Irl: www.alphaprimarycare.com UK: www.alphaprimarycare.co.uk
CMG CLINICAL DIRECTORS CONFERENCE 2017
Managing Poor Performance & Supporting those in Difficulty
Dr Jack P NagleCEO, Alpha
Learning Aims
• Performance Management
• Recognising early signs
• Improvement programs
• Best practice & evaluation
• Managing the budget & resources
Context
Clinical Strategy & Programmes
• National Clinical Programmes (31)
• Integrated Care programmes
– Patient Flow
– Older People
– Children
– Maternity Care
– Prevention & Mngt of Chronic Diseases
Standards - Quality v Compliance…
‘BE QUALITY RATHER THAN COMPLIANCE DRIVEN’
Compliance will then follow…
CQCHIQA
Quality v Compliance• A Compliance focus is putting in sufficient effort to meet HIQA’s & Legal
minimum requirements.
• A Quality focus, on the other hand, is derived from a systematic continuous improvement process where management, resources and measurement systems are aligned and operated in such a way that continuous improvement and compliance is an inescapable outcome.
• An organisation will never achieve those benefits with a compliance-only approach.
• Continuous Improvement (CI) holds the key to not only compliance, but even more so to improved productivity and therefore increased profitability.
28-Jun-17 C. Alpha Healthcare Ltd 2006
Performance Managing Clinical Directors.
– Performance Management Vs Performance Measurement?
– How Has Performance Management Changed?
– Individual Appraisal Vs Joint Review
– Measuring Outputs Or Inputs & Processes
– Reward And Development
– Accountability And Autonomy
– The Role Of KPI’s
– Top Down And 360⁰ Feedback.
28-Jun-17 C. Alpha Healthcare Ltd 2006
Measuring Outputs Against Inputs/Process
28-Jun-17 C. Alpha Healthcare Ltd 2006
The Results and Objectives
that are achieved.
The Skills, Competencies and Processes that achieve these results.
Some Key Indicators
• Level of Complaints
• Level/Severity of Patient Safety
• Audit Results
• Staff Turnover/Recruitment/Retention
• Absence levels
‘Softer Issues’:
• Teamworking
• Conflicts
• Culture
C. Alpha Healthcare Ltd 2006 28-Jun-17
Recognising Early Performance Signs
Checklist:
• Quantity of work,
• Quality of work,
• Absenteeism,
• Role as the centre of conflict,
• Dishonesty,
• Setting of unrealistic targets,
• Refusal to delegate,
• Slowness in taking decisions,
Ref: The management of Poor Performance – J Mayberry Postgrad Med 2007, checklist by Stewart & Stewart
C. Alpha Healthcare Ltd 2006 28-Jun-17
Recognising Early Performance Signs
Recognising, understanding & addressing performance problems
Ref The Management of Poor Performance, J Mayberry, 2007
Recognising, understanding & addressing performance problems
Ref Recognising &addressing performance problems in healthcare organisations –DOH /UK 2006
Improvement Programs
• Agreement on the size of the problem
• Individual mentoring & support
• Development of learning plans
• Tutorials with experienced colleague
• In-house or external training
• Regular review of progress
• Good documentation of activities
28-Jun-17 C. Alpha Healthcare Ltd 2006
Ref The Management of Poor Performance, J Mayberry, 2007
C. Alpha Healthcare Ltd 2006 28-Jun-17
Methods Of Ongoing Evaluation
1. Surveys – Staff and Service Users
2. Focus Groups – Multidisciplinary Team Groups
3. Working Groups
4. Appraisals
Peer Support Groups
• Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other.
28-Jun-17 C. Alpha Healthcare Ltd 2006
Tips For More Effective Management
‒ Value Management As Well As Leadership
‒ Enable Reflective Learning
‒ Extend General Management Networks
‒ Clarity, Accuracy and Thoroughness In Communication
‒ Hire The Right People & Know Your Team
28-Jun-17 C. Alpha Healthcare Ltd 2006
Hire The Right People
“It Wont Be Easy But It Will Be Worth It”
28-Jun-17 C. Alpha Healthcare Ltd 2006
Leading The MDT To Assess & Improve Quality
‒ SWOT Analysis
‒ Formal Learning
‒ Myers Briggs
‒ Facilitating Clinical – Managerial relations
28-Jun-17 C. Alpha Healthcare Ltd 2006
28-Jun-17 C. Alpha Healthcare Ltd 2006
TQM
Total Quality Management is a philosophy that enables the
management of people and business processes to ensure
complete customer satisfaction. It has been widely used in
industry to deliver huge benefits in customer service, efficiency
and cost reductions.
Providing Effective Feedback
• Whether you are providing feedback to an employee during a performance appraisal, disciplinary meeting or during the course of day to day business.
• Feedback is an opportunity, not a threat, feedback enables you to identify strengths & weaknesses, and to improve performance.
28-Jun-17 C. Alpha Healthcare Ltd 2006
Factors affecting Quality of Heath Care Services
Ref the Kings Fund Survey of Medical Directors 2014
Managing The Clinical Directorate Budget/Finances/Resources
• Planning
• Financial allocation
• Expenditure Control
• Decision Timing
• Drivers For Change
• Distribution Of Power
28-Jun-17 C. Alpha Healthcare Ltd 2006
Summary
• Performance Management v Measurement
• ‘Early signs’
• Improvement initiatives
• Best practice & evaluation
• Managing budget v resources v Quality of care
THANK YOU!
C. Alpha Healthcare Ltd 2006
• Founded Alpha 2003
• Prior – Senior Manager & Director Operations and Engineering roles
• Healthcare Business & Change Management experts
• Provides a suite of outsourced management services to healthcare professionals & providers
• Industry methodologies (TQM, LEAN, 6 Sigma) to deliver efficiency improvements
• Launched in the UK in 2010
• Worked more than 650 Clinicians & 125+ healthcare organisations –including DoH & HSE and CCGs & NHS in UK
Contact: [email protected]
Dr Jack Nagle - Background
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