1. science
2. mathematics
3. arithmetic

Taking You and Your
Organization to the
Next Level
Studer Group Mission and Vision
Mission:
To make healthcare a better place for
employees to work, physicians to practice
medicine and patients to receive care.
Vision:
To be the intellectual resource for
healthcare professionals, combining passion
with prescriptive actions and tools, to drive
outcomes and maximize the human
potential within each organization and
healthcare as a whole.
Execution company focused
on achieving and sustaining!
• Exceptional clinical, operational &
financial outcomes.
• Work with over 800 healthcare
organizations in the US and
beyond.
• > 50 Coaches and Speakers
• Educational Resources – Books,
Training Videos, Webinars and
Institutes.
• Web-based software solutions
for operational alignment and
process efficiency/ improvement.
Recipient of the 2010
Malcolm
Baldrige Quality Award
• Ranked #5 Great Small Workplace
in America
• Evidenced-Based tactics that
• produce:
 Accelerated rate of improvement
and efficiency in clinical quality
(core measures, hospital acquired
conditions, and readmissions)
 Favorable HCAHPS results
 Maximized reimbursement
 Increased physician loyalty
 Improved ED flow, operational
metrics and patient experience
External Environment Conclusions
Physicians and Senior leader team feel the
external environment will be more difficult in the
future.
31% feel if an organization stays the same, they
will be the same, better or much better.
If 3 out of 10 people do not recognize
urgency, the organization will never achieve
outcomes and too much pressure is put on
the other 70% of the people.
Top Ten Challenges in Execution
1. Leaders / Others
underperforming and still
receiving a good evaluation
􀂅 (Accountability)
6. Push Back by leaders, staff
and physicians
􀂅 (Accountability)
2. Change not connected to why
􀂅 (Alignment)
7. Not familiar with what “right”
looks like
􀂅 (Action)
3. Lack of necessary urgency
􀂅 (Alignment)
8. Lack of frequency
􀂅 (Action)
4. Leaders do not have the skills to
assure a solid implementation.
􀂅 (Action)
9. Inability to transfer best
practices
􀂅 (Action)
5. Too many changes -- too soon
􀂅 (Action)
10. Poor processes
􀂅 (Action)
Must Haves!!
It depends on the diagnosis-DIAGNOSIS TREATMENT
 Employee Engagement 􀂅 Leader Rounding on
Employees
 Responsiveness to Patient 􀂅 Hourly Rounding
 No-Shows 􀂅 Pre-Calls
 Readmissions 􀂅 Post-Calls with frequency, dependent on
patient condition
 Physician Engagement 􀂅 Quadrant Exercise􀂅 Physician
Rounding
 Side Effects of Medication 􀂅 Bedside Shift Report
 Urgency 􀂅 Toolkit to explain the external environment
..
“People wish to be settled; but only as far as they are
unsettled, is there any hope for them.”
Ralph Waldo Emerson
How many of the employees that
you directly supervise are not
meeting performance expectations?
􀂅 Average = 8%
Performance ManagementHow many employees do you have currently
working for you who have documentation that
they are underperforming?
􀂅 Average = 50%
The Evidence
Heart
Failure
Pneumonia
Healthcare -Associated Infections
Surgical Care Improvement
Heart Attack
1 physician in 3 receives any data about performance.
1 physician in 5 receives data pertinent to clinical outcomes.
1 physician in 4 receives patient survey data.
We have learned that the
reluctance to address low/sub-par
performance keep an organization
from being the best.
Quint Studer
Definition
H=HIGH PERFORMER
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Professionalism Teamwork
Knowledge & Competence
Communication Safety Awareness
Comes to work on time
Good attitude
Problem solves
You relax when they are scheduled
Use of peer interviews
Pillar ownership
Brings solutions
Good influence
Adheres to policies concerning breaks, personal phone calls, leaving the work area, and other
absences from work.
Demonstrates high commitment to making things better for their team and organization as a
whole.
Eager to change for the good of the organization. Strives for continuous professional
development.
Consistently communicates organizational. Does not create we/they. Provides frequent
feedback to staff.
Demonstrates the behaviors of safety awareness in all aspects of work.
Definition
M=MIDDLE PERFORMER
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Solid performer
Good attendance
Loyal most of time
Influenced by high and low performer
Wants to do a good job
Could just need more experience
Helps manager be aware of problems
Professionalism Teamwork
Knowledge & Competence Communication
Safety Awareness
Usually adheres to policies concerning breaks, personal phone calls, leaving the work area, and
other absences from work.
 Committed to improving performance of their team and organization. May require coaching to fully
execute.
 Invested in own professional developments. May require some coaching to fully execute.
 Usually communicates organizational information. Occasionally uses we/they language. Provides
some feedback to staff.
Definition
L-LOW PERFORMER
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Knowledge & Competence
Communication Safety Awareness
Points out problems in a negative way
Positions leadership poorly
Master of “We/They”
Passive aggressive
Thinks they will outlast the leader
Says manager is the problem
Does not communicate effectively about absences from work. Handles personal phone
calls in a manner that interferes with work. Breaks last longer than allowed.
Demonstrates little commitment to their team and the organization.
Shows little interest in improving own performance or the performance of the organization.
Develops professional skills only when asked.
Does not communicate organizational information. Uses language to create we/they
culture. Does not provide feedback.
Performs work with little regard to the behaviors of safety awareness.
Employees
Patients
Rounding with
Employees
EmployeeThankYou
Notes
Leader Rounding on
Patients
Peer Interviewing 30
Individualized Patient
Care
Bedside Shift Report
AIDET®
PreVisit Calls
and 90 Day
Meetings (Input)
EmployeeAttitude Survey
Employee Forums
Bright Ideas Standards
Post Stay/Visit Calls
Hourly Rounding
Physicians
Physician Performance
Feedback System
Got Chart
Physician Preference
Card
Physician Code Patient
Agenda and
Visit Guide
Physician Note Pads
Rounding for
Outcomes
AIDET
Rounding for Outcomes
Employee Rounding
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Tell your staff about rounding
Do rounding with the prescribed frequency
Use a rounding log
Give feedback
Concern and Care
Align Questions to
fit Desired
Outcomes of the
Organization
What is Working Well
People to Recognize
Systems to Improve
Tools and Equipment
Follow-up
Rounding for Outcomes
Senior Leader
Rounding
 Increases Senior Leader Visibility
 Reassures and Engages Staff
 Connects the Dots for Staff Regarding
Organization Decisions/Outcomes
 Validates Department/Unit Leader Rounding
Eliminates We/They Mentality
 Improve Physician Integration
Areas of focus
 Round on direct reports the same
way all leaders round on their
employees
 Round in departments with other
leaders using a scouting report
 Link to department leader rounding logs
 Supply important information about a given department
 Focus on external environment Identify tough questions
 Allow you to reward and recognize the right people
 Acknowledge which systems have been fixed
 Point to tools and equipment that have been purchased
and those that still need attention
To sustain the culture,
selection is paramount.
CURRENT PRACTICE
�
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Department Meetings
Employee Conversations
Employee R&R
Staff Selection and Orientation
Staff and Patient Retention
Staff Policy
Patient Conversations
Pre Phone Calls
Post Phone Calls
Staff and Leader Evaluation
Only new item
EFFECTIVE APPROACH
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Consistent Agendas
Rounding for Outcomes
Thank You Notes
Peer interviewing and 30/90 Day
Meetings
Individual Employee Meetings
Standards of Behavior
Key Word at Key Times
Pre Phone Calls
Post Phone Calls
Staff and Leader Evaluation
Leadership Training
Rounding on Areas Served – Example
Acknowledge
relationship /clarify expectations
“Your dept is very important to us & our patients…”
Rounding, Why & Duration
“Our goal is to provide excellent service. I will be
rounding on you each month…..”
Review Accomplishments
“Since I rounded with you last month, I wanted to
highlight the following items/systems we have put into
place based on feedback….”
Working Well
“What is my department doing well?
Recognition ‐ Individuals
“Is there anyone specific I can recognize for doing great
work? What have they done?”
Opportunities for Improvement
“What 1‐2 things can my department do better? Any
ideas on how we can improve?”
Identify specific areas of focus from survey
process
“We want to respond in a timely manner”, “Can you
explain a time when you had to wait for response from
our department”, “When we did not respond in a timely
manner, what do you typically wait to receive….?”
Is there anything I can help you
with?
“Is there any other questions you have or anything else I can help with right now?....”
Thank you and Appreciation
“Thank you for your time …..”
Establish next rounding date
“I will be back in next month to talk again….”
Studer Group Five Fundamentals AIDET®
A
Eye contact, smile and acknowledge everyone in the room.
Acknowledge
I
Introduce
“Hello Mr. Clark. My name is Jackie and I am your nurse today. I have been a nurse
for 20 years and have worked in this hospital for over 8 years. I have done this
procedure thousands of times and I go back for training each year….”
D
Duration
“This procedure will take about 10 minutes to perform and then about one hour for the
results….”
E
T
Explanation
Thank you
“Let me explain some more about the procedure.” (Explain why performing the
procedure, what will happen and what they should expect, understanding of side
effects, and answer any questions.”
“Thank you for choosing us ….Thank you for waiting
… Thank you for coming in today…What other
questions do you have?”
Pre Visit Calls
The Results!!!
Reduce NoShow’s by:
70%
Reference: Pre and Post Procedure
Calls; Scott A. Strong, M.D., The
Cleveland Clinic, 2003
Reduce
Tardiness
by: 60-70%
Increased
Patient
Satisfaction:
25-30
Percentile
Points
Best Practice Contact Rate
PATIENTTYPE
ATTEMPT %
INPATIENT
•
100% patients discharged home/home with home healthcare
CRITICAL CARE
•
100% of patients discharged home and home with home healthcare
•
100% of eligible patients discharged patients to home
•
If unable to attempt 100% start with specific patient groups based
on acuity (e.g. chest pain) or risk factors (e.g. AMA's)
•
Non-eligible patients are admissions, transfers, deaths, psych
patients and those with no current phone number
(i.e. homeless)
•
Cath-lab 100%,
OUTPATIENTS
•
•
GI 100%,
Radiology certain populations (e.g. 100% invasive procedures; specific
number/day)
MEDICAL
PRACTICE
•
Set number – 5 per staff per week or 20 per week per person
OUTPATIENT
SURGERY
•
100% of patients discharged home
EMERGENCY
DEPARTMENT
CONTACT %
70-80%
100%
50-60%
100%
100%
Reboarding/Onboarding
Information Guide:
Core Competency
Tools & Resources
Accountability
Service and Operational
Excellence Introduction
Hardwiring Excellence, Chapters 1-3
Evidence Based Leadership graphic
Complete Readings
Rounding on Staff
Hardwiring Excellence, Chapter 7
The Nurse Leader Handbook, Chapter 2
Rounding on Staff log
Stoplight Report and Guidelines for Use of Stoplight
Video: Rounding on Direct Reports
Leader rounds on you to
role model practice
Completion of rounding on
100% of staff
Completion of Stoplight
Report
Thank You Notes
Hardwiring Excellence, Chapters 7 & 11
The Nurse Leader Handbook, Chapters 3 & 4
Send TY notes to direct
reports
Manage up thank you
notes to leader
Communication
Hardwiring Excellence, Chapter 10
The Nurse Leader Handbook, Chapter 1
Agenda by Pillars
Department Communication Board
Working With your Leader – The Power of Aligned Messages
webinar (2009)
AIDET® Five Fundamentals of Patient Communication
Building Patient Trust with AIDET®
highmiddlelow® Performer Conversations
Insight and Video: Overcoming Resistance to Change
Insight and Video: The Power of Our Words
Insight and Video: Spinach in your Teeth Messages: The Art of
Giving (and Receiving) Honest Feedback
Use Agenda by Pillar for
staff meetings
Update Dept
Communication Board
Date Completed
Objective Evaluation
Hardwiring Excellence, Chapter 9
The Nurse Leader Handbook, Chapter 15
Leader Evaluation Manager℠
Leader Evaluation Manager℠ tutorials
Organizational Goals
90 Day Plans
Monthly Report Card
Webinar: Accountability Tools and Tactics Webinar (2008)
Leader to review and set your
goals
Obtain Leader Evaluation
Manager℠ training
Complete 1st 90-day plan
Update monthly report card
Monthly Meeting Model
The Nurse Leader Handbook, Chapter 22
Video: Supervisory Meeting Model
Monthly Meeting Model Tools Tab on Studer Group website
Scouting Report
Insight and Video: Senior Leader Rounding
Prepare for and complete MMM
with your leader
Senior Leader Rounding
Effective Meeting Management
Delegation
Change Management
Measurement Tools
Rounding on Patients
The Nurse Leader Handbook, Chapter 21
Agenda by Pillars
Webinar: Leading Effective Meetings webinar (2009)
The Nurse Leader Handbook, Chapter 23
The Nurse Leader Handbook, Chapter 25
Hardwiring Excellence, Chapters 4 & 9
The Nurse Leader Handbook, Chapter 18
Balanced Scorecard
Patient Satisfaction Vendor tools
Leader Evaluation Tools Tab on Studer Group Website
The Nurse Leader Handbook, Chapter 8
Patient rounding log
Four Goals for Rounding on Patients
Hourly Rounding℠ Training Video
A Rounding on Patients “AHA” Moment
Video: Leader Rounding on Patients
Prepare scouting report for your
senior leader
Round in your dept with senior
leader
Complete readings and video
Complete reading
Complete reading
Complete readings
Review Balanced Scorecard
with your leader
Obtain vendor training on
measurement tool
Observe colleague rounding on
patients
Round on your patients
Complete patient rounding
validation with mentor/coach
Follow up with staff post
rounding
Rounding on Patients
The Nurse Leader Handbook, Chapter 8
Patient rounding log
Four Goals for Rounding on Patients
Hourly Rounding℠ Training Video
A Rounding on Patients “AHA” Moment
Video: Leader Rounding on Patients
Observe colleague
rounding on patients
Round on your patients
Complete patient
rounding validation with
mentor/coach
Follow up with staff post
rounding
Rounding on Internal
Customers
Internal Customer Rounding log
Internal Customer Preference Card
Video: Rounding on Departments Served
Observe colleague
rounding on customers
Round on your customers
Complete customer
rounding validation with
mentor/coach
Follow up with staff post
rounding
AIDET®
The Nurse Leader Handbook, Chapter 13
Video: AIDET® Five Fundamentals of Patient Communication
Video: Building Patient Trust with AIDET® video
AIDET® Observation Form
Video: AIDET® and Support Services Leader Rounding
Video: AIDET® Coaching, Food and Nutrition
Video: AIDET® for Physicians
Complete readings and
video
Develop your own AIDET®
Practice your AIDET®
Complete AIDET®
validation with
mentor/coach
Key words at Key Times
Hardwiring Excellence, Chapter 5
The Nurse Leader Handbook, Chapter 13
Develop your own KWKT
Practice your KWKT
Complete AIDET®
validation with
mentor/coach
Service Recovery
The Nurse Leader Handbook, Chapter 14
Webinar: Service Recovery – I’m Sorry to Hear That (2009)
Complete readings and
video
Selecting Talent
Hardwiring Excellence, Chapter 8
The Nurse Leader Handbook, Chapter 6
Video: Selecting Talent
Webinar: Selecting Talent – Peer Interviewing Works
(2009)
Behavioral Based Interview Questions
The Nurse Leader Handbook, Chapter 6
30 & 90 day rounding log
Complete readings and
video
Performance
Conversations
Hardwiring Excellence, Chapter 6
The Nurse Leader Handbook, Chapters 3, 5 & 7
Behavioral Standards
Performance Evaluation
Highmiddlelow® Performance Conversations video
Conducting highmiddlelow® Performance Conversations
webinar (2009)
highmiddlelow® Tools Tab on Studer Group website
Complete readings and
video
Pre and Post Visit Calls
Hardwiring Excellence, Chapter 5
The Nurse Leader Handbook, Chapter 9
Video: Post Visit Phone Calls
Webinar: Centralized Discharge Call Center and
Physician-Led Post-Visit Phone Calls
Complete readings and
video
Hourly Rounding℠
The Nurse Leader Handbook, Chapter 10
Hourly Rounding℠ Toolkit
Webinar: Hourly Rounding℠ webinar (2009)
Video: Hourly Rounding℠ Training Video
Complete readings and
video
Bedside Shift Report
The Nurse Leader Handbook, Chapter 11
Best Practice video on Bedside Shift Report
Complete readings and
video
30 & 90 day meetings
Complete readings and
video
Round on new staff
using 30 & 90 logs
Individualized Patient Care
The Nurse Leader Handbook, Chapter 12
Video: Individualized Patient Care Cards
Complete readings and video
Financial Impact & Productivity
Management
The Nurse Leader Handbook, Chapters 16 & 17
Video: Calculating the Return on Investment of Great Service to Patients
and Employees
Webinar: Time and Energy Management webinar (2009)
Complete readings and videos
Collaborating with Physicians
The Nurse Leader Handbook, Chapter 20
Engaging Physicians
Video: The Art of Physician Courtship: Five Things Healthcare Leaders
Can Do to Lay the Groundwork for Physician Integration
Webinar: Engaging Physicians webinar (2009)
Webinar: Studer Group Physician Webinar Series (2008)
Complete readings and videos
HCAHPS
HCAHPS - It's All About Quality
The HCAHPS Handbook
It Starts in ED: Why Patient’s “First Impression” Sets the Stage for
HCAHPS Success
Webinar: HCAHPS: Hardwiring Your Hospital for Pay-for-Performance
Success Webinar
Webinar: HCAHPS – Part 2: Pay for Performance is Here
Complete readings and video
Insight and Video: Are you holding leaders accountable for only 1/8
of the HCAHPS pie?
Video: The First Performance Period Is Over. What Now?
The Age of HCAHPS: Four Reasons Why Those 27 Survey Questions Will
Change Healthcare Forever
Ask your
Supervisor to find
out more about
these resources
and many more!