Using the LEM to Drive Results at OU Physicians Holly Adams, FACHE, FACMPE Executive Director of Operations OU Physicians & OU Children's Physicians Clinical Services Holly-Adams@ouhsc.edu 405-271-3932

Overview Overview of leader accountability system Share the “everyday” application of the LEM Share OUP leader “toolkit” used to instill accountability and drive results In 2007, OU Medicine recognized the need to implement a competitive strategy to increase volumes and market share.  However, as a non-CON state, the market provided a set of unique challenges and opportunities.  Recognizing that you must first be a market leader before you can lead your region, OU Medicine embarked upon a strategy of transforming a traditional academic culture into one that is focused on service and improved patient outcomes.  This session will outline how OU Medicine went about identifying and outlining their strategy, key challenges faced and specific tools that were used to accelerate results.

LaDonna Tyner – Admin. Coordinator Terry Rinck – Decision Support Mgr TBD – OUCP Admin. Coordinator

Why LEM? We believe accountability in leadership is the cornerstone of achievement. To achieve our OU Medicine goal — positioning OU Medicine as the premier health care provider in our region — the advances, achievements and accomplishments of the organization must be evidence-based and measureable. Success that isn’t measurable is questionable. If it can’t be measured, it can’t be managed. Accountability calls for a level of commitment — ownership of responsibility — and is an essential component for organizational goals to be realized…   .

Why LEM? Each goal we set our sights on, whether achieved, surpassed or even unmet can become a snapshot from which we interpret what works and what we can do better. LEM tools not only capture the snapshots, but they’ll also help us think more strategically in the goal-setting process and guide us in the best ways to achieve them.

Building an Culture “We are what we repeatedly do. Excellence, then, is not an act, but a habit.” - Aristotle In 2009, we set out on a journey to change our culture Required a new focus and concerted effort Changing our daily habits and practices There was discomfort. We questioned the importance. However, you embraced the process and plowed ahead Mantra of “Every patient, every time” After a year, we have seen progress and sustained results 8

What is Leader Accountability at OUP? Accountability is about setting the expectation, clearly communicating it, and then holding yourself and everyone within your sphere of influence responsible for consistently meeting the established expectations In 2007, OU Medicine recognized the need to implement a competitive strategy to increase volumes and market share.  However, as a non-CON state, the market provided a set of unique challenges and opportunities.  Recognizing that you must first be a market leader before you can lead your region, OU Medicine embarked upon a strategy of transforming a traditional academic culture into one that is focused on service and improved patient outcomes.  This session will outline how OU Medicine went about identifying and outlining their strategy, key challenges faced and specific tools that were used to accelerate results. 10

Standards of Behavior Our employees created the Standards and our leadership steered the accountability. In addition to creating balanced goals for each entity of OU Medicine, we have also created the OU Medicine Standards of Behavior. A group of 25 employees from across the enterprise and from all levels joined together to write these standards. The Standards Team worked from May through October 2008 to complete this document. The Standards they have created are considered “must-haves” – that is, they will be expectations for every employee. We believe that this is another important step to align the enterprise. To date we have had over 5,000 employees acknowledge and sign-off on these standards. 11

Clinic Manager Accountability “Tool Box” Provide an overview of leader accountability tools used to substantially impact patient satisfaction and other key performance indicators

Leader Accountability “Tool Box” LEM & Leader Report Cards Monthly Meeting Model (MMM) Leader Rounding on Patients & Staff Employee Incentive Program – EXCEL Scorecards Clinic Performance Review (CPR) Meetings Reward & Recognition (yes, it’s a tool – use it!)

Leader Report Cards Manager Target = Update LEM monthly & bring to meeting with EDO. LEM score targets are built into annual performance evaluation.

LEM – Summary of 3 Important Tools

90 Day Action Plans Every leader should have a 90 day plan in place for goals not met.

Review of Clinic Manager Monthly Meeting Documentation Monthly Meeting Model Review of Clinic Manager Monthly Meeting Documentation

Clinic Performance Review (CPR) Meetings Focus is on leader accountability for clinics with patient satisfaction rankings below target for 3 consecutive quarters. Clinic Manager & Medical Director present the LEM Action Plan to EDO, CEO, CMO, & Department Chair. Meeting Agenda: Desired Outcomes: Increased leader accountability Improvement in patient satisfaction ranking Presentation of Data Presentation of LEM Action Plan Discussion of Obstacles

CPR Results Impact on Patient Satisfaction Ranking Held 18 CPR meetings over past 12 months. 18 LEM Action plans have been approved and implemented with overall success. Meetings widely viewed as very productive. Used as an example of leader accountability across OU Medicine. Clinic Before After Orthopedics 57% 84% Specialty Clinic 48% 99% OUCP Latino 42% 66% OUCP GI 11% Neurology 10% 73%

Service Service 23

Service

2011 GOAL = Maintain a Voluntary FT/PT Turnover Rate of 12.9% or less OUP – Voluntary Turnover FT/PT People Instill and reinforce standards of behavior that will attract, develop and retain outstanding staff, physicians, faculty and students 2011 GOAL = Maintain a Voluntary FT/PT Turnover Rate of 12.9% or less

OUP – Overall Patient Satisfaction Service Promote consistently positive experiences for our patients, staff and community 2011 GOAL = Improve Overall Patient Satisfaction Scores to the 75th Percentile 26

2011 GOAL = Grow Clinic Visits by 3% OUP – Clinic Visits Growth Grow the enterprise to better serve patients and physicians and support the fundamental missions of teaching and research 2011 GOAL = Grow Clinic Visits by 3%

2011 GOAL = Increase Payments by 4% OUP – Payments 1.8% 9.4% Finance Preserve a focus of fiscal responsibility and multidisciplinary planning 7.5% 5.3% 8.8% 2011 GOAL = Increase Payments by 4%

OUP – Ease of Obtaining Test Results Quality Strive to be among the highest ranked health care providers by both regulatory and health care scoring systems 2011 GOAL = Improve Ease of Obtaining Test Results to the 60th Percentile

What It’s All About…

Questions?