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.

Individual donors are an important source of revenue for nonprofit organizations. However, there is limited information on the attraction and retention of individual donors in nonprofit organizations. This single-case study addressed strategies 3 nonprofit leaders in the Northeast United States use to attract and retain individual donors. The conceptual framework was Kaplan and Norton's strategy map and the 2015-2016 Baldrige Excellence Framework used to evaluate organizational performance. Data collection included semistructured interviews; review of company documents; analysis of data available via GuideStar, an online provider of information on U.S. nonprofit organizations; analysis of data available about U.S. agencies; and review of data and information from other publicly available sources with information on nonprofit organizations. Data analysis included coding of collected data and use of thematic analysis. Four themes emerged from the study: strength in fundraising processes, operational alignment of strategy, opportunities in documentation of processes, and systematic evaluation of programs' effectiveness and organizational learning. Findings may assist nonprofit leaders in aligning organizational strategies with key processes and focusing efforts on the achievement of organizational goals. Nonprofit leaders may use the results to improve access to funds from individual donors and to create valuable community services such as increased access to schools and affordable housing in underserved urban areas.