Verification Validation Accountability Colleen Thornburgh February 13

Verification, Validation, & Accountability Colleen Thornburgh February 13, 2009

education Strive to develop the highest quality medical education programs for all levels of learners research Advance medical and scientific knowledge through basic, transitional, and clinical research people Instill and reinforce standards of behavior that will attract, develop and retain outstanding staff, physicians, faculty and students Quality service Strive to be among the highest ranked health care providers by both regulatory and health care scoring systems Promote consistently positive experiences for our patients, staff and community Growth Finance Grow the enterprise to better serve patients and physicians and support the fundamental missions of teaching and research Preserve a focus of fiscal responsibility and multidisciplinary planning 2008 – 2009 pillar Goals • 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% • Reduce COM turnover rate by 5% • Maintain a voluntary turnover rate of 18% or less at OUP and OUMC • Maintain or achieve top 10% in publicly reported JCAHO Core Measures • Improve ease of obtaining test results to 50 th percentile OUP : > 89. 5 • Improve patient satisfaction scores across the enterprise: – OUMC to 2 nd quartile Overall score of > 3. 51 – OUP to 50 th percentile Adult: > 92. 1 Children’s: > 89. 5 • Increase interdepartmental and physician satisfaction scores by 2 ½% • Grow overall OU • OUMC: Increase Medicine market share by 0. 5% net income before taxes by 7. 44% over 2007 pre-tax net income • Grow hospital admissions by 3% • Grow clinic visits by 4% • OUP: Increase payments by 5% • COM: All departments should meet cash reserve goals and have overall operating margin of 5%

Evidence Based Leadership (EBL) Rev 6. 07 gh B Foundation rou eakth r STUDER GROUP: Leader Evaluation Leader Developme nt Aligned Goals Implement an Create organizationprocess to wide assist leadership in developing evaluation skills and system to leadership hardwire competencies objective necessary to accountability attain desired results Must Haves. SM Performanc e Gap Aligned Behavior Must Haves. SM Re-recruit Rounding ☺ high and Thank You Notes middle ☺ performers Employee Selection Move low Pre and Post performers Phone Calls ☺ up or out Key Words at Key Times AIDET ☺ Standards of Behavior Standardizatio Accelerators n Aligned Process Agendas by pillar Peer interviewin g 30/90 day sessions Pillar goals Leader Eval Mgr (LEM) ☺ (2/16) Staff Eval Mgr (SEM) Discharge Call Manager (DCM) Rounding Mgr 3

How do we drive results? 4

Verify and Validate what you expect Verification Tools • Rounding • Observation • Monthly Meeting Model 5

Coach behaviors • Specific • What’s working well • What could be better • Facilitate problem solving 6

AIDET Example • Observe the behavior • Give specific feedback • Incorporate into rounding • Coach performance • Facilitate problem solving 7

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 8

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……. 9

You be the coach! • Specific • What’s working well • What could be better • Facilitate problem solving 10

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 11

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 12

Leader Accountability 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 13

Monthly Meeting Model (MMM) 14

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 15

MMM: What? Tool for leaders to hold meaningful dialogue and measure progress on goals – Identify wins, and opportunities for improvement (OFIs) – Coach leader performance: Ø Recognize great performance (H) Ø Provide coaching (M) Ø Clarify expectations (L) Ø Communicate consequences (L) 16

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? 17

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? 18

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 19

Our Perceived Barriers Current Practice Effective Approach 1. Dept. Meetings 1. Pillar Agendas 2. Rounding for Outcomes 3. Thank You Notes 4. Peer interviewing and 30/90 Day Meetings 5. Individual Employee Meetings 6. Key Word at Key Times 7. Pre and Post Phone Calls 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 20

Real Barriers • Pocket Veto • Feigned buy-in 21

Send the mail to the right address. . . 22

“The strongest principle of growth lies in human choice. ” ~ George Eliot 23

What if it doesn’t go as planned? ? 24