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Creating a Successful Organization

Now and in the FutureKatie Bata, Vice President, Human Resources

Pamela Hyziak, Director, Clinical Excellence

Baldrige Regional Conference

September 8, 2016

Advocate Lutheran General Hospital

• 638 bed tertiary and teaching institution

• Key service lines:– Advanced Surgical

– Cancer

– Cardiovascular

– Level One Trauma Center

– Digestive Health

– Neuroscience

– Orthopedics

– Women’s Health

Advocate Lutheran General HospitalService Statistics

Indicator 2014 2015

Licensed Beds 638 638

Admissions 28,339 29,103

Deliveries 4,157 4,145

Emergency Department Visits

65,438 67,151

Outpatient Visits 223,355 232,743

Surgical Cases – IP 6,824 6,903

Surgical Cases – OP 11,903 12,128

Average Daily Census 409 418

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Our Associates and Medical Staff• Total Associates 4,066

• FTEs 3,158

• Active Medical Staff 1,323

• Graduate Medical Education– 151 Residents

– 29 Fellows

– 37 Rotating Residents

• Nursing Staff– 721 Full time

– 730 Part time

• Nursing/Allied Health Education Affiliations

– 7 Nursing

– 7 Pharmacy

– 15 Physical Therapy

– 6 Occupational Therapy

– 14 Speech & Audiology Therapy

– 4 Respiratory

– 8 Laboratory

Leadership System

Delivers for TodayDefinition Supporting Skills

Executes forOutcomes

Prioritizes and plans work with a data‐driven, outcome‐focusedapproach; monitors work using financial, operational and processdata to track progress and identify process improvementopportunities; achieves optimal outcomes in service, quality, andsafety.

Financial Acumen Results Orientation Project Management Process Improvement

AcceleratesPerformance

Creates and drives a performance culture by setting clear expectations, delegating, empowering and motivating individuals and teams.

Expectation Setting Engagement Accountability

Builds Collaborative Relationships

Partners both formally and informally with others to achieve optimaloutcomes; builds appropriate rapport with people by establishing trust and mutual purpose; modifies approach to engage and influence others through self‐awareness and awareness of personalimpact on others.

Customer/StakeholderFocus

Partnership InterpersonalSavvy/Influence

CommunicatesEffectively

Develops and applies the fundamental mechanics of effectivecommunication: listening, delivery and understanding acrosssettings, audiences and modes of communication; actively engagesin two‐way communication to ensuremutual clarity and positiveoutcomes.

Active Listening Message Delivery Ensuring Effectiveness ofCommunication

Leadership System Foundational Competencies

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Leadership System Foundational Competencies

Leads for the FutureDefinition Supporting Skills

Leads Change

Identifies and prioritizes change needs based on internal needs andexternal best practices; communicates a compelling story to engage andmotivate others in the change process; involves and manages affected people and systems; consistently manages ambiguity and resistance toreach desired change goal.

Planning for Change Setting Context forChange

Executing on Change

Acts Strategically

Creates strategy, develops tactical plans and executes as aligned withAdvocate’s system vision and goals; monitors and adapts to thechanging business of healthcare; involves and communicates to thoseaffected by, and involved in, strategic activities.

Enterprise/SystemThinking

Strategy Development Translating Strategyinto Action Plans

Builds Talentfor the Future

Hires, promotes and retains strong and diverse talent for the benefit ofAdvocate; actively engages associates in career planning anddevelopmental assignments; actively plans and manages self‐development.

Hiring and Onboarding Assessing Talent Developing DirectReports

Self‐Development

Understand Stakeholder Requirements

Understanding Stakeholder Requirements

• Strategic Considerations• Data Analytics using Big Data• Regulatory and External Changes• Assessing Brand Awareness-Marketing

Strategy

• Listening to the Voice of the Customer• Senior Leader Patient Rounding• Patient and Family Advisory Councils• Healthier Communities and the Community

Health Needs Assessment

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Set Direction and Establish Goals

Accelerates Performance

Creates and drives a performance culture by setting clear expectations, delegating, empowering and motivating individuals and teams.

• Expectation Setting• Engagement• Accountability

Set Direction/Establish Goals

KRA Cascade or Watch/SustainKRA Cascade or Watch/Sustain

Evaluation of Potential Measures against Selection Criteria

Evaluation of Potential Measures against Selection Criteria

Meets Criteria Approved and Targets are Set Using 

Rules

Meets Criteria Approved and Targets are Set Using 

Rules

Strategic Planning Business Analysis and Strategy Development

Strategic Planning Business Analysis and Strategy Development

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Keys to Success• We must help staff understand and own our KRAs

– Owner vs. renter mentality

– Shared accountability

• Ratings should differentiate high and low performers and teams

– Alignment with HSL philosophy

• Leaders need tools that are simple and efficient

– More standardized goal setting by function

– Increased automation of entering goals, performance results

Organize, Plan and Align

Putting it into Practice – Goal Cascade

Company and Site Targets Set

Company and Site Targets Set

Vice PresidentsVice Presidents

DirectorsDirectors

Managers, FLLsManagers, FLLs

AssociatesAssociates

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Putting it into Practice – Rating Performance

Goals

50%

Goals

50%

BOEs

50%

BOEs

50%

10% based on overall site performance

10% based on overall site performance

40% based on shared department goals

40% based on shared department goals

100% of Advocate employees are held accountable to KRAs:

32,000 Advocate AssociatesMeasured on KRA Goals

32,000 Advocate AssociatesMeasured on KRA Goals

Our Opportunity: Misaligned Performance Standards

90% of Advocate employees were not held accountable to KRAs:

3,000 LeadersMeasured on 

KRA Performance

3,000 LeadersMeasured on 

KRA Performance

32,000 Advocate AssociatesMeasured on 

Job Accountabilities

32,000 Advocate AssociatesMeasured on 

Job Accountabilities

Advocate’s KRA StrategiesAdvocate’s 

KRA Strategies

Business Case for Goal Alignment

Studies show that goal setting leads to:

Higher associate engagement

Increased productivity

Improved work team performance

Increased satisfaction with performance feedbackAssociate 

EngagementAssociate 

Engagement

KRA Results KRA Results 

Shared Accountability

Shared Accountability

Ownership MentalityOwnership Mentality

Clearer Performance Expectations

Clearer Performance Expectations

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Evidence

KPIPercentile Results

Before After

In‐patient satisfaction 46th 90th

Out‐patient satisfaction 6th 85th

HCAHPS 10th 78th

Associate Engagement 49th 90th

Physician Engagement 50th 78th

Turnover 20% 12%

Advocate Sherman Hospital Hill Country Memorial(2014 Baldrige Winner)

Department goal achievement

Balanced scorecard results

Engagement scores

Manager effectiveness

What Changed?

Evaluations of Job Accountabilities

Evaluations of Shared Outcomes

Reviews Given Year‐Round

Single, Coordinated Review Period

Reviews in Pathways and ATMS

All Reviews in ATMS

Culture of Individual Contribution/ Accountability

Culture of Shared Ownership/ Accountability

Perform to Plan

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Strategic SustainabilityKey Result Area (KRA)

Key Strategy/Responsible Senior Leader Results

SafetyHigh Reliability and the Top 10 Safety ListVPMM, CNE, COO

Patient Safety Event Reporting

QualityPerformance Improvement for Best Quality OutcomesVPMM, CNE, COO, CEO

Health Outcomes Index

ServiceService Excellence TeamsCNE, COO, CEO

Patient EngagementAssociate EngagementPhysician Engagement

Funding our Future

Budgeting, Revenue Cycle, Finance ProceduresCFO, VP Business Development, CEO

Operating MarginHospital Cost per DischargePhilanthropy

GrowthStrategic Planning, Physician Recruitmentand RetentionVPMM, VP Business Development, CEO

Net RevenueVolumes

Care Coordination

APP Clinical Integration AdvocateCare Index

Operational SustainabilitySupport Operations

Key Strategy/Responsible Senior Leader Results

Information Technology (IT) 

& Communications

Information Technology Planning Director of Information Technology and AHC

Meaningful Use Dashboard

Human Resources

Human Resource PlanningVP Human Resources and CEO

HR Dashboard

Supply ChainMaterial OperationsCFO and CEO

Supply Chain Dashboard

RegulatoryQuality Management (DNV and ISO)VPMM and CEO

DNV Annual Report

FacilitiesPhysical Environment ProgramsCOO and CEO

Physical EnvironmentDashboard

PlanFinding Root

CauseAction Plan Who When

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Monthly Meeting Model

Senior Leader Rounding

Senior Leader Rounding Focus

• Core Value-Errors in communication are common. Some of the reasons . . . Remember Communication is not what you say . . .

• Consistency-Can you tell me about the tool for “Communicate Clearly” or how you use it?

• Concerns-Is there anything that makes using this tool difficult?

• Commitment-Can I count on you to regularly use this tool?

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Recognize, Reward and Develop

Builds Talent for the Future

Hires, promotes and retains strong and diverse talent for the benefit of Advocate; actively engages associates in career planning and developmental assignments; actively plans and manages self-development.

• Hiring and Onboarding• Assessing Talent• Developing Direct Reports• Self-Development

Talent Review: Inputs and Outcomes

GoalsGoals

BOEs (HSL)BOEs (HSL)

CompetenciesCompetencies

Desire for More ResponsibilityDesire for More Responsibility

AdaptabilityAdaptability

PotentialPotential

Merit IncreaseMerit Increase

PerformancePerformance

Development Planning

Development Planning

Talent ReadinessTalent 

Readiness

Replacement/ Succession Planning

Replacement/ Succession Planning

Ongoing PerformanceFeedback

Ongoing PerformanceFeedback

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Annual Talent Review Process FlowFeb March April May

Self ‐Assessment

Self ‐Assessment

Manager Assessment of  Performance & Potential Manager Assessment of  Performance & Potential 

Calibration Meeting on Performance & Potential Calibration Meeting on Performance & Potential 

Performance and Talent Feedback Discussions

Performance and Talent Feedback Discussions

Merit IncreaseMerit 

Increase

On‐going DevelopmentOn‐going Development

By Feb 14

By March 14(soft deadline)

By April 11

By April 25

Manager Finalizes Review & Sends to Associate

Manager Finalizes Review & Sends to Associate

By April 30

By April 30

By May 31

Talent Matrix 

• A tool for evaluating talent

• Combines performance and potential ratings

• Generated by ATMS

• Has been revised this year to align with our 5-point performance scale

• The Talent Matrix allows us to:• Assess leaders against a consistent set of criteria

• Help evaluate bench strength for future leadership positions

• Reveal development / coaching priorities

PER

FORMANCE = Goal Achievement & Behaviors of Excellence

POTENTIAL = Leadership Competencies, Adaptability, & Desire for More Responsibility

2

11

15

Sig Exceeds Performance/At Potential

• PERFORMANCE: Highly competent/ role model in current position. Demonstrates exceptional accomplishments.

• POTENTIAL: Can assume a new role at same level of complexity. May not want to move up.

Sig Exceeds Performance/High Potential

• PERFORMANCE: Highly competent/ role model in current position. Demonstrates exceptional accomplishments.

• POTENTIAL: Potential to grow into a role with broader responsibility and complexity. Advance into role one level above current role in 0-2 years, second move in 3-5 years.

Sig Exceeds Perf/Medium Potential

• PERFORMANCE: Highly competent/ role model in current position. Demonstrates exceptional accomplishments.

• POTENTIAL: Capable of taking on an expanded or complex role at same level. Could advance to the next level.

Exceeds Performance/At Potential

• PERFORMANCE: Competent in current role. Frequently exceeds job requirements and accomplishments are above expected levels.

• POTENTIAL: Capable of assuming a new role at same level of complexity. May not want to move up.

Exceeds Performance/Medium Potential

• PERFORMANCE: Competent in current role. Frequently exceeds job requirements and accomplishments are above expected levels.

• POTENTIAL: Capable of taking on a new role at same level of complexity. Could advance to the next level.

Approaches Performance/At Potential

• PERFORMANCE: Lacks competence in current role. Meets most but not all job requirements and performance is less than expected. May be a mismatch with current role.

• POTENTIAL: Exiting organization may be appropriate, especially if they do not demonstrate improvement after development.

Approaches Perf/Medium Potential

• PERFORMANCE: Lacks competence in current role . Meets most but not all job requirements and performance is less than expected. May be new to the position but not adapting as well as anticipated.

• POTENTIAL: Improved performance is needed before advancement can be expected.

Approaches Performance/High Potential

• PERFORMANCE: Hard to assess competence. Meets most but not all job requirements and performance is less than expected. Likely not adapting to a new position.

• POTENTIAL: Able to take on greater responsibilities once performance improves. Anticipate successful results once this person matures in his/her new role.

5

6

7

10 13

Exceeds Performance/High Potential

• PERFORMANCE: Competent in current role. Frequently exceeds job requirements and accomplishments are above expected levels.

• POTENTIAL: Potential to grow into a role with broader responsibility and complexity. Advance into role one level above current position.

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Meets Performance/At Potential

• PERFORMANCE: Competent in current role. Meets job requirements and demonstrates solid performance with few deviations.

• POTENTIAL: Capable of assuming a new role at same level of complexity. May not want to move up.

Meets Performance/Medium Potential

• PERFORMANCE: Competent in current role. Meets job requirements and demonstrates solid performance with few deviations.

• POTENTIAL: Capable of taking on a new role at same level of complexity. Could advance to the next level.

Meets Performance/High Potential

• PERFORMANCE: Competent in current role. Meets job requirements and demonstrates solid performance with few deviations.

• POTENTIAL: Potential to grow into a role with broader responsibility and complexity. Advance into role one level above current position.

4 8 12

Does Not Meet Performance/At Potential

• PERFORMANCE: Lacks competence in current role. Does not meet job requirements. Performance must improve to stay in this position. May be a mismatch with current role.

• POTENTIAL: Exiting organization may be appropriate, especially if they do not demonstrate improvement after development.

Does Not Meet Performance/High Potential

• PERFORMANCE: Hard to assess competence. Does not meet job requirements. Performance must improve to stay in this position. Likely not adapting to a new position.

• POTENTIAL: Able to take on greater responsibilities once performance is demonstrated. Anticipate successful results once this person matures in his/her new role.

15

9

61 Does Not Meet Perf/Medium Potential

• PERFORMANCE: Lacks competence in current role. Does not meet job requirements. Performance must improve to stay in this position. May be new to the position but not adapting as well as anticipated.

• POTENTIAL: Improved performance is needed before advancement can be expected.

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At Potential Medium Potential High Potential

Does Not Meet 

Expectations

Approaches 

Expectations

Meets 

Expectations

Exceeds 

Expectations

Sig Exceeds 

Expectations

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Calibration Sessions

• Changes to performance and/or potential as a result of calibration automated

– Changes made directly in ATMS

– Will automatically make the change to the overall rating and route performance forms to signature step

– Carbon copy of final review form sent to matrix co-leaders

Total Rewards

PAY

PTO Healthe You Rewards

401K Employer

Match

Educational

AssistanceDisability Income 

Protection

Pension

Plan

Medical 

Dental

Vision

Pay for PerformanceSite Composite Goals (YTD Example)

*The purpose of the information presented here is to support the ATMS site composite goal for non‐managerial associates. For more information, see slide 3 or contact your site HR or HR Direct.

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KRA

Key Performance Indicator (KPI) Target Actual Achieved

QUAL

ITY

Modified Health Outcomes Score 100 88

SERV

ICE

Patient Engagement ‐ Overall 3.0 5.0

GROW

TH Net Revenue Growth 

(% of Budget)100.00% 99.59%

Operating Margin 7.19% 6.37%

AdvocateCare® Margin (PMPM)Not 

Available

Not 

Available

Hospital Cost per Discharge $9,078 $8,906 Philanthropy (000) $950 $1,002

COO

RDIN

A-

TED

CARE

AdvocateCare® Index 100 94

ATM

S Site Composite Goal 

(# measures achieving target)4 3 Goal Rating: 2.0

FUND

ING

OUR

FUTU

RE

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• Years of Service Recognition• Thank You Notes• MVP/SPIRIT Awards• Daisy Awards• Showcase at Leadership Development Institutes

and Forums• The Julie Award• Physician Recognition Wall• Magnet Awards• Celebrate Associate, Nurses and Volunteer

Appreciation Weeks and Doctor’s Day

Recognition

Learn and Improve

Innovation – Creating the Environment

Strategic Planning

Performance Review

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Innovation – Senior Leader Role

COPIS‐Feasibility Analysis 6P

Concept Approval

Allocate Resources

Initiate Innovation

Monitor Performance