title: Kaiser Permanente's performance improvement system, Part 1: From benchmarking to executing on strategic priorities.
abstract: BACKGROUND
  By 2004, senior leaders at Kaiser Permanente, the largest not-for-profit health plan in the United States, recognizing variations across service areas in quality, safety, service, and efficiency, began developing a performance improvement (PI) system to realizing best-in-class quality performance across all 35 medical centers. MEASURING SYSTEMWIDE PERFORMANCE: In 2005, a Web-based data dashboard, "Big Q," which tracks the performance of each medical center and service area against external benchmarks and internal goals, was created. PLANNING FOR PI AND BENCHMARKING PERFORMANCE: In 2006, Kaiser Permanente national and regional continued planning the PI system, and in 2007, quality, medical group, operations, and information technology leaders benchmarked five high-performing organizations to identify capabilities required to achieve consistent best-in-class organizational performance. THE PI SYSTEM: The PI system addresses the six capabilities: leadership priority setting, a systems approach to improvement, measurement capability, a learning organization, improvement capacity, and a culture of improvement. PI "deep experts" (mentors) consult with national, regional, and local leaders, and more than 500 improvement advisors are trained to manage portfolios of 90-120 day improvement initiatives at medical centers.
  
  
  CONCLUSIONS
  Between the second quarter of 2008 and the first quarter of 2009, performance across all Kaiser Permanente medical centers improved on the Big Q metrics.
  
  
  CONCLUSIONS
  The lessons learned in implementing and sustaining PI as it becomes fully integrated into all levels of Kaiser Permanente can be generalized to other health care systems, hospitals, and other health care organizations.
authors.affiliation: National Health Care Performance Improvement and Execution Strategy, Kaiser Foundation Health Plan, Inc., Oakland, California, USA. lisa.schilling@kp.org
authors.forename: Lisa
authors.initials: L
authors.lastname: Schilling
authors.forename: Alide
authors.initials: A
authors.lastname: Chase
authors.forename: Sommer
authors.initials: S
authors.lastname: Kehrli
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Liu
authors.forename: Matt
authors.initials: M
authors.lastname: Stiefel
authors.forename: Ruth
authors.initials: R
authors.lastname: Brentari
mesh_terms: D019985:Benchmarking; D006279:Health Maintenance Organizations / Q000592:standards*; D006801:Humans; D015279:Organizational Culture; D009936:Organizational Innovation; D009937:Organizational Objectives; D010934:Planning Techniques; D019984:Quality Indicators, Health Care; D017751:Safety Management / Q000458:organization & administration; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States