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  • 1. Creating a Culture of Performance ExcellenceEnhancing Business Acumen by Leveraging ActiveStrategy to Manage PerformanceCorwin Nathaniel Harper, MHA, FACHESenior Vice President/Area ManagerCENTRAL VALLEY AREA April 20122 | © 2012 Kaiser Foundation Health Plan, Inc.Creating a Culture of Performance ExcellenceManagement &People PracticesRecognition & FeedbackBusinessPerformanceManagement &MetricsWork Processes/Systems& PerformanceImprovementVision &StrategyLeadershipCredibility & TotalPerformanceBehaviorsStructure &OrganizationalDesignCultureThe Journey to Sustainable Excellence
  • 2. 3 | © 2012 Kaiser Foundation Health Plan, Inc.Creating a Culture of Performance ExcellenceKaiser Permanente – Guiding BehaviorsTakes AccountabilityFocuses on the CustomerDrives for ResultsDevelops Self and OthersCommunicates EffectivelyCollaboratesChampions Innovation and ChangeThinks and Acts StrategicallyLeverages TechnologyDemonstrates Resource StewardshipDemonstrates Business Acumen4 | © 2012 Kaiser Foundation Health Plan, Inc.We assessed various models to enhance/improve performance.After careful consideration we settled on the Studer model becausethe Five Pillars and Nine Principles aligned with the priorities atKaiser Permanente.Steps to Enhancing PerformanceDetermining Our Approach
  • 3. 5 | © 2012 Kaiser Foundation Health Plan, Inc.Enhancing PerformanceWhy Build Business Acumen ThroughBusiness Performance Reviews?Requires analysis of business workflowsPrompts critical thinking and strategic planningConsideration of outcomes and financesFocuses on critical drivers and indicators of performanceProvides a forum for managers and directors to present criticalperformance indicators to leaders, and get real-time feedbackEnables leaders, directors, and managers to jointly make proactivedecisions and allocate resources to positively impact future outcomes6 | © 2012 Kaiser Foundation Health Plan, Inc.Dr. Raymond R. Reilly of the Ross School of Business atthe University of Michigan and Dr. Gregory P. Reilly of the University ofConnecticut document traits that individuals with business acumenpossess:– Have an acute perception of the dimensions of business issues– Can make sense out of complexity and an uncertain future– Are mindful of the implications of a choice for all the affectedparties– Are decisive– Are flexible if further change is warranted in the futureEnhancing PerformanceHow Does Business Acumen Drive Performance?
  • 4. 7 | © 2012 Kaiser Foundation Health Plan, Inc.The Road Toward EffectivePerformance ManagementBusiness Acumen + Rounding + Performance Management = Performance ImprovementStrategic thinkingThoughtful analysisUnderstanding the logic behind businessdecisionsRounding integrated into daily businessfunctionsCareful attention to key dimensions ofplanning and executionClear accountability and ownershipMore disciplined performance managementEffective Performance ManagementInvolving Your Staff to Achieve Outcomes – Rounding Tool
  • 5. 9 | © 2012 Kaiser Foundation Health Plan, Inc.Business Performance Management Utilizing theBusiness Performance Review ProcessDefinitionsBusiness Performance Management: A disciplined, structured andongoing management practice supporting strategy execution thatenables leaders at all levels to be fully informed of theirbusiness/operations.Business Performance Review: A highly structured, ongoing,data-driven conversation between a manager and his/her direct reports.2.10 | © 2012 Kaiser Foundation Health Plan, Inc.Business Performance Review: Meetings are focused on strategicgoals and the operational performance of the business units(i.e., patient care services and support services).The meetings are discussions, not report outs. Leaders, directors,and managers meet with key members of the leadership team todiscuss performance, results from rounding, and get input/feedbackfor further enhancements.Rounding: Key rounding questions are integrated into each session.Examples: How can I assist you? What resources or tools do youneed? Do you have the support you need to be successful? Arethere barriers that I can help you with?The Business Performance ReviewHow are the Reviews Structured?
  • 6. 11 | © 2012 Kaiser Foundation Health Plan, Inc.Business Performance Review – ContinuousImprovement Cycles to Enhance PerformancePlan, Do, Study, ActPDSA CycleconstantPLANWhat are the needsof the patient?How can we get timelyand relevant information?DODevelop a tool to collectreal-time information in timeto impact the care and serviceexperience of the patient.STUDYAssess the information collectedand determine the one-time issuesversus trends.Resolve one-time issues and developa rapid plan to change operationsthat impact many patients.ACTDetermine how toimprove data collectionand resolution process-- and begin new PDSA cycle.12 | © 2012 Kaiser Foundation Health Plan, Inc.The evolution of data collection and actions associated with the datais a continuous improvement process at Kaiser Permanente in theCentral Valley Area.It is our desire to gain real-time information to continually enhance thecare and service experience for our patients and members in theCentral Valley Area; this desire helps to focus our efforts.Rounding is the key component of the process and we have learnedto collect real-time information to impact the care and serviceexperience of our patients and members. Because of our approachwith rounding, we can address needs or issues before dischargesoccur. This is what motivates us to continually enhance ourperformance. The patient/member is at the center of our work.The Business Performance ReviewPDSA Cycles
  • 7. 13 | © 2012 Kaiser Foundation Health Plan, Inc.Previously we used a paper process to round on ourpatients and members.Information was collected, entered into a spreadsheet, andreviewed at some point in the future. This is reactive.Now, we use technology to collect data, quickly analyze itand make adjustments to ensure that the patient/memberexperience is excellent. This is proactive.The Business Performance Review ProcessThen and Now14 | © 2012 Kaiser Foundation Health Plan, Inc.The Business Performance Review with PaperPaper-driven processMultiple data sourcesGathering, sorting, andtracking of paper documentsIncreased meetingsCumbersome tracking ofaction plansOngoing email strings
  • 8. 15 | © 2012 Kaiser Foundation Health Plan, Inc.The Business Performance ReviewPast PresentElectronicAutomatedProcessesInformation TechnologyPerformance ImprovementLeveraging Technology is an Integral Component to Greater EfficiencyPaper &ManualProcesses16 | © 2012 Kaiser Foundation Health Plan, Inc.After reviewing resources to helpmanage performance, ActiveStrategywas selected as the next tool to add tothe toolkit.Along with ActiveStrategy, wedetermined that we needed to use anelectronic tool for rounding to allowimmediate data analysis.The iPad with the iRound application wasselected for departmental rounding.The Business Performance ReviewA Look at the Present -- Leveraging Technology
  • 9. 17 | © 2012 Kaiser Foundation Health Plan, Inc.The Business Performance ReviewA Look at the Present -- iPad18 | © 2012 Kaiser Foundation Health Plan, Inc.The Business Performance ReviewTechnology in Health CareThe evolution of health care technology enables us toimprove efficiency and enhance performance to ensurethe highest quality of care and service experience forour patients and members.
  • 10. 19 | © 2012 Kaiser Foundation Health Plan, Inc.Health Care TechnologyThe Systems Theory20 | © 2012 Kaiser Foundation Health Plan, Inc.The Business Performance ReviewRounding for OutcomesSingle source of the “truth”– Centralized scorecard– Single action plan– Single report to meet multiplecommittee/oversight needsPaperlessAbility to meet from diverselocationsRounding for outcomesMore time for open dialogue,business discussions, and jointstrategic decision making.
  • 11. 21 | © 2012 Kaiser Foundation Health Plan, Inc.The Business Performance ReviewPerformance ManagementScorecards easily updated and accessibleFocus on both short-term and long-range outcomesConsistent communication and ongoing feedbackCritical metrics tracked; trends and gaps in performance visible forcourse correctionsOngoing performance and improvement initiativesStrengthen the system/structure for communicating and reinforcingstrategyStreamline method for ongoing review of performance against targets22 | © 2012 Kaiser Foundation Health Plan, Inc.Business Performance ReviewClinical Informatics Improves Outcomes:A Look at the Present and the Future PossibilitiesClinical informatics transforms the health care experience byfacilitating our ability to analyze, design, implement, and evaluateinformation.Future advancements and communications systems allowenhancements to patient care and safety, and strengthen theprovider-patient relationship.
  • 12. 23 | © 2012 Kaiser Foundation Health Plan, Inc.Creating a Culture of Performance ExcellenceWhat are your Contributions to Quality of Care and Service ExcellenceHow are you managing performance?24 | © 2012 Kaiser Foundation Health Plan, Inc.Creating a Culture of Performance ExcellenceQuestions?