Strategic Plans – The Engine of Performance Management March 18, 2015

Strategic Plans – The Engine of Performance Management March 18, 2015
Marni Mason MarMason Consulting, LLC Susan Ramsey Pearls of Wisdom Consulting, LLC

Susan Ramsey More than 25 years in public service for the State of Washington retiring in 2013, served as the Director for the Office of Performance and Accountability with the Washington State Department of Health. Past co-chair for the Standards and Accreditation Workgroup for the Public Health Improvement Partnership in Washington State representing the state and 35 local health departments. National trainer and presenter for performance management, quality planning and improvement and accreditation in more than 10 states and for ASTHO, PHAB, NNPHI, and RWJF. PHAB site reviewer. Member of the PHAB Evaluation and Quality Improvement Committee. Washington State Reviewer and led the State Department of Health to become nationally accredited in 2013. Owner and Managing Consultant of Pearls of Wisdom Consulting, LLC based in Olympia, WA.

Marlene (Marni) Mason More than 30 years in private healthcare and public health as clinician, manager and national performance management/quality improvement consultant Consultant for Public Health performance standards and improvement since 2000; NACCHO CHA/CHIP project ( ), ASTHO QI Demonstration project ( ), NNPHI COPPHI QI Coach (Phase I & II) and for all 3 Multistate Learning Collaboratives ( ), including more than 80 QI teams. National trainer and presenter for QI and Accreditation in more than 20 states and for ASTHO, NACCHO, NIHB, NNPHI, and RWJF. Contributed to the Michigan QI Handbook, the 2009 ASQ Public Health QI Handbook, and authored numerous JPHMP articles including Jan/Feb “Understanding and Controlling Variation in Public Health”. Consultant for PHAB Standards Development and training of site reviewers ( ). Surveyor for National Committee for Quality Assurance-NCQA (17 years) and Senior Examiner for WA state Quality Award (Baldrige Criteria for Performance Excellence- late 1990s) Owner and Managing Consultant of MarMason Consulting, LLC based in Seattle, WA

Workshop Objectives Describe the relationship of the Strategic Plan to the CHA, CHIP, performance management and to quality improvement. Able to identify PHAB requirements for strategic planning. Develop and understand how to operationalize the: Vision Mission Values Goals Objectives Strategies Performance Measures

Why Performance Management?
“Now is the time for governmental leaders to ensure that the organizations they lead are taking responsibility for achieving results that matter to the public – by practicing performance management”.* *Source: A Performance Management Framework for State and Local Government: From Measurement and Reporting to Management and Improving. National Performance. National Performance Management Advisory Commission governments must improve their focus on producing results that benefit the public, and also give the public confidence that government has produced those results. The emphasis on process and compliance that has typified traditional public-sector management has not been sufficient to make this happen. Therefore, governments must change their approach. Public-sector management must become synonymous with performance management. Now is the time for governmental leaders to ensure that the organizations they lead are taking responsibility for achieving results that matter to the public – by practicing performance management.

Power of Strategic Alignment
No Strategic Alignment Execution Gap High Level Goals Public Health Outcomes Other Public Agencies Hospitals Schools Community Groups Faith Communities Nonprofits State Health Dept Families & Individuals Local Health Depts Employers Bill B: Strategy Maps and Community Balanced Scorecards are at the core of creating strategic alignment. This big blue arrow is where states, communities, and organizations usually are: You may be able to get people to agree on high level goals, but then they all get back to their own workplaces and, even with the best intentions, pull in different directions, resulting in an execution gap. And when “random acts of quality improvement” happen, they are often not aligned, so the impact falls short of what could be the case. [CLICK] The bottom arrow is where you want to be—where all partners’ efforts are aligned in a common strategy, and you really achieve desired results. A Community Balanced Scorecard can get you there.

CHA, CHIP, Strategic Plan

CHA, Strategic Plan, CHIP, and QI Plan

Effective Performance Management
Establishing and implementing performance management systems helps: Align agency plans to reduce duplication and increase efficiency and effectiveness. Prioritize planning and improvement efforts. Address specific PHAB Standards requirements Domain 9, Standard 9.1. Demonstrate the results of Public Health programs and services through performance measurement and reporting. The PM work within the agency will help prioritize .. Help demonstrate results so we can go to elected officials, community partners, etc. so we can describe all the public health programs and activities, so we can get support ….. Public Health Performance Management Centers for Excellence

6 Performance Management Principles*
Results focus permeates strategies, processes, organizational culture, and decisions. Information, measures, goals, priorities, and activities are relevant and aligned to health improvement and strategic initiatives. Information is transparent – easy to access, use, and understand. Decisions and processes are driven by timely, accurate, and meaningful data. Practices are sustainable over time and organizational changes. Performance management is transformative to the agency, its management, and the policy-making process. These principles are adapted from an excellent document titled A Performance Management Framework for State and Local Government: From Measurement and Reporting to Management and Improving, published in 2010 by the National Performance Management Advisory Commission. Focusing on results is at the top of this short list. Everything the organization does is aimed at producing desired results. Your plans, data from needs assessments, long term outcome measures, operational measurements – should depict your results – and be used to drive toward improved results through strategy, processes, culture and decisions. Pick measures that are relevant to your desired results. And your goals and performance targets need to be meaningful to your intended audience. If you have a technical water quality target, for example, also have a “plain English” target that the public can appreciated. Something “resident friendly” can help build community support for your efforts. Don’t get pulled off course by sharing information and updates on your measures that are not aligned with your strategic initiatives. Information is transparent when community members, managers, and staff have easy access to targets, goals, and benchmarks that are easy to use and easy to understand. Sharing information with the community can make it easier to help them understand decisions that are made, for example, to reallocate resources to better match community priorities. Decisions and processes are driven by operational data. To do this, data needs to be both accessible and useable, and collection needs to be adequate. Sustainable means that even if you have a change in the director of the agency or need to cut a program in these hard economic times, you still have the mission and performance management practices sustained. This makes successful performance management possible. Transformation, in this context, is about our organization’s culture, and it occurs as a result of the other principles listed here. It means shifting our focus to an emphasis on results, organization-wide, instead of focusing on the number of inputs our outputs we have processed, or the steps we have taken in our work. It means making decisions more and more based on results and data, and increasingly valuing learning as well as accountability. * Based on A Performance Management Framework from the National Performance Management Advisory Commission 2010 10 Public Health Performance Management Centers for Excellence

Challenges of Performance Management Implementation
How do you optimize alignment and reduce duplication in implementation of agency-wide plans? How do you begin to limit your Performance Management measures and indicators? What is a reasonable number to start with? How do we engage leaders and staff appropriately in Performance Management activities? Is QI the same as Performance Management and if not how do they differ? Others??

Turning Point Performance Management Assessment Tool
agement/Pages/Access_the_Performance_Manag ement_Self_Assessment_Tool.aspx For each section, numerous questions serve as indicators of your Performance Management capacity. These questions cover critical elements of your Performance Management capacity such as visible leadership, having the necessary resources, skills, accountability, and communications to be effective in each component.

Section 1. Visible Leadership

PUBLIC HEALTH ACCREDITATION BOARD (PHAB)
STANDARD 1 (CHA) STANDARD 5 (Strategic Plan, CHIP) STANDARD 9 (Performance Management and QI Plan) Transition slide

Connecting The Prerequisites For Accreditation
The Community Health Assessment (CHA), Community Health Improvement Plan (CHIP), and Agency Strategic Plan are not three discrete or isolated processes but rather, they should all connect and inform one another. The CHIP is developed with the community and public health system partners. The CHIP is developed based on the CHA. The Agency Strategic Plan is developed with mostly internal stakeholders and key external stakeholders as needed for input into the process. Planning is similar to the CHIP and consideration of the CHA results and CHIP priorities are part of the process, the result of the strategic plan are priorities and direction for the health department. CHIP priorities that the health department plans to address with their work should be included in the health department strategic plan.

Strategic Plan – Standard 5.3
Strategic planning is a process for defining and determining an organization’s roles, priorities, and direction over three to five years. A strategic plan sets forth what an organization plans to achieve, how it will achieve it, and how it will know if it has achieved it. The strategic plan provides a guide for making decisions on allocating resources and on taking action to pursue strategies and priorities.

Strategic Planning Process Measure 5.3.1
PURPOSE SIGNIFICANCE Department strategic planning process The purpose of this measure is to assess the health department’s strategic planning process A functional and useful organizational strategic plan requires that it be understood by staff and implemented by the health department. The development of such a plan requires a planning process that considers opinions and knowledge from across the health department, assesses the larger environment in which the health department operates, uses its organizational strengths and addresses its weaknesses, links to the health improvement plan that has been adopted by the community, and links to the health department’s quality improvement plan.

Strategic Planning Process Measure 5.3.1
REQUIRED DOCUMENTATION NUMBER OF EXAMPLES DATED WITHIN Use a planning process to develop the organization’s strategic plan: Membership of the strategic planning group (with titles, various levels of staff, representatives of the governing entity) Strategic planning process steps (number of meetings, duration of the planning process, methods used for the review of major elements by stakeholders) 1 strategic planning process 5 years

Adopted Strategic Plan Measure 5.3.2
PURPOSE SIGNIFICANCE Adopted department strategic plan The purpose of this measure is to assess the health department’s completion and adoption of a department strategic plan A strategic plan defines and determines the health department’s roles, priorities, and direction over three to five years. A strategic plan sets forth what the department plans to achieve as an organizations, how it will achieve it, and how it will know if it has achieved it. The strategic plan provides a guide for making decisions and allocating resources to pursue its strategies and priorities.

Adopted Strategic Plan Measure 5.3.2
REQUIRED DOCUMENTATION NUMBER OF EXAMPLES DATED WITHIN Health department strategic plan that includes: Mission, vision, guiding principles/values Strategic priorities Goals and objectives with measurable and time-framed targets Consideration of key support functions required for efficiency and effectiveness (information management, workforce development, communication, and financial sustainability) Identification of external trends, events, or factors that may impact community health or the health department Assessment of health department strengths and weaknesses Link to the health improvement plan and quality improvement plan 1 strategic plan 5 years

Implemented Strategic Plan Measure 5.3.3
PURPOSE SIGNIFICANCE Implemented department strategic plan The purpose of this measure is to assess the health department’s implementation of its strategic plan A plan is useful only when it is implemented and provides guidance for priorities, activities, and resource allocation. A strategic plan sets forth what the department plans to achieve as an organization, how it will achieve it, and how it will know if it has achieved it. It is important to regularly review the implementation of the plan to ensure that the department is on track to meet its targets

Implemented Strategic Plan Measure 5.3.3
REQUIRED DOCUMENTATION NUMBER OF EXAMPLES DATED WITHIN Progress towards achievement of the goals and objectives contained in the plan (must include how the targets are monitored, reports must be completed no less frequently than annually) 2 reports 1 report dated within 14 months; second report may be older

What is Strategic Planning?
Strategic Planning is: The process of taking facts and building plans to help us achieve our Vision. A long term look at the organization (2 years +). Creating measurable objectives, goals, targets and action plans. Involving the whole organization in the creation and achievement of our plans. Management review of our successes and failures. Strategic Planning is NOT: A dusty old book on the shelf that says “Five Year Plan”. The best kept secret in the organization. A list of 157 unrelated things we ought to do. A waste of time. Something we’ll get around to some day.

Are We Moving in The Right Direction?
As an individual, As an employee, As a leader, And what is the right direction anyway? Has anyone taken a train ride? Train ride Story Every business has a course and direction, just like a train on the track. Left alone, the engine drifts with the twists and turns of the track. But if a conductor and officers have a destination in mind and take control of the engine, it becomes a vehicle to get to the future, a vehicle for realizing dreams.

Four Great Reasons to Plan
Saves time and resources. Increases impact of work you are already doing. Fills in gaps. Change. Whatever the circumstances, it will change. It fact, change is not just happening, but at a rapidly accelerating pace, and Darwinian principles will select the survivors. Organizations that try to resist change will fail to adapt and will then lose out. Change is inevitable; if you can’t adapt, you won’t survive. History makes this clear; standing still means death. Change Time The pace of change is always increasing

How are we Going to Create a Strategic Plan?
Take facts describing current conditions and build measurable plans Environmental Issues/ Opportunities Strategic Issues Balanced Scorecard 1.0 Health Prevention, Promotion, and Preparedness 2.0 Financial/and Business Excellence 3.0 Customer/Partner Excellence 4.0 Employee Excellence and Personal Responsibility

LAYING THE GROUNDWORK FOR STRATEGIC PLANNING
Transition slide

The Plan for the Plan We will establish threads from the top to the bottom of the organization!! Develop the Plan Deploy the Plan Review previous process Review/develop Mission, Vision, Values Consider key factors Identify Strategic Objectives Assign champions Determine indicators and targets Implement the Plan Develop service center objectives Develop budgets Ensure plan sufficiency Engage managers, supervisors and staff Review the Plan Communicate plan Develop and prioritize action plans Regular evaluation of results Gap analysis Root causes identified Actions taken

Example Phases of Strategic Planning
Phase I - Management Team – Month One Develop vision/mission/values/goals Phase II - Management Team – Month Two Identify objectives to meet goals Identify strategies to achieve objectives Develop accountability links and performance measures to meet objectives Phase III – Stakeholders & Staff– Month Two Engage Stakeholders and Partners Phase IV – All Staff – Month Six Implementation – Chart and track progress quarterly/semi annually Phase V – All Staff – Month 12 Evaluate and review – What did we accomplish? What do we change/modify? Strategic planning is a multi-step process covering vision, mission, objectives, values, strategies, goals, etc. The pillars of planning are Vision – Mission – and Values. They are the glue that holds a division together. They describe what you are trying to do, how you want to go about it, and where you’re headed. It gives you a yardstick you can always use to measure your present performance and plans against your aspirations.

Steps of the Strategic Planning Guide
Fill out one step at a time on the worksheet as we work through the sheets. Don’t jump ahead! You will miss out on key points! Distribute Smart chart Critical message DON’T JUMP AHEAD FOLLOW ALONG

Internal Stakeholders
Examples may include: Governing body members. Senior staff. Middle managers. Front-line staff. Union representatives. Advisory board/committee members. Other _______________________________

External Stakeholders
Examples may include: Funders. State Health Department or other state agency representatives. Coalition members. Partner agencies. Other health departments (regional or shared service health departments). Competitors. Clients/customers. Community-at-large. Special target populations. Policy makers (all levels). Media representatives. Others _______________________________________________

Three Levels of Stakeholders
Primary Stakeholders are the people or groups that stand to be directly affected by the actions of the agency. For example, if proposing an increased tobacco tax, tobacco users and tobacco suppliers would both be directly affected by the tax through an assumed financial impact. Secondary Stakeholders are people or groups that are indirectly affected by the actions of an agency. Secondary stakeholders for a tobacco tax may include those exposed to second-hand smoke and local businesses who perceive a reduction of revenue based on tobacco product sales. Key Stakeholders, who might belong to either or neither of the first two groups, are those who can have a positive or negative effect on an effort, or are otherwise important to the effort. Key stakeholders for the tobacco tax include elected officials and advocacy staff and organizations.

Identifying Stakeholders, Their Role and Influence - Exercise
Level of Engagement Needed Action Needed and By When

Short Break! Be Back in 15 minutes, please!

10 Stations on the Journey
Station 1: Conduct an Environmental Scan Station 2: Set/Review Organizational Direction Station 3: Develop/Revise Strategic Goals, Objectives, and Strategies Station 4: Develop/Revise Performance Measures Station 5: Develop/Revise Action Plans Station 6: Allocate Resources Station 7: Implement Action Plans Station 8: Track Progress on Actions Station 9: Modify Action Plan based on data Station 10: Evaluate Strategic Planning Process

All Aboard?

Station 1: Conduct an Environmental Scan
Outcomes: Determine the organization’s strengths, weaknesses, opportunities and threats. Market Forces: An assessment of competition the organization must face, including industry trends and competitive analysis. Stakeholder Analysis: Identification of stakeholders and delineation of their needs. Technology: An internal and external assessment of technology to find opportunities for potential innovation. Internal Capability Analysis: A detailed view of the internal workings of the organization, with a focus on workforce development, communication, financial sustainability, and process capabilities. Legal and Regulatory Factors: A view of how the organization can favorably address legal and regulatory factors and minimize any threats by relevant legislation and regulation. A review of regulations that impact/guide your work prior to setting the strategic direction, i.e. – federal laws, statutes, and regulations.

Strengths Weaknesses Opportunities Threats
Strength: In the here and now . . . What are our advantages? What is working well? Weakness: In the here and now . . . What could be improved? What should be avoided? What didn’t work? Opportunity : What might be in the future . . . Ways to capitalize on your strengths. Changes in technology and markets on both a broad and narrow scale. Changes in government policy related to our field. Changes in social patterns, population profiles, lifestyle changes, etc. Local issues can become opportunities. Threats: In the future . . . What are the barriers in responding to an event better the next time? What obstacles do you face? Has your role or responsibility changed? Susan’s slide - A SWOT analysis is a quick way to get an in depth look an organization or group by examining its (internal) strengths and weaknesses and matching these to its (external) opportunities and threats. Collecting these facts and ideas into one place helps you to see the bigger picture at a glance and identify all major factors affecting your organization’s operations. It can help you formulate an effective response strategy. Each organization or group will have its own specific SWOT profile and the process needs to be repeated frequently to reflect ever-changing internal and external relationships. All SWOTs should be “one-handed” - something is either a strength or a weakness but cannot be both. Enter up to six items under each heading and then rank them in order of importance. This exercise can lead to excellent conversation in your organization and help everyone understand why your strategic plan needs particular elements. No single word elements are allowed in your SWOT – more description is needed to define each item, and avoid the temptation to put a topic into more than one category! You’ll find the SWOT Exercise Template on pages 7 to 10 in the Strategic Planning Guide posted at the training page for today’s iLinc In the SWOT, the organization assesses five categories to help determine its strengths, weaknesses, opportunities and threats. Your appraisal of the external environment will include items like: Impact of forces in the outside environment – political, social, technological, or other Changes in economy, increase in problems for your area Potential partners in external environment Trends in customer characteristics

SWOT Analysis Strength GOOD NOW Maintain, Build, Leverage Weakness
BAD NOW Remedy, Stop Opportunity GOOD FUTURE Prioritize, Optimize Threat BAD FUTURE Counter Here is the SWOT format. You’ll use the quadrants to build information that will contribute to your plan. In each quadrant, you can ask questions like these: Strength: In the here and now . . . What are our advantages What is working well Weakness: In the here and now . . . What could be improved What should be avoided What didn’t work Opportunity : What might be in the future . . . What did you learn in order to be more effective in the future Are there ways to capitalize on your strengths Useful opportunities can come from such things as: Changes in technology and markets on both a broad and narrow scale Changes in government policy related to our field Changes in social patterns, population profiles, lifestyle changes, etc. Local issues can become opportunities Threats: In the future… What are the barriers in responding to an event more efficiently the next time What obstacles do you face Has our role or responsibility changed as a result of an event, and what needs to be done in preparation for the next time Now we’ll look briefly at several specific SWOT topics, with examples to help your just-in-time training and your team’s work.

Example SWOT for Capability 3: Emergency Operations Coordination
Strengths Experience in developing and maintaining All-Hazards/Emergency Response Plan Experience in after action reporting Data rich Seen as leaders and innovators Strong track record Weaknesses Uncoordinated approach with subject matter experts Minimal training provided Unclear about Duty Officer role and responsibilities and what is needed Opportunities ACA (Health Care reform) Funding from health reform Focus on health (care delivery) state and national Community partners and engagement Threats Categorical funding Reduction of funding Competing demands Tough attitude towards public health and health care working together Eroding state and federal resources If your team is large enough, an effective way to develop several different SWOTs is to break into small groups to address each topic. You might consider these 5 topics: -- Market Analysis -- Stakeholders -- Internal Capability -- Technology -- Legal/Regulatory Give each small group the SWOT form and let them do the develop their ideas. Then they’ll present their draft to the whole group and get additions or subtractions from them. Here are some important concepts about the SWOT. Your strategic plan-related strengths are the aspects you do well and facilitate your success. They are things that you probably want to maintain, build on, or leverage. These are directly related to the identified Strengths from your SWOT analysis. Your strategic-plan-related weaknesses are the aspects of your organization that you may need to improve or overcome. They are also things that you’ll likely want to prioritize, optimize, fix or remove. These are directly related to identified Weaknesses and Threats from the SWOT analysis.

Example Action Items, Capability 3
Strengths Maintain a robust system with effective methods to implement policy and continue to support existing culture of working well with regulated industries and partners. Weaknesses Take initiative to address priority public health issues after consideration of potential risks. Opportunities Proactively pursue a plan to engage policy makers on key public health issues. Threats Improve our ability to identify and communicate cost and benefits of activities. From your SWOTs, you’ll create action items. This part of your plan will be preliminary. It is a way to give those solutions we all jump to a place to land, and help your team move past them to the next step of planning. Create it using a brainstorming activity. Don’t set priorities yet. You’ll use this as a check near the end of your process.

Example SWOT for Capability 4: Emergency Public Information and Warning
Strengths Strong public health system Strong partnerships/relationships Existing emergency public information system Weaknesses Partners inability to participate due to reduced funding Each community segment doing its own thing Opportunities More engagement with non-traditional partners (planners, transportation, etc.) Build partnerships to get more done Learning from successful partnerships Threats Less priority in Public Health during economic stresses Competition for limited resources Here are examples of related to stakeholders. We’ve shown things you might do well and want to maintain or use to your advantage. For example, a supportive Board of Health is a great asset, and can help you overcome threats or weaknesses. Opportunities to learn from successful community partnerships can shed light on ways to make progress with new partners.

Example Action Items: Capability 4
Strengths Strengthen relationships with partners by actively engaging them in development of the PHEPR (outcome = strengthen public health system). Weaknesses Fully implement the agency on-line meeting system to increase opportunities for partners to participate. Opportunities Map the environment to include identifying new and different partners and actively engage them. Threats Identify an issue that crosses multiple disciplines and develop a workgroup with cross-discipline members to address, capture and share best practices. Incentivize cross-discipline activity. This is an example of another preliminary list, brainstormed without prioritizing. Your list will give you a check at the end, a kind of final gap analysis, to be sure you are addressing threats and leveraging your strengths.

SWOT Exercise Self analysis is always difficult. Still, at the end of the day you are what you are. You are not what you think you are or what you wish you were. You have a particular set of strengths and weaknesses. You have to be honest in order to create a workable strategy. All SWOTs should be “one-handed” something is either a strength or a weakness but cannot be both. Enter up to six items under each heading and then rank them in order of importance.

Station 2: Set/Review Organizational Direction
Outcomes: Your defined Vision, Mission and Values focus the energies and resources of your entire organization. They also serve as a checkpoint to return to whenever you feel yourself going off course. What the organization will look like in the future.

“If You Don’t Know Where You Are
A Pearl of Wisdom “If You Don’t Know Where You Are Going, Any Path Will Do.” Lewis Carroll One way to determine the road to better health in our communities is to use criteria to identify the issues we will work on together.

A Vision . . . . . . is a statement about what your organization wants to become. . . . should resonate with all members of the organization and help them feel proud, excited, and part of something much bigger than themselves. . . . should stretch the organization’s capabilities and image of itself. . . . gives share and direction to the organization’s future. . . . visions range in length from a couple of words to several pages. Visions too often include highly idealistic phrasing and activities which organizations cannot realistically aspire.

Vision Examples A healthy and safe community.
People enjoy longer and healthier lives because the Department of Health leads changes in policies, systems, and environments that prevent illness and injury, promote healthy communities, and encourage healthy lifestyles. The healthiest state in the nation.

Exercise - Is Our Vision . . .
A statement about what we want to become? Going to resonate with all members of the organization and help them feel proud, excited, and part of something much bigger than themselves? Stretch the organization’s capabilities and image of itself? A statement that gives shape and direction to our future? Between two words and several pages long?

Mission: Who Are You? Spreading yourself too thin?
Biting off more than you can chew? Being all things to all people? Read the slide. All these expressions speak to a common problem: lack of focus. Or, think of it this way: you can shoot at a whole bunch of targets a whole bunch of times. Usually, if you study a target for a while, you get better at hitting it. That’s focus. Focus is about drawing lines and understanding what you do by knowing very clearly what you do not do. Car salesman story: Now, most people would think that a car salesman would try to sell a car to every person who came into the showroom with a pulse. But this particular car salesman was very particular about whom he approached. See, he sold Porsches in a dealership that shared space with Volkswagen. And every time a customer came through the door, this car salesman had to decide whether that person was his customer or not. Either a potential customer had $80,000 for a Porsche 911 or the person had only $8,000 and merely wanted to test drive the 911 before buying a Volkswagen Jetta. And so he studied human nature and made intelligent guesses on which people to approach and whom to let be. He knew he sold Porsches. So if you sell Porsches, concentrate on Porsche customers. You will be much better off than if you were to concentrate on people who want to buy a car. That would not be much focus.

A Mission . . . . . . defines why the agency exists communicates fundamental values and beliefs to all employees identifies core services and who we do them for is inspirational and should supply energy and motivation is able to be translated into terms that can be understood and acted upon declares: Agency Commitment, Focus, Identity.

Exercise - Does Our Mission . . .
Define why the agency exists? Communicate fundamental values and beliefs to all employees? Identify core services and who we do them for? Provide inspiration and supply energy and motivation? Translate into terms that can be understood and acted upon? Identify the agency’s commitment, focus and identity?

Values . . . represent the core priorities in the organization’s culture, including what drives members’ priorities and how they truly act in the organization. drive the intent and direction for “organic” planners. well articulated, provide everyone with guiding lights, ways of choosing among competing priorities, and guidelines about how people will work together. should take into consideration the values of customers, stakeholders employees and the community. Establish four to six core values from which the organization would like to operate.

Value Statement Examples

Values - Exercise Review the value statement examples.
Are there examples that resonate with you? Is there a value statement missing? Record each preferred value. Rank the values with 1, 2, or 3 in terms of the priority needed by the agency with 3 very important and 1 least important. Brainstorm: What are values that you believe and have seen demonstrated that are important to you? What are the values your agency should have? Four to six core values are sufficient Record each preferred value, then rank the values with 1, 2, or 3 in terms of the priority needed by the organization with 3 indicating the value is very important to the organization and 1 is least important.

Do Our Values . . . Represent the core priorities in the organization’s culture, including what drives members’ priorities and how they truly act in the organization? Drive the intent and direction for “organic” planners? Well articulated, provide everyone with guiding lights, ways of choosing among competing priorities, and guidelines about how people will work together? Should take into consideration the values of customers, stakeholders employees and the community? Establish four to six core values from which the organization would like to operate?

IDENTIFYING STRATEGIC ISSUES/PRIORITY AREAS

Priority Setting Tools
Many tools available: “Qualitative”, build consensus, based primarily on perceptions and values (e.g., brainstorming, affinity diagrams, Pareto charts, etc.). “Quantitative”, use data (e.g., statistics, scores, indexes, evidence of effectiveness). Mixing tools is often recommended.

Criteria for Prioritizing Health Issues

Strategic Issues Strategic issues (or Vision Areas, Priority Areas) are fundamental policy choices or critical challenges that must be addressed in order for a community to achieve its vision.

Rate the Seriousness of the Health Problem

Rate the Size of the Health Problem

Criteria Matrix

Example: Priority Setting – Individual Scores

Example: Priority Setting – Aggregate Scores

Strategic Issues/ Priority Areas - Exercise
Brainstorm potential strategic issues. Develop an understanding about why an issue is strategic. Consolidate overlapping or related issues. Conduct a prioritization or selection process. Arrange issues into an ordered list. Be prepared to share results.

Station 3: Develop/Revise Strategic Goals, Objectives and Strategies
Outcomes: Goals with broad statements describing a future condition or achievement without being specific about how much and addresses the question: “How do we get there”. Goals that focus on outcomes or results and are qualitative in nature in a specific priority area. Objectives to support the goals and are a specific statement of a desired short term condition or achievement that includes a measurable end result to be accomplished within time limits. Objectives that answer the question: “What do we have to do to get there?” Strategies that state methods to achieve Goals and Objectives. They will be indicators of action, the “How to” achieve the Goal or Objective. They will serve to guide budget activities used to achieve Goals.

Goals Should Be Doable

A Goal . . . … is a broad, organizational intention. … describes a future condition or achievement. … focuses on outcomes or results. … is qualitative in nature, rather than quantitative. … is not specific about how to achieve the goal. … is long-term in nature.

Strategic Choices Incremental Approach
Doable and Measurable Goal (12-18 mos.) Big, Broad Goal (3-5) years): Where you want to be Where you are now One little engine car on the track One little engine car on the track with passenger cars One little engine car on the track with passenger cars and the cars have passengers We have two engine cars on two tracks We have six engine cars on the tracks We’ve moved up to the big leagues I would suggest you take an incremental approach. Read the slide

Data Summary To Define Goals
Possible summary structures: Organize the data by the five perspectives Community Financial Health department State/national/legislative Learning and growth Organize the data by stakeholder input: Community-at-large Staff members Governing body Funders Customer and others

Analyzing Results From SWOT
Strength GOOD NOW Maintain, Build, Leverage Weakness BAD NOW Remedy, Stop Opportunity GOOD FUTURE Prioritize, Optimize Threat BAD FUTURE Counter

Priority Area: Decrease Obesity
Set Goals There can be one or several goals for each Priority Area Example: Priority Area: Decrease Obesity Goal #1: Decrease obesity in the County through promoting healthy lifestyles. Or Goal #1: Decrease obesity through promoting healthy eating. Goal #2: Decrease obesity through increasing activity levels of adults and children.

Identify Strategic Priority Areas
To address weaknesses, opportunities and threats we categorize into buckets and to leverage strengths: This concept is called a “Balanced Perspective” Prevent/Promote/ Prepare Business/Financial Excellence Customer/Partner Excellence Employee Excellence and Personal Resp.

The Balanced Perspective - Traditional
Customer Employee Learning & Growth Goal Statement Goal Statement Objective Measure/Target Objective Measure/Target Strategy Measure/Target Strategy Measure/Target Financial Internal Processes Goal Statement Goal Statement Objective Measure/Target Objective Measure/Target Strategy Measure/Target Strategy Measure/Target

The Balanced Perspective – Public Health
1.0 Prevent/Promote/Prepare 3.0 Customer/Partner Excellence Goal Statement Goal Statement Objective Measure/Target Objective Measure/Target Strategy Measure/Target Strategy Measure/Target 2.0 Business/Financial 4.0 Employee Excellence & Personal Resp. Goal Statement Goal Statement

Are Our Goals . . . Broad organizational intentions?
Describing future conditions or achievements? Focused on outcomes or results? Qualitative rather than quantitative? Not specific about how to achieve the goals? Long-term in nature?

Lunch Break

Outcome Objectives . . . . . . are key activities you need to perform to achieve your goals. . . . are used to operationalize the mission statement. . . . helps to provide guidance on how to fulfill or move toward the mission and vision. As a result, they tend to be more specific and cover a more well-defined time frame. . . . demands a yardstick to measure the fulfillment of the objective. If an objective lacks specificity or measurability, it is not very useful, simply because there is no way of determining whether it is helping to move toward the mission and vision.

Outcome Objectives . . . (cont.)
. . . Measurable. There must be at least one indicator (or yardstick) that measures progress against fulfilling the objective. . . . Specific. This provides a clear message as to what needs to be accomplished. . . . Appropriate. It must be consistent with the vision, mission, and goals. . . . Realistic. It must be an achievable target given the capabilities and opportunities in the environment. In essence, it must be challenging but doable. . . . Timely, there needs to be a time frame for accomplishing the objective.

Objectives are SMART Specific – specify what is to be achieved, by how much, and by when. Measurable – make sure that the objective can be measured (i.e., data is or will be available to measure progress). Achievable – set objectives that are feasible for the agency. Relevant – align objectives with the mission and vision of the agency. Time-oriented – establish a timeframe for achieving the objective.

Why We Measure Performance?
Help guide management and decision- making processes. Help to align with the department’s mission, vision, and strategic directions. Provide employees with feedback on the work they are performing. Predict future performance. Facilitate learning and improvement. Performance measurement –can be viewed as an instrument panel or scoreboard; provides a general information basis for decision-making however, the value in measuring performance comes from: Dialogue around aligning w/ strategic planning and objectives Regular feedback to employees and decision-makers/managers Focus on results rather than individuals and activities Predict future performance Clear vision of the results – everyone moving in the same direction and on the same page Ability to use performance data to make better decisions – on evidence rather than emotion or intuition (another way of saying this is reducing the risk of making things worse) The final bullet, facilitating learning/improvement, is really the heart of the matter.

Principles for Performance Measurement
Know why you are measuring. Be selective. Let your customers tell you what results to measure. Continually ask how you and your stakeholders are doing. Track the internal processes that produce your results. Tell and show people what you learn. Let’s look at some important principals for identifying performance measurement. It is crucial to know why you are measuring. Is this measure important to the stability of your work process? Is it important to your customers’ satisfaction? (other important reasons…?) Be selective Let your customers give you insights into what results to measure Continually ask how you are doing, and be ready to act on what you learn. Track your internal processes – we will talk more about this today. Report your results in more than one way – tell and show. Performance Management Centers for Excellence

Performance Measures Vs. Objectives
Decrease the percent of Best Health County youth who are overweight or obese to 25% by 2016. Objective Here’s another example. This is a SMART objective. See how it’s measurable, specific, time-bound. If you have baseline data, you could insert it here (point to before “to 25%”). For example, from 33% to 25%.

Performance Measures Vs. Objectives
Decrease the percent of Best Health County youth ages who are obese from the baseline of 32% to 25% by December 31, 2016. Direction Performance measure Target Time frame

Let’s Discuss What tools and databases are you using to monitor your performance measures? Do you link customer needs with process outcomes? Do you have a systematic process for reporting? Are staff and managers accountable to review data regularly and take action on the results?

Are Our Objectives . . . Key activities needed to achieve our goals?
Measurable? Specific? A clear message as to what needs to be accomplished. Appropriate? Consistent with the vision, mission, and goals. Realistic? An achievable target given the capabilities and opportunities in the environment. In essence, it must be challenging but doable. Timely? Is there a time frame for accomplishing the objective?

Strategies are . . . . . . Stated methods to achieve Goals and Objectives. . . . Indicators of action, the “How to” achieve the goal or objective. . . . Serve to guide budget activities used to achieve goals. . . . Brings about a desired future, such as achievement of a goal.

Strategy Examples Example of a strategy
Regulate, educate, and provide technical assistance to users on the access of care. Objective vs. Strategy: An example, compare the process of planning a vacation (where, when, duration, budget, who goes, how travel are all strategic objectives) with the final preparations (tasks, deadlines, funding, weather, packing, transport and so on are all strategies).

Are Our Strategies . . . Methods to achieve or Goals and Objectives?
Indicators of action, the “How to” achieve the Goal or Objective? Serve to guide budget decisions? Brings about a desired future, such as achievement of a Goal?

Success can be Measured in Stages
1. Short term “Process Outcome” 2. Mid-range “Results Outcome” 3. Long term ”Health Status Indicator” Health Issue/ Goal: Improve Childhood immunization rates of 2 year olds Percent of planned materials distributed to increase provider awareness (Goal: 100%) Percent of children with records in the immunization registry (Goal: increase % from year to year) Percent of children 0 to 24 mo. completing the recommended series on time (Goal: increase % ) Disease rates related to the series are very low or approaching none (such as Pertussis, measles) Another critical aspect of creating performance measures, is to understand which stage of the process you are measuring. How close is the measure to the actual work? This is a logic model – looking at short term work process outcomes; mid-range results outcomes and long term health status indicators In this example, we want to measure what is very close to the actual work. Sometimes we call it “proximal” to the work as opposed to distal. The example here, for an immunization program might be the % of planned materials distribution that were actually distributed. Or the usefulness of the Immunization Registry as measured by the % of children in a jurisdiction that are included in the Registry. The mid-range measure (state from above) is moving toward longer timeframe and more distant from the activities conducted by the health department. These can be health risk indicators that are measured by BRFSS or Healthy Youth Survey. The long term measure shows actual public health status outcomes such as morbidity and mortality indicators that might be included in Healthy People disconnect from the above example We know / hope that our short term process outcomes actually do lead to improved public health. What we hope to see a few years down the road is decreased rate of disease. But remember: you improve the outcome by improving the work process, and how well the work is designed to allow staff to perform their best in the work they do. QI is about the process, and we are focusing today on the efficiency and effectiveness of our processes.

Line of Sight Framework
How do our day to day job-related activities impact the longer-term health indicators or impact goals of our health department? Example: “My job is to process food stamp applications so that no child goes hungry in Cook County”

Clackamas County, OR EXAMPLE
No child goes hungry in Clackamas County Clackamas County, OR EXAMPLE so that so that Increase Clackamas County children’s access to food so that I% of Clackamas County children served by food stamps that are in low-income households (ultimate goal) % of food stamp applications completed accurately so that (long-term outcome) % of staff participating in food stamp database training (medium-term outcome) (short-term outcome) Degree of influence/control (short-term outcome)

Developed by Kane County IL

Degree of influence/control
so that so that Line of sight so that (ultimate goal) so that (long-term outcome) (medium-term outcome) (short or medium-term outcome) Degree of influence/control (short-term outcome)

Let’s Work on Line of Sight
Work on Line-of-Sight graphs to identify quantifiable outcomes and/or important metrics are described for each level of the agency. Back pocket questions – are there aspects we have outlined that seem most daunting? Why? Are there aspects we’ve discussed that you have implemented with success? Can you say more? 100100 Public Health Performance Management Centers for Excellence

Short Break! Be Back in 15 minutes, please!

STRATGIES FOR IMPLEMENTING THE STRATEGIC PLAN
Transition slide

Strategic Plan HOW WHY WHAT EFFECTIVE EFFICIENT ACCOUNTABLE
Customer-Focused Service Clear Accountability & Responsibility Employee Engagement Stakeholder Involvement Leaders Leading the Way Results and Data-Driven Operations Improved Citizens Outcomes HOW WHY WHAT CREATING AND ENDURING CULTURAL SHIFT

Today: Leave With a Plan
Leading the Way 1 Focus on Alignment and Outcomes 2 Results and Data Driven Operations 3 Customer Focused Service 4 Clear Accountability 5 Employee Engagement 6 7 Stakeholder Involvement

Leaders Make it Happen Strategic planning provides the priorities and direction for making decisions and allocating resources to pursue strategies The Agency’s early success will be realized through engaged employees and stakeholders using an empowered approach for their involvement Leaders “Make-It-Happen”

The Playbook Leading the Way Lead the learning
Deadly sins of management Prepare the culture

Remove Deadly Sins Seven deadly sins of management Unclear direction
No line-of-sight Unclear accountability Inconsistent language Poor issue transparency Inappropriate resources Inadequate tools/skills

The Playbook Focus on Alignment and Outcomes
Review and update CHA data when appropriate Align you CHIP priorities Align your Office/Division/Program’s outcomes Translate goals to outcome measures Establish scorecards for each measure

Align Your Agency Outcomes
Understand the Director’s priorities Define Agency core-mission measures Define Office, Division and Program core- mission measures This is the foundation of ownership Clarity will continue to emerge

The Playbook Results and Data-Driven Operations
Create clarity about how the Agency, Offices, Divisions and Programs work Understand the core work you must be good at in order to achieve your outcomes Map your fundamentals Understand your core processes Establish measures to gauge effectiveness

Example – Fundamentals Map

Benefits of Fundamental Maps
Shared understanding of how the Agency, Offices, Divisions and Programs create value (a common language) Clear ownership for results Visibility as to what is working and what is not Foundation for connecting every employee to the part they play

The Playbook Customer Focused-Service
For each strategy, identify your primary customers Ask them what they need from you Establish measures that indicate success in meeting their needs Work to continuously improve results

Customer Driven End State
We understand who our customers are We know every strategy has a customer We know what our customers value We measure effectiveness in meeting customer needs Customer feedback drives our strategy focus

The Playbook Clear Accountability and Responsibility Assign ownership
For outcome measures For process measures Establish Quarterly Target Reviews Accountability for improvement Triggers for action (red/yellow/green) Safety = True Transparency

Using your Fundamental Maps and the identified process owners and outcome owners move to a process where Leaders engage in a quarterly target review. Outcome Owners

Quarterly Target Reviews
What might this look like – This is an example from Washington State The health department does monthly reviews inside the agency and we do quarterly reviews with the Governor. The monthly reviews are a mix of core mission outcome measures and process measures. At the Governor’s level reviews are done using primarily core mission outcome measures.

The Playbook Employee Engagement
Understand the impact on results of engagement Assess where we are today with the engagement Determine what is required by leadership to move to the ideal state

To Successfully Deploy Strategic Planning
Involve Everyone: Leadership Champion Customers Empowered Employees Involved Stakeholders

Engagement End State I understand where my organization is going I see how my work fits into our goals I understand what processes I am accountable for I have the skills/resources to do my work effectively I always know how well my processes are working

The Playbook Identify Stakeholders and Their Involvement
Understand who your stakeholders are Assess where we are today with their involvement Determine level of engagement

The 10 Factors That Transmit and Embed Culture
Creating an Enduring Culture Shift 1. Formal statements of the organizational philosophy 2. Design for physical spaces 3. Deliberate role modeling, teaching, and coaching by leaders 4. Explicit reward and status system, and promotion criteria 5. Stories, legends, myths and parables about key people and events 6. What leaders pay attention to, measure, and control 7. Leader reactions to critical incidents or organizational crisis 8. Organization design and structure 9. Organizational systems and procedures 10.Criteria used for recruitment, selection, and promotion Dr. Edgar Schein, MIT

Next Steps 10 Stations on the Journey

Next Steps – Leadership Role
Able to articulate the strategic planning process to internal and external stakeholders. Each program should know how they roll up (i.e. where they fit in to the agency big picture). The strategic planning process should be meaningful to Front Line staff; they need a connection. Strategic planning provides clarity for changes and/or new direction. Shows us what/why/how we’re doing as an agency. Defines where we are, where we want to be and includes “SMART” objectives. Tactical How does it feed the strategic planning process? More inclusivity should enhance the strategic planning process. We are really planning strategically for our agency! Let’s do it well!!

Thank You – Questions? Contact Information: Susan Ramsey Marni Mason

Strategic Plans – The Engine of Performance Management March 18, 2015

Similar presentations

Presentation on theme: "Strategic Plans – The Engine of Performance Management March 18, 2015"— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Strategic Plans – The Engine of Performance Management March 18, 2015

Similar presentations

Presentation on theme: "Strategic Plans – The Engine of Performance Management March 18, 2015"— Presentation transcript:

Similar presentations

About project

Feedback