United Advance Practice Registered Nurses of Georgia ...enp-network.s3.amazonaws.com/UAPRN/2016_Conference... · United Advance Practice Registered Nurses of Georgia Presentation

Daniel J. Messina, Ph.D., FACHE

United Advance Practice Registered Nurses of Georgia Presentation

Critical Success Factors for Effective Healthcare Executive Performance


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This Presentation is Dedicated In Loving Memory of My Parents.

Rose H. Messina 1926-2012

Salvatore A. Messina

1924-2016

Outline I. Leadership Quotes To Note

II. Managing Oneself III.  Stuart Levins “The Six Fundamentals of Success“/ Kevin

Cashman “The Pause Principle”

IV. Serving Others

V. Serving the Organization

VI. 7 Habits of Spectacularly Unsuccessful Executives

VII. Critical Success Factors: Final Questions

VIII. Closing: The Ten Laws of Life

IX. Resources

X. Questions


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I. Leadership Quotes to Note

•  “Bosses overestimate the significance of their routine decision-making and underestimate the impact of their personal behavior.”

Walter F. Ulmer, Jr. •  “Paramount to successful leadership is the ability to master the

context.” Warren Bennis

•  “If you want to truly understand something, try to change it.”

Kurt Levin •  “In a time of drastic change, it is the learners who inherit the future.

The learned find themselves equipped to live in a world that no longer exists.” Eric Hoffer


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II. Managing Oneself

•  General Protocols for Managerial Behavior

•  Importance of Perception

•  Recognizing Others

•  Getting Along with All Players

•  Importance of Communication

•  Maintaining an Appropriate Demeanor In and Out

•  Courtesy

•  Managing Concentration: Meetings /Quiet Time


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•  Personal Executive Protocols

•  Appearance

•  Interactions

•  Image

•  Managing the Team


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•  Executive Value Systems

•  Honesty

•  Credibility

•  Integrity


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•  Building One’s Reputation Internally

•  Providing goal oriented leadership

•  Promoting “positivism”

•  Take credit when credit is due

•  Participating actively in all areas of the organization

•  Being punctual

•  Share success

•  Being an idea person

•  Being an organizational cheerleader


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•  Building One’s Reputation Externally

•  Active professional association memberships on a national, state and local basis

•  Teaching

•  Research

•  Advanced credentialing; i.e. FACHE,DNP, etc.

•  Preceptorship

•  Publishing

•  Providing legislative input


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•  Ethics and Accountability

•  Organizational Code of Ethics

•  Professional Ethics

•  Decision Making Ethics


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III. Stuart Levin’s “The Six Fundamentals of Success”

1. Make Sure you Add Value 2. Communicate Up, Down, Inside and Out 3. Know How to Deliver Results

4. Conduct yourself professionally

5. Invest in Relationships 6. Gain Perspective


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III. Kevin Cashman “The Pause Principle”

“Pause, the natural capability to step back in order to move forward with greater clarity, momentum, and impact, holds the power to reframe and refresh now we see ourselves and our relationships, our challenges, our capacities, our organizations and missions within a larger context.”


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III. Pausing Has the Potential to Allow Us To:

1.  Move from self-consciousness to self awareness and self-service. 2.  Move from people dominance and control to people development and

liberation. 3.  Move from conflict and confusion to clarity and hope. 4.  Move from a presentation of knowing and expertise to listening and

learning. 5.  Moving from heroic, unchallenged ideas to collaborative constructive

engagement. 6.  Move from status quo to exploring and innovation. 7.  Moving from accuracy and efficiency to dispose and transform.


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IV. Serving Others

•  Interpersonal Relationships

•  Showing Respect/Dignity - writing notes, etc.

•  Optimizing Interpersonal Relationships

•  Optimizing Supervisory Relationships


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IV. Serving Others

•  Interpersonal Relationships •  Greenleaf’s Servant Leadership

In Servant Leadership, Robert K. Greenleaf described the concept as follows:

A fresh critical look is being taken at the issues of power and authority, and people are beginning to learn, however haltingly, to relate to one another in less coercive and more creatively supporting ways. A new moral principle is emerging which holds that the only authority deserving one’s allegiance is that which is freely and knowingly granted by the led to the leader in response to, and in proportion to, the clearly evident servant stature of the leader. Those who choose to follow this principle will not casually accept the authority of existing institutions. Rather, they will freely respond only to individuals who are chosen as leaders because they are proven and trusted as servants.


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IV. Serving Others

•  Greenleaf’s Servant Leadership

•  Servant leaders are goal-oriented.

•  Servant leaders tend to listen intently to descriptions of problems to gain a better understanding of them.

•  Servant leaders are accepting and empathetic in dealing with their subordinates.

•  Servant leaders do not attempt to manipulate or control subordinates.

•  Servant leaders encourage an open, honest atmosphere that encourages positive interpersonal relationships.

•  The essence of servant leadership is a strong drive to develop and maintain positive interpersonal relationships.

•  To practice the principles of servant leadership, senior managers and executives must first look at what their subordinates need in order to do their work.

•  Senior managers and executives must share information and assist others to accomplish their goals.


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IV. Serving Others

•  Interpersonal Relationships (continued)

•  Protocols for Termination

•  Protocols for Employee Interaction

•  Interacting with Staff

•  Considering Behavior Impacts of Oneself


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IV. Serving Others

•  Protocols for Management Interaction

•  Managing Team Causes of Friction

•  Tunnel Vision/Real Time Info Sharing

•  Fostering Management Teamwork - Group Goals, Equal Footing, Maximum Input, Mutual Dependence


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IV. Serving Others

•  Role and Function of Governing Boards

•  Loyalty to the organization

•  Being diligent with board responsibilities

•  Being prudent in all decisions made on behalf of the organization

•  Respecting the confidentiality of the boardroom

•  Supporting decisions and policies


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IV. Serving Others

•  Role and Function of Governing Boards (continued)

•  Helping define, and then support, the roles delegated to management and the medical staff

•  Engaging in regular self-evaluation processes of the board


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IV. Serving Others

•  Medical Staff Interaction

•  Understand principles for working with physicians - Recognized Business Interests, Patient Advocate Position, Giving Reasons and Explanations

•  Identify physician needs

•  Maintain solid follow-up

•  Recognize the physician as a partner

•  Recognize individual physician players


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IV. Serving Others

•  Human Resource Decision Making

•  Considering one’s decisions

•  Considering the sacred turf of religion

•  Practicing the corporate philosophy and HR policy/walking the talk


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•  Protocols for Oral Communication •  Make oral communication two-way

-  Pause to give staff time to answer questions -  Don’t rush when giving directions; ask staff to repeat instructions -  Offer opportunity to verify an understanding of directions

•  Learn to communicate in a group setting well -  Keep message simple - repeat main points - allow time for questions

•  Manage non-verbal communication as well as verbal •  Learn to disarm -- put the issue right out front first •  Prepare, prepare


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•  Protocols for Written Communication •  Know when not to write •  Send hand-written notes when appropriate •  Decide who should receive copies •  Use clear, direct writing style •  Be consistent •  Use consistent protocols for both electronic and written

communication •  Get facts first •  Send notes expressing concern or condolences


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•  Creating a Dashboard

•  Financial Reporting

•  Benchmark Reporting

•  Labor Distribution Summary

•  Revenue and Expense Reports

•  Explanations of Variances


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•  Creating a Dashboard (continued)

•  Turnaround Time Tracking

•  Patient Satisfaction Data

•  Employee Opinion Survey

•  Physician Satisfaction Surveys

•  Quality Measures

•  New Program Performance Monitoring


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Protocols for Developing a New Program •  Background Data

•  Market research and analysis •  Review regulatory issues •  Competitive analysis •  Demographic data •  Financial review •  National trends applied to the local situations •  Internal strengths/weaknesses


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Protocols for Developing a New Program (continued)

•  Identification and segmentation of target markets

•  Establishment of goals and objectives

•  Identification of provider resources

•  Development of promotion and advertising approach

•  Measurement of outcomes against targets estimated in the goals


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Key Definitions

•  Market Area Analysis - an objective overview of the organization’s environment

•  Market Analysis Outcomes - provides an objective basis for decision making among:

-  Competing product lines

-  Clarification of potential road-blocks to meet program development


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Key Definitions (continued)

-  Provision of specific information describing the prospective patient population.

•  Number and distribution of patients and various ages (information based on hard data revenue assumptions, forms from historical use).

•  Customer/patient opinions and attitudes (information based on what patients say and think, rather than what hospital staff think they think).

- Knowledge of an individual facility’s position in relation to other hospitals and health care facilities.


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Identifying Your Customers

•  In order to increase market capture, it is necessary to design programs that are highly responsive to the needs and expectations of customers.

A new product line could be based on:

-  Age -  Health Status -  Socioeconomic Status -  Employment or Occupation -  Motherhood

- Marital Status -  Ethnic & Cultural Background -  Education -  Religion -  Geography


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Market Segmentation

•  Various market segments have been noted to be particularly responsive to specialized programs and services i.e. women’s services.

-  Educated, upwardly mobile individuals, i.e. women’s health care having a first or second baby

-  Patients who prefer noninterventive, noninstitutional care

-  Professional patients (young, single, married with children, divorced with children)


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Market Segmentation (continued) -  Post-childbearing age woman dealing with life changes: •  Menopause •  Departure of children from home •  Re-entry into work force •  Loss of spouse

-  Older women -  Women employees of the hospital -  Physician office employees -  Unique population


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Initial Decision Necessary in Creating Centers/Programs or Workflow Redesign

•  Status of existing programs and services, i.e. throughput, efficiency, etc. •  Identifying present organizational strengths •  Clarification of role or mission of the hospital •  Identification of the hospital’s image with patients in the community •  Capabilities of the medical and nursing staff •  Market niches filled or unfilled by competing health care providers •  Financial ramifications •  Intangible goodwill and market positioning •  Degree of need and demand identified through the market area analysis •  Regulatory issues


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V. Serving the Organization Development of a Marketing and Communication Plan

•  Establishing measurable goals and objectives

•  Assigning specific responsibilities to specific team members

•  Developing time frames for completion of duties and tasks

•  Developing a process for monitoring the established schedules

•  Allocating adequate time for staff involvement and completion of assigned responsibilities

•  Developing outcome measurements


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Resources Necessary for Success •  Personnel

-  Management & supervisory -  Physicians & nursing staff -  Ancillary

•  Financial -  Start-up funds -  Operating funds

•  Equipment -  Existing -  New


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Resources Necessary for Success (continued) •  Facility

-  Space requirements -  Locations

•  Political Support -  Board -  Management -  Staff -  Physician -  Community

•  Corporate or parent organization •  Affiliated organizations, where appropriate


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V. Serving the Organization Methods for Measuring Patient Satisfaction

•  Written questionnaires •  Telephone interviews •  Input from physicians •  Suggestion boxes •  Web tracking/email •  Informal interviews by managers or supervisors with patients •  Tracking number of phone calls in response to a new program •  Follow up opinion pole, i.e. telephone interviews, focus groups, etc.


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Monitors of Patient Satisfaction (continued)

•  Tracking the sources of information by which the public became aware of a new program or service

•  Track the changes in usage by both patients and physicians of existing program

•  Track the changes in patient origin and market share for new program

•  Assessing changes in morale and attitude among employees - Indirect staff feedback


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V. Serving the Organization Critical Success Factors for New Programs

•  Physician acceptance and agreement

•  Regulatory and licensing issues

•  Timeline for implementation

•  Affiliation of joint venture possibilities

•  Community acceptance

•  Promotional advantage and market position potential

•  Liability assessment Daniel J. Messina, Ph.D., FACHE

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V. Serving the Organization Goals

•  Efficiency •  Provide a high return on investment •  Maximize retention of existing patients •  Attract new patients •  Enhance the image of the hospital •  Provide additional spin-off •  Synergism with existing services and programs •  Solidification of market position •  Uniqueness in the market place •  Maximize physician expertise


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V. Serving the Organization Clinical Decision - Making Components

•  Statement of philosophy

•  Clinical policies and procedures

•  Treatment protocols and care maps

•  Research protocols (if applicable)

•  Forms and information documents

•  Reimbursement procedures

•  Staffing requirements


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1. They see themselves and their companies as dominating their environment.

•  Successful leaders try to shape the future precisely because they can’t dominate the environment.

•  They suffer from the illusion of personal preeminence.

•  They see people as instruments to be used, as materials to be molded, or as audiences for their performances.

•  They tend to believe that their companies are central to suppliers and customers.

•  They act as if their customers are the lucky ones, rather than looking to satisfy customer needs.


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2. They identify so completely with the company that there is no clear boundary between their personal interests and their corporation’s interests.

•  They start to have a “private empire” mentality and begin to behave as if they own their companies.

•  They use their companies to carry out personal ambitions.

•  They tend to use corporate funds for personal reasons.

•  Being manager of a department is probably the closest thing to being king of a small country -- which is a dangerous and sometimes a self-destructive title to assume.


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3. They think they have all the answers. •  Leaders who are invariably crisp and decisive tend

to settle issues so quickly that they have no opportunity to grasp the ramifications.

•  Because these leaders need to feel that they have all the answers, they have no way to learn new answers.

•  Their instinct is to allow no uncertainty whenever something truly important is at stake.


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4. They ruthlessly eliminate anyone who isn’t 100% behind them. •  Executives who think that their job is to instill a belief in

their vision also think that it is their job to get everyone to buy into it.

•  By eliminating all dissenting and contrasting viewpoints, destructive executives cut themselves off from their best change of seeing and correcting problems as they arise.

•  Executives who seek to stifle dissent only drive it underground - if this happens, the entire organization grinds to a halt whether he is right or wrong.


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5. They are consummate spokespersons, obsessed with the company image.

•  They are high-profile executives who are constantly in the public eye giving speeches, etc.

•  Their public persona inspires a false confidence among employees, potential new recruits and the public.

•  Their management efforts become shallow and ineffective. They often settle for the appearance of accomplishing things.

•  They often leave mundane details of their business affairs to others.

•  They treat their financial accounts as a public-relations tool instead of a control tool.


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VI. 7 Habits of Spectacularly Unsuccessful Executives 6. They underestimate obstacles.

•  Executives become so enamored with their vision of what they want to achieve that they overlook or underestimate the difficulty of actually getting there.

•  When certain obstacles that they casually waved aside are more troublesome than they anticipated, these executives have a habit of plunging full steam into the abyss.

•  Some feel an enormous need to be right in every important decision they make, partly for the same reason that they think they are responsible for their company’s success.

•  Most leaders want recognition for their determination and for their persistence.


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VI. 7 Habits of Spectacularly Unsuccessful Executives 7. They stubbornly rely on what worked for them in the past.

• Many executives accelerate their company’s decline by reverting to what they regard as tried-and-true methods.

•  They insist on providing a product to a market that no longer exists, or they fail to consider innovations in areas other than those that made the company successful in the past.

•  Instead of considering a range of options that fit new circumstances, they use their own careers as the only point of reference.

•  Executives who fall prey to this habit owe their careers to some “defining moment” - a critical decision or policy choice that resulted in their most notable success.

• After the experience of that defining moment, they tend to let themselves be defined by it for the rest of their careers.


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Promoting Meaningful Work …strategies to help people make a difference.

•  Do you understand how the work you do fits into the big picture?

•  Do you have ways to help staff understand the value they bring to your organization?

•  Do you do what you can to create an exciting and challenging work environment?


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Promoting Positive Future …strategies to ensure a successful future.

•  Do you have a clear plan for success?

•  Do you have a variety of ways to help people connect with this vision?

•  Do you encourage people to challenge negativity in the system?

•  Do you encourage fun and celebration at work?


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Promoting Clear Communication …the way you share information.

•  Do you place a very high priority on keeping lines of communication open and honest?

•  Is everyone in your department held accountable for both sending and receiving information?

•  Are you constantly evaluating and improving the methods and technologies you use to share information in your area?

•  Do you actively manage rumors and misinformation?


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Promoting Excellence …a focus on being the best.

•  Do you have clear behavioral guidelines that let individuals and groups know what is expected of them?

•  Are individuals and groups held accountable for these expectations?

•  Do your expectations motivate and inspire people to want to get better?

•  Do you hire and orient new employees with these expectations in mind?


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Promoting Learning …the emphasis placed on personal and professional growth and development.

•  Do you place a very high value on learning and development?

•  Do you use the learning opportunities that are available in your area?

•  Do you see yourself as a learner and teacher, leader and follower?

•  Do you share your experiences, both positive and negative, throughout the system so that everyone can learn and grow from each other?


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A Boss Who Cares …the emphasis placed on creating great coaches and mentors.

•  Do you spend time getting to know staff personally and professionally?

•  Do you try to make it safe and worthwhile for employees to experiment and take risks?

•  Do you take full responsibility for bringing out the best in the people you manage?

•  Do you provide training and support so leaders can be effective coaches?


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Looking to Remove Barriers …the way you identify and solve problems.

•  Do you have ways to identify, prioritize and fix things that make it difficult for people to be effective in their roles?

•  Are people in your area clear on who they need to go to and what they need to do when they run into roadblocks and obstacles?

•  Are you systematically trying to improve your service systems, policies and procedures so staff and customers are not frustrated and confused?

•  Do you use a variety of ways to recognize and celebrate barrier removal?


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Facilitating Teamwork …the relationships and interactions between individuals and groups.

•  Do you hold staff accountable for satisfying their internal customers?

•  Do you understand how the work you do relates to the work of other groups and departments?

•  Do you have a variety of ways individuals and teams can get feedback from their internal customers?

•  Are individuals and teams trained and supported in developing win-win relationships?


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Practicing Recognition …the methods you use to let people know they are appreciated and valued.

•  Do you have a variety of ways to recognize individuals and teams for contributing to your mission and purpose?

•  Do your reward systems help promote a true sense of community and success?

•  Is there a great deal of appreciation and recognition among and between individuals and teams within your department?

•  Does the emphasis on celebration happen in every team?


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Maintaining Balance …a focus on creating work life balance.

•  Do you encourage people to have a life outside of work?

•  Are you consciously trying to become known as a family oriented manager?

•  Do you manage time and resources well so you are not always putting out fires?

•  Are you flexible and accessible when dealing with challenges staff face in their personal lives?


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The Ten Laws of Life

Life Law #1: You either get it, or you don’t.

Strategy: Become one of those who gets it.

Life Law #2: You create your own experience.

Strategy: Acknowledge and accept accountability for your life.


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Life Law #3: People do what works.

Strategy: Identify the payoffs that drive your behavior and that of others.

Life Law #4: You cannot change what you do not acknowledge.

Strategy: Get real with yourself about life and everybody in it.


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Life Law #5: Life rewards action.

Strategy: Make careful decisions and then pull the trigger.

Life Law #6: There is no reality; only perception.

Strategy: Identify the filters through which you view the world.


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Life Law #7: Life is managed; it is not cured.

Strategy: Learn to take charge of your life.

Life Law #8: We teach people how to treat us.

Strategy: Own rather than complain about how people treat you.


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Life Law #9: There is power in forgiveness.

Strategy: Open your eyes to what anger and resentment are doing to you.

Life Law #10: You have to name it before you can claim it.

Strategy: Get clear about what you want and take your turn.


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“It is a quantum leap from outstanding individual performer to outstanding manager. It is an even greater leap to outstanding leader of leaders. That is our challenge.”

Larry Mathis


IX. Resources

1. Dye, C. (1993). Protocols for Health Care Executive Behavior: A Factor for Success. Michigan: Health Administration Press.

2. Covey, S. (1991). Principle Centered Leadership. New York: Simon & Schuster.

3. Kovner, A.R. & Neuhauser, D. (1997) Health Services Management: A Book of Cases. Chicago: Health Administration Press.

4. Levine, S.R. (2006) The Six Fundamentals of Success , Randon House

5. McGraw, P., Ph.D. (1999). Life Strategies: Doing What Works, Doing What Matters. New York: Hyperion.

6. Multimedia Case GE’s Two -Decade Transformation: Jack Welch’s Leadership (2000). Boston: Harvard Business School Publishing.

7. Bennis, W. (1989). On Becoming a Leader. Massachusetts: Addison-Wesley Publishing.

8. Cashman, K. The Pause Principle- Berrett-Koehler Publishers - 2012


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X. QUESTIONS


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Documents

United Advance Practice Registered Nurses of Georgia ...enp-network.s3.amazonaws.com/UAPRN/2016_Conference... · United Advance Practice Registered Nurses of Georgia Presentation