1. Hardwiring Leader Evaluations Flagler Hospital
Bill Bielenda
© 2010 Studer Group

2. What you will learn today…
Importance of leader accountability and goal alignment
How to develop effective goals
The basics on accountability tools

3. Healthcare Flywheel® Purpose, worthwhile work and making a difference
Bottom Line Results
(Transparency and Accountability)
Prescriptive To Do’s
Purpose, worthwhile work
and making a difference
Self-Motivation

4. Execution Framework Evidence-Based LeadershipSM
Meeting Title Here (on Notes Master)
Rev
Execution Framework Evidence-Based LeadershipSM
Breakthrough
Foundation
STUDER GROUP®:
Objective Evaluation System
Leader Development
Must Haves®
Performance Gap
Standardization
Accelerators
Aligned Goals
Aligned Behavior
Aligned Process
Implement an organization- wide 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
Agreed upon tactics and behaviors to achieve goals
Re-recruit high and middle/solid performers
Move low performers up or out
Processes that are consistent and standardized
Process Improvement
PDCA
Lean
Six Sigma
Baldrige Framework
Software
Second most important foundational slide next to flywheel is this slide focusing on the execution framework – Evidence-based leadership.
Process improvement, re-engineering, etc. This is not a stand alone item – it will not get you there.
We focus a lot on the aligned goals (dark blue) and Aligned Behavior (yellow)
Aligned Behavior:
Tactics and Behaviors
Dealing with low performance
Aligned Goals:
Biggest miss is aligning goals. Don’t evaluate on competency….but rate on outcomes. Is your evaluation system outcome oriented and weighted?
Skill/Leader Training: Key part of outcomes and success.
© Studer Group®

5. Meeting Title Here (on Notes Master)
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.
© Studer Group®

6. Meeting Title Here (on Notes Master)
Year 1 – Goals
Issue
Reduce Costs / Improve Financial Performance
Provider of Choice (patient satisfaction)
Employer of Choice (employee satisfaction)
Improve Care (Quality, Safety, Effectiveness)
Information Management
Goals
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 you recommend”
YTD 73.5
Reduce overall turnover of:
“permanent” positions to11%
YTD 14% more detail>
“permanent” core RN positions to 13%
YTD 16%
Achieve 90% compliance with CMS measures: Community Acquired Pneumonia
3>90% - 5<90%
Surgical Infection Prevention >90% - 2<90%
Heart Failure
2>90% - 2<90%
Acute Myocardial Infarction >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
Implement Employee Satisfaction Assessment process during 2005
Create projected timeline for the implementation of the Advanced Point of Care (APOC) clinical system
Here is an example of goals and results from an organization. Note the low performance of many of the goals.
© Studer Group® 6

7. Leader Evaluation Results – Year 1
Meeting Title Here (on Notes Master)
Leader Evaluation Results – Year 1
Even though this organization was not achieving the 2006 goals, note that when you look at their leader evaluation results, 73.8% of the leaders were still rated as “substantially exceeds”.
© Studer Group®

8. Meeting Title Here (on Notes Master)
Year 2 – Goals
Excellence
Service
People
Quality
Finance
Growth
Increase Patient Satisfaction (Inpatient)
Goal = 62nd
Current = 51st
Decrease Mortality Index
Goal = .77
Current = .77
Operating Margin Goal = 5%
Current = 5.6%
Reduce Annualized Turnover
Goal = 14.5%
Current = 16.7%
Increase Inpatient Admissions
Goal = 2.7%
Current = 7.6%
Reduce FTE per Adjusted Discharge
Goal = 1.15
Current = 1.15
They realigned their goals and established and implemented the LEM. The positive goal achievement is noted by the green boxes.
Increase Outpatient Visits
Goal = 5%
Current = 8.0%
Increase Patient Satisfaction (Ambulatory)
Goal = 62nd
Current = 65th
Increase Employee Satisfaction
© Studer Group®

9. Leader Evaluation Results – Year 2
Meeting Title Here (on Notes Master)
Leader Evaluation Results – Year 2
With the LEM in place and goals being met, look at the leader evaluation results. A perfect bell-curve is achieved.
Note: Percentages noted account for 93% of the leaders who have entered data as of
© Studer Group®

10. Financial Impact: Hospital Acquired Infections
Metric
Reduction
Hospital Acquired Infections
156
Incremental Costs
$1.93 million
Bed Days Avoided
984
Percent of HAI Over Admissions
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

11. Why Have Leader Evaluations Based on Objective Goals?
Meeting Title Here (on Notes Master)
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 .
© Studer Group®

12. Goal Alignment & Balance

13. What is goal alignment?
Insuring that individual leader activities are consistent with the goals of the organization.

14. Vertical Alignment ORGANIZATION GOALS DIVISION DEPARTMENT
LEADER / UNIT

15. Horizontal Alignment
ORGANIZATION
GOALS
DIVISION
DEPARTMENT

16. How Organizational Balance is Defined
MISSION
Integrating and connecting the vision, value and goals of the organization into daily decisions, behaviors and actions
Innovation
Quality
Service
Community
Finance
© 2012 Studer Group

17. Goal Development Process
Senior leaders set organizational goals
Organizational goals are shared with all leaders
Each leader determines their goals and preliminary weights
Goals are reviewed by each leader’s reporting senior
Goals are shared within leadership team to insure everyone's needs are addressed
Goals are audited for continuity
Leaders finalize their goals

18. Goal Development

19. Goal Development Tips
Develop quantifiable goals.

20. 2 = Partial Accomplishment 1 = No Accomplishment
Goal Scales
5 = Stretch
4 = Partial Stretch
3 = Goal
2 = Partial Accomplishment
1 = No Accomplishment

21. Increase the number of visits to 200 5 is ≥ 250 4 is 225 to 249
Example Goal with Rating Scale
Goal
Increase the number of visits to 200
Rating Scale
5 is ≥ 250
4 is 225 to 249
3 is 200 to 224
2 is 150 to 199
1 is ≤ 149
© 2012 Studer Group

22. LEM Score Distribution3 3 2 3 4 1 2 3 4 5
Opportunity
Target
Excellent

23. Example LEM Results
Average Score = 3.07 1 2 3 4 5

24. Goal Development Tips
Develop quantifiable goals.
Use language that everyone understands.
Connect goals to purpose.
Fewer, rather than more goals, are better.

25. 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.
Examples of CT Scanner – this is a project
Goal is actually CT volume 25

26. Goal or Tactic?
Conduct employee evals on time
Improve staff productivity
Round on 100% of inpatients
Attend all leadership development sessions
Pass OSHA inspection

27. 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

28. SMART Goals are
Specific
Measurable
Attainable
Realistic
Time-bound

29. What might not fit as goals:
Standards of performance
Subjective and vague statements
Tactics to achieve goals
Maintaining regulatory compliance
Routine job activities

30. Middle Management Common Goals (Examples)
Budget
Patient Perception of Care
Interdepartmental Satisfaction
Employee Engagement
Core Measures
Patient Fall Rate

41. Tools of Accountability
Leader Performance Evaluation
Leader Report Card
90 Day Plan

48. www.studergroup.com © 2012 Studer Group

50. No Surprises
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QUARTERLY
YEAR END

51. Thank You!
For valuable tips on creating a culture of organizational excellence, visit our web site at
Bill Bielenda