Moving Organizational Performance Through highmiddlelow Conversations

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Moving Organizational Performance Through highmiddlelow Conversations Pam Bradshaw, RN VP of Nursing/Clinical Services Kristi Faulkner, PHR Director of Human Resources United Regional, Wichita Falls, TX Today s Objectives 1. Articulate outcomes and return on investment from implementing HML performer conversations. 2. Align leadership and HR to address low performer behavior based on standards violations. 3. Achieve and sustain improvement in vacancy rates and voluntary turnover. 1 2008 Studer Group

Managing Expectations There is a better way.! Who is United Regional? Passion, Purpose, and Pillars! Located in north Texas Operate approximately 300 beds On our journey to excellence with the Studer Group since fall 2005 Approximately 1800 FTEs 2 2008 Studer Group

It All Starts with Standards What HML Accomplishes Continually assess organizational and individual performance Consistent methods for providing feedback and addressing low performer issues Shifting our focus to high performers 3 2008 Studer Group

Why is HML Important? A study of high performing organizations revealed the fact that the turning point for organizations for sustaining results is dealing with low performers. Quint Studer United Regional Achieves Significant Results! 4 2008 Studer Group

Retaining Superstars! Organization Goal to Retain 90% of High Performers 95% 94% 93% 92% 91% 90% 89% 88% 87% 86% Q107 Q307 Q108 High Performer Retention Low Performers Stepping Up or Stepping Out! 2007 126 Low Performers 23 Discharged 27 Resigned 41 Moved up to Middle 20 Remain on Corrective Action 5 2008 Studer Group

Physicians Notice Remarkable Improvement Staff also notice improvements 95% "I am proud to tell people I work for this organization" 90% 85% 86% 80% 75% 70% 79% Where We Were (2002) Where We Are (2006) 6 2008 Studer Group

Patient Perception of Care Soars Inpatient Perception of Care 100 80 60 40 20 0 Q104 Q204 Q304 Q404 Q105 Q205 Q305 Q405 Q106 Q206 Q306 Q406 Q107 Q207 Q307 Q407 Q108 Raising the Bar on Performance 70% 60% 50% 40% 30% 20% 10% 0% 2006 2007 YTD 2008 High Middle Low 7 2008 Studer Group

Raising the Bar 5 4 3 Average Dept. Performance Average 2 1 0 30 Days 60 Days 90 Days 6 Mo 9 Mo 12 Mo 18 Mo 2 Yrs 3 Yrs Raising the Bar 5 4 New Employee Peak Performance Average New Employee 3 2 1 0 30 Days 60 Days 90 Days 6 Mo 9 Mo 12 Mo 18 Mo 2 Yrs 3 Yrs 8 2008 Studer Group

Raising the Bar 5 Average New Employee 4 3 2 1 0 30 Days 60 Days 90 Days 6 Mo 9 Mo 12 Mo 18 Mo 2 Yrs 3 Yrs Raising the Bar 5 Average New Employee 4 3 2 1 0 30 Days 60 Days 90 Days 6 Mo 9 Mo 12 Mo 18 Mo 2 Yrs 3 Yrs 9 2008 Studer Group

Raising the Bar 5 Average New Employee High Expectations 4 3 2 1 0 30 Days 60 Days 90 Days 6 Mo 9 Mo 12 Mo 18 Mo 2 Yrs 3 Yrs What made HML Successful at United Regional? 10 2008 Studer Group

Aligning HR with Leadership Agreed on a common goal Retention of High Performers included on LEM Followed a fair, consistent and legal process Developed Reports/Tracking Mechanisms Dealing with the gray areas Address all Levels of Leadership Beginning at the Top Leaders at all levels were rated H.M.L and the appropriate discussions took place. A 90 Day Action Plan was used X managers were removed from leadership positions during the first year 11 2008 Studer Group

Management Accountability Cross referencing low performer list with last year s Cross referencing low performer list with counseling/term list Discussions with managers what are you doing with your low performers? Lessons Learned Ongoing and catch up training for managers is critical New Leader Orientation Reminder e-mails with talking points 12 2008 Studer Group

Establish a Schedule / Tracking Spreadsheet Early 2X Per Year At the end of a quarter Spreadsheet in Shared Folder What to do with 1 st year Employees Monitor compliance with deadlines to hardwire process Clear Conversations Critical It is about the discussion, not the label Start with high performers Refresher training and role play 13 2008 Studer Group

HML Roll Out Steps Criteria established by Senior Leadership Team (SLT) All directors ranked independently by each member of SLT and then discussed and agreed as a group Conversations with Directors Initial training with all management team (LDI) Ensure tracking and deadlines in place prior to rollout Accountability Establish expectations Include deadlines Tie to evaluation Up or Out Timely counseling Identify individuals that remain on low performer list multiple cycles Why are they still here? Report to SLT/Board of Directors 14 2008 Studer Group

Was it worth it? YES! Positive Outcomes Decreased turnover by 6% in 2007 Equates to $2.2 million in one year On track to decrease further in 2008 Staff morale all time high Patient Satisfaction stabilized Physician support/positive comments 15 2008 Studer Group

Questions? Thank You! Pam Bradshaw, RN VP of Nursing/Clinical Services Kristi Faulkner, PHR Director of Human Resources United Regional, Wichita Falls, TX 16 2008 Studer Group