University of Virginia Health System School of Medicine (SOM)...Quality 4.19 4.21 Mission 3.98 3.99...

University of Virginia Health System School of Medicine (SOM)

2015 Engagement Survey Executive Presentation

July 2015

Burning Platform for Engagement

2 Copyright © 2015 Gallup, Inc. All rights reserved.


Gallup sees the connection between engagement and performance across its database and specifically at UVA.

Helps People Work More Effectively

Increases Retention

Among Top Performers

Engagement Helps Produce Better Outcomes for the Organization

Top quartile teams have…

37% Lower Absenteeism

…when compared to

bottom quartile teams.

25% Lower Turnover (in High Turnover Organizations)

65% Lower Turnover (in Low Turnover Organizations)

28% Less Shrinkage

48% Fewer Safety Incidents

41% Fewer Patient Safety Incidents

41% Fewer Quality Incidents (Defects)

10% Higher Customer Metrics

21% Higher Productivity

22% Higher Profitability

4

Across Gallup’s Database, Top Quartile Teams Outperform Bottom Quartile Teams

Copyright © 2015 Gallup, Inc. All rights reserved.

On average, the 13 facilities that were below the Gallup Healthcare 50th percentile in employee engagement were below the CMS 50th percentile on all HCAHPS domains.

46.2

22.8

41.3

34.8 31.0

40.8

30.2

43.5 48.2

45.2

82.5

58.8

69.0

76.6 71.1

73.9

58.9 60.0

77.1 72.3

NurseComm-

unication

DoctorComm-

unication

Clean Quiet BathroomHelp

PainMgmt.

MedicineInfo

DischargeInstruc-

tions

OverallRating

Rec-ommend

Percentile Within CMS Public Release Database

Below Gallup 50th (n=13) At/Above Gallup 50th (n=8)

5

In a Recent Analysis at Another Healthcare System, Engagement Tied Closely to HCAHPS Results


6

At the Medical Center, Engaged Workgroups Had Far Fewer Safety Incidents


6.66

8.77 8.89 9.58

3.72

10.42

9.61 10.12

2.00

4.00

6.00

8.00

10.00

12.00

Top Quarter Upper Middle

Quarter

Lower Middle

Quarter

Bottom Quarter

Safe

ty I

ncid

en

ts p

er 1

00

Team

M

em

bers

2014 2015

41 42 41 41 n=

Note: Departments selected for analysis when survey n >= 5, and when safety incidents were tracked for the department. The top 25% of 2015 engaged departments tends to be much smaller than the size of other departments.

26 74 50 35 Ave Dept Size=

MEDICAL CENTER – TEAM MEMBER SAFETY INCIDENT RATE (per 100 team members)

The focus on “Be Safe” likely added to the number of incidents reported this past year. However, there was still a noticeable difference in incidents reported by top quartile vs.

other workgroups.

7

Engagement at the Medical Center Also Showed a Strong Correlation to Turnover


4.3% 4.0%

5.1% 5.5%

8.4%

11.8%

0%

3%

6%

9%

12%

15%

Engaged Not Engaged Actively Disengaged

Tu

rn

over P

ercen

tag

e

Involuntary Term Voluntary Term

3,563 3,991 1,095 n=

Voluntary turnover rates were higher among less engaged team members.

While it’s true that all turnover is not necessarily “bad” turnover, there are likely some top performers in the Not Engaged and Actively Disengaged groups that the

Medical Center would want to retain.

Note: Turnover rates have been corrected for response rate differences. The overall 2014 response rate was 77%, while rates for voluntary and involuntary terms were 58% and 41%, respectively. Over the past 12 months, 1,347 of 11,322 team members have left the organization with 869 classified as voluntary and 478 as involuntary. 2014 survey data exists for 504 of the voluntary and 194 of the involuntary terms.

20%

28% 32%

38% 42%

46% 50%

54% 58%

62% 68%

72%

80%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Su

ccess R

ate

Probability of Above Average Performance

*Composite of absenteeism, turnover, shrinkage, safety, quality, customer metrics, productivity and profitability

8

Every Bit of Engagement Movement Increases the Probability of Strong Performance*


1st 5th 10th 20th 30th 40th 50th 60th 70th 80th 90th 95th 99th

Engagement Percentile Analysis of Business Units Across Organizations in Gallup’s Database

At the 30th percentile, a workgroup has only a 42% probably of achieving above average performance. By moving to the 50th percentile, that probability increases to 50%.

Engagement Overview


UVA Health System SOM Healthcare Workgroup

3.90 3.98

3.86 3.93

4.13

3.00

3.25

3.50

3.75

4.00

4.25

4.50

4.75

5.00

2014 2015 2014 2015 Gallup

Gran

dM

ean

Note: Percentiles based on Gallup’s Q12 Healthcare Workgroup Level Database from the survey year

10

Engagement at SOM Continued to Improve in 2015


Percentile: 50th 34th 39th 31st 35th

The 0.07 increase in GrandMean in 2015 followed a 0.16 increase in 2014 (from 3.70 in 2013 to 3.86 in 2014).

2015 Mean

(n=1,500)

2014–2015 Mean Change

2015 Percentile

2014 Mean

(n=1,781)

GrandMean: 3.93 +0.07 35th 3.86

Growth Learn & Grow 4.09 41st 4.01

Progress 3.77 29th 3.72

Teamwork

Best Friend 3.49 26th 3.38

Quality 4.22 47th 4.14

Mission 3.99 30th 3.91

Opinions 3.84 50th 3.74

Individual

Development 3.86 35th 3.79

Cares 4.14 37th 4.12

Recognition 3.45 32nd 3.38

Do Best 3.96 26th 3.86

Basic Needs Materials 4.02 40th 3.93

Expectations 4.34 27th 4.27

Note: Percentiles based on Gallup’s 2015 Q12 Healthcare Workgroup Level Database

11

Performance Improved Across All Engagement Items

There were meaningful increases (0.10 or more) on three items: “Best Friend,” “Opinions,” and “Do Best.”

+0.08

+0.05

+0.11

+0.08

+0.08

+0.10

+0.07

+0.02

+0.07

+0.10

+0.09

+0.07


3.72 3.72 3.61

3.83 3.84 3.90 3.83 3.87 3.89 4.01

3.86 3.87

3.00

3.25

3.50

3.75

4.00

4.25

4.50

4.75

5.00

SOM Staff SOM Clinical

Faculty

SOM Research

Faculty

SOM Professional

Research Staff

Gran

dM

ean

2013 2014 2015

12

Engagement Improved for Both Faculty and Staff



n Size:

Percentile: 21st 30th 32nd

1,023 1,021 780 135 121 73 399 453 396 319 278 206

28th 32nd 31st 21st 34th 41st 15th 29th 30th

SOM Clinical SOM Research

3.72 3.73 3.63 3.61

3.91 3.88 3.86 3.81 3.93

4.11

3.81 3.89

3.00

3.25

3.50

3.75

4.00

4.25

4.50

4.75

5.00

TenureIneligible

Tenure Track/Tenured

TenureIneligible

Tenure Track/Tenured

Gran

dM

ean

2013 2014 2015


13

Tenure Track/Tenured Exhibited Greater Increases


n Size:

Percentile: 21st 35th 35th

210 247 224 213 181 132 189 205 172 106 97 74

15th 28th 32nd 22nd 33rd 49th 16th 31st 27th

2.8:1 3.7:1 9.1:1

2014 2015 Top Quartile of Gallup’s Healthcare Database SOM

14

As a Result of Increased Engagement, There Are Now Nearly Four Engaged Team Members for Every One Actively Disengaged Team Member



39%

47%

14%

64%

29%

7%

44%

44%

12%

+0.14

+0.21

+0.26

0.00

0.05

0.10

0.15

0.20

0.25

0.30

Admin 1-2 Admin 1-3 Admin 1-4

Average Increase in GrandMean SOM's Increase in GrandMean

Note: Admin 1–2 includes 113 client orgs., Admin 2–3 includes 85 client orgs., Admin 3–4 includes 58 client orgs.

15

The Goal Is to Continue to Accelerate SOM Along the Engagement Curve


Gallup’s average healthcare client exhibits a +0.26 increase in GrandMean after four administrations.

SOM +0.16

SOM +0.23

16

It Is Important That Engagement Is Not Put on Hold as Other Changes Are Implemented


New Strategic Plan at SOM

Implementation of “Be Safe” Initiative

Upcoming Changes in Leadership

• These changes can be opportunities to drive engagement.

• However, they are more likely to detract from engagement if no further actions are taken.

17

Of Concern, Fewer People Participated in the Process in 2015


Response Rate

70% 60% 81% 83%

2014 2015 HC HC 3rd+ Admin

SOM Gallup Avg.

2014 Mean

(n=1,186)

2014–2015 Mean Change

2015 Mean

(n=1,186)

GrandMean: 3.92 3.93

Growth Learn & Grow 4.09 4.09

Progress 3.78 3.75

Teamwork

Best Friend 3.46 3.57

Quality 4.19 4.21

Mission 3.98 3.99

Opinions 3.83 3.83

Individual

Development 3.86 3.85

Cares 4.18 4.12

Recognition 3.42 3.43

Do Best 3.91 3.97

Basic Needs Materials 3.97 4.02

Expectations 4.31 4.35

0.01

0.00

-0.03

0.11

0.02

0.01

0.00

-0.01

-0.06

0.01

0.06

0.05

0.04

18

Scores for Those Who Took the Survey in Both 2014 and 2015 Were Relatively Flat

The GrandMean for team members who took the survey in both 2014 and 2015 increased by 0.01 (from 3.92 to 3.93). Team members who “dropped out” of the process in 2015 had an average GrandMean of 3.74. Their failure to participate this year was a meaningful driver of

this year’s total increase in GrandMean across SOM.


19

Some Key Areas of Opportunity Remain

There are a number of areas where SOM continues to trail Gallup’s Academic Medical Center Database. SOM is below the 25th percentile on two key foundational items: “Expectations”

and “Do Best.”

Below 25th Percentile At/Above 25th Percentile At/Above 50th Percentile

SOM 2015 Mean

Gallup Academic Medical Center Database

25th Percentile 50th Percentile

GrandMean: 3.93 3.88 4.02

Growth Learn & Grow 4.09 3.89 4.06

Progress 3.77 3.77 3.95

Teamwork

Best Friend 3.49 3.63 3.85

Quality 4.22 4.01 4.10

Mission 3.99 3.99 4.10

Opinions 3.84 3.53 3.63

Individual

Development 3.86 3.78 3.92

Cares 4.14 4.01 4.11

Recognition 3.45 3.46 3.64

Do Best 3.96 4.02 4.17

Basic Needs Materials 4.02 3.94 4.04

Expectations 4.34 4.38 4.49


Local Action


Accountability Index

2015

2014

%1 %2 %3 %4 %5 Mean Percentile

Received Feedback on Previous Survey

2015 4.05 34th

2014 4.04 38th

Team Participated in Effective Action Planning

2015 3.52 25th

2014 3.48 26th

Team Has Made Progress on Action Planning Goals

2015 3.48 26th

2014 3.36 25th

Note: Percentiles based on Gallup’s Q12 Additional Items Accountability Index Overall Workgroup Level Database from the survey year; Due to rounding, percentages may sum to 100% +/-1%

21

While Accountability Improved, a Significant Percentage of Teams Still Aren’t Making Meaningful Progress on Action Plans

6%

6%

13%

14%

12%

13%

6%

6%

11%

11%

11%

12%

13%

13%

19%

18%

23%

25%

26%

26%

24%

26%

26%

28%

49%

48%

33%

31%

28%

23%


3.62 (29th)

3.68 (28th)

22

For the Best Results, Local Teams Need to Focus on Issues, Not Items

Action at the Local Level

Use scores to inform discussions.

Link to a survey item, if necessary, for tracking purposes.

Define success beyond engagement scores.

Look to involve other parties/ departments.


Recurrent Leader-to-Leader Conversations

Brief Action Plan Updates

Mentoring

Engagement Review Panel

Highlighting of Effective Action Plans

23

Additional Steps Leaders Can Take to Drive Accountability at the Local Level


24

Managers Can Learn From Best Practice Examples at SOM


SOM BEST PRACTICE MANAGERS

Name Department GrandMean n Size

Bobby Chhabra Orthopaedic Surgery 4.63 16

Sandra Burks Surgery 4.61 9

Joy Hilton Internal Medicine 4.57 8

Paul Levine Otolaryngology 4.57 5

James Ferguson II OB/GYN 4.52 7

Mitchell Rosner Internal Medicine 4.51 7

James Carnes Radiology 4.49 6

Deborah Carver Pediatrics 4.47 6

Lori Elder Dean’s Office 4.35 5

Veronica Harris Surgery 4.35 5

At SOM, 40% of workgroups are above the 50th percentile of Gallup’s Q12 Healthcare Workgroup-Level Database.

Communicating to Leaders About Engagement


Mean %1 %2 %3 %4 %5

Feel Empowered to Speak Up and Address Problems During Workday

If Suggestions/Concerns Raised, Confident Supervisor/Chair Will Act1

Supervisor/Chair Involves Team in Decisions Affecting Jobs and Work Environment2

Understand How My Role Contributes to Success of the Six UVA Goals

Know the Six UVA Goals

Have Clear Sense of Direction SOM Is Heading

1.00 5.00 0% 100%

26

With All of the Recent Changes, Senior Leadership Needs to Continue to Lay the Groundwork for Engagement


Note: Due to rounding, percentages may sum to 100%, +/-1%; Numerical values shown when 10% or higher; 1Item mean increased by +0.03 from 3.73 in 2014; 2Item mean increased by +0.04 from 3.68 in 2014

3.92

3.76

3.72

3.53

3.33

3.19

11%

14%

10%

10%

10%

10%

13%

16%

18%

18%

18%

21%

21%

33%

29%

30%

30%

33%

27%

27%

41%

35%

34%

26%

24%

14%

27

There Are Some Basic Activities for Senior Leaders to Engage in to Help Drive Engagement


Be transparent and ‘explain the why’ of

decisions

Dedicate sufficient face time to team members

Acknowledge efforts and accomplishments

(say ‘thank you’)

Are you doing these things on a consistent basis?

Could you be spending more on these activities?

What, if anything, is getting in the way?

28

Senior Leaders Can Also Speak Directly to Areas of Opportunity at SOM*

Areas Below the 35th Percentile based on Gallup’s 2015 Q12 Academic Healthcare Database

Establish clear guidelines for conduct and performance during the transition.

Be very clear and consistent on communications once the new

leadership is in place.

Prepare talking points for local managers to reinforce messaging

Expectations

Do Best

Reiterate the importance of trust in the workplace.

Find additional opportunities for team members to provide input on

changes/initiatives.

Recognize/reward contributions from all team members around successes.

Best Friend

Recognition

CO

MM

UN

IC

ATIO

N

CU

LTU

RE


Appendix


Healthcare Workgroup Level

• 1,137,356 Respondents

• 96,412 Workgroups

• 63 Organizations

• 25th Percentile GrandMean: 3.78




Healthcare 3rd and Greater Administration Workgroup Level

• 938,546 Respondents

• 76,601 Workgroups

• 52 Organizations





Academic Medical Center Hospital Level

• 267,530 Respondents

• 53 Hospitals

• 21 Clients




• 90th Percentile GrandMean: n/a


Gallup’s 2015 Q12®

Databases Updated Annually; Contains Three Years of Rolling Data

Survey Items Scored on a 5-Point Scale

• A “5” has been shown to link most strongly to positive outcome measures.

• A “5” has been shown to correlate to a psychological “yes” and indicates consistency in a workgroup.

• A “4” indicates a “yes, but … ” — it is a yes response, but with some reservation.

• A “1,” “2” or “3” response is a form of “no,” varying in degrees.

GrandMean

• Average of the 12 Q12 items • The 75th percentile GrandMean is the high performance

target. • The 50th percentile is mean, or average, performance.


Understanding Q12®

Results (page 1 of 2)

Engagement Index and Ratio

• Index: Engaged data is suppressed when n<30; Not Engaged and Actively Disengaged data are not provided when n<100.

• Ratio: Compares the percent of “Engaged” team members to the percent of “Actively Disengaged” team members in a ratio, e.g., 5:1.

Top Box (%5) • The percent of respondents who answer “5” on a particular

item.

Workgroup • A group of team members who report directly to a specific

leader.


Understanding Q12®

Results (page 2 of 2)

5% 32% 40% 2013 2014 2015

SOM

3.90 (34th)

3.98 (39th)

3.86 (31st)

3.93 (35th)

4.13 (50th)

GrandMean

33

SOM Engagement Dashboard

Note: Percentiles and quartile designation based on Gallup’s Q12 Healthcare Workgroup Level Database from the survey year


Response Rate

2014 2015 2014 2015 Gallup HC Workgroup Database

UVA Health System SOM

70% 60% 81% 83% 2014 2015 HC HC 3rd+

Admin SOM Gallup Avg.

Teams Above 50th Percentile Engagement Index


2.8:1 3.7:1 4.6:1

2014 2015 Gallup Healthcare SOM Database

Ratio:

51% 38%

11% 44%

44%

12% 14%

47% 39%

Dedication

Questions Initial Action Steps

• Do team members have a clear sense of what’s going on at the School of Medicine?

• Do they know how the changes/initiatives affect them personally?

• Do they see how recent changes/initiatives are helping to further the mission (i.e., as leaders, are we taking time to “explain the why”)?

• Do team members feel that this is an organization that continues to command their loyalty?

• Audit your most recent communications to team members.

Assess the clarity and effectiveness of that messaging.

Consider the steps taken to follow up on those communications.

• Develop/refine your “elevator speech” for team members.

Briefly define the purpose, brand and culture of the organization (“organizational identity”).

Highlight what is special or unique about working for UVA or the School of Medicine.

Think about how that value proposition may have changed over the last few years (on its own and relative to competitors).

Test your hypotheses in upcoming rounding sessions.

• Identify one near-term opportunity to reinforce the mission with team members.

34

Steps That Leaders Can Take to Foster Dedication, Trust and Ownership


Trust


• Are team members made a priority?

Are you, as leaders, sending consistent messages to team members (through your words or actions)?

Are you consistently acknowledging team members and thanking them for their for their contributions?

Are you modeling the behaviors you want the team members to follow?

• Are you enabling/promoting cooperation across roles and functions?

• Dedicate a sufficient amount of “face time” with team members.

Walk the halls.

Set up breakfasts, lunches or other mechanisms to meet with team members on an informal basis.

• Continue to call out best practices in department meetings, team member meetings and huddles.

• Highlight the actions being taken to make SOM safer for team members and patients.

Suggest other opportunities for teams to personalize the “Be Safe” initiative.

• Set at least one collaborative session with another unit or function.

Use this session to review protocols and timelines, clear up any misinformation/disconnects or identify opportunities for improvement.

35



Ownership


• Do team members feel supported in their actions?

• Do they have sufficient and meaningful outlets to voice their questions and concerns?

• Are you, as leaders, consistently acknowledging and responding to those comments?

• Do team members feel vested in the overall success of the School of Medicine (or the success of recent initiatives)?

• Initiate team member rounding in your group/make optimal use of the existing rounding process.

Be consistent in your approach.

Listen, don’t judge.

Acknowledge comments; follow up on progress.

Take findings to the broader leadership team and seek out systemic issues and challenges.

Highlight one or two recent “rounding wins” for the group.

• Set goals for team members based on key initiatives.

Define success for the group in their roles.

Establish some sort of reward/recognition system for achieving the goals. [Note: This does not have to be financial.]

36



37

Copyright Standards


This document contains proprietary research, copyrighted materials and literary property of Gallup, Inc. It is for the guidance of your company only and is not to be copied, quoted, published or divulged to others outside of your organization. Gallup

®, Accountability Index

TM and Q12®

are trademarks of Gallup, Inc. All other trademarks are the property of their respective owners.

This document is of great value to both your organization and Gallup, Inc. Accordingly, international and domestic laws and penalties guaranteeing patent, copyright, trademark and trade secret protection protect the ideas, concepts and recommendations related within this document.

No changes may be made to this document without the express written permission of Gallup, Inc.

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