- 2009 Employee Objective Evaluation System Leader Development Must Haves Performance Gap Standardization Accelerators Aligned Goals Aligned Behavior Aligned Process Satisfied customers lead to satisfied employees, and vice versa. Both lead to prosperous companies and both are critical components in the quest for results that last. Results That Last, Quint Studer, Chapter 18, Pg 268 50
- 2009 Patient and Employee Correlations 2008 Hospital Pulse Report, Press Ganey Associates, Inc. Employee Strategies Rounding for Outcomes (Input) Employee Thank You Notes (Reward Desired Performance) Peer Interviewing (Select) 30 and 90 Day Meetings (Input) Employee Attitude Survey (Diagnostic) Employee Forums (Alignment / Recognition) Bright Ideas (Innovation/process improvement and input) Managing up (Communication) Service Teams (Involvement) 51
- 2009 Rounding for Outcomes Aligning Leader Evaluations with Desired Outcomes Rounding for Outcomes Employee Thank You Notes Employee Selection and the First 90 Days Pre and Post Phone Calls Key Words at Key Times Objective Evaluation System Leader Development Must Haves Performance Gap Standardization Accelerators Aligned Goals Aligned Behavior Aligned Process Rounding for Outcomes.It enables a leader to play offense, not defense Results That Last, Quint Studer, Chapter 2, Pg 25 52
- 2009 Turnover Reduction 30% 25.0% 25% 20% 15% 10% 5% Tactic and Tool Implemented: Employee Rounding Selection 30 and 90 day meetings 8.0% 0% YEAR 1 YEAR 2 Source: North Port Toledo Blade Elementary School, North Port, FL Turnover Reduction 12% 10.8% 10% 8.9% 8% 6% 4% 2% 0% Tactic and Tool Implemented: Employee Rounding Thank You Notes YEAR 1 YEAR 2 Source: Ohio Based Healthcare System, Admissions: 39,067, ED visits: 185,279, Beds: 1,009, >6,400 employees 53
- 2009 Rounding for Outcomes - Employees Rounding on Staff Senior Leader Rounding on Staff Rounding on Areas Served Rounding for Outcomes: Staff 54
- 2009 Employee Rounding Employee Satisfaction Increase Tactic and Tool Implemented: Employee Rounding Source: South Carolina Hospital, Admissions=25,837 Total beds = 594, expanding to 644 in 04/08, employee satisfaction measured by PRC. Employee Rounding Employee Satisfaction Increase 100 80 60 40 20 0 Employee Satisfaction Results 96 78 Tactic and Tool Implemented: Employee Rounding 2005 2006 South Carolina Hospital, Total beds = 109, Admissions = 4663, Employees: 772 55
- 2009 Rounding for Outcomes - Employees Concern and Care What is Working Well Rounding with Employees People to Recognize Systems to Improve Tools and Equipment Follow-up Verification Rounding Log Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. What is working well? Staff / physician to recognize? Any systems needing improvement? Do you have the tools and equipment to do the job? Anything else I can do for you right now? 56
- 2009 Rounding for Outcomes: Senior Leader Rounding Employee Complaints Lack of... IV Poles Cafeteria Hours Blood Pressure Cuffs Staffing Hot Water Deliver on the whats and employees will be happier and more productive than ever. Results That Last, Quint Studer, Chapter 10, Pg 161 57
- 2009 Rounding for Outcomes: Senior Leader Rounding 3 areas of focus Rounding on direct reports the same way all leaders round on their employees Rounding in departments using a scouting report Validating direct reports are rounding effectively Senior Leader Rounding Tips Focus on high performing areas Utilize a scouting report Share wins with the organization Follow-up on issues identified 58
- 2009 Senior Leader Scouting Report Accomplishments New equipment Staff to recognize Physician activities/issue Current pillar goal results Heads Up Tough Questions Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. Sample Rounding Stoplight Report Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. 59
- 2009 Rounding for Outcomes: Rounding on Areas Served Support Services 2003/2004 - Overall Average 5 4 3 2 1 2003/4 Department scores range from 2.4-4.9 Budget Construction Custodial Facilities/Maintenance Finance Food Service Purchasing Telecom Transportation 0 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr Source: Sarasota School System, Sarasota, FL, All Departments 60
- 2009 Support Services Fiscal Year 2007 Overall Average 5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 2007 -- All Department scores are 4.4 or above 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr 4.4 Budget Construction Custodial Facilities/Maintenance Finance Food Service Purchasing Safety & Security Telecom Transportation Source: Sarasota School System, Sarasota, FL, All Departments Rounding on Areas Served How? Make a plan Follow up and follow through Capture the wins Don t be defensive Don t give a slow NO 61
- 2009 Rounding for Outcomes: Rounding on Areas Served Why? Understands other point of view Identifies ways to enhance and improve service Builds relationships Reduces barriers Enhances communication Verification: Rounding on Areas Served Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. What are we doing well? Staff to recognize What is the best service we provide/why? When you have a problem do you know who to call? What could we do better to support you? 62
- 2009 Reward Desired Performance Thank You Notes Aligning Leader Evaluations with Desired Outcomes Rounding for Outcomes Employee Thank You Notes Employee Selection and the First 90 Days Pre and Post Phone Calls Key Words at Key Times Objective Evaluation System Leader Development Must Haves Performance Gap Standardization Accelerators Aligned Goals Aligned Behavior Aligned Process Top 5 Workplace Incentives 1. Written Thanks From Manager/Executive Team Leader 2. Personal Thanks From Manager 3. Promotion for Performance 4. Public Praise 5. Morale-Building Meetings Study conducted by Dr. Gerald Graham, Management Professor at Wichita State University Motivating Today s Employees, Bob Nelson Talent+, 1998 63
- 2009 Recognize and Reward Behavior Reinforces positive behavior Creates role models for other staff Shows staff how they can make a difference Creates improved results across organization Manages up senior leader Thank You Note Guidelines Leader assesses how many thank you notes make sense - same number of notes for each leader may not make sense. Leader identifies the number the senior leader to sends based on the staff size they oversee. Senior leaders are the individual to send notes. Total number sent will vary depending on size of the organization. Use rounding logs for follow up and to show the reason why. 64
- 2009 Verification: Log Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. Myths and Excuses Myths: Big Head If I compliment them too much they ll get a big head! Complacency If I tell them they did a good job they ll get complacent! Excuses: I don t need a compliment...why should they? They should just be happy to have a job! I can only give out so many compliments This is silly! 65
- 2009 Reality People like specific feedback Complimented and recognized behavior will be repeated There is more to a job than pay! It is okay to be uncomfortable as you begin to compliment Compliment to Criticism Ratio 3 to 1 2 to 1 1 to 1 3 compliments 1 criticism 2 compliments 1 criticism 1 compliment 1 criticism Positive! Neutral Negative Source: Tom Connellan, Inside the Magic Kingdom, pgs 91-95 66
- 2009 Employee Thank You Note Sample October 30, 2008 Dear Susan, John Smith wrote me the nicest note about the number of positive comments you have been getting on the patient satisfaction surveys. Your patients notice how you check on them every hour and are available to meet their needs. John also told me you are helping interview staff for the unit. This is very important. Thank you for being at our organization! Sincerely, Quint Once we get our corporate culture the way we want it, we have to hire people who fit. Otherwise, the wheels fall off the wagon and we quickly find ourselves back where we started. Results That Last, Quint Studer, Chapter 11, Pg 185 67
- 2009 Select Selection Aligning Leader Evaluations with Desired Outcomes Rounding for Outcomes Employee Thank You Notes Employee Selection and the First 90 Days Pre and Post Phone Calls Key Words at Key Times Objective Evaluation System Leader Development Must Haves Performance Gap Standardization Accelerators Aligned Goals Aligned Behavior Aligned Process Return On Investment All Employee - 90 Day Turnover Reduction 70 60 61 67 Number of employees 50 40 30 20 10 0 $3.32 million (salary = $36,308) $3.8 million (salary = $38,090) Tactic and Tool Implemented: Peer Interviewing 30 and 90 Day Meetings $647K (salary = $39,188) 2005 2006 2007 * 2008 Source: Indiana hospital, 426 beds, 3,100 FTE's, 2007 admissions = 9,035 * 2008 YTD data shown / Jan Nov 2008 11 $182K (salary = $40,506) 3 68
- 2009 Return On Investment RN - 90 Day Turnover Reduction Number of employees 20 18 16 14 12 10 8 6 4 2 0 15 $966K (salary = $42,900) 19 Tactic and Tool Implemented: Peer Interviewing 30 and 90 Day Meetings $1.3 million (salary = $46,200) $283K (salary = $47,300) 2005 2006 2007 * 2008 Source: Indiana hospital, 426 beds, 3,100 FTE's, 2007 admissions = 9,035 * 2008 YTD data shown / Jan Nov 2008 4 0 Return on Investment: Overall and Nursing Turnover Reduction 20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% 17.9% 14.2% 13.3% 15.1% 365 positions retained Tactic and Tool Implemented: Behavioral and Peer Interviewing 30 and 90 Day Meetings Overall Turnover 11.9% 12.1% 69 positions retained 2006 2007 2008 2006 2007 2008 Nursing Turnover Total Estimated ROI: $10 million Overall Source: Kentucky Health System, 42,000 discharges, Total beds = 1,900 beds 69
- 2009 Interdependent Relationships Quality Example Relationship Between Employee Turnover and Patient Care * Average Length of Stay Source: VHA, 2001 Selecting Talent Visit our website Identify characteristics of top performers Conduct behavioral and peer interviewing Retain talent through 30- and 90-day interviews 70
- 2009 Phase 1 Phase 1: Define the Position and Screen for Standards As specific as possible In behavioral terms Education and Experience What education and experience would the ideal candidate possess? Tell me about a time when you exceeded a patient or family member s expectations? (Standards Screening Question) Application Process: Signing the Standards (Early On) PERFORMANCE STANDARDS includes a signed agreement and commitment to the standards and values of the organization A set of performance standards has been developed by the employees of to establish specific behaviors that all employees are expected to practice while on duty. By incorporating these standards as a measure of overall work performance, makes it clear that employees are expected to adhere to and practice the standards of performance outlining the Standards of Performance handbook. I have read and understand the Standards of Performance handbook and I agree to comply with and practice the standards outlined within. Signature of Applicant Date 71
- 2009 Decision Matrix Development: Start with job description and expectations Identify indicators Weight indicators based on: Competencies (job skills) Standards Benefits: Provides staff with a tool to quantify their selection of a candidate Provides quantifiable results for feedback Provides a structured and organized method for the leader and peer interview process Develop Decision Matrix: Sample Candidate: Interviewer: Desired Experience: Minimum 3 years experience in accounting, finance or health care Diligence: Tell me about a time when you worked on a project that did not work out the way it should. Integrity: Tell me about a time when you demonstrated honesty and integrity in a work situation. Total Wt. 1-3 3 3 3 Position: Date: Candidate #1 Candidate #2 Candidate #3 72
- 2009 Phase 2 Phase 2: Leader Interviews Leader uses behavioral based interview questions to assess: Job competencies Standards of Behavior Work environment fit Completes interview using decision matrix Forwards to peer interview team selected applicants Shares decision matrix scores with peer interview team Behavioral Based Questions Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. Work Environment Tell me about a time when your unit was full and you had to care for multiple patients. How did you prioritize your work? Communication Describe a time when you had a miscommunication with a patient or family member. What did you do and what was the outcome? Initiative What processes or techniques have you learned to make a job easier or more effective? What was your discovery process and how did you implement your idea? 73
- 2009 Phase 3 Peer Interview Team: Phase 3: Peer Interviews Works with manager to identify priority competency areas Asks behavioral based questions Conducts interview, completes decision matrix Verification: Complete Decision Matrix Completed Position: Accountant Interviewer: Shannon Lee Date: 10.22.07 Desired Experience: Minimum 3 years experience in accounting, finance or health care Diligence: Tell me about a time when you had to work on a project that did not work out the way it should. Integrity: Describe a situation in which you felt it might be justifiable to break company policy or alter a standard procedure. Wt. 1-3 Candidate #1 Candidate #2 Candidate #3 3 3/9 2/6 4/12 3 5/15 3/9 3/9 3 4/12 3/9 4/12 Total 36 24 33 74
- 2009 Phase 4 Phase 4: Hire Retention Tactics start immediately Welcome note sent to home Letter explaining orientation Orientation (hospital and department) Schedule 30 and 90-day meetings with leader Input Stopping Early Departures 30 and 90 Day Meetings (Employee) Aligning Leader Evaluations with Desired Outcomes Rounding for Outcomes Employee Thank You Notes Employee Selection and the First 90 Days Pre and Post Phone Calls Key Words at Key Times Objective Evaluation System Leader Development Must Haves Performance Gap Standardization Accelerators Aligned Goals Aligned Behavior Aligned Process 75
- 2009 Impact of 30 and 90 Day Meetings Terminations Cost Difference Using 30/90 Day Questions (Checkpoints) 2003 2004 2003 2004 Leader 1 29 4 $580,000 $80,000 $500,000 Leader 2 10 7 $200,000 $140,000 $60,000 Leader 3 50 40 $1,000,000 $800,000 $200,000 Leader 4 2 0 $40,000 $0 $40,000 Not using 30/90 Questions (Checkpoints) Leader 5 15 8 $300,000 $160,000 $140,000 Leader 6 10 13 $200,000 $260,000 ($60,000) Leader 7 3 3 $60,000 $60,000 Even Leader 8 1 5 $20,000 $100,000 ($80,000) Turnover Reduction During the First Year of Employment Recommendations for the Vice President of Human Resources Tammye L. Kaper April 2005 30 and 90-Day Meetings Supervisor asks the following: How do we compare with what we said? What s working well? Have there been any individuals who have been helpful to you? Based on your prior work, what ideas for improvement do you have? What could we do differently? Is there any reason that you feel this is not the right place for you? Do you know of anyone who would be a good fit for our organization? As your supervisor, how can I help you? Added at 90 Days 76
- 2009 Verification: 30 and 90 Day Meetings Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. 3 and 6 month Meetings (Physician) Practicing Excellence, Chapter 9, Physician Selection, page 101 77
- 2009 Physician Selection Toolkit Physician Turnover 47% who leave do so in the first three years 60% leave in first five years (275 AMGA Medical Groups) 78
- 2009 Reasons Why Physicians Leave Physician Selection Orientation 3 and 6 month meetings Rounding Leader Evaluation Manager TM / Score Card Physician Code Physician Selection: Sample Behavioral Based Question Communication: Tell me a time when you realized you needed to change the way you communicated with patients. What was the change and how did it work out? Event Action Result 79
- 2009 Verification: Interview Matrix Template 3 Month and 6 Month Meeting Questions How do we compare with who we we said we were? What s working well? Has there been anyone who has been helpful to you? Based on your prior practice, what are some things we could do better here? Is there any reason that you feel this is not the right place for you? 80
- 2009 Verification: 3 Month and 6 Month Meetings Diagnostic Employee Attitude Survey 81
- 2009 Toolkit For a free toolkit on Employee Attitude Survey Rollout Process visit our website Alignment / Recognition Employee Forums 82
- 2009 Employee Forums Employee Forums are quarterly employee meetings led by senior leaders in the organization. They offer senior leaders a chance to: Communicate a consistent message to all employees Reinforce the organization s mission Gather employee feedback Connect the organization back to purpose Learn about and celebrate their workplace Employee Forum: Mini Employee Evaluation Survey Scale 1-5 I am encouraged by the direction I see within my organization. I have the materials, equipment and supplies needed to provide quality services. I am provided adequate opportunities for advancement. My supervisor exhibits a strong commitment to do what is right for department employees. The benefits package I have encourages long-term employment. I receive sufficient feedback on my performance. My evaluation was completed on time. 83
- 2009 Toolkit For a free toolkit on Employee Forums visit our website Innovation - process improvement - input Idea Express 84
- 2009 Harvesting Ideas Set clear goals and communicate Establish a process for reviewing ideas Reward and recognize for innovation Train leaders how to respond Define metrics for tracking and accountability Launch and continuously refine with focus on your goals ROI for Ideas 1700 Employee Hospital Example: Cost Savings Ideas Year 1: 4,107 Ideas Generated 1,617 Ideas Implemented $794,624.00 Total Savings Cost Savings Ideas Year 2: 1800 Implemented Ideas Over $1.6 million Total Savings Over $5.0 million Total Savings 85
- 2009 Toolkit Free toolkit on Bright Ideas Visit our website So what stops an organization s flywheel that self-perpetuating energy-andenthusiasm cycle that keeps employees striving for excellence from turning? It s we/they. Results That Last, Quint Studer, Chapter 3, Pg 38 86
- 2009 Communication Managing Up Managing Up Positioning Others in a Positive Light... Makes others better Makes your organization better Aligns behavior and energy 87
- 2009 Realistic Expectations Put yourself in your manager s shoes! Manage up when: Things are going well When people deserve praise You need to gain more specific direction Your boss deserves praise (make it specific) TIP: Ask your supervisor If in one year from now, I had exceeded your expectations what outcomes would I have accomplished? 88
- 2009 Transparency: Communication Board Example Involvement Service Teams 89
- 2009 Service Teams Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. Steering Team Standards Measurement Reward and Recognition Service Recovery Inpatient Physician Outpatient Emergency Department Service Team Examples Standards: To allow staff to create and agree upon behavior standards Measurement: To correctly measure, interpret and communicate progress of the organization s initiatives Reward & Recognition: To focus organization on reward and recognition Inpatient: To bring the same level of care to all inpatients Note: A full page electronic sample of this tool is provided in the Studer Group Tools section on the institute website/link provided. Outpatient: To bring the same level of care to all outpatients Service Recovery: To win back patients & families and improve processes (Patient Retention Opportunities) Physician Satisfaction: To improve the level of service to physicians and their patients Emergency Department: Create great service in the Emergency Department 90