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Improving Life, One Breath at a Time

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Report to the American Lung Association Council and Chairs/Chairs ... Create a unique American Lung Association model to increase efficiency and effectiveness. ... – PowerPoint PPT presentation

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Title: Improving Life, One Breath at a Time


1
Improving Life, One Breath at a Time
1-800-LUNG-USA
www.lungusa.org
2
Organizational Effectiveness Initiative
  • Report to the American Lung Association Council
    and Chairs/Chairs-elect
  • By William Kowalewski
  • December 2004
  • Washington, DC

www.lungusa.org
3
Organizational Effectiveness Steering Committee
Members
  • William Kowalewski, Chairperson
  • Alfred Lynne Brannen, II, MD
  • Bruce A. Herring
  • Linda H. Newton
  • Ellen Ceppetelli, MS, RN
  • Stanton H. Hudson, Jr.
  • Dean Schraufnagel, MD
  • Kay Doerr, MS
  • Dennis Duffy
  • Ernest P. Franck
  • Judge Cordell Meeks
  • Edward Carter
  • Edward Miller
  • Lori Pickens
  • Donald Clark
  • Norm Childs ALA Staff
  • Elliot Pagliaccio (TRI)

4
Steering Committee Charge from the American Lung
Association Board
  • Develop a process to examine and make
    recommendations to improve the organizations
    effectiveness in order to increase its impact on
    lung disease.
  • Create a unique American Lung Association model
    to increase efficiency and effectiveness.

5
Phases of Organizational Effectiveness
  • Process Improvement Plan Completed
  • Design Phase Completed
  • Pre-implementation, technical assistance and
    Development Phase Now to May, 2005
  • Implementation Phase Pending Board approval in
    May 2005, begins June 2005
  • Monitoring and Assessment ongoing

6
Background and Rationale for Organizational
Effectiveness
  • A more complex, competitive environment.
  • Organizational lack of focus and follow-through
    on strategic priorities.
  • Related to this, a lack of clarity about our
    identity among the public.
  • Lack of mechanisms to measure organization and
    customer outcomes.
  • Governance that sometimes hampers quick action to
    leverage strategic opportunities.

7
Background and Rationale for Organizational
Effectiveness
  • Many local Lung Associations challenged to
    survive, rather than grow and thrive.
  • Local re-organizations and consolidations in
    reaction to financial pressure, not planning.
  • Need for more effective national/local
    partnerships.
  • Volunteers and staff need new and different
    skills, opportunities and structure that focus on
    critical competencies.

8
Background and Rationale for Organizational
Effectiveness
  • Poor overall revenue position/trends
  • Flat revenue for the last 37 years.
  • Declining net assets.
  • 2003 revenue 20 lower (inflation-adjusted
    dollars) than 1967.
  • 9 of 11 public health competitors grew revenue at
    faster rates than we did in the last 10 years.

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18
Bottom Ten Performing Lung Associations According
to Overall TPI and Per Capita Fundraising Rankings
19
Top Ten Performing Lung Associations According to
Overall TPI and Per Capita Fundraising Rankings
20
Background and Rationale for Organizational
Effectiveness
  • Multiple incorporated entities make alignment and
    impact difficult.
  • Notwithstanding all the challenges
  • Great volunteers and staff.
  • Eagerness for change.

21
Design Phase -- Guiding Principles
  • The organization is committed to improving lung
    health through advocacy, education and lung
    health research.
  • We are committed to retaining our historical and
    pervasive passion for our Mission.
  • We commit ourselves to
  • Our communities, our staff, our volunteers and
    our effectiveness.

22
Design Phase -- Process
  • Stakeholder groups
  • National volunteers Local volunteers
  • Chairs/Chairs-elect CLAS
  • National staff Local staff
  • Local CEOs Past National presidents

23
Design Phase -- Process
  • Six work groups with volunteers, Lung Association
    CEOs and national staff.
  • Charged each to
  • Be open, participatory and communicative.
  • Use input from surveys and individuals.
  • Seek guidance from diverse forums.
  • Continuously assess if we are doing the best
    possible job, getting the best outcomes and
    finding every new opportunity to improve our
    performance.

24
Design Phase Process 6 Work Groups
  • Organizational Assessment Seek and assess input
    on short/long term ways to improve.
  • Balanced Scorecard Develop a practical and
    manageable outcome management and performance
    review system.
  • Historical Perspectives Learn from past
    restructuring.

25
Design Phase -- Process
  • Corporate Design Develop a new corporate model
    and recommendations for governance, structure and
    national/field collaboration.
  • Human Resources Develop mechanisms to aid
    volunteers and staff in transition.
  • Communications Inform and involve all
    stakeholders.

26
Design Phase Recommendations
  • Following are the 37 recommendations of the six
    work groups, numbered as in the written report.
  • We will eliminate redundancies in the final
    product among different groups recommendations.
  • Some recommendations require development
    particularly the Governance section of Corporate
    Design and topic of Regional VPs.

27
Design Phase -- Recommendations
  • These following few recommendations are intended
    to be implemented in the short-term.
  • R11 -- A national advertising campaign.
  • R12 -- Set standards for local associations
    regarding computer technology.
  • R13 -- The national office should provide a
    template for a successful merger.

28
Design Phase -- Recommendations
  • R1 The American Lung Association must become an
    outcome-focused, performance-driven organization.
  • R2 Staff and volunteer training must be conducted
    on the Balanced Scorecard.
  • R3 The American Lung Association must implement
    an annual performance review system the
    Balanced Scorecard Annual Cycle.

29
Design Phase -- Recommendations
  • R4 The Balanced Scorecard must be designed with
    key result indicators that reflect these
    perspectives
  • -- Customers.
  • Internal Processes.
  • Financial.
  • Results Learning.
  • Governance.

30
Design Phase -- Recommendations
  • R5 The Balanced Scorecard should be implemented
    with the following structure
  • Balanced Scorecard Coordinating Committee
  • Balanced Scorecard Peer Support
  • Regional Vice Presidents
  • Constituent Associations/Local CEO
  • National Headquarters Balanced Scorecard

31
Design Phase -- Recommendations
  • R6 To support the Balanced Scorecard
  • Performance Review System we need
  • A robust data tracking system.
  • A measured roll out.

32
Design Phase -- Recommendations
  • R7 Additional Recommendations
  • Strategic plan Lung Health and Operational Goals
    Balanced Scorecards must be integrated into
    performance-based system.
  • A checklist of infrastructure, process and
    administration is needed to support the
    performance review system.

33
Design Phase -- Recommendations
  • R8 Our Organizational Effectiveness Plan
  • should establish a preamble of common
  • vision principles.
  • R9 Mergers resulting in larger economic
  • units are successful and should be encouraged.
  • R10 An evaluation methodology must be built
  • into all levels of the organization, to track and
  • monitor outcomes.

34
Design Phase -- Recommendations
  • R14 Develop Best Practices to focus more
  • directly on the Mission while answering
  • Whom do we help who needs our help most?
  • R15 Maintain engagement with volunteers
  • with reduced responsibilities due to
    restructuring
  • R16 Organize teams and create Tool Kits to
    support field offices.

35
Design Phase -- Recommendations
  • R17 If staffing changes become necessary
  • handle them respectfully.
  • R18 Examine all options including the legal
  • and financial implications of removing the
  • pension early retirement reduction for
    individuals
  • with 30 years of service who are not yet 65 or
  • introducing early retirement buyout packages, to
  • name a few.

36
Design Phase -- Recommendations
  • R19 Recommendation for Long-Term Action
  • Develop regional staff for implementation of
    national communications initiatives.
  • Develop a shared local and national media
    database.
  • Generate data showing progress made in the fight
    against lung disease and report these annually to
    the board.

37
Design Phase -- Recommendations
  • R19 Recommendation for Long-Term Action
  • Formulate a smaller leadership group.
  • Create regional offices with national staff.
  • Provide national office support for mergers.
  • Develop Best Practices to focus more directly on
    the mission.
  • Highlight mission focused activities within Best
    Practices.

38
Design Phase -- Recommendations
  • R19 Recommendation for Long-Term Action
  • Move to strengthen corporate leadership.
  • Develop job descriptions for all volunteers and
    define a growth ladder.
  • Define a career ladder for employees.
  • Fund formal staff training opportunities.
  • Align staffing with the Strategic Plan.

39
Design Phase -- Recommendations
  • R20 The American Lung Association will
  • remain a two-level organization.
  • R21 We will consist of a National Office, with
  • single state and multi-state corporations.
  • R22 We will establish measurable
  • performance standards for maximum Mission
  • impact and alignment.

40
Design Phase -- Recommendations
  • R23 Fund raising to further the Mission will
  • become a prominent, organizational focus.
  • R24 The Lung Association family will ensure
  • cultural diversity in its staff, volunteers, and
  • leadership.

41
Design Phase -- Recommendations
  • R25 Field restructuring to achieve larger,
  • stronger, more efficient, and more effective
  • corporations will be guided by criteria,
  • timetable, tools, and technical assistance.

42
.
Design Phase -- Recommendations
  • R26 Five-Year Plan 6/30/06 California and New
    York along with Chicago and Illinois-Iowa will
    become single state corporation. Concurrently,
    States volunteer to serve as pilot sites and
    create larger scale incorporated entities.
  • 6/30/10 15 --20 larger incorporated entities
    are created. Budget size from 8 million upward.

43
Design Phase -- Recommendations
  • R27 National Office location will be reviewed
    with
  • a decision timed to the end of the lease 6/30/07
  • R28 National Office will decentralize certain
  • functions to improve service delivery and support
  • to the Field.
  • R29 Regional Vice Presidents for Field Support
  • will help implement the Balanced Scorecard and
  • performance standards, to name a few, and
  • collaboration among all levels of the
    organization.

44
Design Phase -- Recommendations
  • R30 Governance structures will be revised to
  • direct strategic planning, fund raising, and
  • decision-making in the most effective,
  • expeditious, and excellent way possible.
  • R31 Additional Possible Design Elements
  • Creation of a Foundation with a separate Board of
    Directors
  • Creation of a National Advisory Board
  • Creation of a Research Foundation

45
Design Phase -- Recommendations
  • R31 Additional Possible Design Elements
  • Creation of a Political Action Committee
  • Formation of a Peer Technical Advice and Support
    Team to assist the Field
  • Training and certification of CEOs and Senior
    Managers as CALL US mentors and coaches who
    provide assistance.
  • Creation of a shared services division.

46
Design Phase -- Recommendations
  • R31 Additional Possible Design Elements
  • Develop National Offices senior level staff
    positions for interaction with the RVPs/CEOs.
  • Use an existing committee or establish a new body
    to oversee the Balanced Scorecard and performance
    standards process.
  • Develop logistics for the RVP positions
  • Define the process for a new Charter and
    implement a performance standard system.
  • Clarify what local presence means.

47
Design Phase -- Recommendations
  • R32 Approve and distribute the Human
  • Resources Principles
  • R33 Approve the Priority Leadership
  • Characteristics and Position Responsibilities
  • R34 Encourage supervisors to lead their staff
  • through the new Staff Learning Needs
  • Assessment and Staff Learning Resources.

48
Design Phase -- Recommendations
  • R36 The Human Resources Management
  • Development Work Group will manage the
  • creation of a Staff Transition Plan.
  • R37 The Human Resources Management
  • Development Work Group will manage the
  • creation of a Volunteer Transition Plan.

49
Pre-implementation, Technical Assistance,
Development Phase
  • The process can and should begin now.
  • Those who choose to begin the process will be
    assisted, and we can learn and benefit from their
    early efforts.
  • The Steering Committee is refocusing various work
    groups to take on new assignments.

50
Pre-implementation, Technical Assistance,
Development Phase
  • These assignment groups will operate going
    forward under the Steering Committee.
  • Organizational Assessment
  • Communications
  • Balanced Scorecard
  • Governance
  • Corporate Design
  • Human Resources
  • Regional Vice Presidents

51
Pre-implementation, Technical Assistance,
Development Phase
  • Open Items
  • Governance
  • Regional Vice Presidents
  • The Tool Kit
  • The new Charter
  • Granting and Foundation sources
  • Early retirement possibilities
  • Balanced Scorecard Development (Field and
    National).

52
10 Most Frequently Asked Questions
  • Q1 -- Why must ALA restructure and move to a new
    model of operation?
  • We are in a declining revenue position versus
    other national health organizations.
  • Many local Lung Associations cannot fully serve
    the states where they are located, and many
    cities lack our presence altogether.
  • Several Field operations are in deficit
    situations without adequate support or resources
    available either from the Field or the National
    Office to reverse this trend.

53
10 Most Frequently Asked Questions
  • Q1 -- Why must ALA restructure and move to a new
    model of operation? (continued)
  • We must reposition ourselves to grow with a
    deeper commitment to fund raising to support our
    strategic priorities of advocacy, programs,
    research, and education.
  • We lack a cohesive nationwide program of work
    that is every association pursues along with work
    that is unique to the associations environment
    and population.

54
10 Most Frequently Asked Questions
  • Q2 -- Why are CA, NY, and IL being asked to form
    single-state corporations?
  • States must be lead and represented by 1 Board
    and 1 CEO and managed through 1 budget in order
    to bring a clear and coordinated nationwide
    effort to statewide advocacy efforts and
    nationally sponsored programs.

55
10 Most Frequently Asked Questions
  • Q3 -- Why is the Field being asked to merge
    and/or restructure to form multi-state or larger
    regional configurations?
  • We lack economies of scale to function
    competitively. Some local Associations lack
    exclusive fund raisers, statewide service
    delivery models, and the capacity to have input
    as advocacy organizations.
  • We need Critical Mass within each entity to
    accomplish our mission.

56
10 Most Frequently Asked Questions
  • Q3 -- Why is the Field being asked to merge
    and/or restructure to form multi-state or larger
    regional configurations? (continued)
  • Local Lung Associations are being asked to
    consider new, better, and larger organizational
    models.
  • This will enable ALA to marshal its most talented
    people in more effective ways.

57
10 Most Frequently Asked Questions
  • Q4 -- Whats the Balanced Scorecard, and why is
    the ALA moving to implement this framework?
  • The traditional corporate balanced scorecard is
    overly complex for our needs.
  • Our balanced scorecard is, in effect, a
    performance review system that allows us to
    measure financial and non-financial results of
    our work based upon standards that are nationally
    agreed-to, quantified and tracked.

58
10 Most Frequently Asked Questions
  • Q5 -- Has Field restructuring in the ALA been
    historically successful?
  • The findings of the Historical Perspective Group
    were positive with clear gains to these
    organizations.
  • Local Lung Associations have completed numerous
    Field restructurings which are documented in the
    survey conducted by this group.
  • Restructuring has provided the benefits of
    economies of scale in all cases.

59
10 Most Frequently Asked Questions
  • Q6 -- Will the National Office change as a result
    of this process, and if so, how?
  • Yes. It, too, will be held to new performance
    targets as will the Field. The Field will be
    surveyed about its performance.
  • The National Office may operate under a new
    governance model still under development.

60
10 Most Frequently Asked Questions
  • Q6 -- Will the National Office change as a result
    of this process, and if so, how? (continued)
  • The National Office will be asked to play new
    roles to ensure stronger Field-National
    relationships and will be asked to service and
    support the Field in new collaborative ways, as
    well as to provide support to volunteer and staff
    transition.

61
10 Most Frequently Asked Questions
  • Q7 -- What is the purpose/function of the new
    National RVPs?
  • Working with the Field CEOs, together they will
  • Manage and coordinate the use of Balanced
    Scorecard.
  • Provide support and facilitation to field
    restructuring efforts.
  • Focus on, highlight, and convene states around
    best practices.

62
10 Most Frequently Asked Questions
  • Q7 -- What is the purpose/function of the new
    National RVPs? (continued)
  • Bring more effective National-Field
    collaboration, and coordination to agreed-upon
    strategic priorities.
  • These regionally-based, Nationally staffed
    positions will be hired by and report to the
    National CEO.
  • The number and geographic scope of
    responsibilities is being developed.

63
10 Most Frequently Asked Questions
  • Q8 -- Has a national map and master plan already
    been developed?
  • NO. The map of new regional or multi-state
    organization will evolve from all Stakeholders
    continuing to work together to determine the best
    possible nationwide look.
  • There is no master plan. You are designing,
    developing, and will implement a unique Strategic
    Alignment Model based upon our collective efforts
    through this process.

64
10 Most Frequently Asked Questions
  • Q9 -- How much will these recommendation cost to
    implement, and what is the impact of all this
    restructuring effort?
  • Volunteer Leadership and National Staff are
    working on models that will estimate
    reorganization costs Return on Investment (ROI)
    Opportunity Costs absent reorganization
    Foundation and other funding sources with the
    goal of authoring a business plan addressing
    these issues.

65
10 Most Frequently Asked Questions
  • Q10 -- What is there to point to that says that
    this time we will actually follow through and
    implement?
  • You! This has been one of the most
    participatory, informative, collaborative, and
    constructive initiatives ever undertaken
  • The number of people who have been involved is
    beyond our best expectations and bodes very well
    for implementation of these recommendations.

66
10 Most Frequently Asked Questions
  • Q10 -- What is there to point to that says that
    this time we will actually follow through and
    implement? (continued)
  • The number of states already considering
    alliances is promising.
  • The number of professionals seeking to begin
    pilot use of the Balanced Scorecard is very
    encouraging.

67
Improving Life, One Breath at a Time
For 100 years, the American Lung Association has
been the lead organization working to prevent
lung disease and promote lung health. Lung
disease death rates continue to increase while
other leading causes of death have declined. The
American Lung Association funds vital research on
the causes of and treatments for lung disease.
With the generous support of the public, the
American Lung Association is Improving life, one
breath at a time. For more information about the
American Lung Association or to support the work
it does, call 1-800-LUNG-USA (1-800-586-4872) or
log on to www.lungusa.org.
www.lungusa.org
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