Leadership Academy. Denise Dwight EXCEL Coach October 28, 2010

Transcription

1 Leadership Academy Denise Dwight EXCEL Coach October 28, 2010

2 Relate not Compare!! 2

3 Learning Objectives: Review Linkage Grid Execution Results to Date Connect to Purpose & How to Make it Stick Hardwire Rounding on Staff Thank You Notes AIDET New Communication Tool Stop Light Report 3

4 So..Who Are You? 4

5 ATTITUDE IS EVERYTHING You Become what you think 5

6 Group Exercise Leadership: Think of the best leader you have every worked for. What was it about that leader that made them a great leader? Write down your thoughts and prepare to share in large group. 6

7 Group Exercise Leadership: As a leader, what legacy do you want to leave behind at OU? 7

8 PASSION Wherever you choose to go, go there with all your heart. Passion fuels Enthusiasm (Passion, Ownership and Urgency) 8

9 Passion and Prescriptives Passion Prescriptives 9

10 Healthcare Flywheel Prescriptive To Do s Rounding for Outcomes AIDET Purpose, worthwhile work and making a difference Bottom Line Results (Transparency and Accountability) Reduced TO Increased Quality Reward & Recognition Increased Satisfaction Self- Motivation 10

11 Evidence Based Leadership (EBL) Foundation STUDER GROUP: Leader Evaluation Leader Development Must Haves SM Performance Gap Standardization Accelerators Implement an organizationwide leadership evaluation system to hardwire objective accountability (Principle 7) Aligned Goals Aligned Behavior Aligned Process Create process to assist leaders in developing skills and leadership competencies necessary to attain desired results (Principle 4 & 8) Must Haves SM Rounding Thank You Notes Employee Selection Pre and Post Phone Calls Key Words at Key Times (Principle 3, 5, 6, & 9) Re-recruit high and middle performers Move low performers up or out (Principle 4) Agendas by pillar Peer interviewing 30/90 day sessions Pillar goals (Principle 1 & 2) Leader Eval Mgr (LEM) Staff Eval Mgr (SEM) Discharge Call Manager (DCM) Rounding Mgr Idea Express 11

12 Linkage Grid Results No Yes DESK Conversations No Yes Rounding on your employees or internal customers No Yes Managing Up Response percent Response total No Yes Thank you notes All responses - 31 Incomplete surveys No Yes Communication

13 Connect to Purpose Communication 13

14 Thank You Notes 14

15 Managing Up 15

16 Round on Employees & Internal Customers 16

17 DESK Conversation 17

18 Barriers Time Extremely Busy Not Enough Hours in the Day Heavy Workload Short Staffed and Training New Employees Have done but not consistent Need note cards to write thank you notes 18

19 Rounding for Outcomes 19

20 Rounding for Outcomes Senior Leader Rounding Rounding on Staff Rounding on Patients Rounding on Internal Customers 20

21 Employee Engagement: The 12 Items That Matter Q12. This last year, I have had opportunities at work to learn and grow. Q11. In the last six months, someone at work has talked to me about my progress. Q10. I have a best friend at work. Q09. My associates or fellow employees are committed to doing quality work. Q08. The mission or purpose of my company makes me feel my job is important. Q07. At work, my opinions seem to count. Q06. There is someone at work who encourages my development. Q05. My supervisor, or someone at work seems to care about me as a person. Q04. In the last seven days, I have received recognition or praise for doing good work. Q03. At work, I have the opportunity to do what I do best every day. Q02. I have the materials and equipment I need to do my work right. Q01. I know what is expected of me at work. 21

22 Employee Satisfaction Increase Overall Overall RSFH 96.8%tile RSFHCorporate Services 96.8%tile 98.4%tile Corporate Bon Secours St. Services Francis 98.4%tile 96.8%tile Roper 96.8%tile Bon Secours St. Francis 96.8%tile Roper 96.8%tile Source: South Carolina Hospital, Admissions=25,837 Total beds = 594, vendor = PRC 22

23 Rounding for Outcomes: Leaders Rounding on Staff and Physicians Impact of Rounding on Willingness to Recommend as a Impact of Rounding on Willingness to Recommend KPNW as a Place to to Work Work % favorable Recommend for Work 100% 80% 60% 40% 20% 0% 50.2% Never 55.6% Rarely (Couple times a year) 79.3% Often (At least quarterly) 87.4% Tactic and Tool Implemented: Leader Rounding on Staff and Physicians Frequently (At least Monthly) Frequency of Rounding Oregon Integrated Health System; 8700 employees * Results are one year following implementation of Leader Rounding on Staff and Physicians; Staff and physicians rounded on at least monthly had the highest satisfaction levels. 23

24 PEOPLE 65% OU Physicians Employee Turnover 55% 45% 35% 25% 15% 5% Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Total 33% 27% 23% 22% 22% 22% 22% 21% 21% 21% 21% 21% 14% 14% 14% 14% 13% 14% Voluntary 27% 21% 19% 18% 18% 18% 18% 17% 16% 16% 16% 16% 12% 12% 12% 11% 10% 11% GOAL = Maintain a Voluntary Turnover Rate of 15% or less 24

25 What All Types of Rounding Have in Common Proactively engaging, listening to, communicating with and supporting our most important customers (family, employees, patients, partners, and other departments) The exact opposite of an open door policy 25

26 Rounding Not a New Concept but will look different 26

27 Rounding on Direct Reports: Outcomes Outcomes: Build relationships Harvest wins Identify process improvement needs Repair and monitor systems Coach and reinforce behaviors What direct reports want in a Leader: A good relationship Approachability Efficient systems Training and development Tools and equipment Appreciation 27

28 Rounding Log Rounding logs are not optional After rounding for outcomes begin to round with coaching 28

29 Stoplight Report (connect the dots from rounding) We can t do now and here is why Work in progress Completed! 29

30 Table Exercise Pair up in two s Round on each other asking prescribed questions and documenting your findings Each will be in the role of leader and staff 5 minutes each round Share experiences as a group Something you learned that you didn t know before? 30

31 Next Steps Share Leader Rounding on Staff with Stoplight Report at next staff meeting Round on Staff at OU Standard Document on rounding log Action items on stoplight report Share learning s each month at Staff Meeting Monthly Meetings with Supervisor Use Monthly Meeting Model Share logs & stoplight report Staff Agenda Manage Up Thank you Note for Staff and Physician 31

32 Denise Dwight, EXCEL Coach A Acknowledge I Introduce D E T Duration Explanation Thank You 32

33 Key Words at Key Times 33

34 Five Fundamentals of Consistent Communication Key Words Safety A Acknowledge Decrease Anxiety Increase Compliance Quality I D E Introduce Duration Explanation Patient Loyalty T Thank You 34

35 HCAHPS Questions Composite Question Summary Response Scale Nurse courtesy and respect ALWAYS, Usually, Sometimes, Never Nurses listen carefully ALWAYS, Usually, Sometimes, Never Nurse explanations are clear ALWAYS, Usually, Sometimes, Never Doctor courtesy and respect ALWAYS, Usually, Sometimes, Never Doctors listen carefully ALWAYS, Usually, Sometimes, Never Doctor explanations are clear ALWAYS, Usually, Sometimes, Never Did you need help in getting to bathroom? 2 Yes No (screening question) Staff helped with bathroom needs ALWAYS, Usually, Sometimes, Never Call button answered ALWAYS, Usually, Sometimes, Never Did you need medicine for pain? 2 Yes, No (screening question) Pain well controlled ALWAYS, Usually, Sometimes, Never Staff helped patient with pain ALWAYS, Usually, Sometimes, Never Were you given any new meds? 2 Yes, No (screening question) Staff explained medicine ALWAYS, Usually, Sometimes, Never Nursing Communication Doctor Communication Responsiveness of Staff Pain Management Communication of Medications Staff clearly described side effects ALWAYS, Usually, Sometimes, Never Did you go home, someone else s home, or Own home, Someone else s home, Another to another facility? 2 facility (screening question) Staff discussed help need after discharge YES, No Written symptom/health info provided YES, No NA Area around room kept quiet at night ALWAYS, Usually, Sometimes, Never NA Room and bathroom kept clean ALWAYS, Usually, Sometimes, Never DEFINITELY YES, Probably Yes, Probably No, NA Willingness to Recommend Definitely No NA Hospital Rating Question 0 to 10 point scale (percent 9 and 10 reported) Discharge Information 35

36 Value Based Purchasing VBP will transition providers from HCAHPS pay-for-reporting to pay-for-performance, and the amount of reimbursement tied to the survey will potentially double by 2017 It s about how well our organization can demonstrate that it has hardwired quality Pay for Quality is here 36

37 CMS Value Based Purchasing Core Measures (70% Weight) P 4 P (Pay for Performance) + Performance will determine total hospital reimbursement HCAHPS (30 % Weight) Plan Due by January 2012 Implementation FY 2013 (Oct 2012) 37

38 AIDET ~ Outcomes Increase of 28%ile points Increase of 17%ile points Outpatient Inpatient ED Increase of 16%ile points Baseline 6 Months Post Source: 2007 AIDET product evaluation survey of PARTNERS and NONPARTNERS, N=68 38

39 AIDET Finance - Decrease Litigation % decrease in complaints # of Complaints # of Compliments 0 *Data provided by University Medical Center, Tucson, AZ 1Q07 2Q07 3Q07 **Source: 2007 AIDET product evaluation survey of PARTNERS and NONPARTNERS 39

40 AIDET SM Impact on Safety and Quality Change in Percentile Ranks Ease of obtaining test results (60.0%) CP instructions for follow-up care (80.0%) CP information about medications (73.5%) CP efforts to include in decisions (73.3%) CP concern for prob/condition (84.2%) Access to care (46.5%) Overall Patient Satisfaction (53.0%) Post AIDET Pre AIDET Percentile Rank Source: Oklahoma University; OUP Hematology/Oncology Clinic & Infusion Center; 10 providers & 22 staff, take care of 15,000 clinic visits & 10,000 chemotherapy infusions per year 40

41 AIDET - Finance and Growth For every customer that complains, 20 dissatisfied customers do not Of those dissatisfied customers who do not complain, 90% do not return The average wronged customer will tell 25 others It is 10 times more expensive to recruit new patients than to keep old ones -Zimowski

42 AIDET - Patient Loyalty In fact the only path to profitable growth may lie in a company s ability to get its loyal customers to become its marketing department. -THE ONE NUMBER YOU NEED TO GROW Frederick F. Reichheld - Harvard Business Review Dec

43 Five Fundamentals of Consistent Communication Key Words Safety A Acknowledge Decrease Anxiety Increase Compliance Quality I D E Introduce Duration Explanation Patient Loyalty T Thank You 43

44 Group Exercise Develop AIDET as you would like to hear your staff execute at the highest level Pair up in two s Role Play AIDET prior to today s LA Role Play New AIDET developed at LA Share experience as a group 44

45 How Do We Make AIDET Stick? 45

46 Rounding Validate AIDET Rounding for Outcomes Rounding on Direct Reports Rounding on Patients Direct Observation Patient Satisfaction Results Patient Perception of Care Results 46

47 Add Questions to Rounding on Staff Log Share with me how you are using AIDET with every encounter? Share with me a tough D you had to deliver? Share example of how you took I to the next level 47

48 AIDET Observed Validation Identifies the purpose of using the AIDET principle. Performance Criteria Utilizes the AIDET principle to communicate with others, with a focus on patients and their families: Self Assessment Place an X in box 1, 2, or 3 (See legend) S D O Evaluator's Assessment (see legend) S D S O ACKNOWLEDGES the customer: A smile, makes eye contact, greets them and calls them by name in a pleasant manner. INTRODUCES self: States name and role at HOSPITAL NAME. Highlights skill and expertise of self and other healthcare team member. DURATION: Gives the customer a time expectation. Keeps the customer informed as to the amount of time a procedure or/process will take. Includes letting them know if there is a wait time; gives time expectation of that wait. EXPLANATION: Keeps customer informed by explaining all processes and procedures Communicates clear expectations of what will be occurring. THANKS the customer: Thanks customer for their time and, Expresses appreciation to the customer for their cooperation and communication Asks if there is anything else he/she can do for the customer before ending the interaction. Ensures non-verbal communication conveys the AIDET principle: Makes eye contact. Respects the patient s personal space (as possible). Listens to what the patient is saying; allows for silence; does not interrupt with his/her own thoughts. Ensures body language is relaxed, open and non-threatening. Displays a calm manner. Competency Met Employee signature Date Evaluator's Signature Date Employee signature Date Improvement Plan Completed Evaluator's Signature Date Employee signature Date D O 48

49 Next Steps Meet with Staff Develop AIDET Guide Update Rounding on Staff Log Add AIDET Questions to Rounding Log Share with me how you are using AIDET with every encounter? Share with me a tough D you had to deliver? Share example of how you took I to the next level Update Leader Rounding on Patient Log - if applicable Observe staff execute AIDET Document on AIDET Competency Form 49

50 Monthly Meetings with your Supervisor Monthly Meeting Model Share Linkage Grid Action Steps to Date Rounding on Staff ~ Manage Up ~ Thank You Notes Share Monthly Agenda with Rounding on Staff Share completed rounding logs & Stoplight Report Share Recognition and Manage Up to Supervisor 1 employee 1 physician AIDET Share AIDET Competency Assessment Forms Progress to Date % Complete 50

51 Leadership & Attitude As a leader, what legacy do you want to leave behind at OU? Closing thought for the day To accomplish great things we must not only act, but also dream; not only plan but also believe. Anatole France 51

52 Never Underestimate the Difference You Can Make ~ Quint Studer ~ 52

53 Thank you!!! Denise Dwight Visit: 53