Focus Management Workshop & Cocktail Reception...•“Measure what you treasure” –REAL issues,...

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Focus Management Workshop& Cocktail Reception

Strategic Planning, Organizing, Leading and Monitoring

Management Model An Interactive Workshop

4th Annual Focus Manager’s – Mini ConferenceDay of the Week, May 7, 2017 2:00 pm – 5:30 pm

Darnetta Clinkscale, MBA, RRTSt. Louis, Missouri

Focus Management Workshop& Cocktail Reception

Strategic Planning, Organizing, Leading and Monitoring

Management Model An Interactive Workshop

6TH Annual Focus Manager’s – Mini ConferenceSunday, May 7, 2017 2:00 pm - 5:30 pm

Darnetta Clinkscale, MBA, RRTSt. Louis, Missouri

Including

138 RRTs

2015 – BY THE NUMBERS

ObjectivesThe learner will be able to:

Utilize a simple framework to build departmental plans

that support the organization’s

vision and priorities

Identify the key components of

delegation, setting expectations,

measuring performance and

holding people accountable

Choose at least one of several

monitoring tools to track

departmental successes

Differentiate between

management and leadership

skills

Have fun

in the

workshop!

Why Plan?

Alice: Which way should I go?

Cheshire Cat: That depends on where you are going.

Alice: I don’t know where I am going.

Cheshire Cat: Then it doesn’t matter which way you go!!

The Plan

• In the beginning was the Plan

• And then came the assumptions

• And the assumptions were without form

• And the plan was completely without substance.

• And the darkness was upon the face of the workers

Strategic Planning is Not:

A SIMPLE APPLICATION OF QUANTITATIVE TECHNIQUES TO

BUSINESS PLANNING

FORECASTING

• …..concerned with making decisions today that will affect the organization (product line) and its future.

• …..a process that helps managers access the risks they must take by gaining a better understanding of the parameters involved in their decisions.

Strategic Planning IS:

Management Skills Pyramid

SUCCESS

IMPROVE SELF

DEVELOP STAFF

GET IT DONE!

LEADERSHIP

TIME MANAGEMENT

MOTIVATION INVOLVEMENT

SELFMANAGEMENT

TRAINING&

COACHING

CONTROLDIRECT

ORGANIZE

Vision:

• Outlines what the organization wants to be, or how it wants the world in which it operates to be (an "idealized" view of the world).

• Is a long-term view - concentrates on the future.

• Can be emotive - is a source of inspiration. 11

Mission:

• Defines the fundamental purpose of an organization or an enterprise, succinctly describing why it exists and what it does to achieve its vision.

Values:

• Beliefs that are shared among the stakeholders of an organization.

• Drives an organization's culture, priorities and provides a framework in which decisions are made.

Strategy:

• Narrowly defined, means "the art of the general".- a combination of the ends (goals) for which the origination is striving and the means (policies) by which it is seeking to get there.

Is sometimes called a roadmap -which is the path chosen to plow towards the end vision.

Hoshin planning systematizes strategic planning. To be truly effective, it must also be cross-functional, promoting cooperation along the value stream, within and between business functions.

Hoshin planning is a seven-step process, in which you perform the following management tasks:

1. Identify the key business issues facing the organization.

2. Establish measurable business objectives that address these issues.

3. Define the overall vision and goals.

4. Develop supporting strategies for pursuing the goals. In the Lean organization, this strategy includes the use of Lean methods and techniques.

5. Determine the tactics and objectives that facilitate each strategy.

6. Implement performance measures for every business process.

7. Measure business fundamentals.

Hoshin Planning Process - Step 1

Identify the key business issues facing the organization.

Establish measurable business objectives that address these

issues.

Hoshin Planning ProcessStep 3

Define the overall vision

and goals.

Hoshin Planning ProcessStep 4

Develop supporting strategies for pursuing the goals.

In the Lean organization, this strategy includes the use of

Lean methods and techniques.

Determine the tactics and objectives that facilitate each

strategy.

Implement performance measures for every business

process.

Measure business fundamentals

Goal 2014 Target 2012 Strategies

Safety

UHC Quality & Accountability:

Top 10

Avoid all preventable harm

Partner with physicians to reduce mortality

Quality

Improve and implement standardized clinical workflows

Support continuum of care initiatives

Improve patient access and flow

Service Overall Satisfaction: Top Decile

Internalize ICARE values to drive service excellence behaviors

Accelerate improvement of overall patient satisfaction levels

People Employee Engagement: 85

Develop, retain & recruit the most talented people

Create culture of diversity & inclusion

Proliferate and mature Lean management model

InnovationAdjusted Patient Days:

Multi-Year Model Level

Develop & strengthen clinical programs

Transform facilities through Master Facility Plan deployment

FinancesOperating Margin: 4%

Supply Expense/Net Revenue: 19%

Lower supply expense growth to less than revenue growth

Ensure efficient, productive use of resources

Effectively provide, measure & communicate community

benefit

Implement world-class systems and processes

RESPIRATORY CARE SERVICES – STRATEGIC PRIORITIES

What we doWhat we measureWhat we improveProjects, Events,

“Just Do It’s”, etc

Mother Strategies

Hoshin -

1. The Big Picture

Patient feedback

ACA, JC, UHC & other

Regulations

Our Team ideals,

plans, etc.Hospital

direction & priorities

The Hoshin - Key Concept We are Pursuing

• Must be meaningful ‘from the gut’

Give Team members (Patients)

what they need,

when they need it

HOSHIN

Mantra

WAR CRY

MANTRA

Mother

Strategies

• Key dimensions to improve

– Per BJH Strategic Framework 2014

– Main goals, Projects MUST branch from them

• For max focus, we work on three vitals:

– Quality-Safety

– People

– Finance

1. ‘Big Picture’ Structure Elements

Give Team members and patients what they need

QUALITY-SAFETY* Do basics right* ↓ readmissions

RCS: Implement best practices

Pulm: 100% Pts demo basic Disease Mgmt skills

Rehab: 80% of Patients meet their Therapy Goals

PEOPLE

* ↑ development

* ↑ communication

Director: Daily rounds

Rehab, RCS: ↑ 200% in Development

RCS: Understand,↓ causes of OT

FINANCE* ↓ unit cost

All Depts: unit cost by 1-5%

Pulm: ↓ avoidable non-reimbursed care

The ‘Real’ Structure Elements

How Projects Relate

• System approach

• Promotes ‘seeing the forest, seeing

the trees’

• Everyone knows how they

support

• Improved accountability

2. Strategic Projects

• LESS projects –ALL strategic

MORE meaning, MORE depth

MORE time, resources, support

MORE visibility & authority

MORE tracking & accountability

• Projects “build on” each other towards

Hoshin

2. Proposed Process

1. Set up Balanced Scorecard, Dashboard, Projects

2. Lay out overall Project at start

3. Set “Tollgate Reviews” at specific phases

a) What main actions & documents close all loops?

b) Milestone to assess progress & next steps

4. Weekly check-plan work sessions

5. Monthly metric-project checks

Team roles

• Project Owner:

– Role: Lead Team to get it done

• Manager:

– Role: Sponsor, enable, support, uphold

• Director:

– Role: Point direction

• Process Owner:

– Role: Care for the baby

• Mentor:

– Role: Tech support

The Key Work Principles

• Every person, every time:

1. Sane

commitment

2. Deep

Understanding

3. Scientific

Thinking

4. Flawless

Execution

• Hold each other

accountable: Open Door

Project Non-Negotiables: Dashboard

Project Non-Negotiables: Charter

• Outlines the basics of the Project –from what, to

what, why, who, how will we know, when

Project non-negotiables: Project graphs

• Leading Metrics & Lagging metrics

• Again, LESS and MORE

Q1 Q2 Q3 Q4

Performance

Q1 Q2 Q3 Q4

Performance

Q1 Q2 Q3 Q4

Performance

Q1 Q2 Q3 Q4

Performance vs. goal

Examples of Project Graphs

Lagging (outcome) Leading (process, behavior)

1 2 3 4 5 6 7 8 9 10 11 12

NCTM's: Workload analyzed & reassigned to

support direct Patient Care

Total hrs Hrs analyzed

NCTM Leading metric 1: Jobs analyzed per week

NCTM-equivalent analyzed

Goal NCTM's analyzed

7-Apr 7-May 7-Jun 7-Jul 7-Aug 7-Sep 7-Oct 7-Nov 7-Dec

NCTM Leading metric 2: Hrs/wk transferred from non-clinical work to direct Patient care

support per week

Goal NCTM's analyzed Hrs/wk released

Goal hrs released

Project non-negotiables: Timeline• Links tasks to dates –then monitors through closure

– What did we do? What came out? What’s next?

Project Non-Negotiables: Tollgates

• Based on PDCA

• Project Owner, Manager agree

how to execute

• Team supports execution

• Check work done

with Director, Mentor @ end of

3. Accountability:

Structure & Tools (Projects)

Weekly Project Check & Plan

•WHY: Assess & plan weekly progress vs. plan; keep focus & accountability

•WHO: Project Owner, Manager [Mentor, guests]

•WHAT: 1:1, 30 min/ea

•HOW: Review previous week plan & actions; assess impact on goals & learning; plan for next week’s work

Monthly Dept. Check

•WHY: Ensure progress per plan; assess impact

•WHO: Director, Manager, all Project Owners [Mentor]

•WHAT: Review-update all projects <15 min/ea

•WHAT: Review and update timeline; capture actions & needs so far; translate impact into VS Plan

Quarterly Strategy Check

•WHY: Big-picture reflection, prioritize action

•WHO: Director, Managers, Mentor

•WHAT: Check-adjust progress vs. plan, <10 min/project

•HOW: Present VS plan, timeline & scoreboard; assess progress, adjust actions for next quarter

References and supporting documents:• Roles and responsibilities• Agenda/checklist guideline for each meeting• Essential Project documents

4. The Discipline

• “Thou shall learn to collect AND use data”

• Leaders:

– Don’t miss the MDI Walk unless you are off-site

– Will train in Leadership & Lean

• Will complete a project

• Will continue to use your learning

• Right process will yield the right results: Build

reliability in your process

• Trust the process

Discipline: Foundation

• Team trained :

– Everyone: Leadership Development &

Beyond (CLL), Situational Leadership,

Appreciative Inquiry, ...

– 5 Yellow Belts (2006-2009)

– 3 Team members trained in Black Belt

– 11 Graduated Lean Facilitators,

3 more by Jul 2014; 8 planned

– Documents, tools, references

• Using Lean & ProbSolv “daily”

Discipline: MDI

• “Measure what you treasure”

– REAL issues, goals; seek what matters

– Celebrate gains & evolve

• Beyond the board: Go for ‘Deep Understanding’

– Weekly meetings: mandatory

– Actively search for trends & actions

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul

2012 2013

RCS: KBMA compliance vs. Goal Jan 2012 - Jul 2013

5. Progress and Future

• All projects started: Project

Owner developed Charter,

Timeline & Graphs

• Key documents in safe, official

location

• Following structure for

accountability

Break out into small groups for interactive activities using the skills presented in this section!

• Organizing can be viewed as the activities to collect and configure resources in order to implement plans in a highly effective and efficient fashion.

• Organizing is a broad set of activities, and often considered one of the major functions of management.

Organize

• Organization Chart

• Task and Job Analysis

• Job Description

• Employee Performance Planning (the overall process ensures ongoing, effective organizing)

• Time Management

Organize

Organization Charts as a Management Tool

Craft an Org Chart that reflects where you want the organization to go, rather than simply reflects how it is now. If you want a flat, horizontal organization, draw the Org Chart that way.

Organize

Respiratory Shared Governance Structure

SharedGovernance

Council

Documentation

PerformanceImprovement

Protocols &Research

Policies &Procedures

Reward &Recognition

Health &Career Fairs

OrganizationalCommittees

Break out into small groups

for interactive activities using the skills presented in this section!

Organize

• Directing is the action step.

• You have planned and organized the work.

• Now you have to direct your team to get the work done.

• Start by making sure the goal is clear to everyone on the team.

• Do they all know what the goal is?

• Do they all know what their role is in getting the team to the goal?

• Do they have everything they need (resources, authority, time, etc.) to do their part? 55

Direct

• Direct

• Now flip the "ON" switch.

• Execute!!!

Direct

Leadership StylesIs the manner and approach of providing direction, implementing plans, and Motivating people. Kurt Lewin (1939) led a group of researchers to identify different styles of leadership. This early study was very influential

and established three major leadership styles.

(U.S. Army Handbook, 1973):

Authoritarian or autocratic

Participative or democratic

Delegative or Free Reign

Direct

“If you want it done

right, do it yourself!”

MYTH BREAKER

DELEGATION

What is delegation?

To “Delegate” means to entrust or transfer the responsibility

and/or authority to complete a task or project to someone

What is delegation?

Three Ways to Delegate…

• By task (i.e., writing a report, coordinating a changeover, researching a patient complaint)

• By function (a group of tasks related to one particular activity, such as inventory and ordering, safety training, scheduling)

• By goal (various tasks necessary to fulfill a particular objective, such as improving productivity or developing a new patient program.

EFFECTIVE DELEGATION OBJECTIVES

If used effectively, delegation can be a useful tool for efficiency, training, coaching, and empowering employees (development).

Successful delegation requires:

thorough planning

clear communication

consistent follow-up, and

feedback

THREE COMPONENTS OF DELEGATION

Authority

The level of autonomy or power relative to the work/task you decide to assign: determining how the work/task will be done, making decisions, calling meetings, collecting information, contacting people, spending money.

Responsibility

Any or all of the actual work or tasks you decide to have the person(s) perform.

FOR TRUE DELEGATION SUCCESS

• You CAN delegate responsibility and authority

• You CANNOT delegate accountability, but you can share it.

Why You Should DelegateDelegation is an essential part of being a leader.

Benefits for You

Save Time

Achieve More

Increase Your Value

Benefits for Your Team Members

Efficiency

Flexibility

Teamwork

Balanced Workloads

Aid Communication

Retain Good Team Members

What To DelegateSuccessful delegation relies, in part, on choosing the right tasks to

delegate

What You Should Delegate

Routine Tasks

Interesting Tasks

Tasks Others Could Do Better

Tasks Others Might Enjoy

Tasks Good for Development

Whole Tasks

Time-Consuming Tasks

Task for Which You are Not Responsible

What You Should Not Delegate

Boring Tasks

Crises

Ill-Defined Tasks

Confidential Matters

Praise or Reprimand

Planning the Development of Your Team

Tasks for Which You Are Responsible

Group Exercise

(Barriers)

Why People Don’t Delegate

Barriers to Delegation:

Barriers from You

Not Enough Time

Losing Control

Not Getting Credit

You Can Do it Better

Delegate out of a Job

No Confidence in Team Members (Selflessness)

Barriers from Your Team Members

Not enough time

Not Enough Experience

Fear of Failure

Not Their Responsibility

Fear of Being a Scapegoat

Reactions from Other Team Members

TO DELEGATE, OR NOT TO DELEGATE…

General Benefits of Delegating

• Frees manager’s time for other things

• Involves, develops, and empowers employees

• Helps build employee interest and teamwork

• Can produce better results or products faster

Reasons We Don’t Delegate

• Concern about losing control/authority

• Hesitant or unwilling to take risks

• Enjoy doing tasks which should be delegated

• Not having or taking the time to delegate

Reasons We Don’t Delegate (cont’d.)

• It will get done better/faster if you do it

• Insist on specific method/level of perfection

• There’s no one to delegate the work to

• Concern about overloading employees

Reasons We Don’t Delegate (cont’d.)

• Things that keep us from delegating are often perceptual

• If they seem real then they are to you

• “Perception is reality”; however they may keep you from meeting your delegation goals!

• To overcome these barriers, you must first know what they are!

TO WHOM SHOULD YOU DELEGATE?

Reasons We Delegate to a Specific Employee

• Learn or improve a specific skill/ability

• Utilize his/her special expertise or skills

• Challenge or motivate the employee

• To reward positive performance

• Develop or prepare for a future position

Components of Effective Delegation

• What additional information or training will they need and what resources are available?

• What are your expectations for staying informed?

• How will you provide feedback during and after delegation?

Levels of Delegation Autonomy

DO IT THIS WAY

TALK TO ME BEFORE

MAKING ANY CHANGES

KEEP ME INFORMED ALONG THE

LET ME KNOW HOW

IT WENT

Complete the task/assignment

as directed

Complete the task assignment. If you run into any issues or think changes should be made, take the initiative to gather relevant information and

bring your recommendations

to me.

Complete the task assignment and

handle all related issues or decisions. Keep me informed

of your progress and the actions and the actions you are

taking.

Complete the task/assignment

and handle all related issues or

decisions. Update me upon

completion.

1 2 3 4

The Process of Delegation

Preparation

1. Make a list of Tasks and Teammates

2. Define Your Outcomes

3. Know Supplies, Resources and Authority Required

4. Anticipate Questions

Choose a Task

1. Deadlines Required

2. Quality of Work Needed

3. Development Opportunities

Choose a Team Member

1. Skills

2. Development

Delegate

1. Schedule a Meeting

2. Explain the Importance

3. State Desired Results

4. Give Clear Instructions

5. Involve the Team Member

6. Explain What; Not How

The Process of Delegation (Cont’d.)

Delegate (Cont’d.)

7. Assign Accountability

8. Check Progress

9. Collaborate on a Deadline

10. Get a Commitment

11. Let Go!

The Process of Delegation (Cont’d.)

Follow-Up at Meetings

1. Support

2. Encourage

3. Modification

When There Are Problems

1. Get a Summary

2. Get a Solution

3. Wait

4. Delegate Corrective Action

5. Guard Against ‘Reverse Delegation’

Evaluation

1. Constructive Criticism

2. Criticize the Actions, Not the Person

3. Give Credit When It’s Due

In Summary: COMPONENTS OF EFFECTIVE DELEGATION

• What does successful completion look like?

• Why are you delegating to them?

• What is the expected timeframe for completion?

• What are the parameters for decision making, level of authority, responsibility and accountability?

Famous DELEGATION Quotes

• “If you want to do a few small things right, do them yourself. If you want to do great things and make a big impact, learn to delegate.” John C. Maxwell

• “If you delegate tasks, you create followers. If you delegate authority, you create leaders.” Craig Groeschel

• “Delegating work works, provided the one delegating works, too.” Robert Half

• “Few things help an individual more than to place responsibility upon him, and to let him know that you trust him.” Booker T. Washington

• “No one will ever be a great leader who does not take genuine joy in the success of those who follow him.” IllusionFactory.com

• “You can do anything, but not everything.” David Allen

ABOUT DELEGATION…..

Fact or Myth:

“If you want it done right, do it yourself”!

Busted Confirmed Plausible

Acknowledgements

• BJC Preparing New Leaders

• Parks Scholarship: North Carolina University

• MDC’s life experiences

for interactive activities using the skills presented

in this section!

Direct

Problem Solving

There are seven basics steps to problem solving:

1. Identify the problem

2. Gather information

3. Develop courses of action

4. Analyze and compare courses of action

5. Make a decision

6. Make a plan

7. Implement the plan

(Butler, Gillian, Hope, 1996)94

Control

• Plan– Understand the problem; identify root cause

– Plan changes

• Do– Implement changes

• Check– Monitor changes

– Follow up

• Act– Adjust

– Celebrate and reward success

PDCA Cycle

Control

Review of several

Monitoring tools

Control

Monitor

• Now that you have everything moving, you have to keep an eye on things.

• Make sure everything is going according to the plan.

Control

This is an ongoing process.

When something is out of sync, you need to

• Adjust to keep the Plan on tract.

• Organize the resources to make it work,

• Direct the people who will make it happen,

• Continue to Monitor the effect of the change.

Control

for interactive activities using the skills presented

in this section!

Control

Darnetta Clinkscaledclinkscale@bjc.org

314-362-1010