Developing and Using Meaningful Performance Measures at Be The Match

Transcription

1 Developing and Using Meaningful Performance Measures at Be The Match Bette Braem, MSSW, CMQ/OE (ASQ) Minnesota ASQ May 12, 2015

2 Agenda Intro: Be The Match Context: Strategic Management System Focus: Developing and Using Performance Measures 2

3 Be The Match* is operated by the National Marrow Donor Program, a nonprofit organization that matches patients with donors, educates health care professionals and conducts research so more lives can be saved. 3

4 Our Mission Jade, marrow transplant recipient, with her mom and brother Saving lives with cellular therapy through science, service and support 4

5 Who we are Non-Profit organization, 1000 employees Headquartered in Minneapolis Authorized by US Congress 5

6 Late 2015: New Facility Adjacent to Target Field 6

7 The reality and the need Every year, 10,000 people in the US are in need of a life-saving cellular therapy transplant 70% of all patients who need a transplant do not have a matching donor in their family. They depend on the Be The Match Registry to find an unrelated donor or cord blood unit. 7

8 We recruit people who want to save a life: We manage Be The Match* Registry 11 million adult donors / 195,000 cord blood units Access to more than 25 million donors and more than 622,000 cord blood units worldwide 8

9 3 sources of marrow cells: 9

10 We save lives Our transplants treat over 75 life-threatening blood disorders, including leukemias and lymphomas We facilitate transplants throughout the world 10

11 We re the Hub of a Global Transplant Network Our global transplant network includes partner centers throughout the U.S. as well as centers and registries in 41 countries. 46% of all transplants we facilitate involve an international patient or donor. 11

12 We have facilitated more than 62,000 transplants since 1987 Transplants by Cell Source 12

13 Thank You for MN ASQ Support

14 History/Evolution of Organizational Strategy Pre-2007 Activity-oriented, 66-page business plan reviewed monthly by Senior Leadership 2007 Overarching Strategic Goal identified: Meet the USA need for 10,000 transplants per year 2007 Senior Leadership selected and launched Balanced Scorecard as new approach; renamed Vision into Action (ViA) 2008 Cascade of strategic objectives to department level 2012 Cascade to individual employee level 2014 Overhaul of strategic objectives and supporting structures to meet changing organizational realities Balanced Scorecard Institute Award for Excellence

15 9 Step Balanced Scorecard Process SWOT Annual Evaluation Annual review: Sr. Leadership+BoD Define/refine Objectives (3-5 yr scope) & establish annual Focus Areas Org level & Dept level Maps Org & Dept Measures - set/recalibrate with targets Line of Sight between strategy maps, focus areas, & projects Quarterly reporting on measures & review of results Strategic Project Roadmap and Dept projects to address gaps 15

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17 I have some specific, unknown objectives for you to measure. 17

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19 Annual Focus Areas* Customer Value Deliver Value to Transplant Centers Efficiency Increase the Efficiency and Effectiveness of our Services Revenue Growth Expand Revenue Sources including International Activity Payer Reduce Financial Barriers to Transplant Government Effectively Engage the Government in Pursuit of the Mission *focused areas of investment for annual projects to close performance gaps 19

20 Intent Every department and employee will find alignment with One or more of the Strategic Objectives; AND One or more of the Annual Focus Areas 20

21 STRATEGIC OBJECTIVE Where do I find myself? 6. Foster a sustainable organization that has the resources to continuously invest in and improve our organization Pursue continuous improvement Assure compliance with laws and regulations FOCUS AREA Efficiency Increase the Efficiency and Effectiveness of our Services 21

22 ViA Process Hierarchy Strategic Altitude 30,000 ft. 25,000 ft. 15,000 ft. Patient/ Stakeholder Needs 1. Mission 2. Strategic Perspectives 3. Organization Strategy Map 4. Strategic Objective Descriptions and Measures 5. Annual Strategic Focus Areas 6. Department Strategy Maps Why do we exist? 7. Department Objective Descriptions and Measures What performance lenses should we use to evaluate results? How do we map our strategic plan to accomplish our mission? How do we describe and measure objectives on the map? Where should we invest to drive shorter term enterprise level continuous improvement? How do departments map their plans to support the strategy? How do we describe and measure objectives on the department maps? Ground 8. Department and Individual Initiatives and Projects What tactical projects and initiatives are needed to support the department? 22

23 ViA Structure Overview Strategic Measures Strategic Measure 1 Strategic Measure 2 Strategic Measure 3 Strategic Projects Roadmap Project 1 Project 2 Project 3 Mission, Strategic Objectives and Focus Areas Department Measures Department Measure 1 Department Measure 2 Department Measure 3 Department Projects & Activities Project 1 Project 2 Project 3 Department Objectives 23

24 How the ViA components work together Mission, Strategic Objectives and Focus Areas ViA Measures - Strategic and Department 1 4 Strategic Project Roadmap and Department Projects 2 3

25 ViA Department Cascading - Aligning Action and Vision NMDP ViA Strategy Map Department ViA Strategy Map Right Objectives Right Measures Right Projects Department Execution Plans

26 Example of how a department supports and is aligned with NMDP strategy - each department has its own strategy map and supporting measures 26

27 All projects are aligned to strategy - Example 8 ViA Strategic Objectives (3-5 years) 1. Successfully serve all patients 5 ViA Strategic Focus Areas (1-2 years) 2. Grow and protect financial resources 1.Deliver Value to the Transplant Centers NMDP Mission Saving lives with cellular therapy through science, service, and support 3. Use all resources cost effectively 4. Deliver best in class registry products 5. Provide global leadership in research 6. Foster a sustainable organization 7. Optimize information technology 2. Increase the efficiency and effectiveness of our services 3. Expand revenue sources including international 4. Reduce financial barriers to transplant 5. Effectively engage the government in pursuit of the mission Specific ViA Projects and Initiatives Network-wide implementation of the ISBT 128 International Standard for Product Coding and Labeling 8. Build organizational effectiveness

28 Performance Measurement The system for sharing multiple levels of performance, including systematic identification of information to support performance improvement - Stephen Hacker, past ASQ chair 28

29 System for sharing multiple levels of performance 40 strategic measures 26 depts. 197 measures All employees 29

30 including systematic identification of information Online, interactive system accessible to all employees: includes all ViA objectives, measures, results and projects 30

31 to support performance improvement PROJECTS to close performance gaps 31

32 What gets measured gets done. - Peter Drucker Yes, but what happens if the wrong thing gets measured? 32

33 Types of Performance Measures Control HIGHER Type INPUT Description Resources allocated and used to produce goods and services Impact LOWER PROCESS Activities/Efforts (workflow) to achieve desired outcomes Focus: EFFICIENCY, EFFECTIVENESS, QUALITY, TIMELINESS, PRODUCTIVITY OUTPUT Actual goods and services produced OUTCOME Results of goods and services provided Intermediate outcome End outcome LOWER HIGHER 33

34 Developing Performance Measures: Five Step Process First, ensure thorough understanding of each objective. THEN, for each objective: 1. Describe the intended results 2. Understand alternative measures choose direct measures of results if possible build composite measures if needed 3. Select the right measurements 4. Set targets and thresholds 5. Define and document measures 34

35 Describe Intended Results Objective: Improve safety for patients through a robust quality management program What does this mean? Imperative to reach agreement Avoid ambiguous weasel words - e.g., we employ best practices Use plain English to describe what successful performance looks like Intended Result: Reduced number of quality-related incidents per transplant 35

36 Understanding Alternative Measures ASK: Can the intended result be measured directly? Example: Intended Result: Reduced quality-related incidents per transplants Direct Measure: # of quality-related incidents per transplant If not, develop indirect, measurable components, based on correlation or contribution Example: Employee Satisfaction Composite Measure: engagement survey score, turnover, absenteeism. 36

37 The Logic Model: a tool to identify measurable components for indirect measurements INPUT PROCESS OUTPUT OUTCOME Use to understand contributing factors of outcomes and identifying potential measures Displays logical relationships between resources invested (inputs), activities undertaken (process), and the outputs and outcomes that result Other cause and effect tools work equally as well 37

38 Increase insurance coverage and reimbursement for transplant INPUT PROCESS OUTPUT OUTCOME Investment in Patient Health Care Efficacy & Cost Studies Focused, timely conferences with key insurance providers # Payer Website traffic #Medicare patients receiving transplants per year Intermediate: insurance coverage % US pop covered for CT transplant End: lives saved Clear cause and effect identified and understood 38

39 Select the right measurements Select measures that Focus on what matters most to organizational success Directly capture the intended result Strongly correlate or contribute to the intended result Relate to inputs, processes, outputs, and outcomes, including both leading and lagging indicators Avoid undue data collection burden Serve to communicate, not to control or blame Incentivize the right behaviors - % projects delivered on time - favorable patient satisfaction index 39

40 Types of Performance Measures Control HIGHER Type INPUT Description Resources allocated and used to produce goods and services Impact LOWER PROCESS Activities/Efforts (workflow) to achieve desired outcomes Focus: EFFICIENCY, EFFECTIVENESS, QUALITY, TIMELINESS, PRODUCTIVITY OUTPUT Actual goods and services produced OUTCOME Results of goods and services provided Intermediate outcome End outcome LOWER HIGHER 40

41 More Control Leading vs Lagging Measures Performance Drivers INPUT Measures PROCESS Measures (Leading) OUTPUT Measures OUTCOME Measures (Lagging) Results Measures More Impact 41

42 Leading Leading vs Lagging Measures Upstream input & process indicators Predictive/forward-looking: Precursors of future performance Lagging Downstream output & outcome indicators Historical: Show actual results of past performance 42

43 Performance Measures Setting Performance Measure Targets HINT: the royal treatment doesn t work well with Measures

44 Set Targets and Thresholds Targets: the desired level of performance for a specific reporting period Thresholds: the upper and lower limits of desired performance around a target value Example: # of facilitated transplants per quarter Outstanding 1632 Target 1600 At Risk 1568 Unacceptable <

45 Set Targets and Thresholds How to establish? Need to be realistic and feasible, yet still challenging, based on: baseline benchmarks customer & compliance requirements Ensure flexibility: review targets against actual performance and adjust as necessary It takes time to get the right measures and the right data! A collaborative negotiation between strategy office and owner 45

46 Define and Document Measures Explicitly define each measure in terms of description, frequency, target, unit of measure, and owner. 46

47 Define and Document Detailed Data Definition 47

48 Where measure development cycles through the cascade process Strategic Altitude 30,000 ft. 25,000 ft. 15,000 ft. Patient/ Stakeholder Needs 1. Mission 2. Strategic Perspectives 3. Organization Strategy Map 4. Strategic Objective Descriptions and Measures 5. Annual Strategic Focus Areas 6. Department Strategy Maps Saving lives with cellular therapy through science, service, and support - end outcome measure Long Term Planning Process: SWOT, environmental scan, scenario analysis, and customer value proposition Longer term time frame - outcome measures Project-specific measures /ROI Department Planning Processes: Capacity, resources, alignment Ground 7. Department Objective Descriptions and Measures 8. Department and Individual Initiatives and Projects Medium term time frame process and output measures Shorter term time frame input and process measures 48

49 Measures Communicate Progress Visible measurement communicates importance and provides a focus for improvement. Yellow or red not necessarily bad Indicator of need for action, resources, etc Measure results reported quarterly Projects status reported quarterly Targeted monthly review at Sr Leadership Meeting 49

50 ViA Strategic Management System Homepage

51 ViA Strategic Management System Homepage Reports Tab and

52 Interactive Drill Down: Strategy Map 52

53 Our Automated System - Interactive Drill Down Department Maps 53

54 Our Automated System - Interactive Drill Down Measurement Details

55 Monthly Senior Leadership Targeted Review Review Template for both Strategic and Department Objectives 1. How did we do in the previous period? What were the trends? 2. What are the measurement targets for 2015? 3. What are the actions being taken to achieve these targets? 4. Discuss other issues that may impact success. 55

56 Lessons Learned where to be cautious 1. Overreliance on simple input measures 2. Overly complicated index roll-ups 3. Too many measures 4. Outcome / lagging measures only 5. Use measures to communicate, NOT to blame 6. Missing true performance because of sand-bagging 7. Letting measures stay static; they need to evolve 8. Lack of documentation - calculations and definitions for future reference 56

57 Summary Meaningful performance measures Align with and measure progress of strategic objectives Focus on what matters most to organizational success Directly capture or strongly correlate to intended results Are easy to understand; clearly defined and documented Serve to communicate, not to control or blame Incentivize the right behaviors Evolve 57

58 Acknowledgements Balanced Scorecard Institute John Rudrud, MBA 58

59 Questions? Thank You! 59