Dirck Clark, chief business development officer for Heartland Health in St. Joseph, Mo., likes to paraphrase Charles Darwin when he describes how his system earned its Malcolm Baldrige National Quality Award in 2009: “It is not the strongest that survive, but those that have the most capacity to change.”

Heartland and the Atlantic City, N.J.-based AtlantiCare each won the coveted Baldrige in 2009, and each started their long trips toward the quality-of-care honor from places of crisis 20 years earlier. AtlantiCare once had Frank Sinatra sing in a fundraiser for the hospital just to make payroll, while Heartland had two serious blood-infusion errors just before the CEO warned staff the hospital was losing $1 million a month.

Executives from each system gave lectures on how their systems rose to the level of winning the award Tuesday during remarks at the American College of Healthcare Executives annual Congress on Healthcare Leadership in Chicago.

“Clearly, quality improvement and a journey toward clinical excellence must be lead by senior leadership, must be lead by the CEO,” said Dominic Moffa, senior vice president of administration at AtlantiCare.

Moffa described a sense of humility as his organization steadily improved toward the national quality benchmarks. “We never once talked to them about winning the Baldrige,” Moffa said of his conversation with his board members. “We talked about getting good enough to deserve the honor.

Clark described an early decision to buck the common notion at the time that enhanced patient safety would cut into financial performance. By making operations more efficient and coordinated, they zeroed in on the excesses that were hurting them on both fronts. “It really did work, that with quality improvement came the financials,” Clark said.

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