Transcript Hardwiring Leader Evaluations Bayhealth

Hardwiring
Leader Evaluations
Flagler Hospital
Bill Bielenda
What you will learn today…
Importance of leader accountability
and goal alignment
How to develop effective goals
The basics on accountability tools
Healthcare Flywheel®
Bottom Line Results
(Transparency and
Accountability)
Prescriptive
To Do’s
Purpose,
worthwhile work
and making
a difference
SelfMotivation
®
Rev 4.8.11
Execution Framework
Evidence-Based LeadershipSM
Foundation
STUDER GROUP®:
Objective
Evaluation
System
Leader
Development
Aligned Goals
Implement an
organizationwide
staff/leadership
evaluation
system to
hardwire
objective
accountability
(Must Haves®)
Create
process to
assist leaders
in developing
skills and
leadership
competencies
necessary to
attain desired
results
Must
Haves®
Performance
Gap
Aligned Behavior
Agreed upon
tactics and
behaviors to
achieve goals
Re-recruit high
and
middle/solid
performers
Move low
performers up
or out
Standardization Accelerators
Aligned Process
Processes that
are consistent
and standardized
Process
Improvement
PDCA
Lean
Six Sigma
Baldrige
Framework
Software
Comparison of those organizations that have the leader
evaluation process hardwired and those that do not
Source: Studer Group® October 2008 Measurement Spreadsheet; Organizations that hardwire the leader evaluation process
in their organization, show patient perception of care ratings that are significantly higher than those that do not. Patient
perception of care mean score average includes all partner selected vendors including Arbor, Avatar, Gallup, HCAHPS,
Healthstream, Jackson, NRC, PRC Picker, Press Ganey, RPM, and Statisquest.
Year 1 – Goals
Reduce Costs /
Provider of Choice
Employer of
Issue Improve Financial
(patient
Choice (employee
Performance
satisfaction)
satisfaction)
Achieve financial
margins of:
– 4.0% in FY ’06
– YTD 4.6%
more detail>
–5.0% in FY ‘07
Achieve
organization-wide
average patient
satisfaction scores
of:
– 93.7 for “Overall
quality of
care/services”
– YTD 93.5
– 76.1 for “Would
Goals
you recommend”
– YTD 73.5
Reduce overall
turnover of:
– “permanent”
positions to11%
– YTD 14%
more detail>
– “permanent” core
RN positions to 13%
– YTD 16%
Improve Care
(Quality, Safety,
Effectiveness)
Achieve 90%
compliance with CMS
measures:
Community Acquired
Pneumonia
3>90% - 5<90%
Surgical Infection
Prevention
1
>90% - 2<90%
Heart Failure
2>90% - 2<90%
Acute Myocardial
Infarction
5>90% - 2<90%
Achieve 90% compliance
with evidence-based
practice for prophylaxis of
the following: DVT/PE,
Post-op UTI, Post-op
Pneumonia, Post-op AMI,
Pressure Sores, Post-op
Sepsis
Information
Management
– Implement
Employee
Satisfaction
Assessment process
during 2005
– Create projected
timeline for the
implementation of
the Advanced Point
of Care (APOC)
clinical system
Leader Evaluation Results – Year 1
Year 2 – Goals
Excellence
Service
Increase Patient
Satisfaction
(Inpatient)
Goal = 62nd
Current = 51st
Increase Patient
Satisfaction
(Ambulatory)
Goal = 62nd
Current = 65th
People
Reduce
Annualized
Turnover
Goal = 14.5%
Current = 16.7%
Increase
Employee
Satisfaction
Quality
Decrease
Mortality Index
Goal = .77
Current = .77
Finance
Operating
Margin
Goal = 5%
Current = 5.6%
Reduce FTE per
Adjusted
Discharge
Goal = 1.15
Current = 1.15
Growth
Increase
Inpatient
Admissions
Goal = 2.7%
Current = 7.6%
Increase
Outpatient
Visits
Goal = 5%
Current = 8.0%
Leader Evaluation Results – Year 2
Note: Percentages noted account for 93% of the leaders who have entered data as of
6.7.07.
Financial Impact:
Percent of HAI Over Admissions
Hospital Acquired Infections
Metric
Reduction
Hospital Acquired
Infections
156
Incremental Costs
$1.93 million
Bed Days Avoided
Tactic and Tool Implemented:
Objective Evaluation System
Source: Arizona Hospital, Total beds = 355, Employees = 4,000, Admissions = 10, 188
HFMA article, “When Hospital Infections Go Down, Pay Raises and Bonuses Go Up at UMC”, July 2009
984
Why Have Leader Evaluations Based on
Objective Goals?
Clearly connects the goals of the organization to
individual leader
Provides prioritization roadmap for leader
Reduces unnecessary work and duplication of
efforts because clear expectations are set
Keeps leaders focused on what is really important
Allows senior leader to continuously monitor leader
performance
Provides for organizational agility
Competencies do not guarantee desired outcomes
Goal Alignment & Balance
What is goal alignment?
Insuring that
individual leader
activities are
consistent with
the goals of the
organization.
Vertical Alignment
ORGANIZATION
GOALS
DIVISION
GOALS
DEPARTMENT
GOALS
LEADER / UNIT
GOALS
Horizontal Alignment
ORGANIZATION
GOALS
DIVISION
GOALS
DEPT X
GOALS
DEPARTMENT
GOALS
DEPT Y
GOALS
How Organizational Balance is Defined
Finance
Innovation
Community
Service
Quality
MISSION
Integrating and
connecting the
vision, value and
goals of the
organization into
daily decisions,
behaviors and
actions
Goal Development Process
1.
Senior leaders set organizational goals
2.
Organizational goals are shared with all leaders
3.
Each leader determines their goals and
preliminary weights
4.
Goals are reviewed by each leader’s reporting
senior
5.
Goals are shared within leadership team to
insure everyone's needs are addressed
6.
Goals are audited for continuity
7.
Leaders finalize their goals
Goal Development
Goal Development Tips
Develop quantifiable goals.
Goal Scales
5 = Stretch
4 = Partial Stretch
3 = Goal
2 = Partial Accomplishment
1 = No Accomplishment
Example Goal with Rating Scale
Goal
Rating Scale
Increase the
number of visits to
200
5 is ≥ 250
4 is 225 to 249
3 is 200 to 224
2 is 150 to 199
1 is ≤ 149
LEM Score Distribution
3
3
1
2
3
4
2
3
4
Opportunity
Target
5
Excellent
Example LEM Results
147
Average Score = 3.07
72
39
17
0
1
1
2
2
3
3
4
4
5
5
Goal Development Tips
Develop quantifiable goals.
Use language that everyone understands.
Connect goals to purpose.
Fewer, rather than more goals, are better.
Goal Development Tips – Cont.
It is not always practical to have a goal
under each pillar.
Goals should be aggressive yet realistic.
Focus on results, not tactics or projects.
Goal or Tactic?
Conduct employee evals on time
Improve staff productivity
Round on 100% of inpatients
Attend all leadership development
sessions
Pass OSHA inspection
Define how much time goal must be
sustained
For fiscal year-to-date (FYTD)
For the month of December
For the 4th quarter
For last 6 months of the year
SMART Goals are
Specific
Measurable
Attainable
Realistic
Time-bound
What might not fit as goals:
Standards of performance
Subjective and vague statements
Tactics to achieve goals
Maintaining regulatory compliance
Routine job activities
Middle Management Common Goals
(Examples)
Budget
Patient Perception of Care
Interdepartmental Satisfaction
Employee Engagement
Core Measures
Patient Fall Rate
Tools of Accountability
Leader Performance Evaluation
Leader Report Card
90 Day Plan
No Surprises
MONTHLY
QUARTERLY
YEAR END
Thank You!
For valuable tips on creating a culture of
organizational excellence, visit our web site at
www.studergroup.com
Bill Bielenda
850-934-1099