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nist-gov/www.nist.gov/baldrige/chickasaw-nation-department-health
Scott Williams 4063bef310 Initital commit.
2025-03-05 18:59:57 +00:00

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<h2><a href="/baldrige">Baldrige Performance Excellence Program</a></h2>
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<a href="/baldrige/how-baldrige-works" data-drupal-link-system-path="">How Baldrige Works</a>
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<a href="/baldrige/how-baldrige-works/about-baldrige/history/how-baldrige-program-began" data-drupal-link-system-path="">How the Baldrige Program Began</a>
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<a href="/baldrige/how-baldrige-works/baldrige-community/board-overseers" data-drupal-link-system-path="">Board of Overseers</a>
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<a href="/baldrige/how-baldrige-works/baldrige-community/executive-fellows" data-drupal-link-system-path="">Executive Fellows</a>
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<a href="/baldrige/how-baldrige-works/baldrige-community/baldrige-foundation" data-drupal-link-system-path="">Baldrige Foundation</a>
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<a href="/baldrige/how-baldrige-works/baldrige-community/state-local-baldrige-based-programs" data-drupal-link-system-path="">State &amp; Local Baldrige-Based Programs</a>
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<a href="/baldrige/how-baldrige-works/baldrige-community/baldrige-ambassadors" data-drupal-link-system-path="">Baldrige Ambassadors</a>
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<a href="/baldrige/how-baldrige-works/baldrige-community/communities-excellence-2026" data-drupal-link-system-path="">Communities of Excellence 2026</a>
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<a href="/baldrige/how-baldrige-works/newsmedia-room/researchers" data-drupal-link-system-path="">Researchers</a>
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<a href="/baldrige/self-assessing" data-drupal-link-system-path="">Self-Assessing</a>
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<a href="/baldrige/self-assessing/getting-started" data-drupal-link-system-path="">Getting Started</a>
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<a href="/baldrige/self-assessing/baldrige-key-terms" data-drupal-link-system-path="">Baldrige Key Terms</a>
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<a href="/baldrige/self-assessing/improvement-tools" data-drupal-link-system-path="">Improvement Tools</a>
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<a href="/baldrige/self-assessing/improvement-tools/foundations-successful-business" title="Foundations for a Successful Business" data-drupal-link-system-path="">Foundations for a Successful Business</a>
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<a href="/baldrige/self-assessing/improvement-tools/are-we-making-progress" data-drupal-link-system-path="">Are We Making Progress?</a>
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<a href="/baldrige/self-assessing/improvement-tools/are-we-making-progress-leaders" data-drupal-link-system-path="">Are We Making Progress as Leaders?</a>
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<a href="/baldrige/self-assessing/improvement-tools/easyinsight-take-first-step-toward-baldrige-self" data-drupal-link-system-path="">easyInsight: Take a First Step Toward a Baldrige Self-Assessment</a>
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<a href="/baldrige/self-assessing/improvement-tools/are-you-role-model-leader" data-drupal-link-system-path="">Are You a Role-Model Leader?</a>
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<a href="/baldrige/self-assessing/improvement-tools/integrating-baldrige-other-tools" data-drupal-link-system-path="">Integrating Baldrige with Other Tools</a>
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<a href="/baldrige/self-assessing/baldrige-sector" data-drupal-link-system-path="">Baldrige by Sector</a>
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<a href="/baldrige/self-assessing/baldrige-sector/manufacturing" data-drupal-link-system-path="">Manufacturing</a>
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<a href="/baldrige/self-assessing/baldrige-sector/manufacturing/are-you-ready-address-your-business-challenges" data-drupal-link-system-path="">Are You Ready to Address Your Business Challenges and Get National Recognition?</a>
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<a href="/baldrige/self-assessing/baldrige-sector/service" data-drupal-link-system-path="">Service</a>
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<a href="/baldrige/self-assessing/baldrige-sector/small-business" data-drupal-link-system-path="">Small Business</a>
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<a href="/baldrige/self-assessing/baldrige-sector/education" data-drupal-link-system-path="">Education</a>
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<a href="/baldrige/self-assessing/baldrige-sector/health-care" data-drupal-link-system-path="">Health Care</a>
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<a href="/baldrige/self-assessing/baldrige-sector/nonprofitgovernment" data-drupal-link-system-path="">Nonprofit/Government</a>
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<a href="/baldrige/products-services" data-drupal-link-system-path="">Products &amp; Services</a>
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<a href="/baldrige/products-services/baldrige-cybersecurity-initiative" data-drupal-link-system-path="">Baldrige Cybersecurity Initiative</a>
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<a href="/baldrige/products-services/baldrige-excellence-framework" data-drupal-link-system-path="">Baldrige Excellence Framework</a>
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<a href="/baldrige/products-services/baldrige-excellence-builder" data-drupal-link-system-path="">Baldrige Excellence Builder</a>
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<a href="/baldrige/products-services/baldrige-executive-fellows-program" data-drupal-link-system-path="">Baldrige Executive Fellows Program</a>
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<a href="/baldrige/products-services/become-baldrige-examiner" data-drupal-link-system-path="">Become a Baldrige Examiner</a>
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<a href="/baldrige/become-baldrige-examiner-welcome" data-drupal-link-system-path="">Director Message</a>
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<a href="/baldrige/products-services/become-baldrige-examiner/examiner-role" data-drupal-link-system-path="">Examiner Role</a>
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<a href="/baldrige/baldrige-examiner-code-ethical-conduct" data-drupal-link-system-path="">Code of Ethical Conduct</a>
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<a href="/baldrige/baldrige-examiner-qualifications" data-drupal-link-system-path="">Qualifications</a>
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<a href="/baldrige/products-services/become-baldrige-examiner/apply" data-drupal-link-system-path="">Apply</a>
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<a href="/baldrige/testimonials-why-serve" data-drupal-link-system-path="">Testimonials</a>
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<a href="/baldrige/products-services/baldrige-examiner-training-experience" data-drupal-link-system-path="">Baldrige Examiner Training Experience</a>
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<a href="/baldrige/publications/baldrige-excellence-framework" data-drupal-link-system-path="">Baldrige Excellence Framework</a>
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<a href="/baldrige/publications/baldrige-excellence-framework/baldrige-excellence-framework-graphics" data-drupal-link-system-path="">Baldrige Excellence Framework Graphics</a>
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<a href="/blogs/blogrige" data-drupal-link-system-path="">Blogrige</a>
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<a href="/blogs/blogrige/2024s-ceo-challenge-implement-systems-perspective-accelerating-speed-trust" data-drupal-link-system-path="">Insights on the Road to Performance Excellence</a>
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<a href="/baldrige/qe" data-drupal-link-system-path="">Quest for Excellence Conference</a>
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<a href="https://www.baldrigeconference.org" data-drupal-link-system-path="">Baldrige Fall Conference</a>
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<a href="/baldrige/conferences/baldrige-exhibit-schedule" data-drupal-link-system-path="">Baldrige Exhibit Schedule</a>
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<a href="/baldrige/award-recipients" data-drupal-link-system-path="">Award Recipients</a>
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<a href="/news-events/news/2024/10/nist-announces-2024-baldrige-awards-performance-excellence" data-drupal-link-system-path="">Current Baldrige Recipients</a>
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<a href="/news-events/news/2024/10/nist-announces-2024-baldrige-awards-performance-excellence/baldrige-best" data-drupal-link-system-path="">Baldrige Best Practice Spotlight</a>
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<a href="/baldrige/award-recipients/name-trademark-guidelines" data-drupal-link-system-path="">Name &amp; Trademark Guidelines</a>
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<li class="usa-sidenav__item usa-sidenav__item--parent">
<a href="/baldrige/baldrige-award" data-drupal-link-system-path="">Baldrige Award</a>
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<a href="/baldrige/baldrige-award/are-you-ready-apply-baldrige-award" data-drupal-link-system-path="">Are You Ready to Apply for the Baldrige Award?</a>
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<a href="/baldrige/baldrige-award/award-criteria" title="Baldrige Award" data-drupal-link-system-path="">Award Criteria</a>
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<a href="/baldrige/baldrige-award/how-apply" data-drupal-link-system-path="">How to Apply</a>
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<li class="usa-sidenav__item">
<a href="/baldrige/baldrige-award/how-apply/application-format" title="Application Format" data-drupal-link-system-path="">Application Format</a>
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</li>
<li class="usa-sidenav__item">
<a href="/baldrige/baldrige-award/award-cycle-overview" data-drupal-link-system-path="">Award Cycle Overview</a>
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<a href="/baldrige/baldrige-award/your-organization-eligible" data-drupal-link-system-path="">Is Your Organization Eligible?</a>
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<li class="usa-sidenav__item">
<a href="/baldrige/baldrige-award/award-process-fees" data-drupal-link-system-path="">Award Process Fees</a>
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<h2
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<div><a href="https://www.x.com/BaldrigeProgram" class="nist-social nist-social--x" title="X (Twitter)" ><span>X (Twitter)</span></a><a href="https://public.govdelivery.com/accounts/USNIST/subscriber/new?qsp=2561" class="nist-social nist-social--envelope" title="GovDelivery" ><span>GovDelivery</span></a><a href="https://www.youtube.com/playlist?list=PL914FB9D44BF49C14" class="nist-social nist-social--youtube" title="Youtube" ><span>Youtube</span></a></div></span></div></div>
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class="nist-page__region nist-page__region--content tablet-lg:grid-col-8 desktop-lg:grid-col-9"
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<h1 class="nist-page__title">Chickasaw Nation Department of Health</h1>
</div>
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class="nist-block"
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<h2 class="nist-social__title">Share</h2>
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<a target="_blank" rel="noopener" href="https://www.facebook.com/share.php?u=https://www.nist.gov/baldrige/chickasaw-nation-department-health"
title="Facebook" class="nist-social nist-social--facebook-gray">
<span>Facebook</span>
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<a target="_blank" rel="noopener" href="https://www.linkedin.com/shareArticle?mini=true&amp;url=https://www.nist.gov/baldrige/chickasaw-nation-department-health&amp;source=https://www.nist.gov/baldrige/chickasaw-nation-department-health"
title="Linkedin" class="nist-social nist-social--linkedin-gray">
<span>Linkedin</span>
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<a target="_blank" rel="noopener" href="https://x.com/intent/tweet?url=https://www.nist.gov/baldrige/chickasaw-nation-department-health&amp;status=https://www.nist.gov/baldrige/chickasaw-nation-department-health"
title="X.com" class="nist-social nist-social--x-gray">
<span>X.com</span>
</a>
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<h2>Malcolm Baldrige National Quality Award<br><strong>2024 Award Recipient, </strong><span lang="EN-US"><strong>Health Care</strong></span></h2><div class="grid-row grid-gap"><div class="grid-col-9">
<div class="nist-image--lightbox nist-image" data-lightbox="https://www.nist.gov/sites/default/files/styles/2800_x_2800_limit/public/images/2024/10/09/Chickasaw-Nation-Department-of-Health.jpg?itok=avkD8bRs" data-media-id="720576" data-copyright="Stock Photo">
<img loading="lazy" src="/sites/default/files/styles/960_x_960_limit/public/images/2024/10/09/Chickasaw-Nation-Department-of-Health.jpg?itok=UkQLAIu7" width="960" height="788" alt="Chickasaw Nation Department of Health residency photo two female doctors discussing an ultrasound of the patient lying in the hospital bed." typeof="foaf:Image">
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Chickasaw Nation Department of Health
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</div><div class="grid-col-3"><p><strong>Highest-Ranking Official*</strong><br><span lang="EN-US">Dr. Charles Grim</span><br><span lang="EN-US">Secretary of Health</span></p><p><a href="https://www.nist.gov/baldrige/award-recipients">Public Affairs Contact</a></p><p><em>*At time of award</em></p><hr><p><strong>For more information</strong><br><span lang="EN-US">Chickasaw Nation Department of Health&nbsp;</span><br><span lang="EN-US">1921 Stonecipher Blvd.&nbsp;</span><br><span lang="EN-US">Ada, OK 74820</span><br>(580) 436-3980<span lang="EN-US"> </span><a href="https://chickasawnationhealth.net" title="CNDH website"><span lang="EN-US">https://chickasawnationhealth.net</span></a></p><div class="OutlineElement Ltr SCXW264683694 BCX0"><p class="Paragraph SCXW264683694 BCX0"><span lang="EN-US"></span></p></div></div></div><p><span lang="EN-US">The Chickasaw Nation Department of Health </span>(CNDH)<span lang="EN-US"> provides inpatient, outpatient, and population health services across a 13-county service area in southern Oklahoma. Health care services offered are as follows: ambulatory and ancillary health care, emergency services, specialty services, therapy services, optometry, dental, laboratory, imaging, pharmacy, public health, behavioral health care, and nutrition services. In 1994, the Chickasaw Nation </span>became one of the first tribes to contract<span lang="EN-US"> with the U.S. Indian Health Service to assume administrative and operational control of its own health care system. The Department of Health was established to serve the needs of the Chickasaw people, First Americans from all 550+ federally recognized tribes, and Alaska Natives. </span>It also <span lang="EN-US">offers public health services to community members who may not be from one of these groups. The Baldrige-based Oklahoma Quality Foundation selected Chickasaw Nation Department of Health to receive its 2021 Leadership in Excellence Award.</span><span>&nbsp;</span></p><hr><h2><strong>Highlights</strong></h2><ul><li><span lang="EN-US">Five-star (highest) </span>Centers for Medicare and Medicaid Services (CMS) <span lang="EN-US">overall ratings (a composite measure of over 40 key quality measures); a five-star rating is only awarded to the best 10% of health care organizations in the nation </span></li><li><span>Top-10% performance nationally for patients' willingness to recommend</span></li><li><span lang="EN-US">Top-10% performance nationally for total workforce turnover </span><br>&nbsp;</li></ul><hr><h2><span lang="EN-US"><strong>National Top-10 Percent Performance for Health Care, Patient Loyalty</strong></span><span>&nbsp;</span></h2><ul><li><p class="p1">Five-star Centers for Medicare and Medicaid Services (CMS) overall ratings for the six years reported—with an exception in fiscal year (FY) 2021 at the height of the COVID pandemic. A five-star rating, a composite measure of over 40 key quality measures, is the highest rating given.</p></li><li><p class="p1">Patients’ willingness to recommend exceeds national, top-10% performance for the past five years across all inpatient services units. Segmented results show ratings for the intensive care unit, obstetrics/gynecology, and CNDH overall above 95% and nearing 100%.</p></li><li><p class="p1">National, top-10% performance is demonstrated for total workforce turnover, which has improved from 13% in 2019 to 9% in 2023. The percentage of training effectiveness is also at the top-10% at 86% in 2023.</p></li></ul><h2><span lang="EN-US"><strong>Superior Performance for Patient Safety Indicators</strong></span><span>&nbsp;</span></h2><ul><li><p class="p1">Improved same-day access for primary care at a rate exceeding 140% of pre-pandemic levels</p></li><li><p class="p1">Patient safety indicators show the best possible results (zero) for all 19 measures over five years—with the exception of just one instance in 2023. Results, which surpass Agency for Healthcare Research and Quality (AHRQ) benchmarks, include inpatient deaths, hospital falls, and post-operative respiratory failure.</p></li><li><p class="p1">In 2017, CNDH created the “Getting to Zero” campaign, benchmarking a similar program from the airline industry. The campaign focuses on 35 measures that represent the most significant safety issues for patients during their stay in the hospital.</p></li><li><p class="p1">Consistent, near-100% performance for ambulatory measures (preventative health, tobacco use cessation, and fall screening) in all locations, from 2019 to 2023</p></li><li><p class="p1">Quality improvement is augmented by baseline training and the Institute for Healthcare Improvement (IHI) Open School training (167 staff completions thus far and over 100 licensures supported this year). The primary improvement methodology for the organization is the IHI Model for Improvement and plan-do-study-act. In addition, other methods are incorporated on a situational basis to include the Toyota Production System and LEAN, which were used extensively in CNDH’s COVID-19 response. </p></li></ul><h2><span lang="EN-US"><strong>Top-10% Patient Ratings Lead to Loyalty and Growth</strong></span></h2><ul><li><p class="p1">As part of the Indian Health Service (IHS), CNDH leverages federal funding and third-party payer sources to ensure that no patient is charged for health care. A team of patient benefit coordinators helps patients attain third-party health insurance coverage and ensures that CNDH receives reimbursement for the provision of services.</p></li><li><p class="p1">CNDH has created programs to fund actual premium payments for insurance policies for specific patient populations. More than 1,600 patients benefit from this program, and CNDH has achieved a return on investment in excess of $200 million over the last decade; this return has been used to meet challenges related to nutrition and clean water for the population.</p></li><li><p class="p1">Top-10% performance for the Patient Survey Star Rating in the national Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS), from 2019 to 2023; performance is at 5, the highest rating possible</p></li><li><p class="p1">Patient satisfaction, as depicted in the HCAHPS results for overall hospital rating, exceed the 90th percentile ranking nationally for the past five years</p></li><li><p class="p1">While the overall population growth rate of CNDH’s service area has remained relatively stagnant, CNDH maintains a dominant and stable market share consistently above 70% of the eligible user population, according to IHS statistics.</p></li><li><p class="p1">Patient retention results have been sustained at well over 90% and well-above the industry benchmark for the past three fiscal years. Such results reflect strong long-term relationships across patients’ life cycles.</p></li></ul><h2><span lang="EN-US"><strong>Top-10% Performance for Workforce and Leader Development</strong></span><span>&nbsp;</span></h2><ul><li><p class="p1">One of the fundamental factors that CNDH measures to determine workforce satisfaction is employees having the resources they need to do their jobs and meet expectations. For associated survey results, CNDH outperforms a 90th-percentile benchmark, exceeding top-10%, national performance.</p></li><li><p class="p1">CNDH has experienced a historically low level of voluntary turnover for hospital/clinic staff, medical providers, and support and program staff from 2021 to 2023. Thinking about looking for a new job, a question in the annual employee engagement survey, shows overall and segmented results at the top 25% or 10% nationally for the past five years.</p></li><li><p class="p1">Results for workforce and leadership development are shown in how employees answer employee engagement survey questions, such as whether employees feel they have the training to do their jobs effectively. Results have been in the top 10% nationally over the past five years. Similarly, for the survey question about employees feeling they can meet career goals, results have been in the top 10% of national performance for the past five years.</p></li><li><p class="p1">Results for the Chickasaw Leadership Academy (CLA) indicate an increase in promotions due to the program, with 72% of participants receiving at least one promotion and 100% of 2024 appointed positions being selected from CLA graduates.</p></li><li><p class="p1">The total recordable incident rate (TRIR), which improved from 2.5 in 2019 to 1.7 in 2023, is much more favorable than the U.S. Bureau of Labor Statistics (BLS) industry benchmark at just under 4. The days away, restricted, or transferred (DART) rate is also better than the BLS industry benchmark.</p></li><li><p class="p1">Sprains/strains per year have continued to decrease each year in all departments, with an overall decline from 18 in 2021 to 1 in 2024. In addition, lost time from slips, trips, and falls shows sustained performance under five and close to zero from 2019 to 2023.</p></li></ul><h2><span lang="EN-US"><strong>Community Contributions Support Referrals, Life-Saving Medication, Grant Funding</strong></span><span>&nbsp;</span></h2><ul><li><p class="p1">Over the past five years, the amount of grant funding acquired by Nutrition Services and the Division of Research and Public Health, along with funding provided for water and sewer projects, has resulted in a combined $50–$60 million annually that CNDH contributes back into the community to address priority issues for community health.</p></li><li><p class="p1">No patient receives a bill for services at CNDH, which extends to referred care services managed through Medisaw, a referral-based program for CNDH. Medisaw serves patients referred to specialty health care services not directly available at CNDH. Those with insurance have most of the cost covered; while, in 2023, CNDH contributed nearly $9 million back into the economy for those most in need of specialized care who do not have the resources to pay on their own.</p></li><li><p class="p1">Naloxone distribution, a life-saving medication that can reverse an overdose from opioids, has increased steadily from FY2021 through FY2024. CNDH has been a leader in the community for making this medication available to help reverse drug-related overdose deaths.</p></li></ul><h2><span lang="EN-US"><strong>Financial Viability Supports Operations, Stewardship</strong></span><span>&nbsp;</span></h2><ul><li><p class="p1">CNDH’s financial viability measures for days cash on hand and current ratio, a measure of liquidity, are superior to Moody’s AA ratings. Days cash on hand increased from about 300 days in 2019 to almost 700 days in 2024. Current ratio increased from 4 to more than 7 from 2021 to 2023.</p></li><li><p class="p1">Number of days revenue in accounts receivable improved from almost 30 to 15 days from 2019 to 2023. Recent trends demonstrate a 40–50% reduction, exceeding the benchmark.</p></li><li><p class="p1">Revenue growth demonstrates consistent improvement from $286 million in FY2019 to $465 million in FY2023, exceeding Moody’s AA rating. CNDH’s overall revenue growth rate has outpaced the Moody’s AA benchmark in each of the past five years, driven primarily by third-party collections, capitalizing on a strategic opportunity with Medicaid expansion in Oklahoma.&nbsp; &nbsp;</p></li><li><p class="p1">Operating margin improved from 11.7% in 2019 to 15.1% in 2023, which is far superior to the current Moody’s AA median operating margin of 2%. CNDH’s sustained performance has been above 10% annually since FY2019.</p></li><li><p class="p1">Expense-to-budget shows role-model performance, improving from 100.2% in 2019 to 78% in 2023.</p></li><li><p class="p1">Medicare spend per beneficiary demonstrates consistent performance of approximately 0.8, which is 20% superior to national norms and a competitor.</p></li></ul><h2><span lang="EN-US"><strong>Effective Risk Management and Governance</strong></span><span>&nbsp;</span></h2><ul><li><p class="p1">The effectiveness of CNDH’s risk management efforts is demonstrated through the percentage of patient safety “fall outs” (any event that occurred during a visit that could affect patient safety or the patient experience, regardless of severity), which has improved from about 5% in 2018 to about 1.5% in 2023.</p></li><li><p class="p1">After a non-critical cyber incident in November 2022, mitigation efforts have prevented any additional incidents over the subsequent sixteen months. Over the past two years, the volume of cyber-related risk events has declined dramatically. Cybersecurity results show improvement in three key metrics: detection and response, system vulnerabilities, and risk mitigation.</p></li></ul><p><a href="/news-events/news/2024/10/nist-announces-2024-baldrige-awards-performance-excellence" title="2024 Baldrige Award Recipients Announced" data-entity-type="node" data-entity-uuid="1d48cefd-6c4c-48f4-a9a5-711da3bfbd68" data-entity-substitution="canonical"><strong>Back to Press Release</strong></a></p><h3><strong>Resources</strong></h3><p><a href="https://www.nist.gov/baldrige/award-recipients">Search All Baldrige Award Recipients</a><br><a href="https://www.nist.gov/baldrige/how-baldrige-works/about-baldrige/baldrige-faqs#Recipients">Baldrige Award Recipient FAQs</a><br><a class="CP___PAGEID_1518986" href="https://www.nist.gov/baldrige/qe">Attend Quest for Excellence</a><br><a href="https://www.nist.gov/baldrige/how-baldrige-works">How Baldrige Works</a><br><a class="CP___PAGEID_2636770" href="https://www.nist.gov/baldrige/how-baldrige-works/about-baldrige/baldrige-impacts">Baldrige Program Impacts</a></p>
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Created September 25, 2024, Updated December 3, 2024
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