1. health and fitness

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
2
Accountability
Definition*
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.
4
* BusinessDirectory.com
“WINNING”
5
Report Card – March 2015
2020 Strategy
Key Result
Area
Measure
Target
Actual
-5.0%
-5.8%
Safety Event Reporting Rate
3.5
4.0
Health Outcomes Score
100
57
Patient Engagement
75
57
Associate Engagement
80
>90
Physician Engagement
75
77
Net 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® Index
100
66
Serious Safety Event Rate Change
SAFETY
ADVOCATE
EXPERIENCE
QUALITY
SERVICE
GROWTH
ACCESS AND
AFFORDABILITY
ADVOCATECARE®
6
FUNDING OUR
FUTURE
COORDINATED
CARE
Achieved








Culture of High of Accountability
Principles
 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
7
®
8
Report Card – March 2015
2020 Strategy
Key Result
Area
Measure
Target
Actual
-5.0%
-5.8%
Safety Event Reporting Rate
3.5
4.0
Health Outcomes Score
100
57
Patient Engagement
75
57
Associate Engagement
80
>90
Physician Engagement
75
77
Net 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® Index
100
66
Serious Safety Event Rate Change
SAFETY
ADVOCATE
EXPERIENCE
QUALITY
SERVICE
GROWTH
ACCESS AND
AFFORDABILITY
ADVOCATECARE®
9
FUNDING OUR
FUTURE
COORDINATED
CARE
Achieved








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
10
Transparency
• Posted in every
department
• Available online
• Distributed to all
managers
• Safety alerts/Root
cause analyses
11
29 Days
Since Last Serious
Safety Event
12
Alignment
Goals 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)
13
Organizational Rhythm
HR: Mgt Reviews
Due
Site Forums
Capital: Finalize
short list of projects
for feasibility
Key Leadership
Health Outcomes
Kickoff
January
MOR
Talent Review and
Plan
Preliminary Site
Growth Plans Due
EMT Retreat
• Talent Review
• ERM / Market Review
Exec. Committee
• ERM
April
March
February
MOR
Draft CI Metrics
Webcast
Site Capital Growth
Projections Due
May
Mid-year
Forecast Due
System Initiatives
quantified
Site Strategic
Plan Updates Due
2020 Update
Completed
June
MOR +
Health
Outcomes
MOR
Mid-Year
Forecast
Review
QOR
MOR
QOR
December
MOR
November
Board of Directors:
• Capital / Operating Budget
Approval
• KRA Approval
Exec. Committee
• Succession Mgt Review
14
Governance Process
Quarterly Operating Review (QOR)
Monthly Operating Review (MOR)
Strategic Planning Process
Operating Budget Process
Capital Budget Process
Health Outcomes Planning Process
People Process
Communication Process
Budget
Reviews
October
APP Board Approval of
CI Metrics
Operating Budgets Due
MOR +
HR
MOR +
Health
Outcomes
September
Board of Directors:
• Preliminary Budget
Outlook
• Draft KRAs
Sr Leadership Retreat
• KRAs
Capital Committee
Webcast
MOR +
Strategy
QOR
QOR:
Budget
Reviews
MOR +
Next Year
Outlook
Talent Board
Succession Review
Key Leadership LDI
July
August
EMT Retreat
• KRAs / STI
Draft Health
Outcomes KRAs
Board Retreat
• 2020 Update
Budget targets
communicated
Site Capital
Feasibility Studies
Due
Operating Practices
• Performance Management
• Management Incentive Plan
• Daily Practices
• Mid-month Financial Review
• Monthly:
– Closes
– Operating Reviews
– Meeting Model
15
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
16
Management Incentive Plan
• Compensation At-Risk
• Annual
• Determined by Key Results
– Health Outcomes
– Patient Satisfaction
– Operating Margin
17
Daily
• Safety Huddle
• Productivity Huddle
• Leader Rounding
18
Mid-month financial briefing sessions
For those sites that are below plan on a
year-to-date basis
20
Monthly Closes
Distributed to Entire Management Team
• Health Outcomes
• Patient Satisfaction
• Financial
21
March 2015 Advocate Experience – Safety & Quality Close Narrative
22
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)
23
Vital Statistics
24
Name: Santulli/Deering
Date: 3/11/14 – 4 pm
Via Telepresence
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 reports
and tracking logs, 3) report on leadership development, and 4) prepare other pertinent updates. The leader comes prepared to lead the discussion. The
one 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 to
review during the meeting based on weighting or results.
Review and Bring:  Monthy Report Card  90 Day Plans  Rounding Logs  Stoplight Report  Linkage Grid  HSL List
Wins:
Goal Outcomes and Action/90 Day Plan:
Review of status of performance goals, plans and monthly report card
Are 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.
Safety
Quality
1. PG Measurements without reporting for key OP areas
Service
Growth
Funding our Future
AdvocateCare
System Integration
Items
Projects/Other
Agenda Items
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8.
Patient Complaint (Sievertson)
Rishi comment 2014 Targets
Hospitalists
Migration to ACL, wait for Care Conncetion vs. Surginet
SWC Strategy
MOB Strategy
Feedback from payroll (Debbie at Support Center)
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15.
16.
ALEX concerns
Common review date / BOE weight
KRA process for matrix leaders
Designee to Presidents Meeting
Nurse Week gift
Alignment Collaborative
Center Street and NENA /City
Selling properties
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
26
QUESTIONS
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