Verification, Validation, & Accountability

February 13, 2009

Colleen Thornburgh

Strive to develop the highest quality medical education

programs for all levels of learners

• All programs meet or exceed national benchmarks

• Increase COM class size by 15% by 2010

• Submit CTSA application by October 2008

• Increase sponsored research by 8%

Strive to be among the highest ranked

health care providers by both

regulatory and health care scoring

systems

• Maintain or achieve top 10% in publicly reported JCAHO Core Measures

• Improve ease of obtaining test results to 50th percentile

OUP : > 89.5

Instill and reinforce standards of behavior

that will attract, develop and retain outstanding staff, physicians, faculty

and students

• Reduce COM turnover rate by 5%

• Maintain a voluntary turnover rate of 18% or less at OUP and OUMC

Promote consistently

positive experiences for

our patients, staff and community

• Improve patient satisfaction scores across the enterprise:

– OUMC to 2nd quartile

Overall score of > 3.51

– OUP to 50th percentile

Adult: > 92.1

Children’s: > 89.5

• Increase inter-departmental and physician satisfaction scores by 2 ½%

Grow the enterprise to better serve patients and

physicians and support the fundamental missions of

teaching and research

• Grow overall OU Medicine market share by 0.5%

• Grow hospital admissions by 3%

• Grow clinic visits by 4%

Preserve a focus of fiscal

responsibility and multidisciplinary

planning

• OUMC: Increase net income before taxes by 7.44% over 2007 pre-tax net income

• OUP: Increase payments by 5%

• COM: All departments should meet cash reserve goals and have overall operating margin of 5%

Advance medical and scientific

knowledge through basic, transitional,

and clinical research

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Evidence Based Leadership (EBL)

Standardization AcceleratorsMust HavesSM

Performance Gap

Leader Evaluation

Leader Development

Foundation Breakthrough

STUDER GROUP:

Rev 6.07

Must HavesSM

Rounding ☺Thank You Notes ☺Employee SelectionPre and Post Phone Calls ☺Key Words at Key TimesAIDET ☺Standards of Behavior

Re-recruit high and middle performers

Move low performers up or out

Agendas by pillar

Peer interviewing

30/90 day sessions

Pillar goals

Leader Eval Mgr (LEM) ☺ (2/16)

Staff Eval Mgr (SEM)

Discharge Call Manager (DCM)

Rounding Mgr

Idea Express

Aligned Goals Aligned Behavior Aligned Process

Create process to assist leaders in developing skills and leadership competencies necessary to attain desired results

Implement an organization-wide leadership evaluation system to hardwire objective accountability

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How do we drive results?

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Verify and Validate what you expect

Verification Tools• Rounding• Observation• Monthly Meeting

Model

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Coach behaviors

• Specific• What’s working well• What could be better• Facilitate problem

solving

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AIDET Example

• Observe the behavior• Give specific feedback • Incorporate into rounding• Coach performance• Facilitate problem solving

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AIDET – Verification, Validation, Coaching

• Lisa, I’m rounding on the unit today and would like to hear what you believe is going well?

• Is there any individual or physician that I should recognize in the unit?

• When I came onto the unit, I heard you introduce yourself to one of your patients using AIDET. I appreciate your doing this and so do your patients. VERIFICATION

• I thought you did an excellent job introducing yourself, your skills and experience. SPECIFIC

• I heard you review Mrs. Jones schedule for the day, but didn’t explain why she would need to have tests completed in radiology. How might you have provided this information to her in a way she might understand? FACILITATE PROBLEM SOLVING

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AIDET – Verification, Validation, Coaching

• When you take the time to use AIDET, you reduce patients’ anxiety and provide information that is helpful to their compliance and outcomes COACH SPECIFIC BEHAVIOR

• Over the next month, I’ll be listening for AIDET as I visit each of our units SET STAGE FOR FURTHER VERIFICATION

• As I do, I’ll be giving feedback and asking how I might support you

• Is there anything I can do to help you with AIDET or any issues in the department that I need to be aware of?

• Thanks…….

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You be the coach!

• Specific• What’s working well• What could be better• Facilitate problem

solving

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What gets recognized, gets repeated!

• John, I noticed how you worked with the family members of Mr. Smith to ensure they had a translator who could answer their questions about his care.

• Thank you for modeling standard of caring by ensuring their needs were met

• Sandy, when you managed up Dr. Hoover to your patient today, you made it easy for Dr. Hoover to come in and take over coverage this weekend. When patients hear that they are in good hands, they are more likely to ask questions and provide important information that helps all of the staff provide better care for them

• Thank you for demonstrating excellent communication by managing up members of the care team

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What do you want repeated?

MODEL

• Specific Feedback• What they did well• Why it matters…

connect the dots• Thank them for doing

the right thing

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Monthly Meeting Model

(n) the quality or state of being accountable; especially: an obligation or willingness to accept responsibility or to account for one's actions

Leader Accountability

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Monthly Meeting Model (MMM)

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Monthly Meeting Model (MMM)

Leaders bring the following items and results to their immediate supervisor for discussion:

• Leader Evaluation - LEM

• Monthly Report Card

• 90-Day Plan-Professional Development

• Linkage Grid from Leadership Development Institute Workshop

• Rounding Logs

• Thank you notes

• People Trends and Issues-Standards of Behavior

• Additional Verification Tools as implemented

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MMM: What?

– Identify wins, and opportunities for improvement (OFIs)

– Coach leader performance: Recognize great

performance (H) Provide coaching (M) Clarify expectations

(L) Communicate

consequences (L)

Tool for leaders to hold meaningful dialogue and measure progress on goals

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MMM: Hold Leaders Accountable

• Tell me what your plans for follow up are.• What is your timeline?• What are your next steps?• What prevented you from meeting the

deadline?

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MMM: Hold Leaders Accountable

• Let’s be sure you understand the expectation.

• Let’s review the timeline and deliverables.• If ________ is not delivered/accomplished,

our next steps will be ____________.• What questions do you have?• How can I further support you?

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MMM: Why?

• It’s what leaders do!• Starts at the top and cascades down• If we don’t do it … who will?• Leader’s tool for understanding and driving

results

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Current Practice

1. Dept. Meetings

2. Talk to employees

3. Employee R&R

4. Selection and Orientation

5. Retention

6. Talking to Patients

7. Pre/Post Calls

8. Evaluation

9. Only new item

Effective Approach

1. Pillar Agendas2. Rounding for Outcomes3. Thank You Notes4. Peer interviewing and

30/90 Day Meetings5. Individual Employee

Meetings6. Key Word at Key Times7. Pre and Post Phone Calls8. Leader Evaluation9. Leadership Training

Our Perceived Barriers

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Real Barriers

• Pocket Veto

• Feigned buy-in

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Send the mail to the right address...

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“The strongest principle of growth lies in human choice.”

~ George Eliot

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What if it doesn’t go as planned??