the mechanism of patients' trust formation in the OCAS. Understanding the determinants related to patients' trust and willingness to use OCAS can provide valuable guidance for medical institutions to establish health information technology-based services in the quality service improvement programs. This research has three significant contributions. First, this research analyzes the role of QM practices in the healthcare industry. Second, this research attempts to develop a unique text mining method. Third, this research provides a validated trust model and contributes to the body of research on the trust of healthcare information technology.

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