Driving a Culture of Continuous Improvement- Part 2 Linking Leadership Competency and Employee Engagement Rebecca Blair, MS, MTS, SPHR, VP, HR, Service Excellence and OD
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Presenter Rebecca Blair, MS, MTS, SPHR, VP, Human Resources, Service Excellence and OD, Faulkner Hospital
Background-Improving Our Patients Experience The Continuous Journey 1998 BWH/FH Affiliation provide the right care in the right place for the right cost. Saw a decline in patient satisfaction scores. Leadership goal to investigate the reasons for the decline. Concerned that as we grow and changed we were losing our reputation of being the Friendly Faulkner.
Press Ganey % Rank compared to all hospital national database 70% 60% 50% 40% 30% 20% 10% 0% '04-'05 '05-'06
Seeking Staff Feedback One Must Have to develop a staff survey process to get feedback from all staff and link feedback to action. I was concerned that the staff would generate a list of needs that we wouldn t be able to accommodate we needed to change our mindset and think about the positives of doing a survey. David Trull, President The key to a successful survey effort is to understand the voice of those responding and link that voice to action. Catherine Flavin MacDonald, Principle, LRI Importance of leadership credibility, see Good to Great., Jim Collins
An engaged culture is different than a satisfied culture Satisfaction Fulfillment of a need or want; enjoyment or gratification Engagement A promise to be present; a state of being in gear ****** Satisfaction is most commonly in relation to benefits, working conditions etc. Engagement is commonly measured by cognitive, emotional and behavioral changes that show the employee in an advocacy role** **Importance of engagement vs. satisfaction see It s Your Ship, Michael Abrashoff
2005 Survey Results and Follow-up Actions N=48% return rate Three key areas for improvement More and Better Communication More Collaborative Problem Solving Ensure competitiveness of work environment Action Steps Emphasize CARE Standards Quarterly Town Meetings Enhanced internal communication vehicles Better access to managers Concerted effort to develop and recognize Involved staff in selection of new technology Increased Tuition Reimbursement (40% increase in use)
Continuous Improvement isn t Linearits Cumulative 07 re survey staff (Count Me In campaign) Leadership and middle management made a commitment to listening, owning and acting on patient and staff feedback Key point Leadership Development is imperative
2007 Employee Survey N=51% return rate All items with history in this dimension are up a meaningful amount since 2005. Favorable Scores - Satisfaction/Commitment Items (A1) All predictors of Satisfaction and Commitment have increased a meaningful amount since 2005. Intend to Stay Recommend 73 74 I feel I can grow and develop.. Faulkner Hospital is a well managed organization. I would feel safe My work gives me a feeling of personal accomplishment. Faulkner Hospital is committed to improving the service experience Good Place to Work Proud to work at FH Actively Support Others 76 84 95 0 20 40 60 80 100 2005 2007
Action Steps- Nursing/Direct Caregiver Examples Faulkner Nurse Newsletter Nursing Town Meetings New Technology with staff input Bedside report handoff Better communication Ideal Patient Experience and Wise Leadership Case presentations Focus on Management and Staff Accountability
Press Ganey % Rank compared to all hospital national database 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% '04-05 '05-'06 '07 '08 '09 '10
2009 Employee Survey Response Rate N= 827 (removing non-scheduled per diems =69.9% response rate) Data showed Increase in employee commitment/engagement questions would recommend would feel safe being a patient intend to stay
Top Box questions over time Q2 I would recommend FH to my family and friends -Increase in Strongly Agree + Agree from 72% ( 05), 73% ( 07), 82% ( 09) Q13 I would feel safe being a patient or customer at FH -Increase from 6% in 2007-Strongly Agree to 83%-Strongly Agree in 2009
Engagement levels sustained on all items in a hard year. Referral item is up, a positive support to growth. Table Shows Agreement with Engagement Items Over Time 8 over 2007!
Select Positive Comments Quality Care and Continuous Improvement Faulkner is committed to improving the service experience of patients and customers. (Admin.) We have expanded our services to better serve the doctors and patients. Both groups have expressed appreciation. (Clin Licensed) Leadership My immediate supervisor listens to our suggestions and answers questions that arise and if possible acts on them. (Financial Support/CS) Technology Emar, Barcoding, new monitors, smart pumps, Vocera, call lights, preregistration etc. are improving our quality of work. (Nursing) Teamwork Daily rounds with the medical team it allows communication between clinicians. (Nursing) My department knows how to acknowledge staff for a good job it motivates other staff to improve their work. (Clin Support)
Impressive gains on managing poor performance continue!
LRI Comparison data Faulkner scored At or Above Best Company in: Willingness to recommend; Pride in organization; job itself, manager accessibility, manager setting clear expectation, employee understanding of their contribution to strategy Faulkner scored Below in: opportunity to grow and develop, help solving problems, coaching and feedback
Overall Findings Positives Quality of patient care with focus in continuous improvement inspire staff New technology with staff input Teamwork is sustained as a core strength Nearly 2/3 see Faulkner as a well managed organization (up 11 points since 05 and a top predictor of staff engagement- managers listen and set clear expectations) Gains in managing poor performance Challenges How to build more confidence that changes support future success Communication is working but can/should be even better Some staff feel resource strains with every day work *Manager variability and consistency in some areas (two-way communication and problem-solving) *Highest potential to drive success faster to raise the level of organizational performance.
What did we do? Generic Identified key drivers of engagement Communicate about the business Support staff in career planning strategies Set context for resource strains- more with less Staff input on solving problems Staff inclusion in decision making Accountability Staff recognition (story telling) Enhance manager/supervisor visibility Develop emerging leaders Department-specific Ensure respect Enhance development opportunities Create more opportunities for team-based problem solving, activities etc. Enhance communication Compensation issues need to be assessed and context set Include MDs in teambased strategies MD accountabilitystrategize with all members of the care team
Represents average scores by group across manager and commitment questionsplotted results 4. Well managed but less committed and engaged 1. Well managed & more committed and engaged Management Development Action Items: Mandatory Leadership Development Identification of Competency model 3. Less effectively managed & less committed/engaged 4. Less effectively managed but more committed and engaged Leadership is key to sustaining improvement
Press Ganey % Rank compared to all hospital national database 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% '04-05 '05-'06 '07 '08 '09 '10
Focus on Leadership Development: TIPS for Improving Engagement Focus on leadership credibility (behaviors/competencies) using three strategies: (1) where possible department based survey; (2) 360 evaluation; (3) identify a management competency model 5 C s or credibility factors/competency model: Competence leader has required levels of experience, training and intelligence Character leader s degree of honesty, fairness, trustworthiness, cooperation Composure leader s poise, stability, and patience Courage Degree leader is decisive and committed Care for People Degree leader treats others with respect and dignity
Other lessons learned: Leadership TIPS for Improving Engagement Be visible Seek input and Listen! Implement suggestions Communication vehicles: Unit councils, staff presentations
Questions?
Wrap-Up Today s session available online. Evaluations
Wrap-Up Upcoming Webinars Health Literacy and Patient Education in Primary Care October 14 th, 12:15pm 1:00pm MA Training Information November 3 rd, 12:15pm 1:00pm http://www.massgeneral.org/stoecklecenter/assets/pdf/patient_exper/fall_2010_catalog.pdf Thank you for your participation!