All ETDs from UAB

Advisory Committee Chair

Larry Hearld

Advisory Committee Members

Nathaniel Carroll

John B McWhorter

Jeff M Szychowski

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


The national Baldrige program has supported performance excellence within healthcare for over twenty years, yet it has seen recent declines in the number of applications despite Baldrige award recipients claiming noteworthy improvements across operational, clinical, and financial outcomes. Previous studies have compared Baldrige hospital recipients to non-recipients, but no studies have empirically investigated the value of pursuing the Baldrige award, regardless of award recognition or not. Furthermore, it is unclear if specific categories of the Baldrige Excellence Framework (BEF) are associated with standardized industry performance outcomes. This study used propensity score matching with linear and quantile regression techniques to understand the impact of hospitals applying the BEF across a comprehensive set of standardized industry performance measures. The analysis demonstrated that Baldrige applicants outperformed non-Baldrige applicants in select operational measures of efficiency (such as inpatient average length of stay), patient experience, and financial measures (including return on net assets, days in accounts receivable, and expenses as a percent of patient revenues). However, there was no statistically significant difference in clinical performance between Baldrige applicants and non-applicants. The study also found relatively few direct and independent associations between the BEF process categories and standardized industry performance measures. The findings from this study suggest that hospital leaders can realize significant gains with some operational and financial measures when applying the BEF within their organizations without compromising clinical outcomes. However, no single criteria may be sufficient on its own to improve performance. Instead the BEF may work systematically to influence performance in select areas, but it may not be enough on its own to generate universal performance improvements.



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