Hardwiring Excellence Summary

Chapter 2

Healthcare Flywheel

 Purpose
 Worthwhile work
 Making a difference

The wheel is turn by self motivation (celebrate the positives), prescriptive to do's (how to
achieve results) and what are results.

Challenges

 Create right environment for patients, staff & physicians

 Don't blame administration
 Changing

In order to get results you must have action. Talking about it isn't doing it!

Chapter 3

How to Align an Organization

The five pillars provide the foundation for setting organizational goals and direction for service
and operational excellence. These pillars also provide the framework for an evaluation process.

 People
 Service
 Quality
 Finance
 Growth

The nine principles provide a road map to achieve goals under the five pillars.
Principle 1: Commit to Excellence.

The service pillar is usually the last pillar to see improvement!

Chapter 4

Measure the Important Things!

 Define specific targets

  Measure progress against those targets
 Align necessary resources

Why measure? Holds individuals accountable for results & determines if things are working.
This data also leads to process improvement.

Key Point- measure often enough so you can reward and recognize soon after the behavior.

Remember

 Focus on opportunities to create desired behaviors- not on measurement

 Act fast
 Put the data to use
 Push for results- not excuses

Chapter 5

Principle 3- build culture around service

Teams

 Service- front line staff harvest good ideas.

 Standards- develop standards of behavior for all employees.
o Begin here. Look at questions on your employee, pt & physician surveys. Hold
employees accountable to the "standards of behavior"
 Pt Satisfaction- responsible for ensuring highest level of service
 Physician Satisfaction- responsible for ensuring highest level of service to physicians
o Determine what they want & what they are most frustrated by
 Focus
 Fix
 Follow up
 Employer of Choice- help the organization become employer of choice.
 Measurement- digs into pt satisfaction measurement & makes easy to read reports.
 Service Recovery- develops service recovery policy & educates staff.
 Communication- responsible for ensuring employees understand a culture of service &
organizational excellence
 Reward & Recognition-responsible for developing processes & ideas to reward &
rccognize employees.

Key Words at Key Times

Let patients know why you're doing things. Develop your own key words based upon survey
results.

AIDET
A-acknowledge the pt
I- introduce yourself
D- duration
E- explanation
T- Thank you

Discharge phone calls

 empathy
 clinical outcomes
 recognition
 service
 process improvement

Chapter 6

Great organizations must have great leaders. You must train & develop leader skill sets. "Any
other gains in the organization will not be sustained with leaders who are continuously
trained."

5 phases of evolutionary change:

 Phase 1- Honeymoon
 Phase 2- Reality sets in
 Phase 3- The uncomfortable gap (the WALL appears)
 Phase 4- Consistency
 Phase 5- Leading the Way

Must have the high/middle/low performers conversation.

Create Leadership Development Institute LDI

Quarterly off site training. Training needs to revolve around the competencies necessary to
acheive organizational goals & strategies. Critical to have CEO review, provide input & support
curriculum.
Role LDI Team

 Curriculum
 Communication
 Social
 Logistics
 Accountability

Chapter 7
Employee Satisfaction tied to:

 right purpose
 worthwhile work
 make a difference

Action to Drive Employee Satisfaction- Rounding for Outcomes

 tell me what is working today?

 who should be recognized?
 any physicians whom should be recognized?
 anything we can do better?
 tools & equipment to do job?

Patient Rounding

 who has done a good job (then share with staff members & other management)
 offer assistance before leaving room

Length of time for rounding decreases over time. Use logs.

Employee Survey

 ask the employees what they think

 share results
 take action

Chapter 8

How to create the culture of owners versus renters?

Ideas
Peer Interviewing- leaders screen candidates and then allow the team to interview and select.

Sign agreement forms about values/behaviors before getting to application.

Use a decision matrix. Select key attributes of job/person and evaluate. Questions should be behavior
based.

30/90 Day Follow up

Questions to ask:
1. How do we compare to what we said?
2. What are we doing well? What people have been helpful to you?
3. What did you see at your previous job that could make us better?
4. Is there anything here that you are uncomfortable with?
Bright Ideas- encourage from ALL employees. Find a way to acknowledge the idea even if not used.
Provide some type of encouragement/prize. Leaders must encourage for this to be successful!

How to Implement
1. Set clear goals & communicate
2. Establish a process for reviewing
3. Reward & recognize for innovation
4. Train leaders how to respond
5. Define metrics for tracking & accountability
6. Launch & continuously refine with focus on goals.

Chapter 9

Leader Eval Tool

Goals created from Pillars & weighted. Use 5 point scale to rate results. Should be no suprises because
leaders know exactly what the goals are! Goals should be cascaded and senior leaders should share
what their goals are.

Tools
Monthly Progress Report- set up to track same metrics on leader eval.

90 day plan- Everybody has full plate with to many "to do's". Helps prioritize.

Support Service Eval- way to provide feedback to support areas pt care relys on. If rated <5 must follow
up with note or phone call.

Chapter 10

How to Communicate

 Manage Up
 Employee Forums- quarterly around goals. Leaders must ensure employee attendance
 Communications Boards- monthly progress and goal specific information
 Storytelling

How to manage up:

-Manage up your boss
-Manage up your staff
-Manage up your yourself
-Manage up your co-workers

Chapter 11

Reward & Recognize

Reward success in employees with specific examples. There should be 3 compliments at least to
every one criticism.

KEY POINT
Keep it going & don't back off.

 Recognition Team
 Thank you notes