1 Creating a Successful Organization Now and in the Future Katie Bata, Vice President, Human Resources Pamela Hyziak, Director, Clinical Excellence Baldrige Regional Conference September 8, 2016 Advocate Lutheran General Hospital • 638 bed tertiary and teaching institution • Key service lines: – Advanced Surgical – Cancer – Cardiovascular – Level One Trauma Center – Digestive Health – Neuroscience – Orthopedics – Women’s Health Advocate Lutheran General Hospital Service Statistics Indicator 2014 2015 Licensed Beds 638 638 Admissions 28,339 29,103 Deliveries 4,157 4,145 Emergency Department Visits 65,438 67,151 Outpatient Visits 223,355 232,743 Surgical Cases – IP 6,824 6,903 Surgical Cases – OP 11,903 12,128 Average Daily Census 409 418
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1
Creating a Successful Organization
Now and in the FutureKatie Bata, Vice President, Human Resources
Pamela Hyziak, Director, Clinical Excellence
Baldrige Regional Conference
September 8, 2016
Advocate Lutheran General Hospital
• 638 bed tertiary and teaching institution
• Key service lines:– Advanced Surgical
– Cancer
– Cardiovascular
– Level One Trauma Center
– Digestive Health
– Neuroscience
– Orthopedics
– Women’s Health
Advocate Lutheran General HospitalService Statistics
Indicator 2014 2015
Licensed Beds 638 638
Admissions 28,339 29,103
Deliveries 4,157 4,145
Emergency Department Visits
65,438 67,151
Outpatient Visits 223,355 232,743
Surgical Cases – IP 6,824 6,903
Surgical Cases – OP 11,903 12,128
Average Daily Census 409 418
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Our Associates and Medical Staff• Total Associates 4,066
• FTEs 3,158
• Active Medical Staff 1,323
• Graduate Medical Education– 151 Residents
– 29 Fellows
– 37 Rotating Residents
• Nursing Staff– 721 Full time
– 730 Part time
• Nursing/Allied Health Education Affiliations
– 7 Nursing
– 7 Pharmacy
– 15 Physical Therapy
– 6 Occupational Therapy
– 14 Speech & Audiology Therapy
– 4 Respiratory
– 8 Laboratory
Leadership System
Delivers for TodayDefinition Supporting Skills
Executes forOutcomes
Prioritizes and plans work with a data‐driven, outcome‐focusedapproach; monitors work using financial, operational and processdata to track progress and identify process improvementopportunities; achieves optimal outcomes in service, quality, andsafety.
Financial Acumen Results Orientation Project Management Process Improvement
AcceleratesPerformance
Creates and drives a performance culture by setting clear expectations, delegating, empowering and motivating individuals and teams.
Expectation Setting Engagement Accountability
Builds Collaborative Relationships
Partners both formally and informally with others to achieve optimaloutcomes; builds appropriate rapport with people by establishing trust and mutual purpose; modifies approach to engage and influence others through self‐awareness and awareness of personalimpact on others.
Customer/StakeholderFocus
Partnership InterpersonalSavvy/Influence
CommunicatesEffectively
Develops and applies the fundamental mechanics of effectivecommunication: listening, delivery and understanding acrosssettings, audiences and modes of communication; actively engagesin two‐way communication to ensuremutual clarity and positiveoutcomes.
Active Listening Message Delivery Ensuring Effectiveness ofCommunication
Leadership System Foundational Competencies
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Leadership System Foundational Competencies
Leads for the FutureDefinition Supporting Skills
Leads Change
Identifies and prioritizes change needs based on internal needs andexternal best practices; communicates a compelling story to engage andmotivate others in the change process; involves and manages affected people and systems; consistently manages ambiguity and resistance toreach desired change goal.
Planning for Change Setting Context forChange
Executing on Change
Acts Strategically
Creates strategy, develops tactical plans and executes as aligned withAdvocate’s system vision and goals; monitors and adapts to thechanging business of healthcare; involves and communicates to thoseaffected by, and involved in, strategic activities.
Enterprise/SystemThinking
Strategy Development Translating Strategyinto Action Plans
Builds Talentfor the Future
Hires, promotes and retains strong and diverse talent for the benefit ofAdvocate; actively engages associates in career planning anddevelopmental assignments; actively plans and manages self‐development.
Hiring and Onboarding Assessing Talent Developing DirectReports
Self‐Development
Understand Stakeholder Requirements
Understanding Stakeholder Requirements
• Strategic Considerations• Data Analytics using Big Data• Regulatory and External Changes• Assessing Brand Awareness-Marketing
Strategy
• Listening to the Voice of the Customer• Senior Leader Patient Rounding• Patient and Family Advisory Councils• Healthier Communities and the Community
Health Needs Assessment
4
Set Direction and Establish Goals
Accelerates Performance
Creates and drives a performance culture by setting clear expectations, delegating, empowering and motivating individuals and teams.
• Expectation Setting• Engagement• Accountability
Set Direction/Establish Goals
KRA Cascade or Watch/SustainKRA Cascade or Watch/Sustain
Evaluation of Potential Measures against Selection Criteria
Evaluation of Potential Measures against Selection Criteria
Meets Criteria Approved and Targets are Set Using
Rules
Meets Criteria Approved and Targets are Set Using
Rules
Strategic Planning Business Analysis and Strategy Development
Strategic Planning Business Analysis and Strategy Development
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Keys to Success• We must help staff understand and own our KRAs
– Owner vs. renter mentality
– Shared accountability
• Ratings should differentiate high and low performers and teams
– Alignment with HSL philosophy
• Leaders need tools that are simple and efficient
– More standardized goal setting by function
– Increased automation of entering goals, performance results
Organize, Plan and Align
Putting it into Practice – Goal Cascade
Company and Site Targets Set
Company and Site Targets Set
Vice PresidentsVice Presidents
DirectorsDirectors
Managers, FLLsManagers, FLLs
AssociatesAssociates
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Putting it into Practice – Rating Performance
Goals
50%
Goals
50%
BOEs
50%
BOEs
50%
10% based on overall site performance
10% based on overall site performance
40% based on shared department goals
40% based on shared department goals
100% of Advocate employees are held accountable to KRAs:
32,000 Advocate AssociatesMeasured on KRA Goals
32,000 Advocate AssociatesMeasured on KRA Goals
Our Opportunity: Misaligned Performance Standards
90% of Advocate employees were not held accountable to KRAs:
3,000 LeadersMeasured on
KRA Performance
3,000 LeadersMeasured on
KRA Performance
32,000 Advocate AssociatesMeasured on
Job Accountabilities
32,000 Advocate AssociatesMeasured on
Job Accountabilities
Advocate’s KRA StrategiesAdvocate’s
KRA Strategies
Business Case for Goal Alignment
Studies show that goal setting leads to:
Higher associate engagement
Increased productivity
Improved work team performance
Increased satisfaction with performance feedbackAssociate
EngagementAssociate
Engagement
KRA Results KRA Results
Shared Accountability
Shared Accountability
Ownership MentalityOwnership Mentality
Clearer Performance Expectations
Clearer Performance Expectations
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Evidence
KPIPercentile Results
Before After
In‐patient satisfaction 46th 90th
Out‐patient satisfaction 6th 85th
HCAHPS 10th 78th
Associate Engagement 49th 90th
Physician Engagement 50th 78th
Turnover 20% 12%
Advocate Sherman Hospital Hill Country Memorial(2014 Baldrige Winner)
Department goal achievement
Balanced scorecard results
Engagement scores
Manager effectiveness
What Changed?
Evaluations of Job Accountabilities
Evaluations of Shared Outcomes
Reviews Given Year‐Round
Single, Coordinated Review Period
Reviews in Pathways and ATMS
All Reviews in ATMS
Culture of Individual Contribution/ Accountability
Culture of Shared Ownership/ Accountability
Perform to Plan
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Strategic SustainabilityKey Result Area (KRA)
Key Strategy/Responsible Senior Leader Results
SafetyHigh Reliability and the Top 10 Safety ListVPMM, CNE, COO
Patient Safety Event Reporting
QualityPerformance Improvement for Best Quality OutcomesVPMM, CNE, COO, CEO
Budgeting, Revenue Cycle, Finance ProceduresCFO, VP Business Development, CEO
Operating MarginHospital Cost per DischargePhilanthropy
GrowthStrategic Planning, Physician Recruitmentand RetentionVPMM, VP Business Development, CEO
Net RevenueVolumes
Care Coordination
APP Clinical Integration AdvocateCare Index
Operational SustainabilitySupport Operations
Key Strategy/Responsible Senior Leader Results
Information Technology (IT)
& Communications
Information Technology Planning Director of Information Technology and AHC
Meaningful Use Dashboard
Human Resources
Human Resource PlanningVP Human Resources and CEO
HR Dashboard
Supply ChainMaterial OperationsCFO and CEO
Supply Chain Dashboard
RegulatoryQuality Management (DNV and ISO)VPMM and CEO
DNV Annual Report
FacilitiesPhysical Environment ProgramsCOO and CEO
Physical EnvironmentDashboard
PlanFinding Root
CauseAction Plan Who When
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Monthly Meeting Model
Senior Leader Rounding
Senior Leader Rounding Focus
• Core Value-Errors in communication are common. Some of the reasons . . . Remember Communication is not what you say . . .
• Consistency-Can you tell me about the tool for “Communicate Clearly” or how you use it?
• Concerns-Is there anything that makes using this tool difficult?
• Commitment-Can I count on you to regularly use this tool?
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Recognize, Reward and Develop
Builds Talent for the Future
Hires, promotes and retains strong and diverse talent for the benefit of Advocate; actively engages associates in career planning and developmental assignments; actively plans and manages self-development.
• Hiring and Onboarding• Assessing Talent• Developing Direct Reports• Self-Development
Talent Review: Inputs and Outcomes
GoalsGoals
BOEs (HSL)BOEs (HSL)
CompetenciesCompetencies
Desire for More ResponsibilityDesire for More Responsibility
AdaptabilityAdaptability
PotentialPotential
Merit IncreaseMerit Increase
PerformancePerformance
Development Planning
Development Planning
Talent ReadinessTalent
Readiness
Replacement/ Succession Planning
Replacement/ Succession Planning
Ongoing PerformanceFeedback
Ongoing PerformanceFeedback
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Annual Talent Review Process FlowFeb March April May
Self ‐Assessment
Self ‐Assessment
Manager Assessment of Performance & Potential Manager Assessment of Performance & Potential
Calibration Meeting on Performance & Potential Calibration Meeting on Performance & Potential
Performance and Talent Feedback Discussions
Performance and Talent Feedback Discussions
Merit IncreaseMerit
Increase
On‐going DevelopmentOn‐going Development
By Feb 14
By March 14(soft deadline)
By April 11
By April 25
Manager Finalizes Review & Sends to Associate
Manager Finalizes Review & Sends to Associate
By April 30
By April 30
By May 31
Talent Matrix
• A tool for evaluating talent
• Combines performance and potential ratings
• Generated by ATMS
• Has been revised this year to align with our 5-point performance scale
• The Talent Matrix allows us to:• Assess leaders against a consistent set of criteria
• Help evaluate bench strength for future leadership positions
• Reveal development / coaching priorities
PER
FORMANCE = Goal Achievement & Behaviors of Excellence
POTENTIAL = Leadership Competencies, Adaptability, & Desire for More Responsibility
2
11
15
Sig Exceeds Performance/At Potential
• PERFORMANCE: Highly competent/ role model in current position. Demonstrates exceptional accomplishments.
• POTENTIAL: Can assume a new role at same level of complexity. May not want to move up.
Sig Exceeds Performance/High Potential
• PERFORMANCE: Highly competent/ role model in current position. Demonstrates exceptional accomplishments.
• POTENTIAL: Potential to grow into a role with broader responsibility and complexity. Advance into role one level above current role in 0-2 years, second move in 3-5 years.
Sig Exceeds Perf/Medium Potential
• PERFORMANCE: Highly competent/ role model in current position. Demonstrates exceptional accomplishments.
• POTENTIAL: Capable of taking on an expanded or complex role at same level. Could advance to the next level.
Exceeds Performance/At Potential
• PERFORMANCE: Competent in current role. Frequently exceeds job requirements and accomplishments are above expected levels.
• POTENTIAL: Capable of assuming a new role at same level of complexity. May not want to move up.
Exceeds Performance/Medium Potential
• PERFORMANCE: Competent in current role. Frequently exceeds job requirements and accomplishments are above expected levels.
• POTENTIAL: Capable of taking on a new role at same level of complexity. Could advance to the next level.
Approaches Performance/At Potential
• PERFORMANCE: Lacks competence in current role. Meets most but not all job requirements and performance is less than expected. May be a mismatch with current role.
• POTENTIAL: Exiting organization may be appropriate, especially if they do not demonstrate improvement after development.
Approaches Perf/Medium Potential
• PERFORMANCE: Lacks competence in current role . Meets most but not all job requirements and performance is less than expected. May be new to the position but not adapting as well as anticipated.
• POTENTIAL: Improved performance is needed before advancement can be expected.
Approaches Performance/High Potential
• PERFORMANCE: Hard to assess competence. Meets most but not all job requirements and performance is less than expected. Likely not adapting to a new position.
• POTENTIAL: Able to take on greater responsibilities once performance improves. Anticipate successful results once this person matures in his/her new role.
5
6
7
10 13
Exceeds Performance/High Potential
• PERFORMANCE: Competent in current role. Frequently exceeds job requirements and accomplishments are above expected levels.
• POTENTIAL: Potential to grow into a role with broader responsibility and complexity. Advance into role one level above current position.
14
Meets Performance/At Potential
• PERFORMANCE: Competent in current role. Meets job requirements and demonstrates solid performance with few deviations.
• POTENTIAL: Capable of assuming a new role at same level of complexity. May not want to move up.
Meets Performance/Medium Potential
• PERFORMANCE: Competent in current role. Meets job requirements and demonstrates solid performance with few deviations.
• POTENTIAL: Capable of taking on a new role at same level of complexity. Could advance to the next level.
Meets Performance/High Potential
• PERFORMANCE: Competent in current role. Meets job requirements and demonstrates solid performance with few deviations.
• POTENTIAL: Potential to grow into a role with broader responsibility and complexity. Advance into role one level above current position.
4 8 12
Does Not Meet Performance/At Potential
• PERFORMANCE: Lacks competence in current role. Does not meet job requirements. Performance must improve to stay in this position. May be a mismatch with current role.
• POTENTIAL: Exiting organization may be appropriate, especially if they do not demonstrate improvement after development.
Does Not Meet Performance/High Potential
• PERFORMANCE: Hard to assess competence. Does not meet job requirements. Performance must improve to stay in this position. Likely not adapting to a new position.
• POTENTIAL: Able to take on greater responsibilities once performance is demonstrated. Anticipate successful results once this person matures in his/her new role.
15
9
61 Does Not Meet Perf/Medium Potential
• PERFORMANCE: Lacks competence in current role. Does not meet job requirements. Performance must improve to stay in this position. May be new to the position but not adapting as well as anticipated.
• POTENTIAL: Improved performance is needed before advancement can be expected.
3
At Potential Medium Potential High Potential
Does Not Meet
Expectations
Approaches
Expectations
Meets
Expectations
Exceeds
Expectations
Sig Exceeds
Expectations
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Calibration Sessions
• Changes to performance and/or potential as a result of calibration automated
– Changes made directly in ATMS
– Will automatically make the change to the overall rating and route performance forms to signature step
– Carbon copy of final review form sent to matrix co-leaders
Total Rewards
PAY
PTO Healthe You Rewards
401K Employer
Match
Educational
AssistanceDisability Income
Protection
Pension
Plan
Medical
Dental
Vision
Pay for PerformanceSite Composite Goals (YTD Example)
*The purpose of the information presented here is to support the ATMS site composite goal for non‐managerial associates. For more information, see slide 3 or contact your site HR or HR Direct.
36
KRA
Key Performance Indicator (KPI) Target Actual Achieved
QUAL
ITY
Modified Health Outcomes Score 100 88
SERV
ICE
Patient Engagement ‐ Overall 3.0 5.0
GROW
TH Net Revenue Growth
(% of Budget)100.00% 99.59%
Operating Margin 7.19% 6.37%
AdvocateCare® Margin (PMPM)Not
Available
Not
Available
Hospital Cost per Discharge $9,078 $8,906 Philanthropy (000) $950 $1,002
COO
RDIN
A-
TED
CARE
AdvocateCare® Index 100 94
ATM
S Site Composite Goal
(# measures achieving target)4 3 Goal Rating: 2.0
FUND
ING
OUR
FUTU
RE
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• Years of Service Recognition• Thank You Notes• MVP/SPIRIT Awards• Daisy Awards• Showcase at Leadership Development Institutes
and Forums• The Julie Award• Physician Recognition Wall• Magnet Awards• Celebrate Associate, Nurses and Volunteer