Slide 1 COPYRIGHT © STUDER GROUP COPYRIGHT … © STUDER GROUP Please ... Increase employee satisfaction ... COPYRIGHT © STUDER GROUP Please do not quote or disseminate without Studer

COPYRIGHT © STUDER GROUP Please do not quote or disseminate without Studer Group authorizationCOPYRIGHT © STUDER GROUP

Please do not quote or disseminate without Studer Group authorizationSlide 1

COPYRIGHT © STUDER GROUP Please do not quote or disseminate without Studer Group authorizationCOPYRIGHT © STUDER GROUP

Please do not quote or disseminate without Studer Group authorizationSlide 2

Alignment & Accountability: Creating

Organizational Goals and Using An

Objective Evaluation System

Bob Murphy, R.N., JD

Studer Group Senior Leader & Speaker

COPYRIGHT © STUDER GROUP Please do not quote or disseminate without Studer Group authorization

Execution Framework

Evidence-Based LeadershipSM

Rev 2.14


Example Organizational ResultsUsing typical Leader Evaluation


Example Distribution of PerformanceUsing typical Leader Evaluation


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


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


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


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


Accountability Tools

Evaluation

Report Card

90-Day Plan

Meeting Model


Leader Evaluation Requirements

Evaluation must be:

• Objective

• Measurable

• Weighted*

• Contain metric ranges (1-5)

Right Leader

Right Goal

Right Weight


Setting Weights

10% 20% >30%

Awareness Focus Urgency


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%


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%


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


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


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


Weight = 10%

Increase HCAHPS to 70th

percentile in 6/8 composites

Weight = 10%

Increase CGCAHPS to

80th percentile

Weight = 10%

Increase ED Patient


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%


Chief Nursing Officer (CNO) Goals

Increase HCAHPS to 70th


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


Weight =10%

Achieve Operating

Budget

Weight = 10%

Increase ED Patient


Weight = 10%

Decrease CMS Never Events to

2 or less

Weight = 20%

Finance 20%

Quality 35%

People10%

Service 35%

Growth 0%


Med Surg Nurse Manager Goals

Increase Med/Surg

HCAHPS to 70th


Weight = 30%

Increase Med/Surg Employee


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%


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


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%


Physician Practice Manager Goals

Increase Employee


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


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%


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%


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


90-Day Plan Example

Goal

Action Steps Manage Up Level Results


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


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


Thank You!

Bob Murphy, R.N., JD

850-393-4481

[email protected]

www.studergroup.com

mailto:[email protected]

Documents

Slide 1 COPYRIGHT © STUDER GROUP COPYRIGHT … © STUDER GROUP Please ... Increase employee satisfaction ... COPYRIGHT © STUDER GROUP Please do not quote or disseminate without Studer