Post on 17-Mar-2018
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Please do not quote or disseminate without Studer Group authorizationSlide 1
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Alignment & Accountability: Creating
Organizational Goals and Using An
Objective Evaluation System
Bob Murphy, R.N., JD
Studer Group Senior Leader & Speaker
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Execution Framework
Evidence-Based LeadershipSM
Rev 2.14
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Example Organizational ResultsUsing typical Leader Evaluation
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Example Distribution of PerformanceUsing typical Leader Evaluation
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Service
Increase Patient
Satisfaction
(Inpatient)
Goal = 62nd
Current = 51st
Reduce
Annualized
Turnover
Goal = 14.5%
Current = 16.7%
Increase
Employee
Satisfaction
Decrease
Mortality Index
Goal = .77
Current = .77
Operating
Margin
Goal = 5%
Current = 5.6%
Reduce FTE
per Adjusted
Discharge
Goal = 1.15
Current = 1.15
Increase
Inpatient
Admissions
Goal = 2.7%
Current = 7.6%
Increase
Outpatient
Visits
Goal = 5%
Current = 8.0%
People Quality Finance Growth
Excellence
Increase Patient
Satisfaction
(Ambulatory)
Goal = 62nd
Current = 65th
Same Organization’s ResultsAfter implementing Weighted and Objective Evaluation
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Note: Percentages noted account for 93% of the leaders who have entered data as of 6.7.07.
Distribution of Performance After implementing Objective and Weighted Evaluation
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Example Hospital
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Feb
Ap
r
Jun
Au
g
Oct
Dec
Feb
Ap
r
Jun
Au
g
Oct
Dec
Feb
Ap
r
Jun
Au
g
Oct
Dec
Feb
Ap
r
Jun
Au
g
Oct
Dec
Feb
Ap
r
Jun
Au
g
Inpatient Monthly Percentile ScoreYear 1 – Year 5
Goal = 90%
Year 1 Year 2 Year 3 Year 4 Year 5
95%
Leader Evaluation Tool Implemented
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Example Hospital
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Jan
Mar
May Ju
l
Sep
No
v
Jan
Mar
May Ju
l
Sep
No
v
Jan
Mar
May
Inpatient Monthly Percentile ScoreYear 5 – Year 7
Year 5 Year 6 Year 7
99%
Goal = 90%
Leader Evaluation Tool Implemented
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Accountability Tools
Evaluation
Report Card
90-Day Plan
Meeting Model
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Leader Evaluation Requirements
Evaluation must be:
• Objective
• Measurable
• Weighted*
• Contain metric ranges (1-5)
Right Leader
Right Goal
Right Weight
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Setting Weights
10% 20% >30%
Awareness Focus Urgency
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Setting Weight Example: Turnover
Leader A Leader B Leader C
Goal: Decrease organization turnover from 18% to 14% as measured by HR Report by FY end.
Current Turnover:
20.5% 16.2% 14%
Weight: 30% 20% 10%
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Example: Senior Team Equity Review
Pillar Entity's Goal Description
CEO
(Org
Goals) CNO CMO CFO COO VP HR
Finance Increase Net Operating Income to budget or higher. 15% 10% 10% 20% 20% 20%
Growth
Increase Inpatient admissions compared to budget. 10% 10% 10%
Increase Outpatient Revenue compared to budget as
measured by Finance Department records. 15% 15%
PeopleIncrease employee satisfaction to 90th percentile as
measured by annual survey. 15% 10% 10% 10% 20% 20%
Quality
Reduce Average Length of Stay (ALOS) to 4.85 days or less. 10% 10% 20% 15% 15%
Achieve Value Based Purchasing Rollup measures.
10% 20% 20% 10%
Service
Maintain overall Emergency Department patient satisfaction at
90th percentile. 10% 10%
Increase HCAHPS in 6/8 composites at 80th percentile.15% 15% 10% 10% 15%
Increase physician satisfaction to 85th percentile as
measured by annual survey. 15% 15% 30% 10% 10% 10%
Other department/cascading metrics. Examples: AR Days,
Door to Doctor, Productivity, Patient Safety Measures,
Physician Satisfaction20% 35%
100% 100% 100% 100% 100% 100%
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Cascading Goal Examples
Chief Executive Officer
Chief Nursing Officer
Med/Surg Nurse Manager
Chief Medical Officer
Physician Practice Manager
Primary Care Physician
Chapter Six:
Objective Leader Evaluation
System: The Birthplace of
Accountability
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Example: Cascading a goal to decrease LOS
Case Management / Discharge Planning / Social Work-
Increase % of patients discharged day the order is written
Ancillary Department Leaders-Increase the number of
inpatient procedures completed the day the order is written
Inpatient Nurse Managers-X% of patients discharged by (fill
in appropriate time)
Medical Staff Leaders-Increase the % of discharge orders
written by (fill in appropriate time)
House Supervisors-Increase % of ED admissions to
inpatient bed within XXX hours
EVS-Improve bed turnaround time after 3pm
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Operating Margin of 3.5%
Weight = 10%
Decrease 30 Day All-Cause Readmissions to 5% or less
Weight = 10%
Decrease CMS Never Events to
2 or less
Weight = 10%
Increase Employee
Satisfaction to 85th percentile
Weight = 10%
Increase Physician
Satisfaction to 70th percentile
Weight = 10%
Increase HCAHPS to 70th
percentile in 6/8 composites
Weight = 10%
Increase CGCAHPS to
80th percentile
Weight = 10%
Increase ED Patient
Satisfaction to 80th percentile
Weight = 10%
Increase Adjusted
Admissions by 2.5% (18,260)
Weight = 10%
Chief Executive Officer (CEO) Goals
Finance 10%
Quality 20%
People20%
Service 30%
Growth 20%
Increase Outpatient
billable encounters to
37,000
Weight = 10%
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Chief Nursing Officer (CNO) Goals
Increase HCAHPS to 70th
percentile in 6/8 composites
Weight = 25%
Decrease 30 Day All-Cause Readmissions to 5% or less
Weight = 15%
Decrease LOS to less than 3.4
days
Weight = 10%
Increase Employee
Satisfaction to 85th percentile
Weight =10%
Achieve Operating
Budget
Weight = 10%
Increase ED Patient
Satisfaction to 80th percentile
Weight = 10%
Decrease CMS Never Events to
2 or less
Weight = 20%
Finance 20%
Quality 35%
People10%
Service 35%
Growth 0%
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Med Surg Nurse Manager Goals
Increase Med/Surg
HCAHPS to 70th
percentile in 6/8 composites
Weight = 30%
Increase Med/Surg Employee
Satisfaction to 85th percentile
Weight = 10%
Decrease CHF Readmissions to 5% or less
Weight = 20%
Decrease fall rate (never
event) to 2.5 or less
Weight = 20%
Achieve 100% Variance to
Budget
Weight = 10%
Growth 0%
Service 30%
People20%
Quality 40%
Finance 10%
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Reduce average Clinic no-show rate to 10% or
less
Weight = 10%
Increase CGCAHPS to
80th percentile
Weight = 10%
Increase HCAHPS Physician
Composite to 70th %tile
Weight = 15%
Increase Physician
Satisfaction to 70th percentile
Weight = 15%
Decrease CHF Readmissions to 5% or less
Weight = 10%
A1C score greater than 7 will decrease to 25% or less
Weight = 10%
Increase Outpatient
billable encounters to
37,000
Weight = 30%
Chief Medical Officer (CMO) Goals
Finance 10%
Service 25%
People15%
Quality 20%
Growth 30%
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Physician Practice Manager Goals
Increase Employee
Satisfaction to 85th percentile
Weight = 10%
Increase in-Network
Referral Rate to 85%
Weight = 10%
People20%
Growth 25%
Finance 15%
Quality 15%
Service 25%
A1C score greater than 7
will decrease to 25% or less
Weight = 15%
Increase Physician
Satisfaction to 70th percentile
Weight = 10%
Increase CGCAHPS to
80th percentile
Weight = 15%
Increase number of
billable patient encounters to
9,000
Weight = 25%
Reduce average Clinic no-show rate to 10% or
less
Weight = 10%
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Increase Employee
Satisfaction with Providers
to 70th
percentile
Weight = 10%
Increase CGCAHPS to
80th percentile
Weight = 15%
Increase in-network
referral rate to 85%
Weight = 10%
Increase number of
billable patient encounters to
3,400
Weight = 20%
Generate 4,600 median work
RVUs
Weight = 10%
Increase elderly annual flu show vaccine rate to
85%Weight = 10%
Increase % of diabetics, ages 18-75, whose
HbA1c was less than 7% (well controlled) to
70%Weight = 15%
Increase percent of
women, ages 42-69, who had a mammogram in the last two years to 85%Weight = 10%
Primary Care Physician Example
People10%
Growth 30%
Finance 10%
Quality 35%
Service 15%
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What is a 90-Day Plan?
Plate Manager
Helps define most
important use of
leader’s time
Allows leaders to set
interim goals in 90
day period to
achieve annual goals
across all pillars
Prioritization Tool
Clearly defines
priorities for leader
and leader’s
supervisor
Identifies key action
steps necessary to
achieve 90 day goals
Helps get less
important items “off
the plate”
Tactics that drive
outcomes
Communication Tool
Creates necessary
conversations in both
directions
Allows high
performing
employees to know
the organizations plan
Allows leaders to
present plan of action
to supervisor and
employees
Discuss any
resources required,
hurdles, or competing
priorities
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90-Day Plan Example
Goal
Action Steps Manage Up Level Results
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Tips for creating action steps
Involve staff
Identify 1-2 key tactics to achieve the 90 day goal
Clearly define each step to achieve the outcome
Set a realistic date to accomplish each step
Assess effectiveness of previous action steps
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Monthly Meeting Model Agenda
Four Key Components
1. Review of performance (via report card and 90-
day plan)
2. Verification of key behaviors that are being used
to achieve results
3. Review of LDI Linkage grid to confirm status of
completing linkage assignment
4. Professional development
NOTE: Senior leader may begin the Supervisory Meeting with Rounding
on their direct report
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Thank You!
Bob Murphy, R.N., JD
850-393-4481
bob.murphy@studergroup.com
www.studergroup.com