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Leadership Workshop - Leading Out of the Mess
- 1. Leading Out of the Mess Michigan Primary Care Association Fall 2009 Annual Conference Roger L. Chaufournier Executive Director CSI Solutions, LLC September 2009
- 4. CHAPEL ROAD HEALTH CENTER
- 8. “ Hardly a competent workman can be found who does not devote a considerable amount of time to studying just how slowly he can work and still convince his employer that he is going at a good pace. Under our system a worker is told just what he is to do and how he is to do it. Any improvement he makes upon the orders given to him is fatal to his success.” Frederick Taylor
- 9. “ We trained hard...but it seemed that every time we were beginning to form up into teams we would be reorganized. I was to learn later in life that we tend to meet any new situation by reorganizing; and what a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency and demoralization.” Who do you think said this and in what era did they live?
- 11. Peter Drucker “ Every few hundred years in the history of Western society a transformation takes place. The transformation transcends all aspects of society; the government, the schools, the values, religion, culture, etc. The transformation is not sudden, but takes place over a 50 year or more period. The transformation is so profound that the children born in that era can not comprehend the time in which their parents were born and in which their grandparents lived.”
- 14. Baldrige Health Care Criteria for Performance Excellence Framework A Systems Perspective 4 Information and Analysis 6 Process Management 2 Strategic Planning 5 Staff Focus 1 Leadership 3 Focus on Patients, Other Customers, and Markets Organizational Profile: Environment, Relationships and Challenges Malcolm Baldrige National Quality Award 7 Organizational Results
- 23. 09/30/09 Dashboards Informed decisions through the use of appropriate and timely data Source: Richard Davis, Johns Hopkins Business of Medicine Program
- 26. Value Stream Mapping Phases Preparation Current State Future State Planning Agreeing on what process to study, how to map it and who will participate. Agreeing on a well understood map of the current situation. Agreeing on a shared vision of a lean future state. Agreeing on how to implement the future state vision Adapted from Lean Enterprise Institute
- 30. Revenue Recovery Accomplishments Activity Baseline FY00 FY01 FY02 FY03 FY04 FY05 (Q2) Competency Scores 65% 80% 90% 92% 91.4% 92.5% 93.5% Admin. Denial Rate 1.4% 1.4% 1.4% 1.4% 1.4% 2.0% 1.7% Clinical Denial Rate 2.3% 1.7% 2.0% 2.0% 1.8% 1.8% 1.8% TOS Collections $13.8m $17.5 $8.7m* $10.1m $8.6M $9.5M $4.4M Collection Rate 85.6% 87.4% 87.5% 88.1% 88.6% 89.3% 87.9% Days in A/R 118 96 75 61 56.3 50.6 53.7 Late Charges 9% 4% 4% 3% 2.6% 3.1% 2.5% Cumulative Revenue FY00 – FY05 = $98,000,000
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- Leadership and Organizational Behavior Session 1: History of Management Theory (May 2000) TAYLOR was a factory worker who was going blind and was moved into a management position. He was asked to analyze the factory work flow so he did time-motion studies. Father of the “scientific method of management”. He said that the best way to increase output was to improve techniques used by the workers and standardize procedures. The role of the manager is to design work so that it is fool proof, then motivate people. But people were instruments to be manipulated by management. Workers are to do what they are told, do not deviate from work tasks. The result was that workers had to adjust to management. In the 1930’s when Taylor was making factories efficient, where did the money go? ****Answer: Corporate boardrooms not the labor. Created the “sweat shop.” Led to the age of “touchy- feely” management. We will be talking in later classes about six sigma and other improvement methods. The goal of six sigma is to standardize operations (Jack Welch did this well at GE). How do you reconcile your reaction to Taylor’s work with the current six sigma movements? 2.00 8:26 Chip
- Leadership and Organizational Behavior Session 1: History of Management Theory (May 2000) QUOTE: Petronius Arbiter, Roman Legionnaire 210 B.C [Read the military quote and ask the currently displayed site the question.] Answer: Petronius Arbiter, Roman Legionnaire, 210 B.C. After Fayol, Max Weber (Va-Ber) came along and expanded his theory of bureaucracy. He said people need rules and regulations at work. Management needs to implement policies and procedures, delegate authority and tasks, need hierarchy and span of control. 1.00 Videoconference: Site: ______________________ 8:18 Chip
- Leadership and Organizational Behavior Session 1: History of Management Theory (May 2000) We’ll use this quote to signify a shift in thinking that occurred in the early 1900s. Luther Gullick, a Harvard guy, built on the work of Fayol, Weber and Taylor. Said you need structural stuff, but there are also core competencies of management THAT CAN BE TAUGHT (this, incidentally, led to the creation of the Harvard Business School. Harvard developed these into courses that guide the school to today!). Gullick created a role for managers, which led to an explosion of “how to” manuals. Planning, Organizing, Scheduling, Delegating, Coordinating, Resource Management, Budgeting. But these cannot become the goal itself; they must be considered as tools and strategies toward an end in order to be successful. During this time, up to WW2, US factories were cranking, productivity had skyrocketed. In fact, many historians credit the fact that we had our act together in the factories as a reason we won the war. We had the ability to produce arms and material and send them out. However, increased productivity eventually led to a fissure between management and labor. From the 30s-60sm the growth of labor and the strain between labor and management led to the rise of the humanistic movement or “touchy feely management”.
- Leadership and Organizational Behavior Session 1: History of Management Theory (May 2000) DRUCKER [ Read the quote .] Wrote a book that captures the epics of management over time. Described three-four epics in our history representing profound shifts in society. These epics triggered shifts in management practice. 2.00 8:01 Chip
- Leadership and Organizational Behavior Session 1: History of Management Theory (May 2000) Drucker argues that to be an effective executive, you can be all over the map in terms of personality, attitudes, values, strengths, weaknesses…extroverted, reclusive, easy-going, controlling, generous or parsimonious. This SYSTEMATIC APPROACH can help any executive get things done. Effective executives get the right things done.
- … and the department aim would be CABG ssis, or BSIs in one particular ICU with one particular subset of patients…etc.
- Leadership and Organizational Behavior Session 4: Strategic Planning (May 2000) What you are looking at is the 30,000 ft level view of performance measures. From an organizational perspective, performance measures should provide enough detail to allow us to understand performance along a number of perspectives (Remember What we discussed about Systems Theory). Just as the dashboard of a car provides just the right information to make informed decisions, without getting you bogged down in data that doesn’t serve you while you are driving, performance measurement in business should follow a similar model by identifying elements critical to daily operations. A dashboard is a graphical representation of performance. It generally provides a very quick visual guide to how we are progressing currently and over time on numerous parameters. The individual and the group should be able to use the performance measures and understand how the pieces of the system fit together. A good set of performance measures will look at the organization from a number of viewpoints. At Hopkins we have an established Balanced Scorecard Dashboard that measures performance on 4 spectra: Fiscal Clinical Service, and Infrastructure Other spectra that can be used include: Financial – Summarizes economic consequences of actions. Provides an overview of the financial state of the organization in terms of growth, sustainability and areas of concern Customers – Identifies customers and market segments Measures Segment specific drivers - Product and service attributes, Customer relationships, and Image and reputation Learning and Growth – Identifies the infrastructure that an organization must build to achieve its strategic imperatives People and any reskilling that is required, Information systems that need to be enhanced, Procedures that need to be aligned to future vision Internal Business Processes – Identifies critical business processes and focuses on the processes which will have the greatest impact on customer satisfaction and achieving financial objectives Innovation, operations, post sales service Keep in mind whenever you are reviewing dashboards and similar types of performance measures, that they are not… A detailed report – they only provides a summary picture of the operation The Final product – Metrics should be updated to account for changes in operations and strategic objectives A computer solution – Determine what you want to measure before you put in onto the computer. Try it to see if it truly measures what you are trying to measure. Ron Petersen, Judy Reitz, etc will have a dashboard developed that will show the operating model for each unit on a daily / weekly basis. The data that you provide / input will feed directly into these dashboards so that they can see progress overall and on specific projects. If they detect problems from these charts they will come down and ask you about the issues and what your plans are to resolve them, also what can they do to help.
- Customer requirements for a Workshop A date commitment 2-4 weeks in advance Sponsor to give 15 min. introduction to Workshop and attend Leadership Panels Sponsor must support the implementation changes (this could mean significant change) All Workshop participants required to commit full-time to Workshop Prepare for Workshop in advance, with TWI assistance Workshop to be held on consecutive days, and customer must provide supplies (suitable room, flip charts, dry-erase markers, projector)
- Chip 2.00 8:49