Category Archives: Blog

PENWorks, Baldrige, and Leadership

By Kruse Scholar Shelby Crespi

After allowing the dust to settle following the whirlwind of my first semester as a Kruse Scholar, my thoughts about leadership and creating change have evolved. So much of my understanding of leadership was rooted in the idea of making tangible change, but not always how exactly this change would be executed. I viewed myself as a leader that could leave something that could be felt and touched - leaving evidence - as so eloquently explained by Dr. Bryan Williams, the Keynote Speak at this year’s PENworks Conference. However, such a large part of leaving behind this evidence is having an underlying structure that allows you to leave your mark.

So much of the leadership skills that we saw so many incredible organizations like Mayo Clinic and the MN Pollution Control Agency demonstrating was rooted in an underlying framework that holds everything together. This conference finally helped me to put into perspective the role of Baldrige. Just as Bianca mentioned being skeptical of this framework when she first entered her time as a Kruse scholar, so was I. What could a manual tell me that being in tune with the community can’t? Hearing the stories of how exactly people treated Baldrige at the PENworks conference helped to understand that Baldrige is not a manual of “how to do things in an organization,” but instead a living document that very much moves in rhythm with the ebb and flow of an organization. When the waves get rough, Baldrige gives us something to anchor ourselves in and weather that storm. (Please excuse the cheesy cliché, but it’s really true.) Baldrige is not a prescriptive problem solver, but a school of thought that demands an organization be honest and self-aware about the populations it serves, it capacity, where they are weak, and where they are strong all with the goal of improving efficiency and capacity through effective management techniques. This all ultimately improves services provided to our beneficiaries whether they are students, patients, clients, or other organizations.

Like Dr. Williams described, Baldrige helps to find the balance between the workplace that always has breakfast burritos and company outings, but cannot meet company goals and the organization that works employees into the ground and meets all productivity goals, but drives away burnt out and fed up employees quickly. Baldrige brings to life the ideal that we can have a breakfast burrito friendly and high efficiency work environment. Baldrige is not meant to be the overt means of operation that dictates exactly how to run the company, but it does force you to be honest about whether a company trip to a Twins game is time and well spent. It forces you to truly consider what the returns for the community are regarding making every decision. I believe that it is the self-reflective component, the questions, that many are fearful of when considering the introduction of the Baldrige Framework into their organization. It forces you to face the fact that you might be too much of the of the “friend manager” or too much of the “dictator manager” --which no one who thinks they have been effectively managing ever wants to hear. However, the best way to tackle these issues is with an effective and honest framework, and I now know that this framework for this task is Baldrige.

After PENworks, my skepticism has been addressed and my questions answered. Seeing how Baldrige has been implemented and how it is improving services to the community’s most vulnerable people, especially Doug Parks’ work at Mayo Clinic, was exactly what I needed to see. Baldrige fosters inspired leadership and innovation in the workplace. Effective organizational management has improved services to the community and that is a major driver for meeting health goals. As this first year as a Kruse Scholar comes to a close, I have a renewed understanding of my goals and my future role in using the Baldrige Framework to promote goals and actions that contribute to improving the health at the community level.

Read more about Shelby Crespi here

Enthusiasm for Baldrige

By Kruse Scholar Jasmin Fosheim

This spring I attended my second PENWorks conference in Minneapolis as a Kruse Scholar. The first conference I attended was largely overwhelming. My understanding of Baldrige and Communities of Excellence was still elementary, and I was a little flabbergasted by the enthusiasm with which people engaged in what seemed to be an incredibly complex and challenging process of identifying and attempting to enact change to systemic problems. This year, however, I have a newfound understanding and appreciation of the Baldrige criteria and Communities of Excellence I credit to the Kruse Scholar program and PENWorks wholly.

It took two years, but I finally get it. Communities of Excellence and Baldrige have invaded my thoughts and I’ve found myself becoming gradually more critical of the same old same old. More importantly, my skepticism regarding the efficiency and effectiveness of the organizations I’m a part of and the employers I work for has become more than just criticism and identification of flaws. I now have a mindset of identifying opportunities for improvement and searching for solutions.

Further, I’ve learned that identifying opportunities for improvement and coming up with solutions on my own to implement isn’t enough; solutions should consider all components of an issue, sectors of an organization, and stakeholders in the mission of the organization.

Finally, after two years of engaging with Communities of Excellence and Baldrige, I feel like I finally understand the crucial need for these strategic approaches to address the systemic issues in organizations, communities, and our nation. This newfound understanding led to a PENWorks conference in which I could be engaged and finally share the enthusiasm of the professionals and Baldrige enthusiasts that I, at one time, just couldn’t relate to. Baldrige and Communities of Excellence have changed the way I perceive, assess, and engage with my entire world.

Read more about Jasmin Fosheim here

Communities of Excellence 2026 Update

There’s certainly been a lot of activity lately.  So much so that I’ve been a bit delinquent in my blog postings.  Here’s an update on the exciting progress we’ve made:

Quest for Excellence/CCE/PENWorks Presentations

Over the last couple months we’ve been presenting both our progress and the progress of our San Diego South Region pilot.  In March, Sarah Rafi from San Diego County’s Health and Human Services Agency (HHSA) and I presented in Long Beach, CA, in April Anabel Poole, also from HHSA presented in Baltimore at the Annual Quest for Excellence Conference.  Most recently, I had the pleasure of facilitating a 90 minute intensive learning session with the Communities of Excellence Kruse Scholars.  These undergrad and graduate level young people are truly inspiring and represent the best in youth leadership.  Among other things, this session featured a panel discussion of their experience learning about Communities of Excellence and the quality and systems thinking skills that they will bring to their organizations and communities in the future.  I can’t emphasize enough how impressive they are.

San Diego County’s South Region

The San Diego South Region leadership has been working hard moving their implementation of the Communities of Excellence Framework from planning to action.  In their last Leadership Team meeting each South Region Live Well San Diego partner organization presented a brief synopsis of their organization’s priorities, resident groups served, data capabilities and target customers.  This information led to a set of key themes that help leverage their shared competencies, resources and priority areas to drive their shared community strategic plan.  At the same time, a cross-sector Ad Hoc committee was formed to provide feedback and add input in their Community Profile.  At the next meeting, coming up next week, that information will be shared to fill in gaps in the Community Profile and start narrowing down their key themes into goals.  I am so impressed by the hard work and dedication of this team.  They are an inspiring and dedicated group.

National Learning Collaborative

On May 2nd we begin the first session of our pilot cohort’s journey in the COE National Learning Collaborative.  This group of five communities has spent the past month preparing for this session through Prework activities and planning.  Over the next four months they will partake in bi-monthly sessions designed to build their collaborative leadership team’s knowledge of community performance excellence and begin to create their Community Profile. 

There is still room for your community to participate in the second cohort of communities joining in September/October of 2017.  You can find information on participation on our website at or contact me directly.

Thank you for your continued support as we work to bring a higher level of performance to our nation’s communities. 

Stephanie Norling, Director

Creating a Culture that Solves Community Problems

By Kruse Scholar Shelby Crespi

It’s the word at the heart of so many conversations today especially as they pertain to the rising discussion surrounding health and social well-being. We ask: how do we promote it? We ask: which one? We ask: where? It holds different meanings for different people. I often find myself saying, when speaking about community, that it’s the solution--the solution to so many problems we’re facing today. But sometimes we forget to ask: what exactly is community? Is it who? Is it where? The truth is that sometimes I find myself speaking about the idea of a “community” without really defining what that is at times.

In these times, I step back to when I learned what that word meant for the first time. I think back to when I was a teen and volunteered at a community center located in a gang hotspot. It changed my understanding of community as a group of people in one place to a frame of thought. I didn’t replace my more geographic understanding of community, but rather I nuanced it. I began to understand community as a way of thinking in which community was a word that described the ways we react to and experience the human condition together. When I discuss community as a solution to many issues, health issues especially, I tend toward the idea of fostering a culture in which solutions to issues that affect certain groups blossom out of these communities themselves. I also envision collaboration of various sectors with the goal of cultivating these community-based solutions.

In order to create a culture that strives to create lasting impact at the community level, it’s necessary to re-orient values toward engaging in the kind of collaboration that puts the desires of the community at the center and supports those goals rather than sets them. Too often, we see hollow collaboration which usually involves one large organization absorbing a community “in need” and hurling what they consider solutions at them. Even in trying to benefit others, we can do harm with this mentality. When we begin to re-think the idea of community as something human-centered, we also begin relinquish ideas of “them” and “us” and more toward embracing “we.” Here is where the trust that is so incredibly necessary for productive collaboration begins to take root. After this, an exchange of ideas takes place and the roles of all entities at the table become more defined. Ideas for how different sectors can contribute to this solution begin to grow organically. This type of thinking in combination with the integration of frameworks for excellence, such as the Baldrige Framework, allows us to come together to build something sustainable and meaningful--something excellent.

As I move forward as a Kruse Scholar and continue to learn different ways in which we can begin to bridge gaps between sectors, I always hold tight to the ideology that a community is so much more than where and who. It’s experiencing the human condition together and acknowledging the humanity of another person before all else. It’s forming frameworks that create human-centered and efficient processes that benefit people, the planet, and can generate profit. I believe that only with this kind of thinking will we truly create a culture that is invested in promoting the health and vitality of communities in positive and meaningful ways especially in the face of adversity.

“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together” - Lilla Watson

Read more about Shelby Crespi here

Collaborative Progress!

As you may know, the Communities of Excellence 2026 staff, board and our many wonderful supporters and volunteers have been focusing much of our attention lately on developing a National Learning Collaborative of communities to start spreading the COE Framework across the country.  This is no easy task, but I am pleased to say that we have a small cohort of communities ready to help us launch in May.  This group, made up of small, large, urban and rural communities and regions will be working with us from May to September to test the learning curriculum, develop a robust best practices and management platform using ManageHub and pave the way for a second cohort to join in September, 2017. There are still opportunities for your community to join us in September for this year-long collaborative effort of communities. 

In a past blog post, Brian Lassiter, COE Board Member and Collaborative Faculty Member wrote, "Imagine a time when leaders within a community – official leaders (those elected or appointed to their formal positions) as well as the many informal community leaders – work together to set community vision; listen to community stakeholders to better understand community assets and needs; (re)allocate resources to address community issues or advance community initiatives; use community scorecards to monitor progress of those initiatives and the outcomes they intend to impact; and engage, mobilize, and align people resources – workers, volunteers, and citizenry – on the initiatives that will make a difference in a given community.  That’s how high performing organizations succeed; we believe that’s how high performing communities will succeed."

This is the vision that guides Communties of Excellence 2026 and motivates us to continually take our work to the next level.  I am excited and thankful to this first cohort of communities who are willing to be the trailblazers on this journey and help us continually improve our approach.  I want to acknowledge the work of San Diego County's South Region and their Backbone Organization, San Diego County's Health and Human Services Agency.  Their willingess to share their journey with us has given us invaluable feedback on how to implement the COE Framework in other communities.  Now we have the opportunity to take what we've learned and spread our efforts to this next group.  

There are many varieties of this quote, but as Nicholas Sparks said, "Nothing that's worthwhile is ever easy.  Remember that."  Thank you to those that have supported us and to all of you that follow our progress.  I think this next stage of our journey is going to be a great one.

Stephanie Norling, Director, Communities of Excellence 2026


How COE fits with existing community work

By Kruse Scholar Amy Jones

Back in January, my fellow Kruse Scholar, Andrea Stoesz, wrote about smaller, but effective models that mirror many aspects of Communities of Excellence and are currently being used by public health professionals around the world. Andrea focused on the One Health model, which connects the health of people to the health of environment and animals. I think she made an important point in her post that Communities of Excellence is coming on the heels of other effective frameworks and models of community engagement and revitalization and is meant not to devalue the work that’s already being done, but to complement and make more robust current work.

As the Communities of Excellence framework begins to be implemented in communities across the country, it becomes even more important to recognize and appreciate the work that has been done and is being done by health departments and non-profits and not to minimize the impact they have had on their community. In Minneapolis, I think about organizations such as the Pillsbury United Communities who has multiple locations throughout the city and who tailors their work at each location to meet the needs of the immediate communities. All centers focus on education, youth and family, wellness and nutrition, employment and training, and asset creation, but do so in unique ways that best fit with the culture of the community they serve. Additionally, each location works cross-collaboratively to partner with other organizations in the community and unify their efforts. For example, in the Cedar Riverside community, the Brian Coyle center works with organizations such as the Confederation of Somali Community of Minnesota, Pan African Legal Aid, the Cedar Riverside Neighborhood Revitalization Plan and EMERGE, a job training and housing support organization. 

Pillsbury United Communities framework focuses on “reclaiming the strength of multi-service, community-focused nonprofit with deeply embedded relationships across neighborhoods, institutions and sectors.” Furthermore, the framework recognizes that “the complexities of poverty, systemic barriers, and the legacy of injustice are interconnected…[and] will not be solved with simple solutions, one program or one path.” Their non-linear approach to close gaps includes:

  1. Prepare through fact gathering and information exploring
  2. Discover by reviewing current realities and analyzing what is needed
  3. Ideate by generating new ideas and improvements
  4. Design a plan a determine measures of success
  5. Implement by putting the plan to work
  6. Evaluation to verify what works and adjust where needed.

With a well-developed framework and proven success in their communities, it begs the question - what role could cross sector collaborations such as Pillsbury United Communities play in the implementation of Communities of Excellence? To me, it seems obvious to identify and seek out organizations that already have a shared vision with that of COE and use them as a springboard for the COE framework. Defining their community is something that Pillsbury has already considered, yet the COE framework provides a different set of questions in defining their community that may expose other gaps and identify new directions. Part of effective community engagement is recognizing and utilizing resources that the community already has. Organizations working in communities who already have a multi-service, cross-collaborative framework should be helping to lead efforts to implement Communities of Excellence. COE will push communities who are already doing great work to do even better work. It pushes these organizations and people to create not just good communities, but excellent communities.

Read more about Amy Jones here

March 9th – The Role of Values-based Leadership

On March 9th we will be hosting our fifth and final Learning Lab with the HealthDoers Network:  The Role of Values-Based Leadership:  Starting the Community Conversation.  For me, it has been an incredible learning experience.  We first started with Lowell Kruse's story about his 25 years in Northwest Missouri and the cirtiical need to engaged community leaders in the overall health of the region.  Then we heard from Brian Lassiter in order to understand a bit more about Baldrige and Communities of Excellence, and what is means for a community to pursue excellence.  We followed the next two Labs with presentations from our first pilot community:  San Diego County's South Region and their Live Well San Diego Vision for a County that is healthy, safe and thriving.  Barbara Jimenez talked about the experience of adopting the framework from the South Region's perspective and Anabel Poole followed with a conversation about the role of the Backbone Organization and how this journey has influenced their own internal Baldrige journey. 

Throughout these Labs, there was one theme that continued to follow in our discussions and questions from attendees:  Leadership.   Therefore, It seemed fitting to end the series with a discussion about Community Leadership and Values.  For this Lab I've invited two inspiring leaders to share examples from their experience in business and community.  I hope you will join us March 9th as our two presenters, Rick Norling and Brenda Grant discuss the importance of shared community values, role-modeling values-based behaviors as a key element of leadership, and how community leadership can go about establihing critical values that will drive the kind of behavior that will both engage residents and produce results.

You can register here to join us

Stephanie Norling, Managing Director, Communities of Excellence 2026







It’s Not What You Think

By Kruse Scholar Bianca Nguyen

In talking about Communities of Excellence thus far, it has been almost impossible to forgo mentioning the communities across the United States who are struggling with poverty, health disparities, and poor educational outcomes. This is the goal of Communities of Excellence—to lift up our communities that are not reaching their full potential and to enable them to attain success in all sectors so that our country can be a proud leader in excellence, whereas, currently, the United States spends far more than other first-world countries and is achieving far poorer health outcomes as a whole.

Part of the purpose of the Affordable Care Act (ACA) was to address the issue mentioned above. Health care costs continue to account for an alarming proportion of the GDP compared to other sectors, and per capita spending seems out of control for the outcomes we achieve compared to other nations. However, the ACA has received widespread criticism from some who debate that the federal statute is socialistic in nature because it imposes the requirement to buy health insurance upon every citizen in order to balance health insurance risk pools so that those who would otherwise have difficulty receiving or paying for health care can get treatment. Whether or not this argument is valid is a discussion for another day, but in realizing that there may be some similarities between the goals of the ACA and COE, I think it is important to recognize what Communities of Excellence is and is not.

Communities of Excellence is not about pouring in resources from one part of the community to subsidize or bail out any other areas in order to bring everyone to an equitable level of vitality. It is not an issue about not having enough resources because, as we know, the U.S. spends more than comparable countries on healthcare, but we are not getting the same bang for our buck. In fact, COE promotes using cross-sector collaboration and the Malcolm Baldrige Framework of Performance Excellence to make better use of the resources already available so that we improve efficiency and eliminate waste to achieve excellence. Now, “improve efficiency” and “eliminate waste” might sound like familiar buzz phrases heard within programs like Lean and Six Sigma which have grown in popularity.  So what makes the Baldrige Framework so special and essential to Communities of Excellence Framework? Why do we need Baldrige when there are other programs like Lean that exist?

The truth is, Baldrige and programs like Lean Six Sigma are not mutually exclusive—they are compatible, and even complimentary! The differentiating factor is that Lean Six Sigma and similar programs can be thought of more as tools, while Baldrige is a framework, but that does not mean that these performance improvement tools cannot be used within the framework. The Baldrige criteria sets a big picture roadmap for an organization or community, and while adopting this framework, we can apply Lean Six Sigma tools to help us achieve the level of excellence as outlined by Baldrige. If we rely on Lean Six Sigma alone, we may be streamlining processes and eliminating waste in many areas, but adopting the Baldrige framework will ensure that we are optimizing the entire system and achieving overarching objectives as a community rather than in siloes. That collaboration across entire systems and communities is what COE is all about and is what makes Baldrige crucial to our success.

Read more about Bianca Nguyen here

Communities of Excellence and the Spatial Fix

By Kruse Scholar Amy Jones

When we look around the country at the racial and wealth distribution in various neighborhoods, it is obvious that the vast majority of the US remains highly segregated along racial and socioeconomic lines. Pockets of high poverty mean that where you are born can have huge impacts on your economic and social mobility opportunities as well as your health outcomes. High-poverty areas have lower quality housing, more exposure to environmental toxins, fewer job opportunities, worse schools, and less resources.

An important aspect of the spatial disparities that we see today are the social and historical contexts that allowed for these to arise. From Slavery to the Jim Crow era to the National Housing Act that redlined certain predominately minority communities, to the US interstate highway program that disproportionately demolished lower income neighborhoods or cut them off from resources.

These huge inequalities led to a big push in the 1990’s and early 2000 for dispersal programs. These programs focused on providing families with opportunities to move out of the city by requiring suburbs to build more affordable housing options or providing families with housing vouchers only valid in low-poverty areas. Programs like Moving to Opportunity (MTO) and HOPE VI had huge hopes for the impacts that they would have on the families that moved out of higher poverty areas to areas lower poverty. Decades later, most of the research on the impact of these programs show only mixed results. MTO brought some better mental health outcomes for girls, but worse mental health outcomes for boys. The $7 million dollar investment for MTO brought only minimal economic benefits for the families that moved and left the areas of high-poverty that they moved out of unchanged.

As researchers began to examine and discuss why programs like MTO and HOPE VI had failed, they saw that moving was causing a huge amount stress on these families - taking them away from social networks and placing them in areas where they will likely be stigmatized because of their lower socioeconomic status or race. They also began to realize the strength of the identity-place attachment and the impact that moving can have on identity. Identity is often intertwined with place, and many people will choose to stay in a higher-poverty area because of that place attachment, rather than move to a lower-poverty suburb that may provide better economic opportunities. MTO in particular brought a select group of families out of an area of high-poverty, but made no efforts to impact that original community, causing a perpetuation of the low-resource spatial disparity that had already existed. 

So how does Communities of Excellence relate to the spatial disparities? After a history of top-down discrimination and poorly planned policy approaches, I think it’s time to empower people to invest in their own communities through community development projects, such as Communities of Excellence. Rather than spend millions of dollars to move people out of their high-poverty areas, why not build the people potential within a neighborhood, recognizing that not all neighborhoods are equal - they have differing levels of resources available to them, and need different resources to survive. Too many of the top-down approaches rely on the idea that there is a homogenous public and the same program will work equally well for each community. Communities of Excellence is unique in its bringing together of community leaders - people who know what people in their community need to thrive and deciding collaboratively what the needs of the community are and how best to build the capacity of people in the community by building on the community identity to strengthen the place-attachment of people and provide them with what they need to work towards a better community.

Furthermore, COE is a fluid approach, not a strict prescription. Through developmental evaluation the community leaders can monitor the impacts that their work is having and adjust their work when things aren’t working to better fit what the community needs. As I wrote about back in September, here’s where the Collective Impact Framework is important, particularly for a more grassroots approach to community development.

Dispersal programs aren’t working. It’s time for policymakers to recognize the history of discriminatory practices that have perpetuated the spatial disparities. It’s time for policymakers to recognize the power of the people within their own communities and provide some water for the grassroots, empowering people through Communities of Excellence Framework to build their communities and ensure that all communities provide more equitable access to opportunities. Perhaps Communities of Excellence will finally provide the spatial fix we’ve been looking for in the US.

Read more about Amy Jones here

Closing the Chasm

By Kruse Scholar Bianca Nguyen

With the transition into the new year, the Kruse Scholars program has welcomed its latest cohort of bright and passionate scholars. After returning to campus for my final semester in the Master of Healthcare Administration program, I joined together with my fellow current scholars and those from the first-year class to discuss the work we have been doing and will go on to do with Communities of Excellence. While listening to the enthusiasm of the new students joining the Kruse Scholar family, I reflected upon why I chose to pursue this path and what it has meant to me along the way.

During my undergraduate at the University of Michigan, I was actively involved in social justice, engaging in conversations across campus and interacting with an array of multicultural groups surrounding issues of diversity and inclusion. Among the many aspects of life that people with varying identities experience differently, healthcare is one of them. In my personal life, I witnessed how being a minority played a role in receiving health care. Although I originally had a passion for medicine and was pursuing a track to medical school at the time, I realized that these inequalities in health could only be addressed at an elevated level using methods beyond just the clinical setting. I ended up in the MHA program with a zeal for minority health and a desire to change the structures that create barriers to addressing the social determinants of health.

However, after my first month in the MHA program at the University of Minnesota, I was experiencing a bit of an existential crisis. Though based in the School of Public Health, I found the MHA program to be deeply rooted in business operations with little attention paid to the communities and population health imperatives that I was so passionate about. On the outside, I was complacently taking notes in my finance class. In contrast, my heart was pounding and my mind was racing on the inside, wondering what kind of decision I had made for my life and how I would spend the rest of my career looking at numbers and scorecards, tracking volumes and revenues, while underserved communities continued to struggle achieving appropriate levels of health. The content I learned in the MHA program was stimulating, and I enjoyed the administrative and management side of healthcare, but I was not sure how to reconcile the apparent disconnect between my personal and professional goals and interests.

It was while I was questioning what I was doing with my life and career that Lowell Kruse, an alumnus from the class of ’67, came to speak to our class. Here was someone who had graduated from the MHA program, but was not just managing margins and services within the confines of a hospital. Although Lowell enjoyed an accomplished and successful career as a healthcare executive for many years, he went further than the traditional duties of serving the health systems he worked for and made remarkable efforts to serve the communities beyond them. His vision for this work resulted in the creation of Communities of Excellence and gave me clarity and a revitalized passion for improving and strengthening communities.

Joining the Kruse Scholar program and entering the work of Communities of Excellence was the answer to the tumultuous cognitive dissonance I was worried would eat at me for the rest of my career. I think that, too often, people end up in roles that suit them professionally, or even settle for jobs just to get the bills paid. Perhaps, like me, you honestly enjoy the field that you chose, but feel compelled to a bigger cause to serve the greater good—a cause that you are unable to reach in your current career or situation. No matter what position you hold or what industry you are in, being part of Communities of Excellence is the opportunity to make that difference in the world.

Read more about Bianca Nguyen here