Outcomes Based Leader Evaluations A Valuable …

1 1 2008 Studer Leader evaluation (LEM):A Valuable tool for the learning OrganizationRob RyderVice President, learning and Leadership DevelopmentLaurie KennedyDirector, learning and Leadership DevelopmentCentura Health, Denver, ColoradoWhat s Right in Health CareSM| Evidence to OutcomesPresentation Objectives Know the difference between outcome - Based Leader evaluation and tactic- Based Leader evaluation Understand the difference between Leader evaluation as a grading tool and Leader evaluation as a learning tool . Appreciate the power of data derived from Outcomes - Based Leader evaluation in determining, implementing, and monitoring effective, aligned, organization-wide 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhat is Centura Health? Centura Health is a large faith- Based healthcare system in Colorado. Centura is the umbrella organization that provides corporate services and leadership to the CHI (Catholic Health Initiatives) and AHS (Adventist Health Systems) healthcare facilities on Colorado s front range.

2 Centura employs about 12,000 human beings Over 800 of the employees are leaders What s Right in Health CareSM| Evidence to OutcomesWhat does Centura Health do? Provides comprehensive healthcare services through its ten acute care facilities in Frisco, Boulder, Denver, Parker, Colorado Springs, Pueblo and Canon City Provides Home Care and Hospice Services in these communities Has an extensive network of Senior Services in these communities3 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhere We re LocatedWhat s Right in Health CareSM| Evidence to Outcomes4 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhat s Right in Health CareSM| Evidence to Outcomes5 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhat s Right in Health CareSM| Evidence to Outcomes6 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhat s Right in Health CareSM| Evidence to Outcomes7 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhat s Right in Health CareSM| Evidence to Outcomes8 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhat s Right in Health CareSM| Evidence to OutcomesGetting Started Had been working towards a balanced approach to system effectiveness for several years

3 In spite of concentrated efforts to create positive change, our metrics were flat We engaged the Studer Group in 2006 because we believed that they could help give legs to the work we were doing Outcomes Based leadership evaluation is a key tactic for moving the dials9 2008 Studer s Right in Health CareSM| Evidence to OutcomesLeadership evaluation Tactics Based Focus is on: Process Programs Outcomes Based Focus is on: ResultsWhat s Right in Health CareSM| Evidence to OutcomesResults in all Pillars10 2008 Studer s Right in Health CareSM| Evidence to OutcomesLeader evaluation ManagerSM(LEM) Software program that allows a systematic way to establish and monitor achievement of strategically aligned goals Commonly referred to as the LEM What s Right in Health CareSM| Evidence to OutcomesGoal Sheet11 2008 Studer s Right in Health CareSM| Evidence to Outcomes90 Day PlanWhat s Right in Health CareSM| Evidence to OutcomesMonthly Report Card12 2008 Studer s Right in Health CareSM| Evidence to OutcomesDecisions we What organizational goals will we align to?

4 What are the targets? , How will we know when a goal has been achieved? Who will participate? How will new leaders learn about the LEM? What data will be used to populate the LEM? What goals should be required? How will achievement of goals be connected to pay?What s Right in Health CareSM| Evidence to OutcomesChallenges Compliance Orienting new leaders to system Selecting tactics instead of goals No interface to our employee database Executive Incentive plans not aligned with LEM Outcomes Understanding that a Rating of 3 means GOOD! Owning overarching goals when Leader only has influence vs. direct control Consistency13 2008 Studer s Right in Health CareSM| Evidence to OutcomesWhy LEM as a learning tool ? LEM is a living document not an event LEM is objective LEM produces data LEM data tells a story About the Leader and About the organizationWhat s Right in Health CareSM| Evidence to OutcomesLEM Goal Data Base Fields Department Division Facility Type Last Name First name Job Type Executive Type Pillar Goal Goal Type Goal Weight14 2008 Studer s Right in Health CareSM| Evidence to OutcomesJob Types Medical Staff Svcs IT Marketing Nursing Units Foundation Pt.

5 Education Gift Shop Cardiology Oncology Facilities Pulmonary Physicians Volunteers HR Rehab Clinical/nursing education. HIM Billing Imaging Health at Home EVS Finance Lab Quality Nut. Services Supply chain Pharmacy Cancer Center Registration O's & VP'sInfrastructureAncillaryClinicalSuppo rtExec/AdminWhat s Right in Health CareSM| Evidence to OutcomesStrategic Focus1. Physician Alignment2. CMS Bundle Scores3. Patient Satisfaction (HCAHPS)4. Associate Satisfaction5. Financial Performance EBITDA Expense Productivity Growth15 2008 Studer s Right in Health CareSM| Evidence to OutcomesGoal Types Accreditation/JCAHO/Compliance Assoc Satisfaction CMS Bundle/ Clinical Outcomes Community Budget Community Board Community Participation Community Perception EBITDA/Margin Expense Fund Raising Interdepartmental Satisfaction Physician Credentials Physician Satisfaction Process/Process Productivity/Staffing/Agency Pt/Res/Client/Customer Satisfaction Revenue/Collections Safety TAT Turnover Volume/GrowthWhat s Right in Health CareSM| Evidence to OutcomesThe Normal Look at Organizational Effort3658 Grand Bundle/ Cinical Sat% of GoalsCountGoal Type Reclass16 2008 Studer s Right in Health CareSM| Evidence to OutcomesA Closer Look3658 Grand Bundle/ Cinical SatAvgWght% of GoalsCountGoal Type ReclassWhat

6 S Right in Health CareSM| Evidence to OutcomesThe Closest Bundle/ Cinical SatAvgWght% of TtlWght% of GoalsCountGoal Type Reclass17 2008 Studer s Right in Health CareSM| Evidence to SatCMS Bundle/ Cinical OutcomesComm BgtComm BoardComm Partic ipationComm PerceptionEBITDA/TTL Bgt/MarginExpenseFund RaisingInterdept SatPhys CredentialsPhys. SatProcess/PI/TrainingProductivity/Staff ing/AgencyPt/Res/Client/Customer SatRevenue/CollectionsSafetyTATT urnoverVolume/GrowthTotalFac ility Ty pe(A ll)Sum of Goal Wt%Goal Type ReclassDrop Series Fields HereEffort Placement by Goal Type by Job TypeWhat s Right in Health CareSM| Evidence to OutcomesExecutive Effort Placement by thPeopleQualityServiceCEOCFOCMOCNOCOOFac ility Type(All)Sum of Goal Wt%Pi l l a rExecutive Type18 2008 Studer s Right in Health CareSM| Evidence to OutcomesExecutive Effort Placement by Goal SatCMS Bundle/ CinicalOutcomesComm BgtComm BoardComm Partic ipationComm PerceptionEBITDA/TTL Bgt/MarginExpenseInterdept SatPhys CredentialsPhys.

7 SatProc es s /PI/TrainingProductivity/Staffing/Agency Pt/Res/Client/Customer SatRevenue/CollectionsSafetyTurnoverVolu me/GrowthCEOCFOCMOCNOCOOFac ility Ty pe(A ll)Sum of Goal Wt%Goal Type ReclassExecutive TypeWhat s Right in Health CareSM| Evidence to SatCMS Bundle/ CinicalOutcomesEBITDA/TTL Bgt/MarginExpensePhys. SatProductivity/Staffing/AgencyPt/Res/Cl ient/Customer SatVolume/GrowthCEOCFOCMOCNOCOOFac ility Ty pe(A ll)Sum of Goal Wt%Goal Type ReclassExecutive TypeExecutive Effort Placement by Strategic Emphasis19 2008 Studer s Right in Health CareSM| Evidence to SatCMS Bundle/ CinicalOutcomesEBITDA/TTL Bgt/MarginExpensePhys. SatProductivity/Staffing/AgencyPt/Res/Cl ient/Customer SatEx e c / A d minFac ility Type(All)DIV(A ll)Sum of Goal Wt%Goal Type ReclassJob TypeCombined Executive Effort by Strategic EmphasisWhat s Right in Health CareSM| Evidence to OutcomesJob Types Medical Staff Svcs IT Marketing Nursing Units Foundation Pt. Education Gift Shop Cardiology Oncology Facilities Pulmonary Physicians Volunteers HR Rehab Clinical/nursing education.

8 HIM Billing Imaging Health at Home EVS Finance Lab Quality Nut. Services Supply chain Pharmacy Cancer Center Registration O's & VP'sInfrastructureAncillaryClinicalSuppo rtExec/Admin20 2008 Studer s Right in Health CareSM| Evidence to OutcomesEffort Placement by Pillar by Job thPeopleQualityServiceAncillaryClinic alEx e c / A d minInf rastructureSupportFac ility Ty pe(A ll)Sum of Goal Wt%PillarJob TypeWhat s Right in Health CareSM| Evidence to OutcomesEffort Placement by Goal Type by Job SatCMS Bundle/ Cinical OutcomesComm BgtComm BoardComm Partic ipationComm PerceptionEBITDA/TTL Bgt/MarginExpenseFund Rais ingInterdept SatPhys CredentialsPhys. SatProc es s /PI/TrainingProductivity/Staffing/Agency Pt/Res/Client/Customer SatRevenue/CollectionsSafetyTATT urnoverVolume/GrowthAncillaryClinic alEx e c / A d minInf rastructureSupportDIV(A ll)Sum of Goal Wt%Goal Type ReclassJob Type21 2008 Studer s Right in Health CareSM| Evidence to SatCMS Bundle/ CinicalOutcomesEBITDA/TTL Bgt/MarginExpensePhys.

9 SatProductivity/Staffing/AgencyPt/Res/Cl ient/Customer SatVolume/GrowthAncillaryClinic alEx e c / A d minInf rastructureSupportFac ility Ty pe(A ll)Sum of Goal Wt%Goal Type ReclassJob TypeEffort Placement by Strategic Emphasis by Job TypeWhat s Right in Health CareSM| Evidence to SatCMS Bundle/ CinicalOutcomesEBITDA/TTL Bgt/MarginExpensePhys. SatProductivity/Staffing/AgencyPt/Res/Cl ient/Customer SatVolume/GrowthTotalFac ility Ty pe(A ll)Sum of Goal Wt%Goal Type ReclassDrop Series Fields HereCombined Effort by Strategic Emphasis (All Job Types)22 2008 Studer s Right in Health CareSM| Evidence to SatCMS Bundle/ Cinical OutcomesComm BgtComm BoardComm Partic ipationComm PerceptionEBITDA/TTL Bgt/MarginExpenseFund RaisingInterdept SatPhys CredentialsPhys. SatProcess/PI/TrainingProductivity/Staff ing/AgencyPt/Res/Client/Customer SatRevenue/CollectionsSafetyTATT urnoverVolume/GrowthTotalFac ility Ty pe(A ll)Sum of Goal Wt%Goal Type ReclassDrop Series Fields HereEffort Placement by Goal Type by Job TypeWhat s Right in Health CareSM| Evidence to OutcomesConclusions Effort tends to be focused on what we control, not what we can influence Number of leaders choosing a given goal is not an indication of the effort that will be expended towards attaining that goal Goal alignment among executives cannot be assumed23 2008 Studer s Right in Health CareSM| Evidence to OutcomesTry not.

10 Do, or do not. There is no 'try.'What s Right in Health CareSM| Evidence to OutcomesThe learning Organization ..How well do we know ourselves? Are individual intentions aligned with organizational intentions? Is our effort aligned towards the same Outcomes ? It s not how well we are doing, it s how well we re doing on the right stuff!24 2008 Studer s Right in Health CareSM| Evidence to -Sept01 Sept-Nov01 Dec01 -Feb02 Mar02 -May02 June-Aug02 Sept- Nov02 Dec02 -Feb03 Mar03 -May03 June- Aug03 Sept- Nov03 Dec03 -Feb04 Mar -May04 June- Aug04 Sept- -Sept01 Sept-Nov01De c01 -Fe b02Ma r02 -Ma y02 June-Aug02 Sept -Nov02 Dec02 -Feb03Ma r03 -Ma y03 June -Aug03 Sept -Nov03 Dec03 -Feb04Ma r -May04 June -Aug04 Sept -No v04 learning .. is what fills the space between where you are .. and where you want to be!The Right People!The Right Effort!On the Right Stuff!What s Right in Health CareSM| Evidence to OutcomesLessons Learned Educate the Board: align goals and incentives Targets must be meaningful and achievable Goal setting process must start at top and cascade down to ensure alignment and focus Data must be accessible and consistent Use more pre-populated goal templates Be clear about philosophy when designing Reporting Outcomes in multiple ways reduces compliance A LEM or LEM-like tool provides a powerful and necessary infrastructure for achieving goals25 2008 Studer s Right in Health CareSM| Evidence to OutcomesNext Steps Educate Board Establish meaningful targets Connect the Dots Education on how each employee group can influence strategic targets Build more pre-populated templates Start goal selection process with Corporate CEO and cascade down Audit to ensure weights reflect strategic direction Automate data mining Use LEM as primary dashboard for monitoring Tie incentives to LEMWhat s Right in Health CareSM| Evidence to OutcomesANY QUESTIONS?