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Quality and Organizational Performance Management: An Integrated Approach Gregory Richards, MBA, Ph.D, FCMC Professor of Performance Management May 7,

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Presentation on theme: "Quality and Organizational Performance Management: An Integrated Approach Gregory Richards, MBA, Ph.D, FCMC Professor of Performance Management May 7,"— Presentation transcript:

1 Quality and Organizational Performance Management: An Integrated Approach Gregory Richards, MBA, Ph.D, FCMC Professor of Performance Management May 7, 2010

2 Agenda 2 Our research Concept of a performance management framework. Where do quality initiatives fit? Technical issues: data, information, analytics The human component

3 Our Research Multiple case studies (private and public sector) Large scale survey (338 private sector, 80 public sector) Experimental: decision modelling/data modelling Participant observation specific to health care: Montfort The Ottawa Hospital University of Pittsburg Medical Centre

4 Performance Management Frameworks Organizational capital created by a managerial process that: Clarifies expected outcomes: what, who and how Reviews key measures on a regular basis Focuses on process improvement, especially in service organizations Closes the loop between outcomes and processes 4

5 The PM framework is based on a model of success Variations of success models: Theory of the business (Drucker) Value-based management (Porter) Causal modelling (Ittner and Larcker) Strategy mapping (Kaplan and Norton) 5

6 Planning for Success: A simple logic model Inputsactivitiesoutputsoutcomes 6

7 Theory of Change & Logic Models Inputsactivitiesoutputsoutcomes Strategies Outcomes/Impact Logic model: service strategy Performance Indicators: Targeted -improved quality of life -reduced cost of health care -healthier communities -early intervention and education -rapid care and issue resolution -continuous learning Theory of Change: understanding outcomes # staff available -# of visits -time per visit -# issues resolved -response time Patient satisfaction 7

8 Example of a Logic Model from MOH-LTC 8

9 DATA, INFORMATION, ANALYTICS "In God we trust, all others bring data." W. Edwards Deming

10 Applying Managerial Analytics: Step 1: Modelling decisions Patient satisfaction Develop service processes and procedures Service and Access Organizations reputation Patients visit the centre Patient well being improves Presumed key success factor Translated into a service standard 10

11 Step 2: understand relationships Number of satisfied patients Number of dissatisfied patients Wait time < 2 hours Wait time > 2 hours "Without a standard there is no logical basis for making a decision or taking action." Joseph M. Juran

12 Outcome of the analysis Chi-Square test of independence = 42.9, df=2; p<.0001 Conclusion: Our service standard of 2 hours does make a difference to patient satisfaction. From analysis to action: What is our cost for maintaining this standard? How much of a difference does it make? Is a 2-hour wait time important for all patients? How can we ensure consistency? 12

13 WHERE QUALITY & LEAN FITS: IMPROVING PROCESSES "If you can't describe what you are doing as a process, you don't know what you are doing." W. Edwards Deming

14 Reducing wait time is a process-level issue ReceptionAssignmentTreatmentDischarge -Capacity -Flow -Value added versus Non-value added time -Consistency < 2 hours 14

15 THE PERSONAL SIDE OF ORGANIZATIONAL PERFORMANCE 15

16 Individual Aspects 95% of performance is related to systems and processes, not to individual effort* Systems and processes are full of people *Joel Barker 16

17 Inverted U: motivation versus performance Engagement reduces uncertainty, builds ownership, develops a sense of of control and self-efficacy. Allows a right shift along this graph so that higher targets can be set and met. The use of LEAN techniques is a powerful way of engaging staff! 17

18 Conclusions High performance in complex environments depends on strategic clarity which brings focus, consistency and continuous improvement. Causal planning is one way of creating clarity: works from the patient backwards; represents hypotheses about how value is delivered. Measures are used to test hypotheses and to point to core processes that need to be examined. Dont forget the human component: the organization should value excellence and accountability but also engagement and support. LEAN processes are exceptional ways of engaging staff. 18

19 École de gestion Telfer Université dOttawa 55 Laurier Avenue Ottawa ON K1N 6N5 Tél. : (613) Télec. : (613) Telfer School of Management University of Ottawa 55 Ave Laurier Ottawa ON K1N 6N5 Tel.: (613) Fax: (613) Gregory Richards, MBA, Ph.D, FCMC Professor of Performance Management x 2611


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