Employee Engagement is easy to achieve if you think about it differently

The most important thing to remember about employee engagement is that it is an emotion that drives employees to want to achieve more for the organization where they work. Now a lot of business leaders don’t like dealing with employee emotions and that is what makes it difficult. Wall street and corporate America knows that they must capture the hearts of their customers to achieve repeat business. Do you remember the Coke commercial with a diverse group singing in harmony? Do you remember the various Nike commercials with sports success as an emotional theme? Yet such campaigns to capture the hearts and minds of our employees is viewed as being a frivolous business strategy.

Quint Studer was making a key statement about employee emotions when he refers to the concept of “connecting to purpose”. Without a connection to purpose it is just work and there is no emotion to drive employees to achieve excellence for the patient, the customer and the organization.

There are three key factors to improving employee engagement. Communication, leader accountability for results and creating a culture of employee participation in making the organization the best it can be.

Communication is one of the keys to getting improved employee engagement. Everyone wants to be a part of something bigger than themselves. The fans of great sports teams always “brag” about how “we” beat this team or that team. At work, does your team talk about how much better they are than the competition? Or do they talk about how bad things are where they work. Great teams have lots of pride about what they do, how they are the best and how they do so much better than the other guys. Just like great sports teams, employees need to feel like they work for a great organization and they contribute to the outcomes of greatness. In order for employees to feel they are part of this greatness, the organization must be communicated how great “we are” and how “the employees make this happen”.

Too many leaders talk about how bad things are, and how hard it is to make budget, how many mistakes we make, etc.. Generally, there is too little talk about the accomplishments, the high performance of our staff, their caring attitude and how we cannot survive without these great people. We must communicate to our staff how great they are and build their self-image. One thing I have learned through over 30 years of HR Experience: Employees who feel worthwhile will always outperform those who feel unworthy. If you don’t think your team is great, get rid of them and get a great team (I have never been an advocate of keeping low performers). But, keep in mind, great organizations need great leaders, and great leaders are able to grow and support great teams. Teams that have great leaders will bring great results.

Leader accountability: Leaders must be held accountable for their department, unit, division, result that they have oversight for… In other words, RESULTS for financials, quality, growth, customer service and EMPLOYEE ENGAGEMENT. They must be held accountable for result for their area of responsibility. If the various pieces of the house: walls, foundation, floors, doors, etc. are not well constructed how can we expect to have a great home? Every department must focus on engagement for their team.

Employee participation. Have you heard the statement “people support the decisions they helped to make”? I think most people would agree that organizations that empower staff to make improvements to their jobs get better organizational results. Many performance improvement programs such as Lean, are built on the concept that employee participation is key to achieving lower cost, higher quality and better outcomes, and yes greater employee engagement… Why? Because I am proud of my contributions that create better outcomes for myself, my team and the organization.

“Imagine the personal and organizational cost of failing to fully engage the passion, talent and intelligence of the workforce. It is far greater than all taxes, interest charges, and labor costs put together.” STEPHEN R. COVEY

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Where to Next? The Fastest Route to Career Advancement

Are you looking to be promoted?

If getting a promotion is important to you, then it is time to sit down and ask yourself what you can be doing to actively advance your career. Here are some suggestions.

Regain Career Momentum

Define what success looks like to you. Once you have established the main target, break it down into smaller achievable steps and goals. Implement a workable system that will increase your technical and emotional skillsets needed to move from one step to the next.

Manage Up

Managing up means that you go above and beyond the tasks outlined in your job description. You continuously go the extra mile. Your job is to make your immediate manager’s life easier. Learning to effectively "manage up" can put you in a great position to align with your immediate supervisor, integrate effectively with the organizational culture, receive great recommendations, and ultimately help you on board effectively.

Help your stakeholders recognize your ability to build and lead a high-performing team that goes above and beyond the call of duty. Leading well on a small scale shows initiative and ability. Report team successes to your direct supervisor, giving credit to both the team and team members. As their leader, their success is your success. Consistent progress in leading a high-performing team will show that you are able to graduate to more responsibility.

Build Your Network

Networking/connecting is essential to your success both while gainfully employed and in transition. Networking with a purpose is a vital component of anybody's career success but is often terribly neglected.

Ask Questions / Survey Your Surroundings

•Have I asked my immediate superior what it takes to get to the next position?

•How has this organization historically handled promotions?

•Do they generally promote from within or seek externally?

•What is the general time-frame for people to get promoted within the organization?

•Is the person you report to going anywhere?

•Does the person you report to have a history of mentoring his/her direct reports?

By defining your goals, developing a strategy, and become intentional about executing your plan, you can increase your chances of advancement immeasurably.

Here's to your success!

Jim

Connect with us on LinkedIn and join our Active Network Program.

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The Man in the Mirror

A courageous person takes an honest look at who they are. A powerful person acknowledges their weaknesses and strengths then understands how to use them both successfully.

Leadership involves building and maintaining a high-performing team. Anything that detracts from your ability to build a team also detracts from your performance as a leader. Behavior impacts performance.

Personality assessments are designed to measure traits/behaviors that are part of an individual’s make up. Organizations attempt to utilize these to assess both fit and performance in certain positions but the real value is that an individual can get real insight into their strengths, potential areas of opportunity, and motivators.

It is good to be able to understand, articulate and utilize your strengths. Think of these as the gas pedal in a car. When utilized properly, they will move your leadership forward. However, it is also important to understand when you’re putting your foot on the brake and negatively impacting your leadership journey. An effective assessment can help you understand what is propelling your journey and what is holding you back.

What Inhibits Your Success?

To help you understand your strengths and motivators as well as identify your risk factors, Wiederhold & Associates offers The Hogan Leadership Forecast Series. Through the series, you will receive a report designed to help you develop as a leader.

It will provide insights about your behavior and traits that showcase strengths as well as behaviors and traits that could potentially undermine or inhibit your performance. And if you’re committed to being the best leader you can be, we will help you determine the best way to enhance your awareness and make impactful change.

If you’re in transition, a seasoned executive looking to take your performance to the next level or a leader who is ready to get off the hamster wheel, the HOGAN LEADERSHIP FORECAST SERIES may be your next step to finding true success.

Learn more about Wiederhold & Associates

HOGAN LEADERSHIP FORECAST SERIES

Here's to your success,

Jim

Connect with us on LinkedIn and join our Active Network Program.

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Performance Excellence-Physician Enterprise

Introductory Comments:

The healthcare industry is at a crossroads. Consumerism, regulatory requirements, payer requirements, employer demands and other factors are driving forces for change in service delivery. Now is the time to get it right. We need to reduce cost, control utilization, streamline delivery of care, deliver care in a manner that exceeds patient expectations at all times, manage the health status of the communities we serve and demonstrate continuous improvement in achieving best in class clinical outcomes.

The industry, as a whole, needs to focus on the “Triple Aim” (low cost, service oriented and high quality). In doing so, we cannot neglect that we can only navigate the course to achieving value based results with a high performing team of leadership representatives, management representatives, physicians, other clinical providers and staff, thus achieving the “Quadruple Aim.”

We must engage and empower our clinical and non-clinical workforce to maintain professional satisfaction and reduce the risk of burn-out from expecting more without addressing resource requirements. It is not easy, but it can be framed in a simplified philosophy of Performance Excellence. Performance Excellence (Operations, Service and Clinical) is the gold standard by which healthcare teams will be measured.

“Every job is a self-portrait of the person who did it. Autograph your work with EXCELLENCE.”
- Jessica Guidobono

Is your physician enterprise designed to allow every member of your organization to autograph their work with excellence?

Workforce (physicians, advanced practice providers, clinical and non-clinical staff) engagement at all levels of your organization is essential to move forward in today’s ever-evolving healthcare market. A Performance Excellence Philosophy provides the systematic methodology to engage your workforce in achieving results.

The Baldrige Excellence Framework (Healthcare): As Systems Approach to Improving Your Organization’s Performance empowers your organization to reach its goals, improve results, and become more competitive. The framework consists of the criteria, the core values and concepts, and scoring guidelines to use as reference, to self-assess, or as a basis for external assessment. Whether or not your organization is “award and recognition oriented,” today’s ever-evolving healthcare environment creates to perfect opportunity to take a step back and assess your ability to achieve value based results.

Through active inquiry regarding your organization’s culture, you learn and develop your ability to accomplish what is important to your organization. A community/customer/patient centered philosophy, along with the critical aspects of: Leadership/Governance; Vision/Strategy; Measurement, Analysis, and Knowledge Management (through data analytics); and Operational Work Processes and Process Management, allows you to evaluate how prepared you are to achieve VALUE BASED RESULTS.

Through internal ASSESSMENT you may find that your organization needs external resources to develop the necessary structure and infrastructure to achieve your VISION. Experienced leadership with a demonstrated track record of achieving results within physician enterprise organizations may be difficult to find. You may need Interim Leadership and Management Advisory Services with the Resilience to do the “initial heavy lifting” of positioning your enterprise for high performance.

Today we explore ways to assess your systematic approach for delivering value in your communities.

Assess Your Physician Enterprise through a Systematic Approach

Vision:

You need a systematic approach to assessing your physician enterprise ability to achieve results. You need a framework to deliver value. The challenge is to critically assess to learn how you are accomplishing your vision and strategic priorities. Today we pose several key questions to begin to assess your organization’s readiness to achieve value based results.

Has your organization set a strategic priority for achieving value based results in your physician enterprise?

How has your organization set a strategic priority for achieving value based results? “Value Based Care is Here to Stay”:

Vision and Strategy-Questions to consider:

Is it important to your organization?
Have you established a shared Vision of physician integration to achieve value based results?
Is your organization prepared to create greater value in the communities you serve?
Does your organization have the leadership with the demonstrated competency of RESLIENCE to navigate the path to value?
Do you need Interim Leadership or experienced external advisors to assess and develop your physician enterprise ability to deliver value based results

Please see Assessing Your Vision and Strategies, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

It all begins with LEADERSHIP:

Leadership must promote a systems perspective. A systems perspective means managing all the components of your organization as a whole to achieve ongoing success. A healthcare system has many inter-related, but not always highly integrated, components. Each component must be led and managed to function as a high performing organization within the context of the entire system. Most importantly, your physician enterprise (whether an employed network or Clinically Integrated Network) must demonstrate a successful track record of achieving results.

Assess your leadership and management structure to achieve results:

“Achieve Results-Leadership and Management”

Question to Consider-Leadership:

Do senior leaders lead the organization, consistent with your systematic approach?

Please see Assessing Your Leadership/Management, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Governance:

How does your governance structure oversee your physician enterprise and address your organizational ability to achieve value based results?

Assess your governance structure to achieve results: "Governance”

Governance - Questions to Consider:

How does your organization ensure responsible governance of the physician enterprise?

How does your governing achieve accountability for:

  • senior leaders’ actions
  • strategic plans
  • fiscal accountability
  • transparency in operations
  • selection of governance board members and disclosure policies for them, as appropriate
  • independence and effectiveness of internal and external audits
  • protection of stakeholder and stockholder interests, as appropriate
  • succession planning for organizational leadership

Please see Assessing Your Governance, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Knowledge Management/Transfer through Data Analytics:

How do you measure, analyze, and then improve organizational performance?

Assess your Performance Measures to achieve results: "Knowledge Management/Transfer through Data Analytics”

Questions to Consider - Performance Measures:

How do you track data and information on daily operations and overall organizational performance?

How do you select, collect, align, and integrate data and information to use in tracking daily operations and overall organizational performance; and track progress on achieving strategic objectives and action plans?

Please see Assessing Your Knowledge Management/Transfer through Data Analytics, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Operations Management/Process Management:

How do you design, manage and improve your key health care services and work processes?

Assess your Work Processes/Process Management Methodology to achieve results: “Process Management-Achieve Value Based Results”

Questions to Consider-Work Processes/Process Management:

How do you design, manage, and improve your key health care services and work processes?

How do you determine key health care service and work process requirements?

Please see Operations Management/Process Management, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Results:

A Performance Excellence Philosophy provides the systematic methodology to achieve results. Your organization will achieve value based results with unrelenting commitment from key stakeholders at every level.

You need a simplified approach to creating a culture of Performance Excellence to achieve results:

Question to Consider-Results

What are your health care and process effectiveness results?

What are your health care results and your results for your patient and other customer service processes?

Is your entire workforce engaged in achieving value based results?

Please see Assessing Your Results, to begin your assessment:

Key Take Aways and Next Steps:

  • Assess and adopt a Vision of Value Based Care in your Physician Enterprise
  • Implement a Culture of Performance Excellence
  • Assess your Leadership/Management
  • Assess your Governance
  • Assess your Knowledge Management/Transfer (Data Analytics)
  • Assess your Operations/Process Management
  • Assess your Results
  • You may need external resources to assist in assessment and development
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Hire Employees with Longevity

Studies show that an average of 50% of newly hired executives not appropriately onboarded, either quit or were fired within their first three years.

A successful onboarding program accelerates the executive’s breakeven point on the investment the organization has made in talent acquisition and retention, as well as, aligns behavioral changes with organizational outcomes and goals. Results are just as important as the process.

Wiederhold & Associates Executive Onboarding Program

Wiederhold & Associates is perfectly positioned to be your partner in ensuring that your investment in new executives continues to reap long-term rewards, rather than ending up with the above-mentioned results. The Wiederhold & Associates team with 26 years of transition expertise in healthcare, focuses on tangible results in addition to ensuring a smooth transition.

Key Program Strategies Include:

  • Defining roles and responsibilities
  • Clarifying strategic results and creating new ones
  • Managing expectations
  • Building relationships and coalitions
  • Managing intellectual and emotional reactions
  • Maintaining balance
  • Aligning and strengthening the leadership team
  • Completing in-process assessments

Specific Areas of Focus Are:

  • Executive’s personality and behaviors
  • Alignment of goals/outcomes
  • Building stakeholder lists
  • Focusing on early wins
  • Navigating organizational politics
  • Learning organization’s culture
  • Maintaining visibility
  • Time management
  • Balancing relationships/results
  • Enhancing executive’s knowledge of the organization’s market
  • Understanding organizational history
  • Assessing skills and behaviors
  • Building confidence
  • Developing executive’s team dynamics
  • Enhancing communication
  • Creating a business journal
  • Establishing a brand
  • Empowering the executive’s voice within the organization
  • Managing change
  • Maintaining balance

To learn more about Wiederhold & Associates Onboarding Program, download a tri-fold brochure here.

Connect with us on LinkedIn and join our Active Network Program.

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Happy Labor Day

We wish you and your loved ones a safe and fun holiday weekend
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Performance Excellence Simplified: Achieve Value Based Results

High performing leaders in healthcare organizations of today are challenged with the uncertainty of healthcare delivery in the future. Many hospitals face a challenge among key stakeholders. That challenge is a brand/reputation shift toward value based care. Mission, Vision and Values typically reflect claims of high quality and customer service, but key stakeholders (physicians, patients, families, employers, payers and regulatory bodies) are not buying the slogans of the past. In today's world, healthcare providers must demonstrate that they are living up to the value based equation (low cost, seamless, patient-centric, high quality care). Stakeholder demand and regulatory requirements drive organizations to demonstrate measurable results in cost, service and quality.

Creating a performance excellence environment is a highly successful leadership approach to navigate the ever-evolving imperatives of service delivery. Value based results will be achieved through a leadership philosophy of performance excellence:


Engage your people: Develop Governance, Leadership and Management structures to engage your key players, especially physicians and other clinical thought leaders to lead the effort. Create a shared Vision of Achieving Value Based Results. Now it’s time to execute your shared Vision.


Evaluate your data; identify best practice: Engage all key players in identifying essential metrics to understand your current performance and identify opportunities for improvement in Operational/Financial, Service and Clinical performance.


Know your process and design your process (es): Utilize advanced process management methodologies to identify current processes that yield current results. Establish consistency in your process improvement methodology. Identify best practices. Design your processes to achieve results.

Hardwire/Standardize best practice, process design to ACHIEVE

Sustainable results will be achieved from your Action, if you are focused on Continuous Operating and Quality Improvement. Remember you may FAIL (“First Attempt In Learning”). Establish your culture of Performance Excellence. Start small, simplify, be resilient, be persistent and be unrelenting in your approach to achieving results. Be prepared to embrace “Polarity Thinking.” Every good conversation begins with good listening. Listen to your key stakeholders. Listen to understand, not to respond. Physician integration and value based strategies inherently present divergent opinions. Learn the power of leveraging Inquiry AND Advocacy: two critical leadership competencies. That’s how leaders achieve results.

Value Based Metrics:

The list of potential measures is endless. Identify what is important to your key players. Start with metrics that present and build a common understanding of current performance. Measure, monitor, report, analyse and improve your key metrics, focused on value: Operational/Financial Excellence, Service Excellence, and Clinical Excellence. A comprehensive list of potential metrics is available at: Mike Jones LinkedIn or This email address is being protected from spambots. You need JavaScript enabled to view it.

Key Takeaways:

  • You have highly engaged employees, physicians, patients, family members, community representatives, employers and payers.
  • You have defined a common and shared vision for your organization through gaining knowledge of your key stakeholders’ perspectives
  • You have defined what outcomes you and your organization are trying to achieve in terms of Operations, Finance, Service and Clinical indicators
  • You have measured your current performance
  • Now you want to improve performance:
  • Everything is a process

    Gain an understanding of your current processes

    Identify your best practices

    Design process to achieve best practice performance

    Re-evaluate your performance to see if you are consistently achieving improved performance

    Modify your processes when necessary to consistently achieve higher levels of performance

    Hard-wire your processes to ALWAYS achieve best practice performance

    Never stop monitoring to verify your preferred state performance/outcomes.

    Never stop monitoring to verify your preferred state performance/outcomes.

    Train for it (all Key Players)

    Build consistency of approach

  • Define your performance excellence culture
  • Focus your leadership on the relentless pursuit of performance excellence
  • Adopt your preferred methodology
  • Formalize and standardize your methodology
  • Listen to your key stakeholders
  • Engage all parties in understanding improvement initiatives
  • Gain understanding of performance through data analytics
  • Design processes to achieve desired results
  • Be prepared to Fail, but failing is your F (first), A (attempts), I (in), L (Learning).
  • Achieve success in all you do
  • Demonstrate that you are creating value based outcomes

Next Steps:

  • View Additional Reference Information:
    • In “Be an Inspirational Leader”, author Dan Nielsen portrays the incredible impact of inspirational leadership on your personal, professional, and organizational success. Read Dan Nielsen’s book: “Be An Inspirational Leader: Engage, Inspire, Empower”
    • Management of healthcare providers’ reputation and brand dramatically changes with consumer demand for value. An organization’s reputation is subject to more than marketing campaigns. Social media and ratings services have significant impact on consumer perception of healthcare organizations. If you do not have on-going audits of your on-line presences and ratings, it is wise to complete and assessment and take corrective action, as necessary. To learn more about Reputation and Brand Management view the work of Claire Faucett with engage5w.
    • Learn more about “Polarity Thinking” and the two essential leadership competencies of Inquiry and Advocacy. View the work of leadership coaches James McKenna and Cliff Kayser, sponsored by Wiederhold & Associates.
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Bad Bosses and Good Leaders

We are facing a critical era of transformation in healthcare. As organizations strategize to find stability through turbulent times, managers, directors, and executives will feel added pressure to achieve continuous, dynamic results.

The success of each department will depend on a single crucial factor: Is there a "boss" or a "leader" in place?

A "boss" refers to an individual who is in charge of the employee or an organization. He exercises control over employees, orders, assigns tasks and duties to them and is entitled to take decisions on some matters. Bad bosses will motivate through fear tactics, defer blame to others, take credit for other's successes and bully members into producing results.

The term "leader" is defined as an individual who possesses the ability to influence and inspire others towards the accomplishment of goals. Communication coupled with integrity compel people to follow. Great leaders think about what their body language, facial expressions, and tone of voice communicate to their staff. They often take the time to say things face-to-face rather than through email in order to build trust, develop relationships, manage conflict, and encourage employees. Leaders pull the best out of each member and inspire group success.

It is important to note that the teams which produce the most effective and long-lasting results are the ones that are directed by leaders, not bosses.

"If your actions inspire others to dream more, learn more, do more and become more, you are a leader." - John Quincy Adams

Transform Bosses into Leaders

Where bosses fail, leaders prevail. If you've noticed that you have more bosses than leaders in your organization- all is not lost. Aspiring and current managers, directors or executives can begin improving their ability to lead. Wiederhold and associates offer specialized assessments as well as a number of training programs designed to develop quality leaders that are custom fit to your organization. If you are interested in learning more, just let me know.

Here's to your success,

Jim

Connect with us on LinkedIn and join our Active Network Program.

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Process Management: Achieve Value-Based Results

“If you can’t describe what you are doing as a process, you don’t know what you are doing.” Such a profound quote by W. Edwards Deming, largely recognized as the Father of the Quality Movement. Dr. Deming's famous 14 Points, originally presented in Out of the Crisis, serve as management guidelines. The points cultivate a fertile soil in which a more efficient workplace, higher profits, and increased productivity may grow. These management principles have a direct correlation to navigating the path to achieving results in the uncertain healthcare industry of today.

Deming’s 14 Points for Leadership/Management

While traditionally applied to product manufacturing, Deming theory has direct application across multiple industries, especially when rising consumer and regulatory requirements demand greater value. View healthcare service delivery as a product in high demand from consumers (patients, families and others). Expectations of lower cost and superb quality, delivered in a highly patient-centric and service-oriented environment, create an imperative healthcare systems must meet to remain relevant.

    Healthcare leaders are served well when focusing on Deming’s 14 Points:
  1. Create constancy of purpose toward improvement of product and service, with the aim to become competitive, to stay in business and to provide jobs.
  2. Adopt the new philosophy. We are in a new economic age. Western management must awaken to the challenge, must learn their responsibilities, and take on leadership for change.
  3. Cease dependence on inspection to achieve quality. Eliminate the need for massive inspection by building quality into the product in the first place.
  4. End the practice of awarding business on the basis of a price tag. Instead, minimize total cost. Move towards a single supplier for any one item, on a long-term relationship of loyalty and trust.
  5. Improve constantly and forever the system of production and service, to improve quality and productivity, and thus constantly decrease costs.
  6. Institute training on the job.
  7. Institute leadership (see Point 12 and Ch. 8 of Out of the Crisis). The aim of supervision should be to help people and machines and gadgets do a better job. Supervision of management is in need of overhaul, as well as supervision of production workers
  8. Drive out fear, so that everyone may work effectively for the company. (See Ch. 3 of Out of the Crisis).
  9. Break down barriers between departments. People in research, design, sales, and production must work as a team in order to foresee problems of production and usage that may be encountered with the product or service.
  10. Eliminate slogans, exhortations, and targets for the work force asking for zero defects and new levels of productivity. Such exhortations only create adversarial relationships, as the bulk of the causes of low quality and low productivity belong to the system and thus lie beyond the power of the work force.
    1. Eliminate work standards (quotas) on the factory floor. Substitute with leadership.
    2. Eliminate management by objective. Eliminate management by numbers and numerical goals. Instead substitute with leadership.
  11. Remove barriers that rob the hourly worker of his right to pride of workmanship. The responsibility of supervisors must be changed from sheer numbers to quality.
  12. Remove barriers that rob people in management and in engineering of their right to pride of workmanship. This means, inter alia, abolishment of the annual or merit rating and of management by objectives (See Ch. 3 of Out of the Crisis).
  13. Institute a vigorous program of education and self-improvement.
  14. Put everybody in the company to work to accomplish the transformation. The transformation is everybody's job.

The focus of this article is to bring home the reality that EVERYTHING IS A PROCESS. “If you cannot describe what you are doing as process, you do not know what you are doing.”

Physician alignment, integration and engagement in integrated delivery systems are essential elements in navigating the complexity of healthcare service delivery. Healthcare organizations need a simplified approach to realize organizational vision of comprehensive and successful alignment and integration strategies. Creating a common Vision is essential. Healthcare organizations that focus on a vision of “maximizing success in the ever-evolving healthcare industry through physician alignment and integration” will ultimately build capability to meet and exceed consumer expectations in navigating the path to value-based care. Today’s ever-evolving healthcare industry requires a comprehensive Vision of Integration. Execution of the Vision is best achieved through a Leadership Philosophy of Performance Excellence.

The first key element in fostering a culture of performance excellence is to define the “WHAT” that constitutes excellence, frequently referred to as “the Triple Aim” of healthcare:

  • Operating/Financial Excellence (low cost, highly efficient and cost effective service delivery),
  • Service Excellence (service delivery exceeding patient and family expectations), and
  • Clinical Excellence (best clinical outcomes for every patient and patient population).

The next essential element of a performance excellence culture is to define the “HOW” the organization will be led through:

  • Stakeholder Engagement
  • Knowledge Management/Knowledge Transfer
  • Process Management

Organizations will not only achieve the “triple aim”, but will enhance performance through achieving the “quadruple aim” of healthcare. In addition to achieving traditional value-based results, a culture of performance excellence will yield higher levels of provider satisfaction and engagement while redefining service delivery. As highlighted in previous articles:

  • Value Based Care is here to stay and healthcare organizations must overcome multiple organizational gaps that may contribute to not fully realizing a vision of success in a high performing integrated delivery system. Here
  • Key Stakeholder Engagement is essential to execution of a common Vision:
    • Physician Stakeholders (as well as others) should be engaged in organizational Governance, especially among healthcare providers, is essential to success in a value based environment. Here.
    • Physician Stakeholders should also be engaged in Leadership and Management to achieve sustainable results. Here.
    • Knowledge Management/Knowledge Transfer
      • A common understanding of performance is best achieved through measuring, monitoring, reporting and analysis of key outcomes: Operational, Service and Clinical Metrics (Data Analytics) Here.
      • Opportunities for performance improvement are quickly identifiable when using data analytics in evaluating current outcomes.Here.

This article expands on development of a Philosophy of Performance Excellence to achieve a vision of success through Performance Management. Measuring, monitoring, reporting, analyzing and improving performance begins with defining key metrics to create a common understanding. Internal and external benchmark measures are available through a variety of sources to build an improved understanding of: Operational/Financial, Service, and Clinical Performance. Now you need a methodology to achieve your desired outcomes.

Physicians and other care providers work within a defined process everyday of their lives when addressing and resolving patient needs for care. What is done when presented with multiple patients with complex healthcare needs? SOAP is a traditional approach to addressing patient needs:

The SOAP note (an acronym for subjective, objective, assessment, and plan) is a method of documentation employed by health care providers to write out notes in a patient's chart, along with other common formats, such as the admission note. Documenting patient encounters in the medical record is an integral part of practice workflow starting with patient appointment scheduling, to writing out notes, to medical billing. The SOAP note originated from the Problem Oriented Medical Record (POMR), developed by Lawrence Weed, MD.[1] It was initially developed for physicians, who at the time, were the only health care providers allowed to write in a medical record. Today, it is widely adopted as a communication tool between inter-disciplinary healthcare providers as a way to document a patient’s progress. SOAP notes are now commonly found in electronic medical records (EMR) and are used by providers of various backgrounds. Prehospital care providers such as EMTs may use the same format to communicate patient information to emergency department clinicians. Physicians, physician assistants, nurse practitioners, pharmacists, podiatrists, chiropractors, acupuncturists, occupational therapists, physical therapists, school psychologists, speech-language pathologists, certified athletic trainers (ATC), sports therapists, occupational therapists, among other providers use this format for the patient's initial visit and to monitor progress during follow-up care.

It is a well-defined thought process. Complete a SUBJECTIVE EVALUATION, an OBJECTIVE EVALUATION, an ASSESSMENT and a PLAN. Engage patients and family members when seeking to understand what is happening with a patient (Subjective). Gather facts/data regarding what is happening with a patient through diagnostic procedures (Objective). Review the information gathered and knowledge gained from the evaluations (Assessment) and take action to address what has been presented (Plan). Why not apply a similar process that is highly effective to leadership and management. That is a process management/performance management approach.

Performance Management

The days of simply making claims of high-quality, service-oriented and low cost care delivery are gone. Patients, families, communities, payers, regulatory agencies and other key stakeholders demand proof of performance. Measures of performance should focus on Operations/Financial, Service and Clinical Excellence. Internal and external benchmarking of performance is imperative. Once you understand current performance through data analytics, you need tools to achieve continuous improvement.

There are many theories of performance/process management. Theories and practices have evolved over time. Many are inter-related and draw on common practices. Process Management philosophies include, but are not limited to:

  • Total Quality Management (TQM):
    • Focus on the Consumer
    • Continuous Improvement
    • Quality Improvement
    • Accurate Evaluation
  • Continuous Quality Improvement (CQI):
    • Analyse
    • Refine
    • Improve
  • Plan Do Study Act (PDSA): Model for Improvement: What are we trying to accomplish? How will we know that a change in an improvement? What change can we make that will result in improvement?
    • Plan: Objective, Questions and Predictions, Plan to carry out the cycle (who, what, where, when)
    • Do: Carry out the plan. Document problems and unexpected observations. Begin data analysis.
    • Study: Complete the data analytics. Compare data to predictions. Summarize what you have learned.
    • Act: What changes are to be made? Begin the next cycle.
  • Lean Management:
    • Leadership Commitment to Project (s)
    • Project Charter (Standardized for ease of understanding).
    • Project Tracking (verify milestones)
    • Assign Project Manager
    • Engage Key Stakeholders
    • Communicate Frequently
    • Achieve Results
  • Lean:
    • Waste Reduction
    • Continuous Improvement
    • Respect for People
  • Six Sigma-DMAIC:
    • Define: Define project purpose and scope. Identify high level processes for improvement. Determine customer needs and benefits.
    • Measure: Baseline data on current processes. Pinpoint problem locations and occurrences. Identify potential areas for improvement.
    • Analyse: Identify root causes and validate root causes against captured data. Determine improvements that need to be made.
    • Improve: Implement the improvements that have been determined to address the root causes.
    • Control: Perform before and after analysis. Monitor processes/systems. Document results. Determine next steps/recommendations.
  • Lean/Six Sigma:
    • Lean: focuses on waste reduction by streamlining process
    • Six Sigma: focuses on preventing defects through problem solving
    • Lean/Six Sigma: Lean strengthens Six Sigma-Problem solving plus improving process delivers greater value-based results

The common thread in all methodologies is an unrelenting focus on seeking improved outcomes in everything we do:

  • Cycles of improvement
    • Engaging in a customer focus
    • Understanding key stakeholder perspective
    • Measuring current performance through data analytics
    • Engaging those closest to the work:
      • to define current processes (value stream mapping, flowcharting)
      • to define desired outcomes of current processes
      • to define undesirable outcomes (failures) of current process
      • identify and define best practices
      • identify and define outcomes
      • identify and define preferred processes to achieve best practice performance and outcomes
      • transfer best practices, best practice outcomes and preferred processes to:
        • gain consistency across all players
        • reduce variation in outcomes and results across all players
        • meet and exceed customer expectations at all times
        • reduce cost of service delivery
        • increase throughput in service delivery
        • provide consistent, high-quality outcomes

Performance Management Simplified

High performing leaders in healthcare organizations of today are challenged with the uncertainty of healthcare delivery in the future. Creating a performance excellence environment is the best to navigate the ever-evolving imperatives of service delivery. Value based results will be achieved through a leadership philosophy of performance excellence:


Engage your People


Evaluate your data; identify best practice


Know your process and design your process

Hardwire/Standardize best practice, process design to ACHIEVE

Key Take Aways:

  • You have highly engaged employees, physicians, patients, family members, community representatives and payers.
  • You have defined a common and shared vision for your organization through gaining knowledge of your key stakeholders’ perspectives
  • You have defined what outcomes you and your organization are trying to achieve in terms of Operations, Finance, Service and Clinical indicators
  • You have measured your current performance
  • Now you want to improve performance:
    • Everything is a process
    • Gain an understanding of your current processes
    • Identify your best practices
    • Design process to achieve best practice performance
    • Re-evaluate your performance to see if you are consistently achieving improved performance
    • Modify your processes when necessary to consistently achieve higher levels of performance
    • Hard-wire your processes to ALWAYS achieve best practice performance
    • Never stop monitoring to verify your preferred state performance/outcomes.
    • Pick a methodology for process management (they all work)
    • Train for it
    • Build consistency of approach

Next Steps:

  • Define your performance excellence culture
  • Relentless leadership focus on performance excellence
  • Adopt your preferred methodology
  • Formalize and standardize your methodology
  • Listen to your key stakeholders
  • Engage all parties in understanding improvement initiatives
  • Gain understanding of performance through data analytics
  • Design processes to achieve desired results
  • Achieve success in all you do
  • Demonstrate that you are creating value based outcomes
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Enhanced Regional Referral

The Problem – Across the nation, health systems are reporting a sustained decline in Emergency Department utilization, resulting in decreased admission rates and reduced patient days. Regardless of the cause (Healthcare Reform, economic challenges, rising unemployment, etc.), the impact is clear – an average 3-5% drop in census and a significant loss of revenue.

The Emergency Department Imperative – On average, 12-15% of Emergency Department visits result in patients being admitted, which accounts for approximately 40-50% of a facility’s total admissions, and a contribution margin between $1k - $15k per admit. The direct connection between Emergency Department utilization, subsequent admissions and the resulting revenue indicates that the success of any facility in this changing healthcare landscape depends on increasing the number of times that new patients pass through the Emergency Department doors. Health systems operating Trauma Centers will have contribution margins exceeding the national average.

The Million Dollar Question – Understanding the concept of countering a declining census by increasing Emergency Department utilization is easy, but successfully operationalizing that strategy may not be. Simply put, how does one hospital or health system get more patients into their Emergency Departments than another? Although there are many potential answers to that question, experience shows that the most effective solution is for a facility or health system to develop a highly functional Regional Referral Program.

The Regional Referral Solution – Health systems should be able to successfully capitalize on its current Trauma status and market itself as regional destination, which will significantly increase patient admissions. A key to success will be aligning referring facilities, physicians, and transport providers through an efficient Transfer Center operation. Your organization will be able to benefit from those opportunities. Additionally, current successes show that facilities and health systems that have implemented Regional Referral Programs have grown their influence significantly garnering patient care and admission opportunities from facilities far outside of traditional referral patterns. This has proven beneficial because the payor mix of patients being referred from out-of-area tend to be equal to or better than the receiving facility’s current Emergency Department mix, resulting in a 15 to 1 return on investment.

Regional Referral Program Priorities – Numerous successful hospitals and health systems have developed very effective Regional Referral Programs by prioritizing the following:

Identification and Development of Key Service Lines – Determining which specialties (Trauma, Cardiology, Neurology, Pediatrics, etc.) the facility wishes to specifically solicit patients for. The goal is to develop a solid reputation as the “go to” receiving facility for the targeted service lines.

Aligning Physician Partners – The success of any Regional Referral Program depends on the participation and support of the facility’s physician partners, whether by promoting the program with regular visits to the region’s referring facilities, or by being consistently available and accepting patients. To achieve this, successful Regional Referral Programs have implemented effective Hospitalist Programs to receive the patients and specialist compensation programs that reward participation.

Transfer Center Utilization and Marketing – Effective Regional Referral Programs require three primary components; necessary specialties, physician participation, and a simple, consistent way for facilities to refer their patients. Structured Transfer Centers tie the entire referral program together with “one call does it all” ease, coordinating patient transfers from the initial request through completion of the transport. Mature Transfer Centers will also provide extensive operational reporting and key patient flow analytics for hospital administration. Focused marketing strategies can also convert the Transfer Center from a passive patient flow processing service into an aggressive volume builder for the facility or health system. Proven techniques can be employed to grow desired business through sound relationships with the referring parties.

Note: There are generally two methods of implementing a Transfer Center service; a facility can develop the service in-house or they can seek out a professional third-party Transfer Center service provider. An internal Transfer Center allows the facility or health system to maintain strict control of the staffing, customer interactions and processes, but a professional external Transfer Center will generally provide outstanding service delivery at a fraction of the cost.

Regional Referral programs are showing exceptional returns in the form of increased Contribution Margins per referral. The chart below – based on actual Regional Referral Programs – highlights the benefits:

Transfer Center Costs – Studies of current successful internal Transfer Center services show that the average cost per transfer request is approximately $230 for new centers and $190 for established centers (assuming a daily request volume of ~12). For facilities or health systems that prefer to forego the expense and coordination of operating their own Transfer Centers in favor of utilizing the expertise of a professional external service, the cost is obviously significantly lower – with no associated reduction in the contribution margin per transferred patient.

Conclusion – For hospitals or health systems seeking to counter the downward trend in Emergency Department utilization and subsequent census declines, it is essential that they develop a Regional Referral Program. By establishing themselves as “centers of excellence” in key service lines, partnering with their physician specialists, and easily facilitating patient flow through efficient Transfer Centers, facilities can continue to thrive even in today’s constantly shifting healthcare environment.

Solution - We can provide a comprehensive assessment of the opportunity for your organization to expand your market as a Regional Referral Center with a state of the art Transfer Center.

✔ Current situation
✔ Market potential for referrals
✔ Business plan for the recommended approach with a Return on Investment analysis
✔ Sensitive issues
✔ Hospital capacity readiness
✔ Medical Staff readiness
✔ Hospitalist Program effectiveness
✔ Case management strategies
✔ Nursing coordination
✔ Administrative and Medical Leadership buy-in

Please let us know if you would like to explore the assessment of the potential for your health system. We look forward to possibly assisting you with this important project.

Thank you,

This email address is being protected from spambots. You need JavaScript enabled to view it.

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Connectdoc

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Leadership Key: Impact Conversations

By Joy W. Goldman | Leadership Coaching

In the March, 2017 newsletter, I introduced the topic of trust and highlighted five ways leaders increase trust in their organizations. Today, I wanted to provide an overview of two very practical tools that can be used to engender trust in ALL relationships, regardless of how challenging you may find some to be:

Conversational Intelligence and Polarity Thinking

You can deepen your learning on Polarities during an upcoming Wiederhold & Associates webinar on Aug 1.

Wiederhold & Associates Webinar
August 1, 2017 - "Polarity Thinking"

Register ASAP to obtain needed pre-work for this interactive webinar

Click to pay Registration Fee

No Fee For Premium Active Network Members and current clients.

For more information contact This email address is being protected from spambots. You need JavaScript enabled to view it.

Judith Glaser in her book, Conversational Intelligence, asserts that ALL work is conducted through conversations. Think about it! Is there anything you do that does not involve a conversation? From a pure productivity perspective, think about the time you could save if most of your conversations were impactful.

During July’s webinar, Cliff Kayser and James McKenna, two phenomenal executive coaches, illustrated in their usual humorous way, one element of effective conversations: The power of leveraging Inquiry AND Advocacy: two critical leadership competencies. The May/June 2017 issue of Harvard Business Review included an article that talked about four key attributes that distinguished high performing CEOs: the ability to be decisive was one of them. As a leader, “telling,” and “advocacy” is essential in certain circumstances.

The most powerful leaders know how to leverage advocacy AND inquiry, and they know when they’re being effective, and when they risk derailment. Signs of an overuse of advocacy may include noticing that they are doing most of the talking and others aren’t offering their opinions; leaders may notice that their audience seems less engaged. In the extreme, they may also notice that not too many people are following them!

Glaser’s levels I and II conversations consist of “telling,” or using questions that are geared toward eliciting what the leader already knows to be true. They are using inquiry but only with a goal to validate their own thinking. Glaser discusses the more powerful level III conversation that is focused on “Sharing And Discovery.” Level III conversations ask questions for which the leader doesn’t know the answer to the question.

    Sample discovery questions include:
  1. Sample discovery questions include:
  2. What matters most to you right now?
  3. To resolve this conflict successfully, what would need to occur for you?
  4. Tell me what I might not be seeing or understanding right now?
  5. If we couldn’t fail, what would we be doing right now?
  6. If we could better leverage Safety AND Risk, how might we better serve our customers/ community?

When leaders ask questions that come from a place of curiosity, we tap into our audience’s prefrontal cortex and quiet their amygdala, the primitive part of our brain, which kicks into high gear when we feel threatened. Creativity and trust come from our prefrontal cortex: through sharing and discovery conversations.

In healthcare, our habit is to look for problems. Simple problems often have a right or wrong answer. Complex problems/ situations rarely do and are better served by leveraging interdependent tensions or pairs: polarities. Come to the webinar in August to learn more about leveraging Inquiry AND Advocacy.

    In future newsletters, we’ll also explore other healthcare tensions like:
  • Mission AND Margin
  • Confidence AND Humility
  • Centralization AND Decentralization
  • Standardization AND Customization

I look forward to our next conversation!

Joy W. Goldman RN, MS, PCC, PDC
Executive Director, Leadership Coaching
Wiederhold & Associates

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Happy 4th of July!

Wishing you and your loved ones a happy
and safe Fourth of July

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Target Success with Advanced Networking Strategies

Because you've been a part of the Wiederhold & Associates Network, we wanted to share some exciting news with you first.

As you know, networking/connecting is essential to your success both while in transition and gainfully employed. Networking with a purpose is a vital component of anybody's career success but is often terribly neglected. Being intentional is necessary.

Therefore, we have formalized a streamlined process to make it easier for you to expand your network through Wiederhold Intentional Networking (WIN) program. Becoming an active WIN participant will enable you to:

  • With limited effort, expand your own network with quality connections
  • Exchange key information about market and industry trends
  • Increase ability for quality transitions through network connections
  • Affect others in a positive way
Are You Ready to WIN?

The WIN strategy gathers key information from each premium active network member and targets meaningful matches within our client list. As an active member in our program, W&A will introduce you to key members of our current network, helping you gain significant connections that you would not otherwise have access to. Remember, most of our clients are Vice President through C-level executives.

Once you have made the connection, we will send you a short anonymous evaluation form. Each member's feedback will bring value to helping our clients grow their skills in effective networking/connecting as well as passing along current industry trends.

If you want to know more about expanding your network with little effort while affecting others in a positive way, contact This email address is being protected from spambots. You need JavaScript enabled to view it. and she will let me know of your interest and follow up.

Here's to your success!

Jim

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Goal Setting: Preventable Patient Harm – 'Target Zero?'

During a recent goal-setting cycle, I worked on setting reasonable, although loftier, strategic goal metrics due to significant LEAN expert resourcing for my management team to focus on making transformative leaps in process improvements rather than small, incremental changes. In analyzing the strategic goal area of preventable patient harm, the Patient Safety Composite observed to expected ratio baseline was 0.629. A ratio above 1 is undesirable and a ratio below 1.0 is highly desirable. So, 0.629 is excellent, correct? Instead of improving the stretch goal by 5%, we considered 10% improvement. That is stretch goal, chest pounding, we are doing a fantastic job material!

Amid this goal setting, I was at the beach watching the news and drinking a cup of coffee readying myself for a day of fellowship, bocce ball, and sun. The local station in Myrtle Beach, SC ran a story with some interviews regarding the Target Zero – South Carolina’s Highway Safety Plan 2015 -2018. The plan was developed by the SC Departments of Public Safety and Transportation with many stakeholders including the SC Highway Patrol.

At the time, South Carolina’s 5-year average highway mortalities were ~800 per year. Immediately, I thought what an audacious goal considering they do not have control of every aspect of the events – human error, human disregard for rules, or processes/design flaws/mechanical failures. Think about this strategy compared to preventable patient harm with a Just Culture mindset as illustrated below:

If South Carolina is setting a target of zero highway fatalities, what is preventing me/us from setting a target of zero for preventable patient harm? The way we analyze data with observed to expected ratios with results below 1.0 informs us we are doing better than expected and inadvertently depersonalizes this issue. At 0.629, we were knocking it out of the park. At the end of the day, it is about perspective. The interviews shown on the newscast drove this point home for me. The interviewers asked residents around South Carolina two separate questions regarding goal setting for decreasing highway fatalities. Please view the video for about 2 minutes (from WMBF News in Myrtle Beach, SC) here.

Again, the Patient Safety Composite observed to expected results of 0.629 were fantastic! Well, not for the 53 patients harmed that we, as an industry, deem to be preventable. So, how will you set future goals and allocate resources to achieving those goals? Are small incremental improvements satisfactory or do we look to transform our thinking, people, and processes to achieve Target Zero for Preventable Patient Harm?

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Building and Repairing your Online Reputation

The Internet has changed the game for job seekers. The paper resume has been swapped out for a LinkedIn profile. Face-to-face meetings have been replaced with Facetime. Your local word-of-mouth reputation is small potatoes next to someone with a well-developed online presence. When it comes to the Internet, you are who Google says you are.

Fact: 92 percent of recruiters “Google” potential candidates according to a social recruiting survey. LinkedIn is the clear favorite, with 94 percent of recruiters searching it to find top talent. Potential employers also look at Facebook, Twitter, Google+ and really anything that search engines render when your name is entered.

Can you take control of your online reputation?

Be Informed. Monitor your personal brand. The first step in protecting and building your online brand is by knowing what is being said or has already been said. It’s impossible to control everything that is written about you, but even though you can’t always control what is published, you can at least know and respond to it.

Monitoring your personal brand is a two-step process. First, you figure out what is being communicated around your personal brand currently. Second, create a positive plan to improve it, build upon it.

Easy ways to monitor your reputation online:

  • Google Yourself – do this at least once a month. Look for your name not only in the search results, but also the image search, news search, and video search.
  • Create Google News Alerts containing your name. You can find this screen under google alerts. Note: you will have to establish a Gmail address.

How to repair and build your online reputation:

You’ve Googled yourself and found that there is at least one article that really gets in your craw. Perhaps it’s misleading, a lie, or just not flattering, and it is published on a website you have absolutely no control over. You want to wave your magic wand and just make it disappear. What can be done?

1) Get legal involved. You may have a case if:

  • Defamation has occurred. For instance, someone has published a false statement that is damaging to the company or person.
  • Google will remove links from search results when presented with a court order, even though they’re not legally required to do so. (Internet publishers of third-party materials may not be required to remove links, unlike offline publishers.)
  • Legal action will come at a high price, on average $5,000-$10,000 per article and may not work.

2) Create and publish online through news publications and social media platforms such as LinkedIn. This is the most effective way to rid yourself of unwanted search results over time. How it works: Say you have a negative news article you want to push off the front page of the Google search results. The more content you publish with your name mentioned the more likely positive search results will be rendered when your name is searched. It should be noted that it takes time to push negative articles down the list and off the first page of results. This is due to a number of complicated algorithm factors, all dependent on Google’s rules surrounding credible content. For example, it will be much easier to bury an article posted by a local or regional paper than it would an article or video posted on CNN. Reason being is that the more credible or popular the site is, the more weight Google gives it. So your goal should be to match or overtake the negative article with your original content published on equally credible sites.

Key Take-Aways

  • Always be aware of what is being said about you online. If nothing is being said, you are uniquely positioned to create a positive online reputation by populating the Internet with content and online profiles where you are in full control of the message.
  • If you do have a negative online reputation, it’s never too late to start the repair process. Ignoring it won’t make those links disappear and the problem will still exist five years from now. Better to take the time now to start rebuilding your presence online.

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Achieve Value-based Results in Healthcare: Knowledge Management/Transfer Through Data Analytics

Physician alignment, integration and engagement in integrated delivery systems are essential elements in navigating the complexity of healthcare service delivery. Healthcare organizations need a simplified approach to realize organizational vision of comprehensive and successful alignment and integration strategies. Creating a common Vision is essential. Healthcare organizations that focus on a vision of “maximizing success in the ever-evolving healthcare industry through physician alignment and integration” will ultimately build capability to meet and exceed consumer expectations in navigating the path to value-based care.

Today’s ever-evolving healthcare industry requires a comprehensive Vision of Integration. Execution of the Vision is best achieved through a Leadership Philosophy of Performance Excellence.

The first key element in fostering a culture of performance excellence is to define the “WHAT” that constitutes excellence, frequently referred to as “the Triple Aim” of healthcare:

  • Operating/Financial Excellence (low cost, highly efficient and cost effective service delivery),
  • Service Excellence (service delivery exceeding patient and family expectations), and
  • Clinical Excellence (best clinical outcomes for every patient and patient population).

The next essential element of a performance excellence culture is to define the “HOW” organization will be led through:

  • Stakeholder Engagement
  • Knowledge Management/Knowledge Transfer
  • Process Management

Organizations will not only achieve the “triple aim”, but will enhance performance through achieving the “quadruple aim” of healthcare. In addition to achieving traditional value-based results, a culture of performance excellence will yield higher levels of provider satisfaction and engagement while redefining service delivery.

As highlighted in previous articles:

  • Value Based Care is here to stay and healthcare organizations must overcome multiple organizational gaps that may contribute to not fully realizing a vision of success in a high performing integrated delivery system. Here
  • Key Stakeholder Engagement is essential to execution of a common Vision:
    • Physician Stakeholders (as well as others) should be engaged in organizational Governance, especially among healthcare providers, is essential to success in a value based environment. Here.
    • Physician Stakeholders should also be engaged in Leadership and Management to achieve sustainable results. Here.

This article expands on development of a Philosophy of Performance Excellence to achieve a vision of success through Knowledge Management/Knowledge Transfer. Measuring, monitoring, reporting, analyzing and improving performance begins with defining key metrics to create a common understanding. Internal and external benchmark measures are available through a variety of sources to build an improved understanding of:

  • Operational/Financial Performance,
  • Service Performance, and
  • Clinical Performance.

Knowledge Management/Knowledge Transfer Through Data Analytics

The days of making claims of high-quality, service oriented and low cost care delivery are gone. Regulatory requirements and consumers of healthcare demand demonstrated proof. On October 14, 2016, the Department of Health and Human Services (HHS) issued its final rule with comment period implementing the Quality Payment Program that is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Program is intended to improve Medicare by helping you focus on care quality and focusing on making patients healthier (population health management). The Quality Payment Program’s purpose is to provide new tools and resources to help organizations to provide patients with the best possible, highest-value care. The Quality Payment Program has two tracks to choose from:

  • The Merit-based Incentive Payment System (MIPS), and
  • Advanced Alternative Payment Models (APMs).

Healthcare providers are required and must report key measures of performance in order to maintain a competitive edge and to maximize reimbursement for services rendered. Measures of performance should focus on Operations/Financial, Service and Clinical Excellence. Internal and external benchmarking of performance is imperative. The best place to start is to define your measures, based on industry standards. Engaging your Governance, Leadership and Management representatives, as well as other key stakeholders, in defining performance metrics is essential to gain a common understanding. Begin by gathering potential sources of industry standards (see table).

Knowledge Management/Knowledge Transfer Process:

The quest for appropriate data analytics to measure, monitor, report, analyze, improve and control can be challenging. Once sources of industry standards have been identified, engage stakeholders in organization-wide effort to define your measures of Operational, Service and Clinical metrics:

  • Review and select meaningful measures:
  • Verify the organizational capacity to measure, monitor and report measures:
    • Be sure all metrics of performance are measurable.
    • Operational and Financial Metrics are typically readily available, but may not be reported in an intuitive format with full-transparency across the organization and among key stakeholders.
    • Service Metrics (patient engagement) should be standardized using a formal survey tool, administered by a vendor approved for use by The Centers for Medicare & Medicaid Services (CMS).
    • Measures of Clinical Performance may present the greatest challenge:
      • While sources of key measures are readily available, the ability to measure performance across all providers may be limited.
      • Desperate systems in multiple healthcare settings increase complexity of data collection.
      • Clinical information may be captured as free form text and may require manual/human intervention for interpretation.
      • Manual data abstraction may present a high cost alternative to automated reporting.
      • Lack of interoperability of information systems creates complexity.
      • Clinical and claims data are not typically consolidated.
      • The good news is: multiple vendors are available with advanced tools to aggregate data to support your efforts to measure, monitor, report, analyze, improve and control clinical performance.

  • If necessary, select reliable vendors to provide external support for the purposes of understanding measurable performance.
  • Create detailed analytics reports across the organization at the Enterprise, Specialty, Practice Location and Individual Provider levels,
  • Determine baseline performance at all levels,
  • Set routine reporting intervals (daily, weekly, monthly, quarterly and annually), as appropriate,
  • Set levels of performance:
    • minimum level of performance,
    • expected/goal level of performance, and
    • Level of performance exceeding goal.
  • Utilize high level dashboard reporting tools for ease of review and understanding across the organization:
    • A simple “stop light analysis” provides ease of review (see below):

    Click here for Reference Sources.
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    A Strategic Nursing Career

    What would it take to build your career strategically?

    Nursing Leaders think strategically about the work they do, often considering the needs of their organizations, their staffs, and the patients they care for as their primary focus of their careers. Rarely, however, do they spend much time thinking about a personal strategy for their own careers.

    Have you considered what you want for the next chapter of your career?

    If you are in the middle of your leadership career or heading to the end of traditional employment, making the next phase of your career the most intentional and thoughtful of your life is within your reach. At Wiederhold and Associates, we have witnessed the tremendous outreach nursing leaders can have when they take their careers to the next level. Be it within the same position, or a new direction, the strategic career does not wait for opportunities to come along.

    Strategic careers are often designed and created by individuals who have developed shifts in thinking that utilize an increased awareness of themselves to confidently self-determine their offerings and value. Learning to communicate that value to others is a key part of the strategy.

    A personal career strategy is not a selfish endeavor. When a nursing leader combines passions, talents (or potential talents) with intention, many lives and careers can be changed for the better. It could be the most important work of your life.

    Taking stock of new or unrealized potential is the work of our organization as we expertly coach leaders to understand their career trajectory and make self-determination strategic goals for the most optimal work experiences. We have been honored to work with great leaders and assisting them to achieve their potential is some of the most important work we do.

    As an experienced consultant in strategic and transformational change, Diane has an extensive background in helping leaders develop and succeed. Her healthcare experience spans three decades as a healthcare administrator, clinician, and graduate school educator. To learn more, click here.

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    The Concept of Networking

    The whole concept of networking is one of my favorite and most passionate subjects.

    In prior articles, we have touched on many aspects of effective networking, whether in transition or not. Building a broad and deep network is so essential to one's success that it cannot be ignored.

    What I have personally observed over a 28 year period and confirmed through colleagues is clear: We can't make it without solid key relationships. Many people will find expanding their network to be challenging, but with practice and effort, you can begin to make meaningful and fruitful connections.

    There are three key components to effective network communication.

    Connecting Point: If you're going to get somebody to take interest in your phone call, you must differentiate yourself so they choose to respond to you. The connecting point is finding something that you share in common. This can be any person, place or thing. It requires homework but it also ensures greater success as you expand your network. Whether you connect on the first attempt, leave a message, text, or send an email. The connection point is the most powerful tool in developing a memorable network relationship.
    Seeking Information: Obviously, expanding your network means making initial calls to people you've never connected with before. For those in transition, resist the temptation to focus on jobs until you have created a solid connection. Seeking information makes it easier for the other person to open the door to friendly conversation. That information could be around what this individual has done, an organization that you're exploring, or a location that you have an interest in. There are a lot of options here.
    Value Statement: It is important that you understand and can articulate your value. When this connection is concluded, that individual should know that you and your team are good at what they do. Your network will not refer you to others unless they understand what you do and are confident that you do it well.

    If you are looking for career advancement, you must become the most effective networker you can be. Include these three components when you're expanding your network and I promise you will find success.

    Here's to your success,

    Jim

    Connect with us on LinkedIn and join our Active Network Program.

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    Career development- Top 5 ways to stand out

    Developing one’s career is multifaceted and takes time, energy and intentionality. In a competitive market one must differentiate. Here are five ways to stand out and help your career develop over the long-term:

    • Grow your network- it’s about who you know and who knows you. Spend time each month connecting with new people to expand your network. 70%-80% of jobs are found through networking.
    • Know your value proposition- what is your calling card? Communicate this through words and actions. Include tangible results when communicating your value- not just phrases like “hard-worker” or “loyal”.
    • Help others- don’t always make it about you. Help other people find solutions to their problems. Give referrals to recruiters.
    • Perform in your job- help your boss win. Create value for the company and your boss.
    • Have a learner’s mindset - never stagnate. Learn new skills and never stop growing. Become indispensable.

    Respond on this blog what you would add to this list!

    Thanks,

    Greg

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    Strategies for Active Career Advancement

    Are you looking to be promoted?

    If getting a promotion is important to you, then it is time to sit down and look at the external and internal factors that will influence your strategy of advancement.

    Define Your Target

    The very first and most important step in your career advancement strategy is to define what success is to you. From my observations, too many individuals choose a path that is somebody else's dream rather than their own. It's how you define moving up that really counts. It's also hard to be passionate about a direction that isn't your dream.

    Do Your Part

    The internal factors are all about you. This is where you exert the highest level of control. Are you being intentional about putting yourself in a position to be promoted? [Click to read more]

    Survey Your Surroundings

    If you are seeking to move to the next level within your organization, there are a few items that need to be explored:

    • How has this organization historically handled promotions?
    • Do they generally promote from within or seek externally?
    • What is the general timeframe for people to get promoted within the organization?
    • Is the person you report to going anywhere?
    • Does the person you report to have a history of mentoring his/her direct reports?

    I call these external factors because you can only influence them not control them. Your answers to these questions may suggest that the only way you're going to move up is to move out. If these external factors align with an internal promotion, then you have additional steps.

    • Have I asked my immediate superior what it takes to get to the next position?
    • Did their answer have enough specificity to suggest that they had thought about this possibility?
    • Can I continue to gain clarity around the possibility of promotion? (If you cannot gain clarity, then more than likely that's not a real possibility.)

    By defining your goals, developing a strategy, and become intentional about executing your plan, you can increase your chances of advancement immeasurably.

    Here’s to Your Success-

    Jim

    Connect with us on LinkedIn and join our Active Network Program.

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