Building a Culture of Accountability, Alignment and Transparency

April 22, 2015| Bill Santulli, Executive Vice President/Chief Operating Officer

Building a Culture of Accountability, Alignment and Transparency

Outline

• Advocate Health Care• Accountability Defined• Principles• Alignment and Organizational Rhythm• Operating Practices• Q & A

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AccountabilityDefinition*

The obligation of an individual or organization to account for its activities, accept responsibility for them, and to disclose the results in a transparent manner.

* BusinessDirectory.com4

“WINNING”

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Report Card – March 20152020 Strategy

Key Result Area

Measure Target Actual Achieved

Serious Safety Event Rate Change -5.0% -5.8% Safety Event Reporting Rate 3.5 4.0

QUALITY Health Outcomes Score 100 57

Patient Engagement 75 57

Associate Engagement 80 >90 Physician Engagement 75 77

GROWTHNet Revenue Growth (% vs Prior Year)

6.18% 6.83% Operating Margin 1.81% 5.09% Hospital Cost per Discharge $8,077 $8,004 Medical Group Cost per Visit $116.80 $118.23

Philanthropy (millions) $2.19 $2.30 ADVOCATECARE®

COORDINATED CARE

AdvocateCare® Index 100 66

SAFETY

SERVICE

ACCESS AND AFFORDABILITY FUNDING OUR

FUTURE

ADVOCATE EXPERIENCE

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Culture of High of AccountabilityPrinciples

Focused on who we serve: Our Patients Inspired by our Mission, Values and

Philosophy Guided by Vision Living Our Values through Observable

Actions - Behaviors of Excellence Intent on Collaboration with All

Stakeholders to Provide a Safe, Superior Experience Transparency of results Committed to systematic operating

practices

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®

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Report Card – March 20152020 Strategy

Key Result Area

Measure Target Actual Achieved

Serious Safety Event Rate Change -5.0% -5.8% Safety Event Reporting Rate 3.5 4.0

QUALITY Health Outcomes Score 100 57

Patient Engagement 75 57

Associate Engagement 80 >90 Physician Engagement 75 77

GROWTHNet Revenue Growth (% vs Prior Year)

6.18% 6.83% Operating Margin 1.81% 5.09% Hospital Cost per Discharge $8,077 $8,004 Medical Group Cost per Visit $116.80 $118.23

Philanthropy (millions) $2.19 $2.30 ADVOCATECARE®

COORDINATED CARE

AdvocateCare® Index 100 66

SAFETY

SERVICE

ACCESS AND AFFORDABILITY FUNDING OUR

FUTURE

ADVOCATE EXPERIENCE

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Behaviors of Excellence Signed by each new hire Evaluated in every

performance review Foundation for

differentiating performance

Values demonstrated by associates, physicians, and volunteers are recognized through MVP quarterly and annual awards

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Transparency• Posted in every

department

• Available online

• Distributed to all managers

• Safety alerts/Root cause analyses

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29 DaysSince Last Serious

Safety Event

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AlignmentGoals Set Annually for Key Result Areas: Goals are outcome-oriented (vs process), weighted, and associated with a

target and a stretch level of performance. Watchlist goals defined.

Targets/stretch levels aim for top quartile or top decile performance

Timelines:

o AHC System goals, targets/stretch identified (Sept- Oct)

o Site goals (aligned with system goals) determined (Oct-Dec)

o Site goals cascaded throughout the management team (to supervisor level) to achieve alignment between organizational and department goals (Dec – Jan)

o Goals loaded into electronic system – Advocate Management System (AMS) (Feb)

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January

FebruaryApril May

June

SeptemberAugust

JulyNovember

December

October

March

Organizational Rhythm

MOR

MOR

Site Forums

Key Leadership

MOR

HR: Mgt Reviews Due

MOR + Health

Outcomes

Talent Review and Plan

MOR

Mid-Year ForecastReview

MOR + Strategy

MOR +HR

Board Retreat• 2020 Update

MOR + Health

Outcomes

Sr Leadership Retreat• KRAs

Exec. Committee• Succession Mgt Review

Budget Reviews

Operating Budgets Due

MOR

MOR + Next Year Outlook

Talent Board Succession Review

QOR

QORQOR: Budget

Reviews

QOR

Site Capital Growth Projections Due

Budget targets communicated

Board of Directors:• Capital / Operating Budget

Approval• KRA Approval

Capital: Finalize short list of projects

for feasibility

Mid-year Forecast Due

Webcast

Webcast

Site Strategic Plan Updates Due

Health Outcomes Kickoff

APP Board Approval of CI Metrics

Draft CI Metrics

Draft Health Outcomes KRAs

Governance ProcessQuarterly Operating Review (QOR)Monthly Operating Review (MOR)Strategic Planning ProcessOperating Budget ProcessCapital Budget ProcessHealth Outcomes Planning ProcessPeople Process Communication Process

EMT Retreat• KRAs / STI

EMT Retreat• Talent Review• ERM / Market Review

System Initiatives quantified

Site Capital Feasibility Studies

Due

Capital Committee

Key Leadership LDI

Exec. Committee• ERM 2020 Update

Completed

Preliminary Site Growth Plans Due

Board of Directors:• Preliminary Budget

Outlook• Draft KRAs

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Operating Practices• Performance Management• Management Incentive Plan• Daily Practices• Mid-month Financial Review• Monthly:

– Closes

– Operating Reviews

– Meeting Model

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Performance Management Structured process and tool to determine level of

performance on the Behaviors of Excellence: High Performer, Solid Performer, Low Performer (HSL) Rating on Behaviors of Excellence determines 30%

of annual performance rating Annual goal achievement determines 70% of

leaders annual performance rating Overall rating (Behaviors and Goal Achievement) a

factor in merit increase

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Management Incentive Plan• Compensation At-Risk• Annual• Determined by Key Results

– Health Outcomes– Patient Satisfaction– Operating Margin

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Daily

• Safety Huddle• Productivity Huddle • Leader Rounding

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Mid-month financial briefing sessions

For those sites that are below plan on a year-to-date basis

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Monthly Closes Distributed to Entire Management Team

• Health Outcomes

• Patient Satisfaction

• Financial

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March 2015 Advocate Experience – Safety & Quality Close Narrative

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Monthly Operating Reviews (MORs)• Routine focus on safety, service, and financials

• Once /year deep review into health outcomes, strategy(Spring-before budget process is launched), and human resources

• Mid-year forecast (July)

• Operating budget run rate analysis (December)

• Most support functions have Quarterly Operating Reviews (QORs)

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Vital Statistics

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The monthly meeting model provides a framework to review outcome and align focused action plans to achieve goal outcomes and hardwire evidence based leadership practices (EBLs). This preparation facilitates a meaningful dialogue that helps to remove barriers and provide focus. This meeting structure is intended to be utilized on a monthly basis, and can be utilized more frequently as needed.

The leader prepares for meeting by 1) reviewing current goals performance and developing action plans to achieve targets, 2) reviewing stoplight reportsand tracking logs, 3) report on leadership development, and 4) prepare other pertinent updates. The leader comes prepared to lead the discussion. Theone up asks clarifying questions and sets priorities.

All KRA areas are listed as the intent is to ensure a balanced review of performance outcomes. The one up and leader can set priority for which goals toreview during the meeting based on weighting or results.

Review and Bring: Monthy Report Card 90 Day Plans Rounding Logs Stoplight Report Linkage Grid HSL ListWins:Goal Outcomes and Action/90 Day Plan:Review of status of performance goals, plans and monthly report cardAre you meeting your target? If so, what will you continue to do to stay on track?

If you are not meeting your target, what will you do differently over the next 90 days to meet your target?Project updates and support needed.SafetyQuality 1. PG Measurements without reporting for key OP areas

Service 2. Patient Complaint (Sievertson)3. Rishi comment 2014 Targets4. Hospitalists

Growth 5. Migration to ACL, wait for Care Conncetion vs. Surginet6. SWC Strategy7. MOB Strategy

Funding our Future 8. Feedback from payroll (Debbie at Support Center)

AdvocateCareSystem IntegrationItems

9. ALEX concerns10. Common review date / BOE weight11. KRA process for matrix leaders

Projects/Other Agenda Items

12. Designee to Presidents Meeting13. Nurse Week gift14. Alignment Collaborative15. Center Street and NENA /City16. Selling properties

Name: Santulli/Deering Date: 3/11/14 – 4 pmVia Telepresence

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Conclusions• Every manager must know what winning looks like

• Results should determine performance and incentive

• Alignment

– With Mission/Values/Vision

– Vertical

• Operating practices and infrastructure need to support accountability

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QUESTIONS

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