Outcomes Based Leader Evaluations A Valuable Tool for …€¦ · 1 © 2008 Studer Group...

1 © 2008 Studer Groupwww.studergroup.com

Outcomes-Based Leader Evaluation (LEM):A Valuable Tool for the Learning Organization

Rob RyderVice President, Learning and Leadership Development

Laurie KennedyDirector, Learning and Leadership Development

Centura Health, Denver, Colorado

What’s Right in Health CareSM | Evidence to Outcomes

Presentation Objectives

• Know the difference between outcome-based leader evaluation and tactic-based leader evaluation

• Understand the difference between Leader Evaluation as a grading tool and Leader Evaluation as a learning tool.

• Appreciate the power of data derived from outcomes-based leader evaluation in determining, implementing, and monitoring effective, aligned, organization-wide strategies.



What is Centura Health?

• Centura Health is a large faith-based healthcare system in Colorado.

• Centura is the umbrella organization that provides corporate services and leadership to the CHI (Catholic Health Initiatives) and AHS (Adventist Health Systems) healthcare facilities on Colorado’s front range.

• Centura employs about 12,000 human beings• Over 800 of the employees are “leaders”


What does Centura Health do?

• Provides comprehensive healthcare services through its ten acute care facilities in Frisco, Boulder, Denver, Parker, Colorado Springs, Pueblo and Canon City

• Provides Home Care and Hospice Services in these communities

• Has an extensive network of Senior Services in these communities



Where We’re Located





Getting Started

• Had been working towards a balanced approach to system effectiveness for several years

• In spite of concentrated efforts to create positive change, our metrics were flat

• We engaged the Studer Group in 2006 because we believed that they could help give “legs” to the work we were doing

• Outcomes based leadership evaluation is a key tactic for moving the dials



Leadership Evaluation

• Tactics based– Focus is on:

• Process• Programs

• Outcomes based– Focus is on:

• Results


Results in all Pillars



Leader Evaluation ManagerSM (LEM)

• Software program that allows a systematic way to establish and monitor achievement of strategically aligned goals

• Commonly referred to as the “LEM”


Goal Sheet



90 Day Plan


Monthly Report Card



Decisions we made…

• What organizational goals will we align to?• What are the targets? i.e., How will we know

when a goal has been achieved?• Who will participate?• How will new leaders learn about the LEM?• What data will be used to populate the LEM?• What goals should be required?• How will achievement of goals be connected to

pay?


Challenges

• Compliance• Orienting new leaders to system• Selecting tactics instead of goals• No interface to our employee database• Executive Incentive plans not aligned with LEM

outcomes• Understanding that a Rating of “3” means

GOOD!• Owning overarching goals when leader only

has influence vs. direct control• Consistency



Why LEM as a Learning Tool?

• LEM is a living document not an event• LEM is objective• LEM produces data• LEM data tells a story

– About the leader and– About the organization


LEM Goal Data Base Fields

• Department• Division• Facility Type• Last Name• First name• Job Type

• Executive Type• Pillar• Goal• Goal Type• Goal Weight



Job Types

• Medical Staff Svcs

• IT• Marketing• Nursing Units• Foundation• Pt. Education• Gift Shop• Cardiology• Oncology• Facilities• Pulmonary• Physicians• Volunteers• HR• Rehab

• Clinical/nursing education.• HIM

• Billing• Imaging• Health at Home• EVS• Finance• Lab• Quality• Nut. Services• Supply chain• Pharmacy• Cancer Center• Registration• O's & VP'sInfrastructureAncillaryClinicalSupportExec/Admin


Strategic Focus

1. Physician Alignment2. CMS Bundle Scores3. Patient Satisfaction (HCAHPS)4. Associate Satisfaction5. Financial Performance

– EBITDA– Expense– Productivity– Growth



Goal Types

• Accreditation/JCAHO/Compliance• Assoc Satisfaction• CMS Bundle/ Clinical Outcomes• Community Budget• Community Board• Community Participation• Community Perception• EBITDA/Margin• Expense• Fund Raising• Interdepartmental Satisfaction

• Physician Credentials• Physician Satisfaction• Process/Process Imp./Training• Productivity/Staffing/Agency• Pt/Res/Client/Customer Satisfaction• Revenue/Collections• Safety• TAT• Turnover• Volume/Growth


The Normal Look at Organizational Effort

3658Grand Total

0.11%4Comm Board

0.19%7Comm Bgt

0.27%10Phys Credentials

0.46%17Comm Perception

0.33%12Fund Raising

0.55%20Accreditation/JCAHO/Compliance

1.56%57EBITDA/TTL Bgt/Margin

1.97%72Safety

2.08%76TAT

3.47%127Turnover

3.61%132Phys. Sat

6.23%228Comm Participation

3.72%136Revenue/Collections

5.11%187Process/PI/Training

5.52%202CMS Bundle/ Cinical Outcomes

8.17%299Productivity/Staffing/Agency

7.11%260Volume/Growth

6.59%241Interdept Sat

9.73%356Pt/Res/Client/Customer Sat

15.31%560Expense

17.91%655Assoc Sat

% of GoalsCountGoal Type Reclass



A Closer Look

3658Grand Total

12.50%0.11%4Comm Board

12.14%0.19%7Comm Bgt

21.00%0.27%10Phys Credentials

17.29%0.46%17Comm Perception

29.00%0.33%12Fund Raising

20.25%0.55%20Accreditation/JCAHO/Compliance

16.97%1.56%57EBITDA/TTL Bgt/Margin

19.28%1.97%72Safety

19.97%2.08%76TAT

13.52%3.47%127Turnover

14.34%3.61%132Phys. Sat

10.11%6.23%228Comm Participation

21.34%3.72%136Revenue/Collections

19.55%5.11%187Process/PI/Training

19.28%5.52%202CMS Bundle/ Cinical Outcomes

15.66%8.17%299Productivity/Staffing/Agency

18.99%7.11%260Volume/Growth

20.66%6.59%241Interdept Sat

18.52%9.73%356Pt/Res/Client/Customer Sat

15.67%15.31%560Expense

20.84%17.91%655Assoc Sat

AvgWght% of GoalsCountGoal Type Reclass


The Closest Look

100.00%3658Grand Total

12.50%0.08%0.11%4Comm Board

12.14%0.13%0.19%7Comm Bgt

21.00%0.32%0.27%10Phys Credentials

17.29%0.45%0.46%17Comm Perception

29.00%0.53%0.33%12Fund Raising

20.25%0.62%0.55%20Accreditation/JCAHO/Compliance

16.97%1.48%1.56%57EBITDA/TTL Bgt/Margin

19.28%2.13%1.97%72Safety

19.97%2.33%2.08%76TAT

13.52%2.63%3.47%127Turnover

14.34%2.90%3.61%132Phys. Sat

10.11%3.53%6.23%228Comm Participation

21.34%4.45%3.72%136Revenue/Collections

19.55%5.60%5.11%187Process/PI/Training

19.28%5.97%5.52%202CMS Bundle/ Cinical Outcomes

15.66%7.18%8.17%299Productivity/Staffing/Agency

18.99%7.57%7.11%260Volume/Growth

20.66%7.63%6.59%241Interdept Sat

18.52%10.10%9.73%356Pt/Res/Client/Customer Sat

15.67%13.45%15.31%560Expense

20.84%20.92%17.91%655Assoc Sat

AvgWght

% of TtlWght% of GoalsCountGoal Type Reclass



Total

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%Ac

cred

itatio

n/JC

AHO

/Com

plia

nce

Asso

c Sa

t

CM

S Bu

ndle

/ Cin

ical

Out

com

es

Com

m B

gt

Com

m B

oard

Com

m P

artic

ipat

ion

Com

m P

erce

ptio

n

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Fund

Rai

sing

Inte

rdep

t Sat

Phys

Cre

dent

ials

Phys

. Sat

Proc

ess/

PI/T

rain

ing

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Rev

enue

/Col

lect

ions

Safe

ty

TAT

Turn

over

Volu

me/

Gro

wth

Total

Facility Type (All)

Sum of Goal Wt%

Goal Type Reclass

Drop Series Fields Here

Effort Placement by Goal Type by Job Type


Executive Effort Placement by Pillar

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

Community Cost Grow th People Quality Service

CEO

CFO

CMO

CNO

COO

Facility Type (All)

Sum of Goal Wt%

Pillar

Executive Type



Executive Effort Placement by Goal Type

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%As

soc

Sat

CM

S Bu

ndle

/ Cin

ical

Out

com

es

Com

m B

gt

Com

m B

oard

Com

m P

artic

ipat

ion

Com

m P

erce

ptio

n

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Inte

rdep

t Sat

Phys

Cre

dent

ials

Phys

. Sat

Proc

ess/

PI/T

rain

ing

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Rev

enue

/Col

lect

ions

Safe

ty

Turn

over

Volu

me/

Gro

wth

CEO

CFO

CMO

CNO

COO

Facility Type (All)

Sum of Goal Wt%

Goal Type Reclass

Executive Type


0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

Asso

c Sa

t

CM

S Bu

ndle

/ Cin

ical

Out

com

es

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Phys

. Sat

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Volu

me/

Gro

wth

CEO

CFO

CMO

CNO

COO

Facility Type (All)

Sum of Goal Wt%

Goal Type Reclass

Executive Type

Executive Effort Placement by Strategic Emphasis



Exec/Admin

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

Asso

c Sa

t

CM

S Bu

ndle

/ Cin

ical

Out

com

es

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Phys

. Sat

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Exec/Admin

Facility Type (All) DIV (All)

Sum of Goal Wt%

Goal Type Reclass

Job Type

Combined Executive Effort by Strategic Emphasis


Job Types

• Medical Staff Svcs

• IT• Marketing• Nursing Units• Foundation• Pt. Education• Gift Shop• Cardiology• Oncology• Facilities• Pulmonary• Physicians• Volunteers• HR• Rehab

• Clinical/nursing education.• HIM

• Billing• Imaging• Health at Home• EVS• Finance• Lab• Quality• Nut. Services• Supply chain• Pharmacy• Cancer Center• Registration• O's & VP'sInfrastructureAncillaryClinicalSupportExec/Admin



Effort Placement by Pillar by Job Type

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

Community Cost Grow th People Quality Service

Ancillary

Clinical

Exec/Admin

Infrastructure

Support

Facility Type (All)

Sum of Goal Wt%

Pillar

Job Type



0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

Accr

edita

tion/

JCAH

O/C

ompl

ianc

e

Asso

c Sa

t

CM

S Bu

ndle

/ Cin

ical

Out

com

es

Com

m B

gt

Com

m B

oard

Com

m P

artic

ipat

ion

Com

m P

erce

ptio

n

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Fund

Rai

sing

Inte

rdep

t Sat

Phys

Cre

dent

ials

Phys

. Sat

Proc

ess/

PI/T

rain

ing

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Rev

enue

/Col

lect

ions

Safe

ty

TAT

Turn

over

Volu

me/

Gro

wth

Ancillary

Clinical

Exec/Admin

Infrastructure

Support

DIV (All)

Sum of Goal Wt%

Goal Type Reclass

Job Type



0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

Asso

c Sa

t

CM

S Bu

ndle

/ Cin

ical

Out

com

es

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Phys

. Sat

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Volu

me/

Gro

wth

Ancillary

Clinical

Exec/Admin

Infrastructure

Support

Facility Type (All)

Sum of Goal Wt%

Goal Type Reclass

Job Type

Effort Placement by Strategic Emphasis by Job Type


Total

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

Asso

c Sa

t

CM

S Bu

ndle

/ Cin

ical

Out

com

es

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Phys

. Sat

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Volu

me/

Gro

wth

Total

Facility Type (All)

Sum of Goal Wt%

Goal Type Reclass


Combined Effort by Strategic Emphasis (All Job Types)



Total

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%Ac

cred

itatio

n/JC

AHO

/Com

plia

nce

Asso

c Sa

t

CM

S Bu

ndle

/ Cin

ical

Out

com

es

Com

m B

gt

Com

m B

oard

Com

m P

artic

ipat

ion

Com

m P

erce

ptio

n

EBIT

DA/

TTL

Bgt/M

argi

n

Expe

nse

Fund

Rai

sing

Inte

rdep

t Sat

Phys

Cre

dent

ials

Phys

. Sat

Proc

ess/

PI/T

rain

ing

Prod

uctiv

ity/S

taffi

ng/A

genc

y

Pt/R

es/C

lient

/Cus

tom

er S

at

Rev

enue

/Col

lect

ions

Safe

ty

TAT

Turn

over

Volu

me/

Gro

wth

Total

Facility Type (All)

Sum of Goal Wt%

Goal Type Reclass




Conclusions

• Effort tends to be focused on what we control, not what we can influence

• Number of leaders choosing a given goal is not an indication of the effort that will be expended towards attaining that goal

• Goal alignment among executives cannot be assumed



Try not. Do, or do not. There is no 'try.'


The “Learning Organization” . . .How well do we know ourselves?

• Are individual intentions aligned with organizational intentions?

• Is our effort aligned towards the same outcomes?

• It’s not how well we are doing, it’s how well we’re doing on the right stuff!



0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

July-Sept01

Sept-Nov01

Dec01 -Feb02

Mar02 -May02

June-Aug02

Sept- Nov

02

Dec02 -Feb03

Mar03 -May03

June- Aug

03

Sept- Nov

03

Dec03 -Feb04

Mar -May04

June- Aug

04

Sept- Nov

04

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

July-Sept01

Sept-Nov01

Dec01 -Feb02

Mar02 -May02

June-Aug02

Sept -Nov02

Dec02 -Feb03

Mar03 -May03

June -Aug03

Sept -Nov03

Dec03 -Feb04

Mar -May04

June -Aug04

Sept -Nov04

LEARNING . . . .

is what fills the space between where you are . . . .

. . . . . and where you want to be!

The Right People!The Right Effort!On the Right Stuff!


Lessons Learned

• Educate the Board: align goals and incentives• Targets must be meaningful and achievable• Goal setting process must start at top and

cascade down to ensure alignment and focus• Data must be accessible and consistent• Use more pre-populated goal templates • Be clear about philosophy when designing• Reporting outcomes in multiple ways reduces

compliance• A LEM or “LEM-like” tool provides a powerful

and necessary infrastructure for achieving goals



Next Steps

• Educate Board• Establish meaningful targets• “Connect the Dots” Education on how each

employee group can influence strategic targets• Build more pre-populated templates• Start goal selection process with Corporate

CEO and cascade down• Audit to ensure weights reflect strategic

direction• Automate data mining• Use LEM as primary dashboard for monitoring • Tie incentives to LEM


ANY QUESTIONS?


Thank You! Rob Ryder

[email protected](303) 804-8169

Laurie Kennedy, [email protected]

(303) 804-8169

Outcomes Based Leader Evaluations A Valuable Tool for …€¦ · 1 © 2008 Studer Group...

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Transcript of Outcomes Based Leader Evaluations A Valuable Tool for …€¦ · 1 © 2008 Studer Group...