I was fortunate to attend the 2019 Quest for Excellence Conference for the Malcolm Baldrige National Quality Award. The process and criteria for the award are managed by the National Institutes of Standards and Technology (NIST), which is a part of the US Department of Commerce.

The award criteria are a series of industry-specific questions published by NIST. The criteria are detailed and rigorous, asking many process oriented questions, including how well organizations know their processes, how well they are followed, and if the processes yield positive results.

The award winners are always extremely impressive. Many of these organizations make the “Baldrige journey” for a decade or longer. My current employer, Adventist HealthCare, is on its own Baldrige journey and it’s been an immensely valuable learning experience for both the organization and personally, for myself.

The Baldrige Criteria frequently asks the organization to identify its competitors and assess how it performs relative to its competition. Most businesses view the competition as other similar businesses offering similar products. For example, if you are opening up a neighborhood coffee shop, you may identify your competitors as the closest Starbucks, Pete’s Coffee, or the closest neighborhood McDonalds. After identifying the competitors, you would need to collect their data and show your shop’s performance results relative to theirs.

However, one winner this year took a different tactic when answering competitor questions. The Alamo Colleges District, based in San Antonio, TX, identified its main competitor as poverty. Alamo Colleges District is a group of higher education institutions offering 2-year degrees. They expressed during the conference that many students were not completing their schooling because of the cost, not just the cost of attending classes, but also of food, housing and other basics for living.

So, in their case, Alamo Colleges District determined that the choice for students was actually not whether to go to Alamo or another school, but whether or not to successfully complete school at all. Alamo rightly then identified their competitor as poverty and took steps to mitigate it, such as establishing a food pantry for students, which has since expanded to a full scale, “shop” in recent years.

Alamo teaches us an important lesson in thinking differently about our work. For many of us, the real obstacles we face are not relative to other businesses but relative to broader challenges. In health care, we are struggling with similar challenges. In Maryland, hospital revenues are capped, based on the needs of a population. Unlike other businesses, more business (volume) does not mean more money. As a result, competition between hospitals still exists, but has lessened. One leader aptly described the sentiment as “coopertition” (cooperation and competition).

From the patient’s perspective, there are many breakdowns due to problems with “health care literacy.” This includes educating health care consumers on topics like how the body works, how to be compliant with treatment, or how insurance works to cover their care. These practical skills in navigating the health care environment in the United States are lacking, and a system that makes it simpler for consumers is probably still a ways off.

Health care literacy will be the subject of my post next week. For now, think more about your competitors. Is it really other businesses in your area, or is there plenty of business to go around except for some external environmental factors that are limiting?

KEY TAKEAWAY: Correctly identifying your competition in business can be a deeper question for leaders to comprehend. Taking time to correctly identify competitors can help the business stay focused on its mission and achieve its vision.