Leading Practices in Talent Management and Succession Planning

Ninfa Saunders, RN, MSN, MBA PhD Executive VP & COO, Health Services

Annmarie Horan, SPHR Assistant Vice President, Talent Management

2

We are located in a highly competitive Philadelphia, Pennsylvania metropolitan area

We serve three counties in Southern New Jersey (Burlington, Camden & Gloucester)

Dominant provider in SJ: 29% of the market

1.25 million financially and ethnically diverse households

Over 8,000 employees

1,800 Voluntary Medical Staff

More than 135 Employed Physicians

About Virtua

3

About VirtuaAcute Care

Four hospitals (975 licensed beds)

Post-acute CareTwo Home Care agenciesTwo rehabilitation centers

Sub acute and residential long term care

Ambulatory and Outpatient ServicesDelivered at four hospitals and multiple ambulatory settingsFour Joint VenturesFitness CenterEmerging Occupational Health/Immediate Care and Retail ClinicsEmerging Retail Strategy (Med SPA) and Wellness

Emergency ServicesDelivered at four hospitalsSatellite EDMobile intensive care services

4

Virtua’s Journey to Prominence

Top Performer - Operating MarginGovernors Award for Quality#1 Best Place to Work

Philadelphia Business JournalJoint Commission RecognitionTop 2%tile in Employee SatisfactionImproving Patient Satisfaction ScoresOn the Baldrige Journey

5

Virtua 2009 – Employee Satisfaction & Engagement

6

Virtua’s Journey from Average to Excellence…

7

What to do?

What do we want to differentiate?

How do we want to differentiate?

How will we know we are more than AVERAGE?

How will we reward the differentiated performance?

How will we sustain it – how will we know we are BUILT TO LAST?

It all started with the STAR!

8

Excellent service

Best people

Caring culture

Highest clinical quality

Resourcestewardship

Outstanding Patient

Experience

StrategyStrategy

Mission and

Mission and

ValuesValues

Performance

Performance

The VirtuaThe Virtua

9

How will we know we are How will we know we are not AVERAGE?not AVERAGE?

Metrics around the points of the STARBest People – Overall Job Satisfaction

Service Excellence/Caring Culture – Patient Satisfaction – Inpatient, Ambulatory & Emergency

Clinical Quality & Safety – Annual Quality/Safety indicators

Resources Stewardship – Financial Goals

10

Goals Cascading Process

Integral to deployment of strategy

Guided by Mission, Vision, Values, and Strategic Imperatives

Global goals are developed then deployed throughout the various organizational levels

At each level individuals are held accountable to goals and performance targets

Fully aligns measures and goals top-to-bottom

Initiates the ‘action plan’discussions which fully integrate goals

11

Annual STAR Launch

G&O review & signoff

Management Meeting (QMM)

QMM Meeting & celebration Best People & G&O Q3

QMM Nov. 10Annual Service Awards Nov. 4

POE Growth PlaybookBudget Process

Best People Review

QMM

January 20

February 26April 27

May 26, 27

June 3

September

August 18, 19

July 29

November17, 18

December 8October 26, 27

Outstanding Patient Experience

Stewardship

Patient Safety

Best PeopleCaring CultureClinical

March 10, 24

Virtua Values

1st Quarter 2nd Quarter

3rd Quarter4th Quarter

Virtua STAR Calendar 2010

Resource

Service Excellence

Quality &

January 26, 27Feb 23, 24

2011 Star Launch10 G&O 4th Q.

SuperSTAR Awards

G&O Review 1st Q

G&O Review 2nd Q.

12

Virtua’s Leadership System

Community/BOT

EmployeesPhysiciansPa

rtner

s

Set Direction, Metrics & Plan

VisionMission

Analyze & AdjustAnalyze & AdjustAlign

&Cascade

Execute &

Measure

By Engaging, Motivating, Inspiring

By Empowering andMobilizing CommitmentBy Driving

Passion and Accountability

By ImprovingandInnovating

13

Virtua’s Best People Review

14

What is the Best People Review (BPR)?

A systematic process that differentiates and rewards individuals based on a consistent measurement of Values and Performance and provides ongoing opportunities and growth.

15

What tools are utilized in the Best People Evaluation?

Virtua Values Guideline

Talent Matrix

Vitality Curve

Best People Review Form

16

Values Drive Behavior at Virtua

17

Virtua Values Guideline Behavioral Descriptors

Value Behavioral Demonstration and Values Rating Definition

Red

Not Consistently living Virtua’s Values /Needs Improvement

Green

Reliably Demonstrates Virtua Values

Virtua Blue

Exceeds Standard/Role Model *consistently meets standards

as defined in the Green category plus:

Integrity

To adhere to the Code of Conduct

set forth by Virtua and

demonstrate Confidentiality, Trustworthiness and a display of

Ethics.

• Does not adhere to confidentiality standards; requires ongoing guidance, education, and/or prompting to ensure confidentiality is maintained.

• Demonstrates unprofessional

behavior and/or a negative attitude towards clients, colleagues, and/or general work duties.

• Does not keep commitments or

does so only with ongoing prompting and coaching.

• Does not adhere to Virtua’s

policies and procedures.

• Did not adhere to Virtua’s ethical standards on at least one occasion.

• Demonstrates respect for confidentiality.

• Acts in an honest and truthful

manner when interacting with patients, employees, co-workers, physicians and the community.

• Adheres to Virtua’s ethical

standards; seeks appropriate guidance when necessary.

Acts as a role model/mentor by:

• Independently addressing confidentiality violations.

• Creating an environment

where people are encouraged to bring compliance issues forward.

• Inspiring and teaching

others to honor commitments.

• Mentoring others to walk

the talk and align actions/behaviors with words.

18

Talent Matrix: Combines the measures of Values and Performance

Note: All Managers must be placed in one of these 9 Blocks.

PERFORMANCE

Exceeds Standards/Role

Model

Reliably Demonstrates Virtua Values

Does Not Consistently

Demonstrate the Virtua Values

HighPerformer(Exceeds Expectations)

Promote/Expand

Coach –Values

Values Improvement

Needed

MiddlePerformer(Meets Expectations)

Coach –Performance

Coach –Perf & Values

Values Improvement

Needed- Coach Performance

LowPerformer(Does Not Meet Expectations)

PerformanceImprovement

Needed

Performance Improvement

Needed – Coach Values

Fails to Meet Performance &

Values

19

“Valued Contributor”

“Top Talent”

“Needs Improvement”

No more than 30% 5 - 10%

Differentiated Performance Key to Driving Results

Driving Performance: The Vitality Curve

20

Best People Ratings

Top Talent (no more than 30%)

Valued Contributor (60-65%)

Needs Improvement (no less than 5%)

21

Sally PeopleBest People ReviewEmployee Information

1)Name: Sally People

2)Title: Nursing Director

3)Job Code: 9850

4)Department: ABC

5)Reports To: Administrative Director – J. Doe

6)Location: Corporate

7)Employee ID: 12345

8)Date of Hire: 8/79

9)Start Date of current position: 9/04

Increased by 11%8% under budget

Increase procedures by 10% Budget under by 5%

5)Resource Stewardship:

80%Improve Supervisory Consideration score - 79% 4)Best People:

3)Excellent Service:

Outpatient 75%Patient Satisfaction:Outpatient 91%

2)Caring Culture

96%Inpatient screening for Depression Program95%

1)Clinical Quality & Patient Safety

YEAR END PERFORMANCETARGETS

(Please shade ENTIRE block to the color matching year end performance = Green/Red )

Performance Data

22

Significant Accomplishments/AchievementsDescribe significant accomplishments/achievements during the last twelve months. • Initiated co-pay cash, check and credit card payment process (average collection now $11,000/mo)• Education of front desk with PBS, VPA and coding seminar • Audit quarterly for accurate registration and billing (04/04 -30% accurate, 12/04 96% accurate)• Initiated Service Request Form for accurate appointment and referral collection information• Participated in Workout and Physician Coding Seminar• Enhanced waiting area for customer satisfaction• Initiated patient survey and added to quality dashboard • Revised record keeping process• Incorporated insurance tools for accurate referrals, pre-certifications and authorizations

Evaluation of Performance Against Job Expectations

Provide a clear statement of Overall Job Performance against Job expectation:Successfully completed two stretch assignments this year that were over and above the expectations of current role. Actively participated on six sigma project and facilitated one work out. Shows devotion to her work, the success of the organization and everyone she works with by helping others without being asked.

2005 Performance against Job Expectation: xExceeds Expectations □Meets Expectations □Needs Improvement □Does Not Meet

Strengths Development Needs

Able to communicate with other in a kind, constructive and effective manner

Develop direct reports

Detail oriented Delegation of duties

Finances- budget management Continue education

Multi-task well

Executes quickly and completely

Sally People

23

Developmental Progress

Highlight progress towards last year’s self-development goals:

•Completed Green Training and lead a project•Successfully completed Dale Carnegie course and utilized skills learned when delivering presentations to my work group.

•Enrolled in the MBA program offered through Virtua

Sally People

Education & Certification1)Completed Education:(Institution(s), Degree Type(s), Major(s), Year Completed)

•Diploma in Nursing, Thomas Jefferson- completed 12/77•Bachelor of Science in Health Administration, Lamar University-completed 5/03

2) College/Graduate Coursework in Progress:(Institution, Start Date, Credits Earned, Degree, Completion Dt.)

•Rutgers University (3/05 – present)•Completed two courses towards MBA•Anticipated completion date - 2007

3) Significant Certifications:(Certification Date, Association, Expiration Date)

•AWHONN member

4) Six Sigma Training:(Type of Training, Certification Date)

•Green Belt Training (Completed 6/05)•Yellow Belt•Certified STAR Coach

5) Six Sigma Workouts/Project Participation:(Project Name, Date, Short Description of Contribution)

•Lead Green Belt Project – 9/05

Outside Activities and Community Service (during current performance period)

•March of Dimes•Parish Nursing Committee of Burlington County

24

Sally PeopleValues Grid (use colors and numbers)

Green is Exceeds Expectations; Yellow is Meets Expectations; Red is Below Expectations

Integrity Respect Caring Excellence Commitment Teamwork

Examples of Green Values and Red Values in Practice:

Virtua realized increased revenue through Sally’s efforts to share and implement best practice in the units across the Virtua System Salary expense savings were created by her ability to “do it all”…

PreviousBP Rating

CurrentBP Rating

TT □VC □NI □

TT □VC □NI □

TALENTMATRIX

Exceeds Standards/Role

Model

Reliably Demonstrates Virtua Values

Not Consistently Living the Virtua

Values

High Performer(Exceeds

Expectations)

Promote/Expand

X

Coach/Values

□

Values Improvement

Needed

□

Middle Performer

(Meets Expectations)

Coach-Performance

□

Coach Performance

& Values

□

Values Improvement

Needed-Coach Performance

□

Low Performer

(Does Not Meet Expectations)

Performance Improvement

Needed

□

Performance Improvement

Needed Coach Values

□

Fails to Meet Performance &

Values

□Next Logical Position at Virtua Health:Administrative Director

25

Calibrating Performance & Values

Self Evaluation

Manager Evaluation

Cluster meetings (peer leaders calibrate performance and values)

26

Cluster Groups

Cluster groups are determined by reporting relationships to the CEO, EVP and Chiefs

Cluster I: Managers level 6-10

Cluster II: Managers level 11-13

Cluster III: Managers level 14-16

Cluster IV: OMG & AVP’s

Cluster V: VP’s

Cluster VI: Chiefs

Titles included in each cluster group will be found on VINE

27

Post Cluster Meeting

Performance ratings reviewed and finalized

Employee performance review discussion

Individual development plan created

28

BPR Outcomes

Creates high performing organization through talent analysis, leadership development and coachingCreates a high performing culture of accountabilityStrategically aligned systems that result in the RIGHT people in the RIGHT jobs at the RIGHT timeDifferentiates and rewards performanceLeads to retention of top and solid performersElement of succession planningProvides clarity and direction to those needing improvement

29

Recognition of Top Talent Performers

Traditional methods of employee recognitionOur Top Talent receive:

Enhanced tuition benefitsDonation made to a charity of their choiceParticipation in some of the Virtua’s high profile organizational initiativesFinancial incentives

Virtua recognizes our STAR achievers (individual and groups) in our internal and external marketing campaign Annually Virtua recognizes our STAR achievers at our Super Star Awards banquet

30

Individual Development Plans

Connects BPR and development

Used to identify learning trends and drive our educational focus & offerings offered through Virtua University

Used to guide and drive accountability of the coaching process

31

Culture of Coaching

32

Coaching at Virtua Master coaches deployed to client groups/business unitsStrategically coach Top Talent, Valued Contributors & those Needing ImprovementIdentifies organizational talent and competencies Increases engagement and retention of high potential performersDrives performance by providing a dedicated focus on top talent Increases accountabilityIdentifies individual developmental needs and allows for tailored educational opportunitiesIncreases the skill set of the least effective or assists them in transitioning to an alternate roleLeads to succession planning

33

Coaching at Virtua…

Next Steps

Development and implementation of an organizational coaching model

Expansion of coaching

Develop all managers to assure all have core coaching competencies

Develop skill levels as developmental path for leaders

Create a distinction between mentor vs. coach

34

Results

35

2009 Leadership Review

412 (72%)

122 (21%)40 (7%)

Top Talent Valued Contributor Needs Improvement

574 total participants

36

2009 Movement of Top Talent

1% (2)

15% (21)1% (1)

83% (116)

Promoted/Stretched Terminated

Same Role Moved to Staff

37

2009 Movement of Needs Improvement

Terminated (25)53%

Same Position (14)

30%

Transfer (8) 17%

Same Position Transfer Terminated

38

2009 Patient Care BPR

(82) 6.06%

(1016) 75.09%

(252) 18.72%

Top Talent Valued Contributor Needs Improvement

1,350 total participants

39

2009 Non-Union Staff Review

17%

78%

5%

4,359 total participants

40

Employee Engagement Levels

Ambivalent, 46% (59% Norm; BIC Norm 58%)

Actively Disengaged, 8% (16% Norm; BIC 

Norm 6%)

Actively Engaged, 45% (25% Norm; BIC Norm 36%)

Virtua’s Employee Engagement Levels

Levels of Engagement 2008 2009Actively Engaged 42 45Ambivalent 47 48Actively Disengaged 11 8

41

Management Turnover2007 - 2009

The turnover rate for Top Talent has declined from 9.1% in 2007 to 1.3% in 2009. Value Contributor turnover rate has declined from 18% in 2007 to 5.6% in 2009.

T/O % T/O % T/O %Top Value Needs T/O %

Talent Contributor Improvement Overall2007 9.1% 18.0% 30.0% 16.3%2008 6.5% 12.9% 42.3% 12.7%2009 1.3% 5.6% 16.7% 4.9%

42

Questions?

Copyright 2010 43

Next Leadership Webcasts

April 16th

Nursing and the Executive Team: Leadership for Quality and Patient SafetyMarie Sinioris, President and CEO, NCHL

May 21st

The Quest for Excellence – Atlanticare, 2009 Malcolm Baldrige National Quality Award WinnerRoseann Kobialka, Corporate Director Organizational DevelopmentJoan Brennan, Vice President of Quality and Performance Excellence

1:00‐2:00 p.m. EST, 12:00‐1:00 p.m. CST, 10:00‐11:00 a.m. PST

Copyright 2010 44

Upcoming Learning Lab: Leading Clinical Innovation and Excellence

Host Lucile Packard Children’s Hospital at Stanford University, Palo Alto, California

Date August 26 – 27, 2010

Presentation/ Discussion Focus

August 26: Building Pre‐eminent Clinical ServicesAugust 27: Infrastructure and Leadership

Who should attend Clinical leaders – CMOs, CNOs, etc.Operation leaders – COOs, quality leaders, etc.Leadership development executives – CHROs, CLOs, etc.

Copyright 2010 45

LENS Contact

Catherine Maji

Director, Leadership Collaborative

National Center for Healthcare Leadership

cmaji@nchl.org

312.755.7070