i

Contents

ii About the Baldrige Excellence Framework

The Baldrige framework empowers your organization to reach its goals, improve results, and become more 

competitive. The framework consists of the Criteria, the core values and concepts, and the scoring guidelines.

v How to Use the Baldrige Excellence Framework

You can use this booklet as a reference, for self-assessment, or as the basis of an external assessment. 

1 Health Care Criteria for Performance Excellence Overview and Structure 

The Health Care Criteria include the Organizational Profile and seven interconnected categories.

3 Health Care Criteria for Performance Excellence Items and Point Values

4 Health Care Criteria for Performance Excellence

4 Organizational Profile

7 1 Leadership

10 2 Strategy

13 3 Customers

16 4 Measurement, Analysis, and Knowledge Management

19 5 Workforce 

22 6 Operations

25 7 Results 

29 Scoring System 

Performance against Health Care Criteria items is scored on two evaluation dimensions: process and results.

32 Process Scoring Guidelines 

33 Results Scoring Guidelines 

35 How to Respond to the Health Care Criteria

This section explains how to respond most effectively to the Health Care Criteria item questions. 

38 Core Values and Concepts

These embedded beliefs and behaviors form the foundation of the Health Care Criteria. 

44 Changes from the 2019–2020 Baldrige Excellence Framework

46 Glossary of Key Terms 

The glossary includes definitions of terms in small caps in the Health Care Criteria and scoring guidelines. 

54 Index of Key Terms

58 List of Contributors

On the Web

Health Care Criteria Commentary (https://www.nist.gov/baldrige/baldrige-criteria-commentary-health-care)

• This commentary provides the “why” behind the Health Care Criteria, as well as additional examples and guidance.

From Baldrige Performance Excellence Program. 2021. 2021–2022 Baldrige Excellence Framework (Health Care): Leadership 

and Management Practices for High Performance. Gaithersburg, MD: U.S. Department of Commerce, National Institute of 

Standards and Technology. https://www.nist.gov/baldrige.
14 2021–2022 Health Care Criteria for Performance Excellence

3.2 Customer Engagement: How do you build relationships with patients and other 

customers and determine satisfaction and engagement? (45 pts.)

a. Patient and Other CuStoMer Experience

(1) Relationship Management HoW do you build and manage relationships with patients and other CuStoMerS?

how do you

• acquire patients and other customers and build market share;

• manage and enhance your brand image;

• retain patients and other customers, meet their requirements, and exceed their expectations in each stage of

their relationship with you?

(2) Patient and Other CuStoMer Access and Support HoW do you enable patients and other CuStoMerS to seek

information and support? how do you enable them to access your services? What are your key means of patient

and other customer support and communication? how do they vary for different patient and other customer

groups or market segments, as appropriate? how do you

• determine your patients’ and other customers’ key support requirements, and

• deploy these requirements to all people and processes involved in patient and other customer support?

(3) Complaint Management HoW do you manage patient and other CuStoMer complaints? how do you

resolve complaints promptly and effectively? how does your management of complaints enable you to recover

your patients’ and other customers’ confidence, enhance their satisfaction and engagement, and avoid similar

complaints in the future?

(4) Fair Treatment How do your patient and other CuStoMer experience ProCeSSeS ensure fair treatment for

different patients, patient groups, other CuStoMer groups, and market SeGMentS?

b. Determination of Patient and Other CuStoMer Satisfaction and enGaGeMent

(1) Satisfaction, Dissatisfaction, and enGaGeMent HoW do you determine patient and other CuStoMer satisfaction, dissatisfaction, and enGaGeMent? how do your determination methods differ among your patient and

other customer groups and market segments, as appropriate? how do your measurements capture actionable

information?

(2) Satisfaction Relative to Other Organizations HoW do you obtain information on patients’ and other

CuStoMerS’ satisfaction with your organization relative to other organizations? how do you obtain information on your patients’ and other customers’ satisfaction

• relative to their satisfaction with your competitors; and

• relative to the satisfaction of patients and other customers of other organizations that provide similar health

care services or to health care industry benchmarks, as appropriate?

c. Use of voiCe-of-tHe-CuStoMer and Market Data

HoW do you use voiCe-of-tHe-CuStoMer and market data and information? how do you use voice-of-thecustomer and market data and information to build a more patient-focused culture and support operational

decision making?

Terms in small caps are defined in the Glossary of Key Terms (pages 46–53).

Notes

3.2. Results for patient and other customer perceptions and 

actions (outcomes) should be reported in item 7.2.

3.2a(4). You should ensure that your approaches for 

managing patient and other customer relationships, 

enabling patient and other customers to seek information 

and support, and managing complaints promote equity and 

inclusion, and that they do not inadvertently discriminate 

unfairly or inappropriately against specific patients or 

patient groups.

3.2b(1). Determining dissatisfaction should be seen as more 

than reviewing low satisfaction scores. It should be independently determined to identify root causes and enable a 

systematic remedy to avoid future dissatisfaction. 

PROCESS
3.2b(2). Information you obtain on relative satisfaction may 

include comparisons with competitors; comparisons with 

other organizations that deliver similar health care services 

in a noncompetitive marketplace; or comparisons obtained 

through third-party surveys or surveys endorsed or required 

by payors, such as the Consumer Assessment of Healthcare 

Providers and Systems (CAHPS). Such information may 

also include information on why customers choose your 

competitors over you.

3.2c. Patient and other customer data and information 

should be used to support the overall performance reviews 

addressed in 4.1b. Voice-of-the-customer and market data 

and information to use might include aggregated data on 

complaints and, as appropriate, data and information from 

social media and other web-based or digital sources. 

For additional guidance on this item, see the Health Care 

Criteria Commentary (https://www.nist.gov/baldrige

/baldrige-criteria-commentary-health-care).

3 Customers 15