Building a Culture of Accountability, Alignment and Transparency
April 22, 2015| Bill Santulli, Executive Vice President/Chief Operating Officer
Building a Culture of Accountability, Alignment and Transparency
Outline
• Advocate Health Care• Accountability Defined• Principles• Alignment and Organizational Rhythm• Operating Practices• Q & A
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AccountabilityDefinition*
The obligation of an individual or organization to account for its activities, accept responsibility for them, and to disclose the results in a transparent manner.
* BusinessDirectory.com4
“WINNING”
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Report Card – March 20152020 Strategy
Key Result Area
Measure Target Actual Achieved
Serious Safety Event Rate Change -5.0% -5.8% Safety Event Reporting Rate 3.5 4.0
QUALITY Health Outcomes Score 100 57
Patient Engagement 75 57
Associate Engagement 80 >90 Physician Engagement 75 77
GROWTHNet Revenue Growth (% vs Prior Year)
6.18% 6.83% Operating Margin 1.81% 5.09% Hospital Cost per Discharge $8,077 $8,004 Medical Group Cost per Visit $116.80 $118.23
Philanthropy (millions) $2.19 $2.30 ADVOCATECARE®
COORDINATED CARE
AdvocateCare® Index 100 66
SAFETY
SERVICE
ACCESS AND AFFORDABILITY FUNDING OUR
FUTURE
ADVOCATE EXPERIENCE
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Culture of High of AccountabilityPrinciples
Focused on who we serve: Our Patients Inspired by our Mission, Values and
Philosophy Guided by Vision Living Our Values through Observable
Actions - Behaviors of Excellence Intent on Collaboration with All
Stakeholders to Provide a Safe, Superior Experience Transparency of results Committed to systematic operating
practices
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®
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Report Card – March 20152020 Strategy
Key Result Area
Measure Target Actual Achieved
Serious Safety Event Rate Change -5.0% -5.8% Safety Event Reporting Rate 3.5 4.0
QUALITY Health Outcomes Score 100 57
Patient Engagement 75 57
Associate Engagement 80 >90 Physician Engagement 75 77
GROWTHNet Revenue Growth (% vs Prior Year)
6.18% 6.83% Operating Margin 1.81% 5.09% Hospital Cost per Discharge $8,077 $8,004 Medical Group Cost per Visit $116.80 $118.23
Philanthropy (millions) $2.19 $2.30 ADVOCATECARE®
COORDINATED CARE
AdvocateCare® Index 100 66
SAFETY
SERVICE
ACCESS AND AFFORDABILITY FUNDING OUR
FUTURE
ADVOCATE EXPERIENCE
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Behaviors of Excellence Signed by each new hire Evaluated in every
performance review Foundation for
differentiating performance
Values demonstrated by associates, physicians, and volunteers are recognized through MVP quarterly and annual awards
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Transparency• Posted in every
department
• Available online
• Distributed to all managers
• Safety alerts/Root cause analyses
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29 DaysSince Last Serious
Safety Event
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AlignmentGoals Set Annually for Key Result Areas: Goals are outcome-oriented (vs process), weighted, and associated with a
target and a stretch level of performance. Watchlist goals defined.
Targets/stretch levels aim for top quartile or top decile performance
Timelines:
o AHC System goals, targets/stretch identified (Sept- Oct)
o Site goals (aligned with system goals) determined (Oct-Dec)
o Site goals cascaded throughout the management team (to supervisor level) to achieve alignment between organizational and department goals (Dec – Jan)
o Goals loaded into electronic system – Advocate Management System (AMS) (Feb)
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January
FebruaryApril May
June
SeptemberAugust
JulyNovember
December
October
March
Organizational Rhythm
MOR
MOR
Site Forums
Key Leadership
MOR
HR: Mgt Reviews Due
MOR + Health
Outcomes
Talent Review and Plan
MOR
Mid-Year ForecastReview
MOR + Strategy
MOR +HR
Board Retreat• 2020 Update
MOR + Health
Outcomes
Sr Leadership Retreat• KRAs
Exec. Committee• Succession Mgt Review
Budget Reviews
Operating Budgets Due
MOR
MOR + Next Year Outlook
Talent Board Succession Review
QOR
QORQOR: Budget
Reviews
QOR
Site Capital Growth Projections Due
Budget targets communicated
Board of Directors:• Capital / Operating Budget
Approval• KRA Approval
Capital: Finalize short list of projects
for feasibility
Mid-year Forecast Due
Webcast
Webcast
Site Strategic Plan Updates Due
Health Outcomes Kickoff
APP Board Approval of CI Metrics
Draft CI Metrics
Draft Health Outcomes KRAs
Governance ProcessQuarterly Operating Review (QOR)Monthly Operating Review (MOR)Strategic Planning ProcessOperating Budget ProcessCapital Budget ProcessHealth Outcomes Planning ProcessPeople Process Communication Process
EMT Retreat• KRAs / STI
EMT Retreat• Talent Review• ERM / Market Review
System Initiatives quantified
Site Capital Feasibility Studies
Due
Capital Committee
Key Leadership LDI
Exec. Committee• ERM 2020 Update
Completed
Preliminary Site Growth Plans Due
Board of Directors:• Preliminary Budget
Outlook• Draft KRAs
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Operating Practices• Performance Management• Management Incentive Plan• Daily Practices• Mid-month Financial Review• Monthly:
– Closes
– Operating Reviews
– Meeting Model
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Performance Management Structured process and tool to determine level of
performance on the Behaviors of Excellence: High Performer, Solid Performer, Low Performer (HSL) Rating on Behaviors of Excellence determines 30%
of annual performance rating Annual goal achievement determines 70% of
leaders annual performance rating Overall rating (Behaviors and Goal Achievement) a
factor in merit increase
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Management Incentive Plan• Compensation At-Risk• Annual• Determined by Key Results
– Health Outcomes– Patient Satisfaction– Operating Margin
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Daily
• Safety Huddle• Productivity Huddle • Leader Rounding
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Mid-month financial briefing sessions
For those sites that are below plan on a year-to-date basis
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Monthly Closes Distributed to Entire Management Team
• Health Outcomes
• Patient Satisfaction
• Financial
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March 2015 Advocate Experience – Safety & Quality Close Narrative
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Monthly Operating Reviews (MORs)• Routine focus on safety, service, and financials
• Once /year deep review into health outcomes, strategy(Spring-before budget process is launched), and human resources
• Mid-year forecast (July)
• Operating budget run rate analysis (December)
• Most support functions have Quarterly Operating Reviews (QORs)
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Vital Statistics
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The monthly meeting model provides a framework to review outcome and align focused action plans to achieve goal outcomes and hardwire evidence based leadership practices (EBLs). This preparation facilitates a meaningful dialogue that helps to remove barriers and provide focus. This meeting structure is intended to be utilized on a monthly basis, and can be utilized more frequently as needed.
The leader prepares for meeting by 1) reviewing current goals performance and developing action plans to achieve targets, 2) reviewing stoplight reportsand tracking logs, 3) report on leadership development, and 4) prepare other pertinent updates. The leader comes prepared to lead the discussion. Theone up asks clarifying questions and sets priorities.
All KRA areas are listed as the intent is to ensure a balanced review of performance outcomes. The one up and leader can set priority for which goals toreview during the meeting based on weighting or results.
Review and Bring: Monthy Report Card 90 Day Plans Rounding Logs Stoplight Report Linkage Grid HSL ListWins:Goal Outcomes and Action/90 Day Plan:Review of status of performance goals, plans and monthly report cardAre you meeting your target? If so, what will you continue to do to stay on track?
If you are not meeting your target, what will you do differently over the next 90 days to meet your target?Project updates and support needed.SafetyQuality 1. PG Measurements without reporting for key OP areas
Service 2. Patient Complaint (Sievertson)3. Rishi comment 2014 Targets4. Hospitalists
Growth 5. Migration to ACL, wait for Care Conncetion vs. Surginet6. SWC Strategy7. MOB Strategy
Funding our Future 8. Feedback from payroll (Debbie at Support Center)
AdvocateCareSystem IntegrationItems
9. ALEX concerns10. Common review date / BOE weight11. KRA process for matrix leaders
Projects/Other Agenda Items
12. Designee to Presidents Meeting13. Nurse Week gift14. Alignment Collaborative15. Center Street and NENA /City16. Selling properties
Name: Santulli/Deering Date: 3/11/14 – 4 pmVia Telepresence
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Conclusions• Every manager must know what winning looks like
• Results should determine performance and incentive
• Alignment
– With Mission/Values/Vision
– Vertical
• Operating practices and infrastructure need to support accountability
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QUESTIONS
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