Kaiser Permanente: Culture of Performance Excellence

Creating a Culture of Performance ExcellenceEnhancing Business Acumen by Leveraging ActiveStrategy to Manage Performance

Corwin Nathaniel Harper, MHA, FACHESenior Vice President/Area Manager

CENTRAL VALLEY AREA April 2012

2 | © 2012 Kaiser Foundation Health Plan, Inc.

Creating a Culture of Performance Excellence

Management & People Practices

Recognition & Feedback

Business Performance

Management &Metrics

Work Processes/Systems

& Performance Improvement

Vision &Strategy

Leadership Credibility & Total

PerformanceBehaviors

Structure & Organizational

Design

Culture

The Journey to Sustainable Excellence


Creating a Culture of Performance ExcellenceKaiser Permanente – Guiding Behaviors

� Takes Accountability

� Focuses on the Customer

� Drives for Results

� Develops Self and Others

� Communicates Effectively

� Collaborates

� Champions Innovation and Change

� Thinks and Acts Strategically

� Leverages Technology

� Demonstrates Resource Stewardship

� Demonstrates Business Acumen


� We assessed various models to enhance/improve performance.

� After careful consideration we settled on the Studer model because the Five Pillars and Nine Principles aligned with the priorities at Kaiser Permanente.

Steps to Enhancing PerformanceDetermining Our Approach


Enhancing Performance Why Build Business Acumen ThroughBusiness Performance Reviews?

� Requires analysis of business workflows

� Prompts critical thinking and strategic planning

� Consideration of outcomes and finances

� Focuses on critical drivers and indicators of performance

� Provides a forum for managers and directors to present critical performance indicators to leaders, and get real-time feedback

� Enables leaders, directors, and managers to jointly make proactivedecisions and allocate resources to positively impact future outcomes


� Dr. Raymond R. Reilly of the Ross School of Business at the University of Michigan and Dr. Gregory P. Reilly of the University of Connecticut document traits that individuals with business acumenpossess:

– Have an acute perception of the dimensions of business issues

– Can make sense out of complexity and an uncertain future

– Are mindful of the implications of a choice for all the affected parties

– Are decisive

– Are flexible if further change is warranted in the future

Enhancing Performance How Does Business Acumen Drive Performance?


The Road Toward EffectivePerformance Management

Business Acumen + Rounding + Performance Management = Performance Improvement

� Strategic thinking

� Thoughtful analysis

� Understanding the logic behind business decisions

� Rounding integrated into daily business functions

� Careful attention to key dimensions of planning and execution

� Clear accountability and ownership

� More disciplined performance management

Effective Performance ManagementInvolving Your Staff to Achieve Outcomes – Rounding Tool


Business Performance Management Utilizing the Business Performance Review Process

Definitions

� Business Performance Management: A disciplined, structured and ongoing management practice supporting strategy execution that enables leaders at all levels to be fully informed of their business/operations.

� Business Performance Review: A highly structured, ongoing, data-driven conversation between a manager and his/her direct reports.

2.


� Business Performance Review: Meetings are focused on strategic goals and the operational performance of the business units (i.e., patient care services and support services).

� The meetings are discussions, not report outs. Leaders, directors, and managers meet with key members of the leadership team to discuss performance, results from rounding, and get input/feedback for further enhancements.

� Rounding: Key rounding questions are integrated into each session. Examples: How can I assist you? What resources or tools do you need? Do you have the support you need to be successful? Are there barriers that I can help you with?

The Business Performance ReviewHow are the Reviews Structured?


Business Performance Review – Continuous Improvement Cycles to Enhance Performance

Plan, Do, Study, Act

PDSA Cycleconstant

PLANWhat are the needs

of the patient?

How can we get timely

and relevant information?

DODevelop a tool to collect

real-time information in time

to impact the care and service

experience of the patient.

STUDYAssess the information collected

and determine the one-time issues

versus trends.

Resolve one-time issues and develop

a rapid plan to change operations

that impact many patients.

ACTDetermine how to

improve data collection

and resolution process

-- and begin new PDSA cycle.


� The evolution of data collection and actions associated with the data is a continuous improvement process at Kaiser Permanente in the Central Valley Area.

� It is our desire to gain real-time information to continually enhance the care and service experience for our patients and members in the Central Valley Area; this desire helps to focus our efforts.

� Rounding is the key component of the process and we have learned to collect real-time information to impact the care and service experience of our patients and members. Because of our approach with rounding, we can address needs or issues before discharges occur. This is what motivates us to continually enhance our performance. The patient/member is at the center of our work.

The Business Performance Review PDSA Cycles


� Previously we used a paper process to round on our patients and members.

� Information was collected, entered into a spreadsheet, and reviewed at some point in the future. This is reactive.

� Now, we use technology to collect data, quickly analyze it and make adjustments to ensure that the patient/member experience is excellent. This is proactive.

The Business Performance Review ProcessThen and Now


The Business Performance Review with Paper

� Paper-driven process

� Multiple data sources

� Gathering, sorting, and tracking of paper documents

� Increased meetings

� Cumbersome tracking of action plans

� Ongoing email strings


The Business Performance Review

Past Present

Electronic

Automated

Processes

Information Technology

Performance Improvement

Leveraging Technology is an Integral Component to Greater Efficiency

Paper &

Manual

Processes


� After reviewing resources to help manage performance, ActiveStrategy was selected as the next tool to add to the toolkit.

� Along with ActiveStrategy, we determined that we needed to use an electronic tool for rounding to allow immediate data analysis.

� The iPad with the iRound application was selected for departmental rounding.

The Business Performance ReviewA Look at the Present -- Leveraging Technology


The Business Performance Review A Look at the Present -- iPad


The Business Performance ReviewTechnology in Health Care

The evolution of health care technology enables us to improve efficiency and enhance performance to ensure the highest quality of care and service experience for

our patients and members.


Health Care TechnologyThe Systems Theory


The Business Performance ReviewRounding for Outcomes

� Single source of the “truth”

– Centralized scorecard

– Single action plan

– Single report to meet multiple committee/oversight needs

� Paperless

� Ability to meet from diverse locations

� Rounding for outcomes

� More time for open dialogue, business discussions, and joint strategic decision making.


The Business Performance ReviewPerformance Management

� Scorecards easily updated and accessible

� Focus on both short-term and long-range outcomes

� Consistent communication and ongoing feedback

� Critical metrics tracked; trends and gaps in performance visible for course corrections

� Ongoing performance and improvement initiatives

� Strengthen the system/structure for communicating and reinforcing strategy

� Streamline method for ongoing review of performance against targets


Business Performance ReviewClinical Informatics Improves Outcomes:

A Look at the Present and the Future Possibilities

� Clinical informatics transforms the health care experience by facilitating our ability to analyze, design, implement, and evaluate information.

� Future advancements and communications systems allow enhancements to patient care and safety, and strengthen the provider-patient relationship.


Creating a Culture of Performance ExcellenceWhat are your Contributions to Quality of Care and Service Excellence

How are you managing performance?


Creating a Culture of Performance Excellence Questions?

Kaiser Permanente: Culture of Performance Excellence

Health & Medicine

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