Using Studer, mission and values to create a culture of making a difference

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• Using Studer, mission and values to create a
  culture of making a difference
• Deborah Cole

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• Acknowledgement
• Calvary Health Care ACT a facility of Little
  Company of Mary Health Care
• for the people, their values, enthusiasm and the
  opportunity
• The Studer Group
• for the system

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• every person who comes to be cared for in a
  public hospitalshould be treated with respect by
  an appropriately skilled clinician in a safe and
  cost effective way to achieve the best outcome
  possible for the patient
• The Garling Report Nov 2008

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Healthcare Flywheel

• Bottom Line Results
• (Transparency and Accountability)

• Prescriptive To Dos

Purpose, worthwhile work and makinga difference

• Self-Motivation

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• Challenge is to align mission, values and
  behaviour

Mission, Purpose, Vision Business Goals
Staff beliefs and values drive behaviour
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Nine Principles

Build Individual Accountability
Commit to Excellence
Align Behaviors with Goals and Values
Measure the Important Things
Build a Culture Around Service
Communicate at All Levels
Create and Develop Great Leaders
Recognise and Reward Success
Focus on Employee Satisfaction
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Calvary Health Care, ACT

• Patient satisfaction
• Tripled scores, some areas now meet 75th
  percentile target range
• Employee satisfaction
• Significantly improved
• Quality
• Accreditation moved from 48 major
  recommendations 2004 to 3 OAs and 11 EAs
  February 2009
• Finance costs
• Work hours now better controlled multi million
  dollars saved
• Living the values
• Significant reduction in bullying and harassment

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Staff Satisfaction - Excellent Results
All Staff
Department Managers
ED Nursing Staff
Best Practice Australia Survey (Nov 08)
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Calvary Health Care, ACT

• Clear goals and accountability system now in
  place
• Increase in team work and hospital wide problem
  solving
• Measurement of the right things now driving
  decisions
• Consistency - every patient, every time

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So what did we do?

• Clear purpose, mission or goals
• Strong commitment to the values
• Provide the management skills
• Accountability framework (Studer)
• You go on a journey without a clear direction
  (mission)
• You cant manage what you cant measure
• Was it easy? No
• Did it work? Yes

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Focus on Sustainability

• Studer Group helps organisations
• HARDWIRE
• shifts in values and behaviours linked to purpose
  to support sustainable cultural change
• Links well to values based organisations

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Keys to Hardwiring

• Hardwiring is
• Not a program but rather a systems of
  accountability tied to the mission and strategies
  of the organisation
• Built on engagement to gain efficiencies and
  effectiveness
• Senior leader led and includes all constituent
  groups and operations
• Not about Studer Group its about organisational
  success

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How are Results Sustained?
By aligning resources and executing best
practices . . . not sometimes not
usually but ALWAYS.
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Evidence-Based LeadershipSM (EBL)
Objective Evaluation System
Leader Development
Must HavesSM
Performance Gap
Standardisation
Accelerators
Aligned Goals
Aligned Behavior
Aligned Process

• Hardwire consistency

• Sequence tools and techniques

• Retain High Performers, Coach Mid Performers,
  Help deal with low performers

• Better align training to outcomes

• Implement objective accountability system

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Some of the tools we introduced

• Leadership Development Institute
• LEM goals - annual and 90 day plans
• Rounding for outcomes
• Staff
• Service providers
• AIDET
• Employee Thank you notes
• Patient rounding
• Whiteboards
• Our stories
• Scoreboards
• High/middle/low conversations

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Aligned Behaviours
Annual and 90 Day Plans
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Aligned Behaviours
Staff Rounding Thank you notes
Managers round regularly to seek feedback from
staff. 4 targeted questions are asked
What is working well? What systems issues do you
have? Staff to reward and recognise and why? Do
you have the tools and equipment to do your job?
Thank you cards are sent in response to question
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Aligned Behaviours
AIDET
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Aligned Behaviours
Patient Rounding
Introduce self (AIDET) Update whiteboard Check
medications Check for environmental safety Check
observations Check that patient knows plan of
care Check patient comfort Answer questions Ask
is there anything else I can do before I go..?
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Aligned Behaviours
Scoreboards

• Progress against Key Performance Indicators is
• displayed in each clinical and non clinical area.
• Relationships between KPIs can be analysed.
• You manage what you measure!
• Service
• People
• Quality
• Finance
• Growth
• Community

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Aligned Behaviours
High Middle Low
What you permit you promote! Always/ Usually/
Sometimes/ Never? Every Patient Every Time! Up or
out! Focus energy on the high performers
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Aligned Behaviours
Patient Whiteboards
Patient comments I really want to know about
my diet as I have not eaten properly since my
surgery and this is important to me. The fact
that my name is there, and is correct, is
reassuring. I really want to know the name of
my nurse and the date I am going
home. Expected date of discharge is
important. Having my discharge date written
down is good for me.
I really want to know the date Im going home
name of my nurse Frankie
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Bottom-line Results ROI(Balanced Scorecard)
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Lessons Learned

• Measure, measure, measure whats important
• Sequencing of tools/techniques is vital
• One should not move on to the next tool or step
  if the preceding tool or step is not hardwired
• Cant rush an organisation due to artificial
  deadlines
• There are a lot of excuses

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Lessons Learned

• This is a lot harder than anyone thought.
• Why?
• Consistency is the key
• Trying to align behaviour of more people than any
  other initiative
• As an organisation improves, inconsistencies
  become more apparent
• Non-documented performance issues

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Lessons Learned

• This is all about
• Leadership
• Listening deeply
• Providing gratitude and encouragement to staff
• Acknowledging the importance of the people
• Being courageous bringing order to the chaos
• sourced from Richard Jacobs, 2005
• Clear direction and purpose (the Mission)
• Aligned values
• Aligned behaviour
• An accountability framework (Studer)

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Focus on Sustainability

• Patient focused care requires that we dont
  provide care a particular way sometimes, or
  usually but we must do it
• ALWAYS.
• It must be every patient, every time.

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• salus populi suprema lex esto
• Cicero
• The welfare of the people shall be the supreme
  law
• Deborah Cole