1. Engagement Education Session #2 Creating Powerful Action Plans October/November, 2014 R

2. II. Select 2 survey items on which to focus a)One Q12 item that is most negatively impacting patient or team member safety in your area b)One Q12 item that is most positively impacting patient or team member safety in your area Discuss Select Plan Follow Up You are here! III. Plan an A3 for 2 survey items a)Need/Rationale b)Current Condition c)Target Condition and Reasoning d)Action Plan

3. Today’s topics 1 Understanding the current state of engagement 2 Using A3 problem solving to create powerful action plans 3 Addressing the different levels of engagement 4 Identifying root causes & action steps

4. 29 th 35 th Percentile Our Engagement Journey

5. Gallup Health Care Clients

6. Recruiting & Onboarding Leadership & Learning Reward & Recognition Informal Leader Power of One/Stepping It Up/ Balance commitment form referral program Peer Interviews Buddy Program ID badge team member profile 1:1 manager meetings BP II BP I Influential Leadership engagement series New Leader Orientation suggestion Box Uteam meetings skip level meetings tools job aids videos social media $15/ team member Bravo Urewards Uteam Perks Outstanding Contributor Impromptu celebrations

7. % of Workgroups 2014=<3.763.76-<4.114.11-<4.454.45+ n=130113958656733955 n 113 n 86 n 73 n 55 Despite those efforts 61% of our workgroups are in the bottom two quartiles RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR

8. % of Workgroups 2014=<3.763.76-<4.114.11-<4.454.45+ n=130113958656733955 n 2907 n 1729 n 1347 n 475 4636 team members are in the bottom half 46361822 RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR

9. Note: Percentiles based on Gallup’s 2014 Q 12 Healthcare Workgroup Level Database 71 st 3070.09 60 th 2110.07 59 th 2620.01 43 rd 6300.15 43 rd 3240.11 34 th 188-0.05 33 rd 9330.02 32 nd 2220.04 26 th 1,9120.10 22 nd 6960.11 20 th 1520.04 2014 Percentile 2014 n Size YOY Change 2014 Medical Center GrandMean: 3.91 Percentile: 35 th 8 out of 11 job families are in the bottom half

10. Front-line manager input regarding barriers to improving work environment Time/competing priorities Unclear expectations/directions Staffing issues – Not enough staff – Span of control – Disengaged/actively disengaged team members “Broken” processes Lack of support from senior leaders – Fear of speaking out – Poor performers continue to work here – Fear of the budget Learned helplessness – They have given up asking 127 respondents to SurveyMonkey BP I BP II Influential L-ship I hope it gets better in 2015…

11. Hope is not a strategy to solve a problem… neither is a survey

12. 1 Understanding the current state of engagement 2 Using A3 problem solving to create powerful action plans 3 Addressing the different levels of engagement 4 Identifying root causes & action steps

13. 2014 Q12 Results Q 12 Items Medical Center 2014 Mean (n=6,235) 2014 Percentile RankingChange Opportunities to learn and grow 4.0140 th +0.11 Progress in last six months 3.7831 st +0.21 Best friend 3.6234 th +0.13 Coworkers committed to quality 4.0937 th +0.08 Mission/Purpose of organization 3.9930 th +0.11 My opinions count 3.6238 th +0.10 Encourages development 3.8939 th +0.08 Supervisor/Someone at work cares 4.1035 th +0.04 Recognition last seven days 3.5136 th +0.02 Do what I do best every day 4.0334 th +0.03 Materials and equipment 3.9233 rd +0.03 I know what is expected of me at work 4.3932 nd +0.00 Note: Percentiles based on Gallup’s 2014 Q 12 Healthcare Workgroup Level Database

14. Q 12 Items Medical Center 2014 Mean (n=6,235) 2014 Percentile RankingChange Do what I do best every day 4.0334 th +0.03 Materials and equipment 3.9233 rd +0.03 I know what is expected of me at work 4.3932 nd +0.00 Note: Percentiles based on Gallup’s 2014 Q 12 Healthcare Workgroup Level Database The highlighted items continue to be lower ranking items for the Medical Center; additionally, these items had some of the smallest improvement this past year. For many team members, the ‘Expectations’, ‘Materials’ and ‘Do Best’ items are about more than just job descriptions and equipment. Provide support at the base of the (traditional) engagement hierarchy

15. 1.Need/ Rationale 3.Target Condition 4.Reasoning 3.Target Condition 4.Reasoning 2.Current Condition 5. Action Plan - Action steps - Timeline - Expected outcomes - Accountability 6. Key Learning 5. Action Plan - Action steps - Timeline - Expected outcomes - Accountability 6. Key Learning A3 problem solving: Know what’s expected Discovery meeting discussion revealed that team members were not clear on their day-to-day responsibilities. The group identified that certain people tend to have different expectations i.e., requesting time off. Why don’t people know how to request time off? Because everyone does it differently Why does everyone request time off differently? Because the manager has not set expectations. Why hasn’t the manager set expectations? Because she hasn’t thought about the ideal way to request time off. Why hasn’t the manager created an ideal process to make time off requests? Because she has other competing priorities. Why can’t team members recommend a consistent process? Team members can make recommendations for approval by the manager and team. Team members will know what is expected of them as evidenced by consistent communication and application of the request for time off process. Team members who understand how to request time off will better understand what is expected of them within the department.

16. Action Plan: Know what’s expected 5. Action Plan – Requesting time off WhatWhoWhenOutcome Determine various ways team members currently request time off Mary2 week periodClear illustration of current practices Evaluate the current practice which meets the needs of the department and team member Mary & Steve1 week period1st draft of time off request process Review 1 st draft with team members in team meeting ManagerDecember Team Meeting Approval of time off process Implement new processAll team membersBy January 1, 2015All team members request time off using same process Explore additional areas where team members may not have clarity All team membersBy April 1, 2015Increased understanding of team member expectations

17. 1.Need/ Rationale 3.Target Condition 4.Reasoning 3.Target Condition 4.Reasoning 2.Current Condition 5. Action Plan - Action steps - Timeline - Expected outcomes - Accountability 6. Key Learning 5. Action Plan - Action steps - Timeline - Expected outcomes - Accountability 6. Key Learning A3 problem solving: Materials & Equipment During Discovery Meetings team members report they are consistently looking for supplies they need to perform their job. Examples: “We cannot find X when we need it” “We had to put in a rush request for X the past 4 times we needed it” Why cant people find needed supplies? Because everything is not stored in a consistent place Why are supplies not stored in a consistent place? Because people don’t put things back in proper place Why don’t people put supplies back? Because they are in a hurry and no process has been established Why isn’t there a process in place? Because no one has taken the time to do this Why doesn’t the manager delegate this responsibility to some team members? He can. Team members can come up with a recommended process for storing supplies. Team members will have the supplies they need to perform their job duties efficiently and effectively in order to prevent work disruptions (5S: sort, store, shine, standardize, sustain). Team members who have what they need to perform their jobs well will be more satisfied with work and deliver better service to customers.

18. Action Plan: Materials & Equipment 5. Action Plan – Locating needed supplies WhatWhoWhenOutcome Sort out unnecessary items, keep items based on frequency of use Rick, Julia and Tami2 week periodSegregate and eliminate supplies Arrange items so they can be found quickly Rick & Julia2 week periodOrganize and rearrange Visually sweep area after use and clean any mess All team membersDecember Team MeetingDaily cleanup process Standardize cleanup activities so that these actions are specific and easy to perform All team membersBy December 1, 2014Constant adherence to first 3 steps and safety Make a habit of maintaining established procedures and ensure they are followed by promoting adherence and using visual measurement tools All team membersBy January 1, 2015Achieve habitual compliance

19. 1.Need/ Rationale 3.Target Condition 4.Reasoning 3.Target Condition 4.Reasoning 2.Current Condition 5. Action Plan - Action steps - Timeline - Expected outcomes - Accountability 6. Key Learning 5. Action Plan - Action steps - Timeline - Expected outcomes - Accountability 6. Key Learning A3 problem solving: Do what I do best Discovery meeting revealed that several team members believe they are completing mundane tasks at work and are not utilized to their highest potential. Examples: checklists, audits, etc. Why do people believe the tasks they perform are mundane? Because no one has asked them about their individual strengths Why don’t people know about each other’s strengths? Because everyone is focused on the primary tasks of the role – no one has inquired Why don’t we collect information on each person’s strengths/interests? We can – we will! Team members will be given opportunities to leverage their individual strengths and interests while performing their role. Team members who are given the opportunity to do what they do best feel more valued as a member of the team and feel more confidence in the team overall.

20. Action Plan: Do what I do best 5. Action Plan – Leveraging strengths WhatWhoWhenOutcome Create a tool to gather professional interests and strengths Sara1 week periodLearn what inspires team members to do their best work Complete toolAll team members2 week periodClear list of professional interests/ strengths Review listManager1 week periodDevelop follow up questions to gain clarity from each team member Conduct follow up meetings with each team member Manager & team members By January 15, 2015All team members discuss ways to leverage strengths within the role/department and share with peers Share everyone’s strengths/ interests with all team members Manager & team members By February 15, 2015Each team member sets 1 goal/task that aligns with their strength

21. Entering Action Plans via Gallup Online Handout

22. Gallup Online Impact Plan Section Utilizing A3 problem solving methodology prepares you for Action Plan submission Turn to page 7

23. What can individual team members do? Assess their own goals and satisfaction drivers to clearly define what success looks like to them Communicate with the manager and share aspirations and needs in order to clarify where to focus energies Take Action by taking ownership of their own engagement A C T

24. What can front-line managers do? Build solid coaching relationships with team members for both performance & development Align interests & priorities to organizational goals Recognize & show appreciation for discretionary effort that’s in line with the strategy Engage yourself and each individual with dialogue about what matters most C A R E

25. What can senior leadership do? Foster a sense of community Be authentic in words and actions Convey to team members their individual significance Demonstrate excitement as the team moves forward C A S E

26.  Share what you have learned today & modify action plans where necessary  Enter action plans into Gallup Online  Utilize your Informal Leaders as Engagement Champions  Integrate engagement into your team meetings  Use tools found on engagement website  Incorporate engagement into your discussions about other initiatives (i.e. quality, patient satisfaction, etc.)  Share best practices and lessons learned at leadership meetings Next Steps

27. 1 Understanding the current state of engagement 2 Using A3 problem solving to create powerful action plans 3 Addressing the different levels of engagement 4 Identifying root causes & action steps

28. Previously we viewed & discussed 2 videos http://www.youtube.com/watch?v=y4nwoZ02AJM http://www.youtube.com/watch?v=gZ3wxgog4nc

29. 3 are busting their butts 5 are looking at the scenery And 2 are trying to sink the boat EngagedDisengaged Actively Disengaged RR Imagine your team members are more like crew members

30. Who are the Engaged? Engaged: high on both contribution and satisfaction Almost Engaged: large group, doing a decent job, reasonably satisfied; more employable than disengaged, more likely to consider a new employer than the fully engaged decent performers who get less of your attention

31. Achieve results – get team members involved in goal setting Mark progress – structure work so progress is visible and prevent setbacks Maximize performance – make top performance worthy of team member attention and provide feedback Authentic recognition – show team members that accomplishments are appreciated Build relationships – work is social, develop and maintain a strong network of relationships What to do with the Engaged Catch people doing something right

32. Enliven energy – physical, emotional, and mental Leverage strengths – productivity increases when people enjoy what they are doing Make meaning – meaningful work results in engaged, sustained and enriched people Master moments – each connection made has the potential to become a high point or low point in someone’s day Enhance well-being – eliminate the toxic elements of the workplace What to do with the Engaged Catch people doing something almost right

33. Who are the Disengaged? Honeymooners (new job/new role): high on satisfaction but not fully up to speed Hamsters: working hard but not on the right things or tucked away comfortably content with minimal contribution

34. What to do with the Disengaged Interpersonal style & integrity - explore individual interests, increase availability, role model personal manners and strong ethics Monitor direction - review, guide, and clarifying expectations; manage time & resources, and follow processes and procedures Support growth – embody autonomy, empowerment, development, feedback, praise and recognition You’re likely going to have to look for ways to engage this group… there are so many of them

35. Who are the Actively Disengaged? Crash & Burners: delivering great results but not getting what they want from the work – 2 exit routes (Quit or Quit & Stay) – Have turned an emotional corner whereby their attitudes and behaviors can be contagious to others – Partnership between the company and the individual is in need of a fix – Existing performance management processes have failed to address the situation

36. What to do with the Actively Disengaged Ask him/her: – How do you define satisfaction? – What does success look like for you personally? – Are you content with minimal contribution? – How might this be impacting your individual performance? – How might this be impacting your team’s performance?

37. Open, fair and consistent communication Build and sustain relationships Provide knowledge, clarity and guidance Support development & progress – prevent setbacks Handle conflict and problems Simultaneously, role model what you expect

38. If necessary, work on yourself Am I…Consider…The commitment... projecting my “stuff” onto others?What negativity might I be projecting onto others? I will have a bad days but I don’t have to be unpleasant about it. struggling with time management?What is overwhelming me and how is it impacting my ability to manage my time? I will want to vent, but I need to have the right conversations with the right people. trying to make everyone happy?Why do I think it is my job to make team members happy? I will get frustrated but I need to create an environment where they will be successful, make a difference, and contribute to the rest of the team. allowing frustration with a single concern overshadow all other efforts? What can I focus on that is working and translate it to something else? I will act upon issues within my control and escalate more systemic issues through my help chain. managing to the survey scores?What components of how I lead and manage will increase engagement? I will make it easy to do the right thing and hard to do the wrong thing. beating my head against a brick wall?What might I need to rephrase in order to be heard? I will expect positive attitudes and hold myself and others accountable.

39. 1 Understanding the current state of engagement 2 Using A3 problem solving to create powerful action plans 3 Addressing the different levels of engagement 4 Identifying root causes & action steps

40. Handout

41. Compilation of Best Practices

42. Uteam Resources Handout

43. Action Plan Reflection Complete this handout

44. Coming up…  Enrollment in Education Session #3 will begin in January via the Learning Management System Oct/Nov 2014MC Management Education #2 – Creating Powerful Action Plans Feb/Mar 2015MC Management Education #3 – Reviewing Plans & Sharing Key Learnings May 2015 Health System Census Survey