Session 97AB Leading Transformational Change to Impact Business Outcomes: Engaging Associates as Partners

Transcription

1 Prepared for the Foundation of the American College of Healthcare Executives Session 97AB Leading Transformational Change to Impact Business Outcomes: Engaging Associates as Partners Presented by: Frances Roy, EdD Patricia A. Maryland, DrPH

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3 Leading Transformational Change to Impact Business Outcomes: Engaging Associates as Partners Disclosure of Relevant Financial Relationships The following faculty of this continuing education activity has no relevant financial relationships with commercial interests to disclose: Patricia Maryland, DrPH Frances Roy, Ed.D. 2 1

4 Faculty Patricia Maryland, DrPH Frances Roy, Ed.D. 3 Patricia A. Maryland, DrPH Patricia A. Maryland, Dr PH, is the President, Healthcare Operations and Chief Operating Officer of Ascension Healthcare. She previously served as the President and Chief Executive Officer of St. John Providence Health System, Warren, Michigan, and as the Michigan Ministry Market Leader for Ascension Health, where she provided strategic and operational leadership for St. John Providence Health System while promoting alignment among Health Ministries within the Michigan market and with the System Office on issues related to Mission and Vision. Dr. Maryland has extensive experience in strategic planning, patient care operations, service line management, finance, clinical program development and evaluation. At St.Vincent Health she helped to create six Centers of Excellence, and developed an agreement with Cincinnati Children s Hospital Medical Center to enhance the pediatric subspecialty services to St.Vincent Children s Hospital. Under her leadership, St.Vincent Indianapolis Hospital received top-ranking recognitions by Anthem, Leapfrog and Healthgrades, and received the Consumer Choice Award nine years straight. Contact at Ascension Patricia.Maryland@ascension.org 4 2

5 Frances B. Roy, Ed.D Dr. Roy serves as the SVP, Chief Talent Officer for Ascension with responsibility for learning and development, associate engagement, organizational effectiveness, strategic initiatives consulting, performance management, succession planning and strategic workforce planning and analytics. Before moving to her present role, Frances served as VP of Leadership Development for Hospital Corporation of America (HCA) with responsibility for learning and development, talent management and organizational effectiveness. She was also President of Frances Roy and Associates, a leadership development and consulting firm that provided HR consulting, executive coaching, training and development, and employee assistance services. After completing her undergraduate degree in Sociology and Business at Vanderbilt University, Frances was an insurance broker at Lloyd s of London. When she returned to the States, she completed her Masters and Doctorate Degree in Counseling and Organizational Consulting at Vanderbilt. Contact at Ascension Frances.Roy@ascension.org 5 Learning Objectives Gain insight into a transformational leadership model that is linked to achieving business results. Define the relationship of associate engagement and organizational culture to transformational leadership behaviors. 6 3

6 Agenda Ascension Overview Who Are We? Transformation The Journey to One Ascension Understanding the Impact of Change on Our Associates Patient Pulsing to Measure Their Experience in Real Time Linking Feedback to Business Outcomes Change Leadership Competencies/Behaviors Next Steps in the Process 7 Who Are We? Healthcare that works. Healthcare that is safe. Healthcare that leaves no one behind. 8 4

7 Largest Not-For-Profit Healthcare Company in the US Sites of Care 2,500 Acute Care Hospitals 111 Rehabilitation Hospitals 6 Behavioral Health Hospitals 9 Long-Term Acute Care Hospitals 2 Joint Venture Hospitals (<50% ownership) 13 Available Beds 22,416 Associates 150,000 9 One Ascension: Exceptional Care. Our Calling. 10 5

8 Focus Areas We Will Discuss Delivering on our Consumer Promise- One Ascension: Exceptional Care. Our Calling. Exceptional Outcomes Affordable Care Exceptional Experiences for Providers Exceptional Experiences for Those We Serve 11 Transformation: Our Journey to One Ascension 12 6

9 What We Want to Measure Model Community Culture Engagement Change Leadership Alignment with Our Mission/Values One Integrated Ministry Alignment Index (OIMAI) 13 One Integrated Ministry Alignment Index (OIMAI) Index Alignment with Vision and Strategic Priorities Organizational Effectiveness and Leadership Action Questions The Senior Leadership of my organization embraces, encourages, and personally leads change efforts. My organization is effective at providing associates with the support and information to deal with change successfully. Regarding the changes we are experiencing, including adjustments in staffing and operating structures: I believe these changes are handled in a way consistent with our Values I have a clear understanding of the reasons for these changes. Ascension has been making changes to help operate more effectively as a national health ministry Our leaders have shared information concerning these changes. Our leaders are effectively helping us adapt to these changes. Personal Action and Commitment Communication Effectiveness I am satisfied with the amount of voice I have in the decisions that affect my work. I understand the advantages of operating as a national health ministry. I understand my role in making changes successful. I support our efforts to act as a national health ministry. I understand how the work I do contributes to the overall success and mission of the organization. I am proud to be associated with Ascension. My organization does a good job providing information on how well we are performing towards our goals. 14 7

10 One Integrated Ministry Alignment Goals FISCAL YEAR 2017 Increase % favorable scores by 2 percentage points from the last large Model Community Survey conducted in 2013 FISCAL YEAR 2018 Increase % favorable scores by an additional 3 percentage points from FY17 15 Measuring the Impact of Change in Real Time Our Challenge Needed timely, actionable information to measure associate engagement and progress on our One Ascension. Journey Annual Survey Dissatisfaction* *TinyPulse

11 Our Journey Pulse Surveys Model Community Survey Pulse Surveys Pulse Surveys 17 Three Components of the Pulse Survey Customized Single Question Cheers For Peers Suggestions 18 9

12 Associates Engage with Pulse Surveys in Many Ways 14,000 Program-to-Date myvoice Pulse Stats* 30% 12,000 10,000 8,000 6,000 4,000 2,000 15% 22% 54.3% of Associates 0 have submitted a survey response to myvoice since launch 25% 24% 24% 24% 24% 23% 23% 23% 22% 22% 22% 22% 22% 22% 23% 21% 21% 22% 22% 22% 22% 22% 22% 23% 25% 198K Comments submitted since launch 46K Virtual Suggestions submitted since launch Response Rate Comments Cheers Virtual Suggestions 317K 25% 20% 15% 10% 5% Cheers sent 0% since launch *Aggregate stats through 9/14/ What We Expected Positive Organizational Rebuilding Impact Status Quo Exploration Commitment Shock, Denial Disruption Acceptance Anger, Fear Negative Personal Time 20 10

13 Ministry Market Executives: KNOW SHARE DO Items you should Know, Share, and Do for myvoice Engagement Know this! Share this! Do this! What We re Hearing Understanding the changes associated with One Ascension across the Ministry has been growing since this question was first asked in the April 2016 question. Though associates are acknowledging increased communication between staff and direct management regarding changes (heavily front line staff), there is room for improvement of communication coming from senior leadership within the Ministry and/or national level. Communications are sometimes received after change has already occurred. Associates are unsure who to go to for help after changes have occurred (i.e., services provided by local HR). Associates are relating reorganization with budget cuts/job eliminations leaving concerns of understaffing and lower quality of patient care. What Leaders Can Do Consistently use standard communication channels for associates to receive notice of updates on ministry level (i.e., Intranet, s, newsletters). Continue emphasizing strategic direction of One Ascension journey and connect Mission with direct impact on impacted departments. (Include associates by asking : How can you help? ) Communicate changes effectively, timely, and adapt accordingly. Focus on what we are becoming and not just the changes. Address concerns about unavailability of equipment/resources needed as well as increase in workload related to restructuring to identify any new policies/procedures /processes needed due to reorganization. Utilize myvoice private messaging via myvoice tool dashboard to reach out to associates for more information and to reinforce and support communication efforts. myvoice Stats Average Rating 3.5 out of 5.0 Response Rate 24.2% % Favorable % April % November % Engagement Tactics/Resources Set aside time in meetings to specifically talk about how people are being affected by the change and identify ways to help with moving through the change Become familiar with Change Management practices and integrate them into your conversations. As a starting point, read the article: Guiding Your Team Through Change and determine how you can integrate some of these ideas into your leadership style or provide mentoring to others. 21 What Our Associates Say Is Going Well Strong support from associates regarding Ascension s structure as a National Health Care Ministry Sense of support regarding the benefits to patients and associates of Ascension s national operating structure Strong connection to Ascension s Mission and Values and paralleled personal commitment

14 What Our Associates Say Are Opportunities Different implementation approaches of national Ministry initiatives Senior leadership communication cascades (particularly around change efforts and how changes are being made) Staffing and patient care Compensation and benefits 23 The Change Curve Demonstrated with an OIMAI Question Ascension has been making changes to help operate more effectively as a national health ministry: Our leaders are effectively helping us adapt to these changes. Positive Impact May % Target: % October % Negative April % Time Note: The percentage of associates that responded with a 4 or 5 on a 1 5 scale

15 Retention/Attrition Analytics Compared 12-month (2016) myvoice results to CY2016 turnover percentages for associates by each Ascension location Evaluated mid- and senior-level leader turnover Also acquired anonymized, associate-level myvoice results for next phase exploration and evaluation for potential relationships 25 Findings: Associate Turnover & Perceptions of Personal Value Ministries with associates who rated higher on feeling personally valued and recognized for their work had significantly higher leader retention and HCAHPS scores. Across all the 2016 myvoice survey items, the strongest associations found with turnover were those involving personal validation and recognition. Results provided here are a sampling of overall findings and promote further exploration of the impact that cultural values and personal perspectives have in workplace performance and system quality measures

16 Leader Turnover & myvoice Ratings of Personal Value myvoice ratings of feeling valued and recognized for their contributions showed strong inverse correlations with turnover of mid level leaders (supervisor to director) and executives (VP and above); r s =.485 and.617, respectively, p < 0.01). 27 Leader Turnover and myvoice Ratings of Community For associates who responded favorably to the question I feel part of a community at work, a strong, inverse correlation was found with mid-level and executive overall turnover (r s = and -.612, p < 0.05). Comparable relationships were found when evaluating voluntary turnover for mid-level leaders and executives (r s = and -.611, p < 0.01), indicating lower turnover for those who felt part of their work community

17 OIMAI Scores Associated with Leadership Stability Similar relationships found when examining the aggregated OIMAI scores. Ministry locations with the strongest OIMAI scores have: 42% lower executive turnover 21% lower midlevel leadership turnover Leadership stability, particularly among senior leaders, is a critical component in the transformation to One Ascension 29 Program Participation Associated with Retention Associates who stayed vs. exited Ascension were. 30% more likely to send a Cheers to colleagues 25% more likely to receive a Cheers from colleagues 33% more likely to provide a Comment 12% more likely to send a Suggestion 30 15

18 Logistic Regression Predicting Voluntary Turnover Based on Received Cheers for Peers Logistic regression model prediction accuracy of voluntary turnover: All Markets: 64.48% Indiana Market: 72.7% Texas Market: 68.9% Michigan Market: 65.9% Observations: Time frame is less than 12 months. More longitudinal data is needed test predictive model beyond 12 months Cheers depicts a negative relation with voluntary turnover (see adjacent chart) Strength of Cheers as a (voluntary) turnover predictor was significant Strong potential for including this data into more comprehensive predictive models of turnover 31 HCAHPS Scores and myvoice Positive correlation found between YTD Hospital Consumer Assessment of Healthcare Provider and Systems (HCAHPS) patient survey scores and myvoice: Supporting system efforts to act as a national health ministry-oimai (r s =.445,p < 0.15) Feeling part of a community at work (r s =.474, p < 0.05) Feeling valued and recognized (r s =.482, p < 0.05; not graphed) 32 16

19 A Cost-Effective and Valued Workforce There were also positive correlations found between associate ratings of feeling valued and recognized for their contributions and average labor cost per equivalent discharge variance (r s =.462, p < 0.05). This indicates that those Ministries who are more favorable to budget or under budget for labor costs have higher myvoice ratings on the question, I feel valued and recognized for my contributions. This finding lends weight to the hypothesis that, with the right leadership behaviors, an organization can operate at lean levels while still maintaining an engaged workforce More investigation is being done to better understand and validate this relationship; exploring person-level associations and interactions. 33 myvoice Summary Results Associate ratings of feeling valued, part of a community, and aligned to our One Ascension strategic direction are closely related to leadership stability/turnover Associates receiving recognition from peers are significantly more likely to stay at the organization Locations with higher myvoice scores also receive higher patient satisfaction scores on a national healthcare survey (HCAHPS) Initial evidence to suggest that our organization can achieve both labor efficiency and a valued workforce at the same time 34 17

20 The Next Step - Patient Pulsing Measuring patient satisfaction in real-time Correlating associate engagement with patient satisfaction 35 myvoice & PATIENTpulse Pilot Initial results from a Communication themed pairing in December 2016 suggest that departments with higher myvoice scores tended to have higher PATIENTpulse scores, on average Expanding the pilot will allow us to test this potential relationship in a more robust manner 36 18

21 Responding to What We Hear 37 Responses Enterprise compensation study by market Creating consistent communications for leaders across Ascension to help associates understand why we are making the changes being made Focusing on our talent acquisition process which will impact vacancies and staffing levels Utilizing myvoice/tinypulse analytics to focus on: Assess high vs low scoring ministries Strategies to increase scores for specific populations such as nurses, physicians, etc. Focusing on themes from feedback which correlate most significantly with moving improving scores 38 19

22 LEADERSHIP COMPETENCIES ORGANIZATIONAL LEADERSHIP Results Orientation Earns Trust Through Results Drives Performance Improvement Business Acumen Understands What Drives the Business Demonstrates Financial Acumen Ministry Identity Integrates the Key Elements of Catholic Identity in Shaping Organizational Culture Ensures Ongoing Personal Formation to Grow in Virtue and Servant Leadership PEOPLE LEADERSHIP Builds Capabilities Develops the Capability of Others Enhances the Capability of the Organization Influence and Collaboration Leads with Energy and Passion, Modeling Virtue and Values Commits to the Vision Influences/Inspires Others Builds Collaborative Partnerships Emotional and Spiritual Intelligence Accurately Assesses Emotions of Self and Others Regulates One s Own Emotions and Understands Impact of Behavior on Others Leads as a Spiritual Practice and a Service of Persons Stewards and Integrates Ministry Identity for the Sake of Realizing our Mission THOUGHT LEADERSHIP Strategic Orientation Identifies Transformational Opportunities for the Business Creates a Compelling Vision and Strategy that Advance our Mission and Demonstrate Ministry Identity Change Leadership Initiates Change Influences Change Consumer Orientation Translates Customer Expectations Based on an Outside-in Perspective Creates Value for the Customer 39 Leadership and Associate Behaviors Listen to understand Seek differing perspectives: Welcome the Other Respond to the needs of others: Care for those we serve and those who serve beside us. Communicate openly and respectfully: Speak Truth in Love Proactively offer perspectives and solutions Take personal ownership Reflect on my actions, words, and intent 40 20

23 The most basic and powerful way to connect to another person is to Listen. Just listen. Perhaps the most important thing we ever give each other is our attention. Rachel Naomi Remen Respond: do something as a reaction to something that has been said or done 41 Bibliography/References Garr Sherman, Stacia. The Employee Recognition Maturity Model: A Roadmap to Strategic Recognition. Bersin & Associates Research Bulletin 2 Nov. 2012: 18. Print. Armitage, Sheila, PhD & Joseph, Janel, M.S. C-Suite Agility: Three Ways Executives Build Organizational Performance. Texas CEO Magazine Nov./Dec. 2016: 2. Print. Whitehurst, Jim. Leaders Can Shape Company Culture Through Their Behaviors. Harvard Business Review Harvard Business Publishing,13 Oct. 2016: Web. Dive, B. The Accountable Leader: Developing Effective Leadership Through Managerial Accountability. London: Kogan: Page. Patterson, K. Crucial Conversations: Tools for Talking When Stakes are High. 2002: New York: McGraw-Hill. Patterson, K., Grenny, J., Maxfield, D. G., McMillan, R., & Switzler, A. (2013). Crucial Accountability: Tools for Resolving Violated Expectations, Broken Commitments, and Bad Behavior. New York: McGraw-Hill. Sasscer, M., & McNeill, M. (2010). Accountability Now!: Living the Ten Principles of Personal Leadership. Bloomington, In: IUniverse Inc Sudbrink, L. (2015). Leading With GRIT: Inspiring Action and Accountability with Generosity, Respect, Integrity, and Truth. Hoboken: Wiley