Taking You and Your Organization to the Next Level

Studer Group Mission and Vision

MissionTo make healthcare a better place foremployees to work physicians to practicemedicine and patients to receive care

VisionTo be the intellectual resource forhealthcare professionals combining passionwith prescriptive actions and tools to driveoutcomes and maximize the humanpotential within each organization andhealthcare as a whole

Execution company focused on achieving and

sustaining

bull Exceptional clinical operational amp financial outcomes

bull Work with over 800 healthcareorganizations in the US andbeyond

bull gt 50 Coaches and Speakersbull Educational Resources ndash Books

Training Videos Webinars andInstitutes

bull Web-based software solutionsfor operational alignment andprocess efficiency improvement

Recipient of the 2010 Malcolm

Baldrige Quality Awardbull Ranked 5 Great Small Workplace

in Americabull Evidenced-Based tactics thatbull produce Accelerated rate of improvement

and efficiency in clinical quality (core measures hospital acquired conditions and readmissions)

Favorable HCAHPS results Maximized reimbursement

Increased physician loyalty Improved ED flow operational

metrics and patient experience

External Environment Conclusions

Physicians and Senior leader team feel the external environment will be more difficult in the

future31 feel if an organization stays the same they

will be the same better or much betterIf 3 out of 10 people do not recognize

urgency the organization will never achieve outcomes and too much pressure is put on

the other 70 of the people

Top Ten Challenges in Execution

1 Leaders Others underperforming and still receiving a good evaluation1048709 (Accountability)

2 Change not connected to why1048709 (Alignment)

3 Lack of necessary urgency1048709 (Alignment)

4 Leaders do not have the skills to assure a solid implementation1048709 (Action)

5 Too many changes -- too soon1048709 (Action)

6 Push Back by leaders staff and physicians1048709 (Accountability)

7 Not familiar with what ldquorightrdquo looks like1048709 (Action)

8 Lack of frequency1048709 (Action)

9 Inability to transfer best practices1048709 (Action)

10 Poor processes1048709 (Action)

Must Haves

It depends on the diagnosis-DIAGNOSIS TREATMENT

Employee Engagement 1048709 Leader Rounding on Employees

Responsiveness to Patient 1048709 Hourly Rounding No-Shows 1048709 Pre-Calls Readmissions 1048709 Post-Calls with frequency dependent on

patient condition Physician Engagement 1048709 Quadrant Exercise1048709 Physician

Rounding Side Effects of Medication 1048709 Bedside Shift Report Urgency 1048709 Toolkit to explain the external environment

ldquoPeople wish to be settled but only as far as they are unsettled is there any hope for themrdquo

Ralph Waldo Emerson

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Studer Group Mission and Vision

MissionTo make healthcare a better place foremployees to work physicians to practicemedicine and patients to receive care

VisionTo be the intellectual resource forhealthcare professionals combining passionwith prescriptive actions and tools to driveoutcomes and maximize the humanpotential within each organization andhealthcare as a whole

Execution company focused on achieving and

sustaining

bull Exceptional clinical operational amp financial outcomes

bull Work with over 800 healthcareorganizations in the US andbeyond

bull gt 50 Coaches and Speakersbull Educational Resources ndash Books

Training Videos Webinars andInstitutes

bull Web-based software solutionsfor operational alignment andprocess efficiency improvement

Recipient of the 2010 Malcolm

Baldrige Quality Awardbull Ranked 5 Great Small Workplace

in Americabull Evidenced-Based tactics thatbull produce Accelerated rate of improvement

and efficiency in clinical quality (core measures hospital acquired conditions and readmissions)

Favorable HCAHPS results Maximized reimbursement

Increased physician loyalty Improved ED flow operational

metrics and patient experience

External Environment Conclusions

Physicians and Senior leader team feel the external environment will be more difficult in the

future31 feel if an organization stays the same they

will be the same better or much betterIf 3 out of 10 people do not recognize

urgency the organization will never achieve outcomes and too much pressure is put on

the other 70 of the people

Top Ten Challenges in Execution

1 Leaders Others underperforming and still receiving a good evaluation1048709 (Accountability)

2 Change not connected to why1048709 (Alignment)

3 Lack of necessary urgency1048709 (Alignment)

4 Leaders do not have the skills to assure a solid implementation1048709 (Action)

5 Too many changes -- too soon1048709 (Action)

6 Push Back by leaders staff and physicians1048709 (Accountability)

7 Not familiar with what ldquorightrdquo looks like1048709 (Action)

8 Lack of frequency1048709 (Action)

9 Inability to transfer best practices1048709 (Action)

10 Poor processes1048709 (Action)

Must Haves

It depends on the diagnosis-DIAGNOSIS TREATMENT

Employee Engagement 1048709 Leader Rounding on Employees

Responsiveness to Patient 1048709 Hourly Rounding No-Shows 1048709 Pre-Calls Readmissions 1048709 Post-Calls with frequency dependent on

patient condition Physician Engagement 1048709 Quadrant Exercise1048709 Physician

Rounding Side Effects of Medication 1048709 Bedside Shift Report Urgency 1048709 Toolkit to explain the external environment

ldquoPeople wish to be settled but only as far as they are unsettled is there any hope for themrdquo

Ralph Waldo Emerson

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Execution company focused on achieving and

sustaining

bull Exceptional clinical operational amp financial outcomes

bull Work with over 800 healthcareorganizations in the US andbeyond

bull gt 50 Coaches and Speakersbull Educational Resources ndash Books

Training Videos Webinars andInstitutes

bull Web-based software solutionsfor operational alignment andprocess efficiency improvement

Recipient of the 2010 Malcolm

Baldrige Quality Awardbull Ranked 5 Great Small Workplace

in Americabull Evidenced-Based tactics thatbull produce Accelerated rate of improvement

and efficiency in clinical quality (core measures hospital acquired conditions and readmissions)

Favorable HCAHPS results Maximized reimbursement

Increased physician loyalty Improved ED flow operational

metrics and patient experience

External Environment Conclusions

Physicians and Senior leader team feel the external environment will be more difficult in the

future31 feel if an organization stays the same they

will be the same better or much betterIf 3 out of 10 people do not recognize

urgency the organization will never achieve outcomes and too much pressure is put on

the other 70 of the people

Top Ten Challenges in Execution

1 Leaders Others underperforming and still receiving a good evaluation1048709 (Accountability)

2 Change not connected to why1048709 (Alignment)

3 Lack of necessary urgency1048709 (Alignment)

4 Leaders do not have the skills to assure a solid implementation1048709 (Action)

5 Too many changes -- too soon1048709 (Action)

6 Push Back by leaders staff and physicians1048709 (Accountability)

7 Not familiar with what ldquorightrdquo looks like1048709 (Action)

8 Lack of frequency1048709 (Action)

9 Inability to transfer best practices1048709 (Action)

10 Poor processes1048709 (Action)

Must Haves

It depends on the diagnosis-DIAGNOSIS TREATMENT

Employee Engagement 1048709 Leader Rounding on Employees

Responsiveness to Patient 1048709 Hourly Rounding No-Shows 1048709 Pre-Calls Readmissions 1048709 Post-Calls with frequency dependent on

patient condition Physician Engagement 1048709 Quadrant Exercise1048709 Physician

Rounding Side Effects of Medication 1048709 Bedside Shift Report Urgency 1048709 Toolkit to explain the external environment

ldquoPeople wish to be settled but only as far as they are unsettled is there any hope for themrdquo

Ralph Waldo Emerson

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

External Environment Conclusions

Physicians and Senior leader team feel the external environment will be more difficult in the

future31 feel if an organization stays the same they

will be the same better or much betterIf 3 out of 10 people do not recognize

urgency the organization will never achieve outcomes and too much pressure is put on

the other 70 of the people

Top Ten Challenges in Execution

1 Leaders Others underperforming and still receiving a good evaluation1048709 (Accountability)

2 Change not connected to why1048709 (Alignment)

3 Lack of necessary urgency1048709 (Alignment)

4 Leaders do not have the skills to assure a solid implementation1048709 (Action)

5 Too many changes -- too soon1048709 (Action)

6 Push Back by leaders staff and physicians1048709 (Accountability)

7 Not familiar with what ldquorightrdquo looks like1048709 (Action)

8 Lack of frequency1048709 (Action)

9 Inability to transfer best practices1048709 (Action)

10 Poor processes1048709 (Action)

Must Haves

It depends on the diagnosis-DIAGNOSIS TREATMENT

Employee Engagement 1048709 Leader Rounding on Employees

Responsiveness to Patient 1048709 Hourly Rounding No-Shows 1048709 Pre-Calls Readmissions 1048709 Post-Calls with frequency dependent on

patient condition Physician Engagement 1048709 Quadrant Exercise1048709 Physician

Rounding Side Effects of Medication 1048709 Bedside Shift Report Urgency 1048709 Toolkit to explain the external environment

ldquoPeople wish to be settled but only as far as they are unsettled is there any hope for themrdquo

Ralph Waldo Emerson

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Top Ten Challenges in Execution

1 Leaders Others underperforming and still receiving a good evaluation1048709 (Accountability)

2 Change not connected to why1048709 (Alignment)

3 Lack of necessary urgency1048709 (Alignment)

4 Leaders do not have the skills to assure a solid implementation1048709 (Action)

5 Too many changes -- too soon1048709 (Action)

6 Push Back by leaders staff and physicians1048709 (Accountability)

7 Not familiar with what ldquorightrdquo looks like1048709 (Action)

8 Lack of frequency1048709 (Action)

9 Inability to transfer best practices1048709 (Action)

10 Poor processes1048709 (Action)

Must Haves

It depends on the diagnosis-DIAGNOSIS TREATMENT

Employee Engagement 1048709 Leader Rounding on Employees

Responsiveness to Patient 1048709 Hourly Rounding No-Shows 1048709 Pre-Calls Readmissions 1048709 Post-Calls with frequency dependent on

patient condition Physician Engagement 1048709 Quadrant Exercise1048709 Physician

Rounding Side Effects of Medication 1048709 Bedside Shift Report Urgency 1048709 Toolkit to explain the external environment

ldquoPeople wish to be settled but only as far as they are unsettled is there any hope for themrdquo

Ralph Waldo Emerson

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Must Haves

It depends on the diagnosis-DIAGNOSIS TREATMENT

Employee Engagement 1048709 Leader Rounding on Employees

Responsiveness to Patient 1048709 Hourly Rounding No-Shows 1048709 Pre-Calls Readmissions 1048709 Post-Calls with frequency dependent on

patient condition Physician Engagement 1048709 Quadrant Exercise1048709 Physician

Rounding Side Effects of Medication 1048709 Bedside Shift Report Urgency 1048709 Toolkit to explain the external environment

ldquoPeople wish to be settled but only as far as they are unsettled is there any hope for themrdquo

Ralph Waldo Emerson

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

ldquoPeople wish to be settled but only as far as they are unsettled is there any hope for themrdquo

Ralph Waldo Emerson

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

How many of the employees that you directly supervise are not meeting performance expectations1048709 Average = 8

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Performance Management-How many employees do you have currently working for you who have documentation that they are underperforming1048709 Average = 50

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

The Evidence

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Heart Failure

Pneumonia Healthcare -Associated Infections

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Surgical Care Improvement Heart Attack

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

1 physician in 3 receives any data about performance1 physician in 5 receives data pertinent to clinical outcomes1 physician in 4 receives patient survey data

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

We have learned that the reluctance to address lowsub-par performance keep an organization from being the best Quint Studer

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Definition H=HIGH PERFORMER

Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Comes to work on time Good attitude Problem solves You relax when they are scheduled Use of peer interviews Pillar ownership Brings solutions Good influence Adheres to policies concerning breaks personal phone calls leaving the work area and other

absences from work Demonstrates high commitment to making things better for their team and organization as a

whole Eager to change for the good of the organization Strives for continuous professional

development Consistently communicates organizational Does not create wethey Provides frequent

feedback to staff Demonstrates the behaviors of safety awareness in all aspects of work

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Solid performer Good attendance Loyal most of time Influenced by high and low performer Wants to do a good job Could just need more experience Helps manager be aware of problems Professionalism Teamwork Knowledge amp Competence Communication Safety Awareness Usually adheres to policies concerning breaks personal phone calls leaving the work area and

other absences from work Committed to improving performance of their team and organization May require coaching to

fully execute Invested in own professional developments May require some coaching to fully execute Usually communicates organizational information Occasionally uses wethey language Provides

some feedback to staff

Definition M=MIDDLE PERFORMER

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Definition

L-LOW PERFORMER

Knowledge amp Competence Communication Safety Awareness Points out problems in a negative way Positions leadership poorly Master of ldquoWeTheyrdquo Passive aggressive Thinks they will outlast the leader Says manager is the problem Does not communicate effectively about absences from work Handles personal phone

calls in a manner that interferes with work Breaks last longer than allowed Demonstrates little commitment to their team and the organization Shows little interest in improving own performance or the performance of the organization

Develops professional skills only when asked Does not communicate organizational information Uses language to create wethey

culture Does not provide feedback Performs work with little regard to the behaviors of safety awareness

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Employees Patients Physicians

Rounding with EmployeesEmployee Thank You Notes

Peer Interviewing

30 and 90 DayMeetings (Input)Employee Attitude Survey

Employee Forums

Bright Ideas

Standards

Leader Rounding on Patients

Post StayVisit Calls

Hourly Rounding

Individualized

PatientCare

Bedside Shift Report AIDETregPre Visit Calls

Physician Performance Feedback SystemGot ChartPhysician Preference Card

Physician Code

Patient Agenda andVisit Guide

Physician Note Pads

Rounding forOutcomesAIDET

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Rounding for OutcomesEmployee Rounding

Tell your staff about rounding Do rounding with the prescribed frequency Use a rounding log Give feedback

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Align Questions to fit Desired

Outcomes of the Organization

Concern and Care

What is Working Well

People to Recognize

Systems to Improve

Tools and Equipment

Follow-up

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Rounding for Outcomes Senior LeaderRounding

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Increases Senior Leader Visibility

Reassures and Engages Staff

Connects the Dots for Staff Regarding

Organization DecisionsOutcomes

Validates DepartmentUnit Leader Rounding

Eliminates WeThey Mentality

Improve Physician Integration

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Areas of focus Round on direct reports the same

way all leaders round on their employees

Round in departments with other

leaders using a scouting report

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Link to department leader rounding logs

Supply important information about a given department

Focus on external environment Identify tough questions

Allow you to reward and recognize the right people

Acknowledge which systems have been fixed

Point to tools and equipment that have been purchased

and those that still need attention

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

To sustain the culture selection is paramount

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

CURRENT PRACTICE Department Meetings Employee Conversations Employee RampR Staff Selection and Orientation Staff and Patient Retention Staff Policy Patient Conversations Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Only new item

EFFECTIVE APPROACH Consistent Agendas Rounding for Outcomes Thank You Notes Peer interviewing and 3090 Day

Meetings Individual Employee Meetings Standards of Behavior Key Word at Key Times Pre Phone Calls Post Phone Calls Staff and Leader Evaluation Leadership Training

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Rounding on Areas Served ndash Example

Acknowledgerelationship clarify expectations

ldquoYour dept is very important to us amp our patientshelliprdquo

Rounding Why amp Duration ldquoOur goal is to provide excellent service I will berounding on you each monthhelliprdquo

Review Accomplishments

ldquoSince I rounded with you last month I wanted tohighlight the following itemssystems we have put intoplace based on feedbackhelliprdquo

Working Well ldquoWhat is my department doing well

Recognition ‐ Individuals ldquoIs there anyone specific I can recognize for doing greatwork What have they donerdquo

Opportunities for Improvement ldquoWhat 1‐2 things can my department do better Anyideas on how we can improverdquo

Identify specific areas of focus from survey process

ldquoWe want to respond in a timely mannerrdquo ldquoCan youexplain a time when you had to wait for response fromour departmentrdquo ldquoWhen we did not respond in a timelymanner what do you typically wait to receivehelliprdquo

Is there anything I can help youwith

ldquoIs there any other questions you have or anything else I can help with right nowrdquo

Thank you and Appreciation ldquoThank you for your time helliprdquo

Establish next rounding date ldquoI will be back in next month to talk againhelliprdquo

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Studer Group Five Fundamentals AIDETreg

A

AcknowledgeEye contact smile and acknowledge everyone in the room

I

Introduce

ldquoHello Mr Clark My name is Jackie and I am your nurse today I have been a nurse for 20 years and have worked in this hospital for over 8 years I have done this procedure thousands of times and I go back for training each yearhelliprdquo

D

Duration ldquoThis procedure will take about 10 minutes to perform and then about one hour for the resultshelliprdquo

E

Explanation

ldquoLet me explain some more about the procedurerdquo (Explain why performing the procedure what will happen and what they should expect understanding of side effects and answer any questionsrdquo

T

Thank youldquoThank you for choosing us hellipThank you for waitinghellip Thank you for coming in todayhellipWhat otherquestions do you haverdquo

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Pre Visit Calls

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

The Results

Reduce No-Showrsquos by 70

Reduce Tardiness by 60-70

Increased Patient Satisfaction25-30 Percentile Points

Reference Pre and Post Procedure Calls Scott A Strong MD The Cleveland Clinic 2003

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Best Practice Contact Rate

PATIENT TYPE ATTEMPT CONTACT

INPATIENT bull 100 patients discharged homehome with home healthcare 70-80

CRITICAL CARE bull 100 of patients discharged home and home with home healthcare 100

EMERGENCY DEPARTMENT

bull 100 of eligible patients discharged patients to homebull If unable to attempt 100 start with specific patient groups based

on acuity (eg chest pain) or risk factors (eg AMAs)bull Non-eligible patients are admissions transfers deaths psych

patients and those with no current phone number (ie homeless)

50-60

OUTPATIENTS

bull Cath-lab 100

bull GI 100bull Radiology certain populations (eg 100 invasive procedures specific

numberday)

100

MEDICAL PRACTICE

bull Set number ndash 5 per staff per week or 20 per week per person

OUTPATIENT SURGERY

bull 100 of patients discharged home

100

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

ReboardingOnboardingInformation Guide

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Core Competency Tools amp Resources Accountability Date Completed

Service and Operational Excellence Introduction

Hardwiring Excellence Chapters 1-3Evidence Based Leadership graphic

Complete Readings

Rounding on Staff Hardwiring Excellence Chapter 7The Nurse Leader Handbook Chapter 2Rounding on Staff logStoplight Report and Guidelines for Use of Stoplight Video Rounding on Direct Reports

Leader rounds on you to role model practiceCompletion of rounding on 100 of staffCompletion of Stoplight Report

Thank You Notes Hardwiring Excellence Chapters 7 amp 11The Nurse Leader Handbook Chapters 3 amp 4

Send TY notes to direct reportsManage up thank you notes to leader

Communication Hardwiring Excellence Chapter 10The Nurse Leader Handbook Chapter 1Agenda by PillarsDepartment Communication BoardWorking With your Leader ndash The Power of Aligned Messages webinar (2009)AIDETreg Five Fundamentals of Patient Communication Building Patient Trust with AIDETreghighmiddlelowreg Performer Conversations Insight and Video Overcoming Resistance to ChangeInsight and Video The Power of Our WordsInsight and Video Spinach in your Teeth Messages The Art of Giving (and Receiving) Honest Feedback

Use Agenda by Pillar for staff meetingsUpdate Dept Communication Board

Objective Evaluation Hardwiring Excellence Chapter 9The Nurse Leader Handbook Chapter 15Leader Evaluation ManagerLeader Evaluation Manager tutorialsOrganizational Goals90 Day PlansMonthly Report CardWebinar Accountability Tools and Tactics Webinar (2008)

Leader to review and set your goalsObtain Leader Evaluation Manager trainingComplete 1st 90-day planUpdate monthly report card

Monthly Meeting Model The Nurse Leader Handbook Chapter 22Video Supervisory Meeting ModelMonthly Meeting Model Tools Tab on Studer Group website

Prepare for and complete MMM with your leader

Senior Leader Rounding Scouting ReportInsight and Video Senior Leader Rounding

Prepare scouting report for your senior leaderRound in your dept with senior leader

Effective Meeting Management The Nurse Leader Handbook Chapter 21Agenda by PillarsWebinar Leading Effective Meetings webinar (2009)

Complete readings and video

Delegation The Nurse Leader Handbook Chapter 23 Complete readingChange Management The Nurse Leader Handbook Chapter 25 Complete readingMeasurement Tools Hardwiring Excellence Chapters 4 amp 9

The Nurse Leader Handbook Chapter 18Balanced ScorecardPatient Satisfaction Vendor toolsLeader Evaluation Tools Tab on Studer Group Website

Complete readingsReview Balanced Scorecard with your leaderObtain vendor training on measurement tool

Rounding on Patients The Nurse Leader Handbook Chapter 8Patient rounding logFour Goals for Rounding on PatientsHourly Rounding Training Video A Rounding on Patients ldquoAHArdquo MomentVideo Leader Rounding on Patients

Observe colleague rounding on patientsRound on your patientsComplete patient rounding validation with mentorcoachFollow up with staff post rounding

Rounding on Patients The Nurse Leader Handbook Chapter 8Patient rounding logFour Goals for Rounding on PatientsHourly Rounding Training Video A Rounding on Patients ldquoAHArdquo MomentVideo Leader Rounding on Patients

Observe colleague rounding on patientsRound on your patientsComplete patient rounding validation with mentorcoachFollow up with staff post rounding

Rounding on Internal Customers

Internal Customer Rounding logInternal Customer Preference CardVideo Rounding on Departments Served

Observe colleague rounding on customersRound on your customersComplete customer rounding validation with mentorcoachFollow up with staff post rounding

AIDETreg The Nurse Leader Handbook Chapter 13Video AIDETreg Five Fundamentals of Patient Communication Video Building Patient Trust with AIDETreg videoAIDETreg Observation FormVideo AIDETreg and Support Services Leader Rounding Video AIDETreg Coaching Food and Nutrition Video AIDETreg for Physicians

Complete readings and videoDevelop your own AIDETreg Practice your AIDETreg Complete AIDETreg validation with mentorcoach

Key words at Key Times Hardwiring Excellence Chapter 5The Nurse Leader Handbook Chapter 13

Develop your own KWKTPractice your KWKTComplete AIDETreg validation with mentorcoach

Service Recovery The Nurse Leader Handbook Chapter 14Webinar Service Recovery ndash Irsquom Sorry to Hear That (2009)

Complete readings and video

Selecting Talent Hardwiring Excellence Chapter 8The Nurse Leader Handbook Chapter 6Video Selecting Talent Webinar Selecting Talent ndash Peer Interviewing Works (2009)Behavioral Based Interview Questions

Complete readings and video

30 amp 90 day meetings The Nurse Leader Handbook Chapter 630 amp 90 day rounding log

Complete readings and videoRound on new staff using 30 amp 90 logs

Performance Conversations

Hardwiring Excellence Chapter 6The Nurse Leader Handbook Chapters 3 5 amp 7Behavioral StandardsPerformance EvaluationHighmiddlelowreg Performance Conversations videoConducting highmiddlelowreg Performance Conversations webinar (2009)highmiddlelowreg Tools Tab on Studer Group website

Complete readings and video

Pre and Post Visit Calls Hardwiring Excellence Chapter 5The Nurse Leader Handbook Chapter 9Video Post Visit Phone CallsWebinar Centralized Discharge Call Center and Physician-Led Post-Visit Phone Calls

Complete readings and video

Hourly Rounding The Nurse Leader Handbook Chapter 10Hourly Rounding ToolkitWebinar Hourly Rounding webinar (2009)Video Hourly Rounding Training Video

Complete readings and video

Bedside Shift Report The Nurse Leader Handbook Chapter 11Best Practice video on Bedside Shift Report

Complete readings and video

Individualized Patient Care The Nurse Leader Handbook Chapter 12Video Individualized Patient Care Cards

Complete readings and video

Financial Impact amp Productivity Management

The Nurse Leader Handbook Chapters 16 amp 17Video Calculating the Return on Investment of Great Service to Patients and EmployeesWebinar Time and Energy Management webinar (2009)

Complete readings and videos

Collaborating with Physicians The Nurse Leader Handbook Chapter 20Engaging PhysiciansVideo The Art of Physician Courtship Five Things Healthcare Leaders Can Do to Lay the Groundwork for Physician IntegrationWebinar Engaging Physicians webinar (2009)Webinar Studer Group Physician Webinar Series (2008)

Complete readings and videos

HCAHPS HCAHPS - Its All About QualityThe HCAHPS HandbookIt Starts in ED Why Patientrsquos ldquoFirst Impressionrdquo Sets the Stage for HCAHPS Success Webinar HCAHPS Hardwiring Your Hospital for Pay-for-Performance Success Webinar Webinar HCAHPS ndash Part 2 Pay for Performance is Here Insight and Video Are you holding leaders accountable for only 18 of the HCAHPS pieVideo The First Performance Period Is Over What NowThe Age of HCAHPS Four Reasons Why Those 27 Survey Questions Will Change Healthcare Forever

Complete readings and video

Ask your Supervisor to find out more about these resources and many more

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