An empirical test of the causal relationships in the Baldrige Health Care Pilot Criteria

This research is the first to empirically test the causal relationships in the Malcolm Baldrige National Quality Award (MBNQA) Health Care Pilot Criteria. The Baldrige model of quality management for the health care industry is tested here using data from 220 US hospitals. Results of confirmatory structural equation modeling show that many of the hypothesized causal relationships in the Baldrige model are statistically significant. For example, Leadership (Baldrige Category 1.0) is identified as a driver of all components in the Baldrige System, including Information and Analysis, Strategic Planning, Human Resource Development and Management, and Process Management. This study also clarifies and improves understanding of within-System performance relationships. Baldrige components of Leadership and Information and Analysis are significantly linked with Organizational Performance Results while Human Resource Development and Management and Process Management significantly link with Customer Satisfaction. In addition, a comprehensive “measurement model” grounded in the Baldrige Health Care Criteria for the 28 dimensions of measurement is developed, tested, and found to be valid and reliable. This valid and reliable measurement model allows a fair test of the “structural model”, which tests the relationships among the Baldrige model constructs. Ten major findings and future research ideas are discussed. © 2001 Elsevier Science B.V. All rights reserved.