Performance Improvement: What Matters Most€¦ · Performance Improvement: What Matters Most RaNae...

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Performance Improvement: What Matters Most

RaNae Wright, MHA

Community Market Leader

[email protected]

513-236-9092

Jessica Jones, CHFP

Managing Director

[email protected]

303-619-1379

mailto:[email protected]



Art and Science of Performance Improvement

2

Why Implement Performance Improvement

Getting Started

Performance Improvement Tools and When to Use

Tips and Traps


Mission

To make healthcare a better place for employees to work, physicians to practice medicine,

and patients to receive care.

Vision

To be the intellectual resource for healthcare professionals, combining passion with

prescriptive actions and tools, to drive outcomes and maximize the human potential within

each organization and healthcare as a whole.

3

We Are Studer Group®

What We Do

• Apply evidence-based tactics to achieve and

sustain exceptional clinical, operational, and

financial outcomes

• Develop web-based software solutions for

operational alignment and process efficiency

• Provide a wealth of educational resources—

including books, training videos, webinars, and

institutes

Awards

Received the 2010

Malcolm Baldrige Quality

Award

Ranked #5 on Great Place

to Work® 2014 Best Small

& Medium Workplaces

List


Why

What

How

4

Communicating: The Suggested Sequence


5

Heart (People)

Mind (Process)

WHY: Connecting Heart and Mind


Market Drivers

Payment Reform Cost Pressures

Information Boom Improved Care

Performance

Improvement

8-12% Total

Improvement

Asset

Rationalization

3-6% Total

Improvement

Scale and

Integration

4-8% Total

Improvement

Clinical

Transformation

6-14% Total

Improvement

6

WHY: Market Demands Improvement

Market Will Demand 20 – 40% Overall Improvement, Requiring a Multi-

Pronged Approach


7

WHY: Top 10 Issues in Healthcare

Top Issues*Performance

Improvement

Opportunities

1. Financial challenges X X

2. Healthcare reform implementation X X

3. Governmental mandates X

4. Patient safety and quality X X

5. Care for the uninsured/underinsured X

6. Patient satisfaction X X

7. Physician-hospital relations X

8. Population health management X X

9. Technology X

10. Personnel shortages X X

*10 most concerning issues for hospital CEOs, Survey published January 12, 2015 by the American College of Healthcare Executives


WHAT is Performance Improvement?

Performance

Improvement

sometimes has a

bad reputation…


Measuring

• … the output of a particular process

• … or procedure, then

Modifying

• …the process or procedure

• … to increase the output,

• … to increase efficiency, or

• … to increase the effectiveness of the process or procedure


PI

People

Process

Tools

Organiza-

tionalCulture


10

WHAT: Where to start with PI

A BALANCED approach

• Establish clear priorities for your

future

• Focus on strengthening current

stability

• Optimize current operational

performance

• Establish the capabilities and

infrastructure for a long term

strategy

Consider a 3-4 year

horizon with a goal of 5-

10% improvement / year

Performance improvement

solutions can lead to one

year / 8-12% improvement


12

WHAT: Structures that Support PI

• Establishing the PI vision and continuous monitoring of the proper implementation of that vision

Governance

• Disciplined measurement and monitoring of implementation activities and the associated benefits

Project Management

• Collection and consolidation of data into information scorecards used to drive business decisions

Business Intelligence

Execution Framework


Governance and Project Management

Governance

Project

Mgmt.


14

Business Intelligence

Strategy

• Define Performance Improvement objectives and gain additional understanding of the business drivers, focus areas, and benefits expected

Gap Analysis

• Define the competencies and infrastructure required for implementing the new analytics platform and jointly assess existing competencies and infrastructure

Technology Evaluation

• Build a framework to critically evaluate and ultimately recommend an analytics technology choice

Implementation Planning

• Define the implementation plan – the primary phases and objectives associated with the upcoming work required to deliver desired objectives


15

What Are You Tracking? Is it Clear?


WHAT: Metrics

Even simple metrics can become complicated and

have multiple definitions . . .


Metrics Tips

• Organizational Strategic Goals

• In-Process Metrics that drive

organizational goals

• Identify key summary metrics

with ability to drill down on detail

for analytics

• Two Key Metrics Types

• Unimpact-able (Volumes)

• Impact-able (Point of Service

Collections, Overtime, etc.)

• Clearly define each metric and

keep those definitions visible

• Track weekly or monthly by

leader and relevant department

• Compare to national standards

and internal benchmarks

• Ensure impact-able metrics are

supported by data that identifies

accountable parties

17

WHAT: Basics of PI Metrics


HOW: Performance Improvement Tools

Pareto Chart

?Evidence-Based LeadershipSM

Fishbone Diagram


Execution Framework: Evidence-Based LeadershipSM

19

LEADER EVALUATIONImplement an organization-wide

leadership evaluation system to

hardwire objective accountability

LEADER DEVELOPMENTCreate process to assist leaders in

developing skills and leadership

competencies necessary to attain

desired results

MUST HAVES®

Rounding, Thank You Notes, Employee

Selection, Pre and Post Phone Calls, Key

Words at Key Times

PERFORMANCE GAPRe-recruit high and middle performers,

Move low performers up or out

STANDARDIZATIONAgendas by pillar, peer interviewing, 30/90 day

sessions, pillar goals

ACCELERATORSLeader Evaluation Manager®

Validation MatrixSM

Provider Feedback SystemSM

Studer Group Rounding

Patient Call ManagerTM


Words that drive compliance in hospitals

20

Mandatory

98%

Required

69%

Expected

26%

Mandatory vs. Optional


• Rounding for Outcomes

• Interviewing, Validation, Observation

• Objective Evaluation System, Validation Matrix

21

Tactics That Align Process and People


22

Rounding


• Appreciative Inquiry – what

has worked before

• Practice makes perfect

• Schedule time to see for

yourself

• Create train-the-trainer wins

• Provide coaching in the

moment

• Annual competency

23

Interviews, Observations and Validation


• Are goals specific, measurable, achievable, realistic, timely

• Do you track goal results monthly?

• Do you track in-process metrics monthly?

• Do you discuss outcomes monthly without fail?

• Is the action plan clear and reviewed monthly?

24

Leader Evaluation Manager® (LEM), Validation

Matrix, etc.


Culture: Our Expertise

Are you Really Focused on Culture

or Training?

BUILD SKILLS

• Educational

Conferences

• Speakers

• Books

• Videos

• Online learning

TRAINING

GET RESULTS

Fast improvement

on a key

organizational

metric, e.g. patient

experience,

employee &

physician

engagement, ED

turnaround

IMPROVEMENT

CHANGE

CULTURE

Comprehensive

organizational

transformation

through expert

coaching to

hardwire

evidence-based

practices across

the board

TRANSFORMATION


• What is a Blind Spot?

• How do you know you have one?

• How do you name it?

26

Blind Spots


• Which personal

aspects form the

basis of my

leadership style?

• Which personal

weaknesses do I

reveal to those I

lead?

• How well do I read

situations?

• Do I have a good

sense of

organizational time?

• How well do I

communicate?

• Do I conform

enough?

• How well do I manage

social situations?

Self-Awareness Exercise for Blind Spots

Ask Another …


• Own it

• Know it

• Practice seeing it

• Get feedback on success

• Add it to your development plan

28

How do you get rid of it?


29

Identifying Black Holes

.

Communication

and reinforcement

must cascade

level by

management level

down the

organization

Don’t skip a level!

Black Holes are formed when commitment or

compliance is not sustained at each management level

and driven to the next level


30

Key Role Map

Tips for Creating a Key Role Map

Use post-it notes to build a Key Role

Map/Org hart based on current state


31

Key Role Map

Successful Sponsor Strategy

.Cascading sponsorship must occur at each level between the Authorizing Sponsor (SA) and the final Targets (T3).

There must be Reinforcing Sponsors (SR) at each level between the Authorizing Sponsor (SA) and the final Targets (T3).


“The biggest obstacle in achieving high performance

is not achieving the needed urgency for change.”

Kotter, John P (2008)

A Sense of Urgency. United States: Harvard

Business Review Press.

32


33

Thank You!

RaNae Wright, MHA

Community Market Leader

[email protected]

513-236-9092

Jessica Jones, CHFP

Managing Director

[email protected]

303-619-1379



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