1. Creating a Culture of Performance Excellence
Enhancing Business Acumen by Leveraging ActiveStrategy to Manage Performance
Corwin Nathaniel Harper, MHA, FACHE
Senior Vice President/Area Manager
CENTRAL VALLEY AREA April 2012
2 | © 2012 Kaiser Foundation Health Plan, Inc.
Creating a Culture of Performance Excellence
Management &
People Practices
Recognition & Feedback
Business
Performance
Management &
Metrics
Work Processes/
Systems
& Performance
Improvement
Vision &
Strategy
Leadership
Credibility & Total
Performance
Behaviors
Structure &
Organizational
Design
Culture
The Journey to Sustainable Excellence

2. 3 | © 2012 Kaiser Foundation Health Plan, Inc.
Creating a Culture of Performance Excellence
Kaiser Permanente – Guiding Behaviors
Takes Accountability
Focuses on the Customer
Drives for Results
Develops Self and Others
Communicates Effectively
Collaborates
Champions Innovation and Change
Thinks and Acts Strategically
Leverages Technology
Demonstrates Resource Stewardship
Demonstrates Business Acumen
4 | © 2012 Kaiser Foundation Health Plan, Inc.
We assessed various models to enhance/improve performance.
After careful consideration we settled on the Studer model because
the Five Pillars and Nine Principles aligned with the priorities at
Kaiser Permanente.
Steps to Enhancing Performance
Determining Our Approach

3. 5 | © 2012 Kaiser Foundation Health Plan, Inc.
Enhancing Performance
Why Build Business Acumen Through
Business Performance Reviews?
Requires analysis of business workflows
Prompts critical thinking and strategic planning
Consideration of outcomes and finances
Focuses on critical drivers and indicators of performance
Provides a forum for managers and directors to present critical
performance indicators to leaders, and get real-time feedback
Enables leaders, directors, and managers to jointly make proactive
decisions and allocate resources to positively impact future outcomes
6 | © 2012 Kaiser Foundation Health Plan, Inc.
Dr. Raymond R. Reilly of the Ross School of Business at
the University of Michigan and Dr. Gregory P. Reilly of the University of
Connecticut document traits that individuals with business acumen
possess:
– Have an acute perception of the dimensions of business issues
– Can make sense out of complexity and an uncertain future
– Are mindful of the implications of a choice for all the affected
parties
– Are decisive
– Are flexible if further change is warranted in the future
Enhancing Performance
How Does Business Acumen Drive Performance?

4. 7 | © 2012 Kaiser Foundation Health Plan, Inc.
The Road Toward Effective
Performance Management
Business Acumen + Rounding + Performance Management = Performance Improvement
Strategic thinking
Thoughtful analysis
Understanding the logic behind business
decisions
Rounding integrated into daily business
functions
Careful attention to key dimensions of
planning and execution
Clear accountability and ownership
More disciplined performance management
Effective Performance Management
Involving Your Staff to Achieve Outcomes – Rounding Tool

5. 9 | © 2012 Kaiser Foundation Health Plan, Inc.
Business Performance Management Utilizing the
Business Performance Review Process
Definitions
Business Performance Management: A disciplined, structured and
ongoing management practice supporting strategy execution that
enables leaders at all levels to be fully informed of their
business/operations.
Business Performance Review: A highly structured, ongoing,
data-driven conversation between a manager and his/her direct reports.
2.
10 | © 2012 Kaiser Foundation Health Plan, Inc.
Business Performance Review: Meetings are focused on strategic
goals and the operational performance of the business units
(i.e., patient care services and support services).
The meetings are discussions, not report outs. Leaders, directors,
and managers meet with key members of the leadership team to
discuss performance, results from rounding, and get input/feedback
for further enhancements.
Rounding: Key rounding questions are integrated into each session.
Examples: How can I assist you? What resources or tools do you
need? Do you have the support you need to be successful? Are
there barriers that I can help you with?
The Business Performance Review
How are the Reviews Structured?

6. 11 | © 2012 Kaiser Foundation Health Plan, Inc.
Business Performance Review – Continuous
Improvement Cycles to Enhance Performance
Plan, Do, Study, Act
PDSA Cycle
constant
PLAN
What are the needs
of the patient?
How can we get timely
and relevant information?
DO
Develop a tool to collect
real-time information in time
to impact the care and service
experience of the patient.
STUDY
Assess the information collected
and determine the one-time issues
versus trends.
Resolve one-time issues and develop
a rapid plan to change operations
that impact many patients.
ACT
Determine how to
improve data collection
and resolution process
-- and begin new PDSA cycle.
12 | © 2012 Kaiser Foundation Health Plan, Inc.
The evolution of data collection and actions associated with the data
is a continuous improvement process at Kaiser Permanente in the
Central Valley Area.
It is our desire to gain real-time information to continually enhance the
care and service experience for our patients and members in the
Central Valley Area; this desire helps to focus our efforts.
Rounding is the key component of the process and we have learned
to collect real-time information to impact the care and service
experience of our patients and members. Because of our approach
with rounding, we can address needs or issues before discharges
occur. This is what motivates us to continually enhance our
performance. The patient/member is at the center of our work.
The Business Performance Review
PDSA Cycles

7. 13 | © 2012 Kaiser Foundation Health Plan, Inc.
Previously we used a paper process to round on our
patients and members.
Information was collected, entered into a spreadsheet, and
reviewed at some point in the future. This is reactive.
Now, we use technology to collect data, quickly analyze it
and make adjustments to ensure that the patient/member
experience is excellent. This is proactive.
The Business Performance Review Process
Then and Now
14 | © 2012 Kaiser Foundation Health Plan, Inc.
The Business Performance Review with Paper
Paper-driven process
Multiple data sources
Gathering, sorting, and
tracking of paper documents
Increased meetings
Cumbersome tracking of
action plans
Ongoing email strings

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The Business Performance Review
Past Present
Electronic
Automated
Processes
Information Technology
Performance Improvement
Leveraging Technology is an Integral Component to Greater Efficiency
Paper &
Manual
Processes
16 | © 2012 Kaiser Foundation Health Plan, Inc.
After reviewing resources to help
manage performance, ActiveStrategy
was selected as the next tool to add to
the toolkit.
Along with ActiveStrategy, we
determined that we needed to use an
electronic tool for rounding to allow
immediate data analysis.
The iPad with the iRound application was
selected for departmental rounding.
The Business Performance Review
A Look at the Present -- Leveraging Technology

9. 17 | © 2012 Kaiser Foundation Health Plan, Inc.
The Business Performance Review
A Look at the Present -- iPad
18 | © 2012 Kaiser Foundation Health Plan, Inc.
The Business Performance Review
Technology in Health Care
The evolution of health care technology enables us to
improve efficiency and enhance performance to ensure
the highest quality of care and service experience for
our patients and members.

10. 19 | © 2012 Kaiser Foundation Health Plan, Inc.
Health Care Technology
The Systems Theory
20 | © 2012 Kaiser Foundation Health Plan, Inc.
The Business Performance Review
Rounding for Outcomes
Single source of the “truth”
– Centralized scorecard
– Single action plan
– Single report to meet multiple
committee/oversight needs
Paperless
Ability to meet from diverse
locations
Rounding for outcomes
More time for open dialogue,
business discussions, and joint
strategic decision making.

11. 21 | © 2012 Kaiser Foundation Health Plan, Inc.
The Business Performance Review
Performance Management
Scorecards easily updated and accessible
Focus on both short-term and long-range outcomes
Consistent communication and ongoing feedback
Critical metrics tracked; trends and gaps in performance visible for
course corrections
Ongoing performance and improvement initiatives
Strengthen the system/structure for communicating and reinforcing
strategy
Streamline method for ongoing review of performance against targets
22 | © 2012 Kaiser Foundation Health Plan, Inc.
Business Performance Review
Clinical Informatics Improves Outcomes:
A Look at the Present and the Future Possibilities
Clinical informatics transforms the health care experience by
facilitating our ability to analyze, design, implement, and evaluate
information.
Future advancements and communications systems allow
enhancements to patient care and safety, and strengthen the
provider-patient relationship.

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Creating a Culture of Performance Excellence
What are your Contributions to Quality of Care and Service Excellence
How are you managing performance?
24 | © 2012 Kaiser Foundation Health Plan, Inc.
Creating a Culture of Performance Excellence
Questions?