quality and organizational performance management: an integrated approach gregory richards, mba,...
TRANSCRIPT
Quality and Organizational Performance Management:
An Integrated Approach
Gregory Richards, MBA, Ph.D, FCMCProfessor of Performance Management
May 7, 2010
Agenda
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• Our research• Concept of a “performance
management framework”. Where do quality initiatives fit?
• Technical issues: data, information, analytics
• The human component
Our Research Multiple case studies (private and public sector) Large scale survey (338 private sector, 80 public
sector) Experimental: decision modelling/data modelling “Participant” observation specific to health care:
• Montfort• The Ottawa Hospital• University of Pittsburg Medical Centre
Performance Management Frameworks
“Organizational capital” created by a managerial process that:• Clarifies expected outcomes: what, who and
how• Reviews key measures on a regular basis• Focuses on process improvement,
especially in service organizations• Closes the loop between outcomes and
processes
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The PM framework is based on a “model” of success
Variations of success models:• “Theory” of the business (Drucker)• Value-based management (Porter)• Causal modelling (Ittner and Larcker)• Strategy mapping (Kaplan and Norton)
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Planning for Success: A simple logic model
Inputs activities outputs outcomes
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“Theory of Change” & Logic Models
Inputs activities outputs outcomes
Strategies Outcomes/Impact
Logic model: “service” strategy
Performance Indicators:
Targeted-improved quality of life-reduced cost of health care-healthier communities
-early intervention and education-rapid care and issue resolution-continuous learning
Theory of Change: understanding outcomes
# staff available
-# of visits-time per visit
-# issues resolved-response time
Patient satisfaction
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Example of a Logic Model from MOH-LTC
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DATA, INFORMATION, ANALYTICS
"In God we trust, all others bring data." W. Edwards Deming
Applying “Managerial” Analytics: Step 1: Modelling decisions
Patient satisfaction
Patient satisfaction
Develop service
processes and procedures
Develop service
processes and procedures Service and
AccessService and
Access
Organization’s reputation
Organization’s reputation
Patients visit the centre
Patients visit the centre
Patient well being
improves
Patient well being
improves
Presumed key success factorTranslated into a service standard
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Step 2: understand relationshipsNumber of satisfied patients
Number of dissatisfied patients
Wait time < 2 hours
220 160 380
Wait time > 2 hours
90 190 280
310 350 660
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"Without a standard there is no logical basis for making a decision or taking action."Joseph M. Juran
Outcome of the analysis
Chi-Square test of independence = 42.9, df=2; p<.0001
Conclusion: Our service standard of 2 hours does make a difference to patient satisfaction.
From analysis to action:
What is our cost for maintaining this standard?How much of a difference does it make?Is a 2-hour wait time important for all patients?How can we ensure consistency?
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WHERE QUALITY & “LEAN” FITS: IMPROVING PROCESSES
"If you can't describe what you are doing as a process, you don't know what you are doing." W. Edwards Deming
Reducing wait time is a process-level issue
Reception Assignment Treatment Discharge
-Capacity-Flow-Value added versusNon-value added time-Consistency
< 2 hours
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THE PERSONAL SIDE OF ORGANIZATIONAL PERFORMANCE
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Individual Aspects
95% of performance is related to systems and processes, not to individual effort*
“Systems and processes” are full of people
*Joel Barker16
Inverted “U”: motivation versus performance
Engagement reduces uncertainty, builds ownership, developsa sense of of control and self-efficacy. Allows a “right shift”along this graph so that higher targets can be set and met.
The use of LEAN techniques is a powerful way of engagingstaff!
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Conclusions High performance in complex environments
depends on strategic clarity which brings focus, consistency and continuous improvement.
Causal planning is one way of creating clarity: works from the patient backwards; represents hypotheses about how value is delivered.
Measures are used to test hypotheses and to point to core processes that need to be examined.
Don’t forget the human component: the organization should value excellence and accountability but also engagement and support. LEAN processes are exceptional ways of engaging staff.18
École de gestion Telfer
Université d’Ottawa
55 Laurier Avenue
Ottawa ON K1N 6N5
Tél. : (613) 562-5731
Télec. : (613) 562-5164
www.gestion.uottawa.ca
Telfer School of Management
University of Ottawa
55 Ave Laurier
Ottawa ON K1N 6N5
Tel.: (613) 562-5731
Fax: (613) 562-5164
www.management.uottawa.ca
Gregory Richards, MBA, Ph.D, FCMCProfessor of Performance Management
613-562-5800 x [email protected]