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Implementing the Charter on Professionalism

Griffith, John R. MBA

doi: 10.1097/ACM.0000000000001975
Letters to the Editor

Professor emeritus, School of Public Health, University of Michigan, Ann Arbor, Michigan;

Disclosures: None reported.

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To the Editor:

“The Charter on Professionalism for Health Care Organizations”1 is an exceptional contribution to an important but complex problem. The Charter articu lates 22 “commitments” to “nurture professionalism, to encourage the pursuit of excellence by all employees, and to achieve outstanding health care.”1 Of particular interest are 6 commitments addressing the overall ambience, or culture, of the organization: engagement, shared decision making, collaboration, the well-being of individuals, teamwork, and accountability. These characteristics are accepted as critical to both individual motivation and team effectiveness.2 “Commitments,” however, are unlikely to be enough. Health care has made few gains since the publication of the seminal report “To Err Is Human.”3 The variability remains unacceptable.4 The critical need is to rebuild our delivery organizations with fundamental changes that support the commitment concepts.

There is a small but diverse set of health care provider organizations that have documented and sustained success in achieving these concepts. They are the 19 winners of the Baldrige Quality Award in Healthcare. The winners routinely achieve top-quartile and often top-decile performance in health care quality, patient satisfaction, and worker satisfaction. The “Baldrige Model”5—work practices that are fully documented, audited, and publicly available (—fulfills the Charter’s commitments in the six critical areas and provides a foundation for the entire Charter. We need a national effort to make it the new standard of practice.

John R. Griffith, MBA
Professor emeritus, School of Public Health, University of Michigan, Ann Arbor, Michigan;

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1. Egener BE, Mason DJ, McDonald WJ, et al. The charter on professionalism for health care organizations. Acad Med. 2017;92:10911099.
2. Barends E, Rousseau DM, Briner RB. Evidence-Based Management: The Basic Principles. 2014. Amsterdam, the Netherlands: Center for Evidence-Based Management; Accessed August 21, 2017.
3. Kohn LT, Corrigan J, Donaldson MS; Institute of Medicine. To Err Is Human: Building a Safer Health System. 2000. Washington, DC: National Academy Press; Accessed August 21, 2017.
4. Rosenberg BL, Kellar JA, Labno A, et al. Quantifying geographic variation in health care outcomes in the United States before and after risk-adjustment. PLoS One. 2016;11:e0166762.
5. Griffith JR. An organizational model for excellence in healthcare delivery: Evidence from winners of the Baldrige Quality Award. J Healthc Manag. 2017;62:114.
Copyright © 2017 by the Association of American Medical Colleges