Planting the Seeds for Excellence –
The WHY and WHAT of highmiddlelow® performer conversations
Lynne Cunningham, Studer Group coach and International Speaker
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Healthcare Flywheel®
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Objectives
• Nurture an appreciation of the importance of highmiddlelow®
conversations in building organizational excellence.
• Cultivate the skills needed to differentiate among high, middle/solid and
low performers.
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Do You Suffer From Kainotophobia or are You Building
the Choluteca Bridge?
 Denial
 Rationalization
 Blame
 Uniqueness
 Unwillingness
 Not Skilled
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Execution Framework: Evidence-Based LeadershipSM
LEADER EVALUATION
MUST HAVES®
STANDARDIZATION
Implement an organization-wide
leadership evaluation system to
hardwire objective accountability
Rounding, Thank You Notes, Employee
Selection, Pre and Post Phone Calls, Key
Words at Key Times
Agendas by pillar, peer interviewing, 30/90 day
sessions, pillar goals
LEADER DEVELOPMENT
Create process to assist leaders in
developing skills and leadership
competencies necessary to attain
desired results
PERFORMANCE GAP
Re-recruit high and middle performers,
Move low performers up or out
ACCELERATORS
Leader Evaluation Manager®
Validation MatrixSM
Provider Feedback SystemSM
Studer Group Rounding
Patient Call ManagerTM
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Communicating: After WHY, then tell us WHAT…
Why
What
How
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Why Organizations Do Not Achieve
Desired Results
1.
Dots are not connected
consistently to purpose,
worthwhile work and making a
difference
2.
Do not achieve critical mass Lack of balanced approach
3.
Absence of an objective
accountability system
4.
Leaders do not have the
training to be successful
5.
Too many new behaviors
introduced at once – need of
sequenced approach
6.
No process in place to rerecruit the high and middle
performers and address low
performers (HML)
7.
Inability to take best practices
and standardize across
organization
8.
Failure to have leaders
“always” do desired behaviors
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HML Distribution
Who’s looking for another
job?
• 47% of high performers
• 25% of middle performers
Typical HML distribution
• 34% High
• 58% Middle
• 8% Low
• 18% of low performers
Source: Leadership IQ, 2006
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Evidence:
highmiddlelow® Works!
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highmiddlelow® Conversations & Organizational
Results
How would your rate your organization's ability to:
(1=Very Poor, 10=Excellent)
Before implementing HML
10
9
8
7
6
5
4
3
2
1
0
After implementing HML
7.9
5.7
7.7
7.4
5.2
4.0
Retain High
Performers
Further Develop
Middle Performers
Move Out Low
Performers
Source: highmiddlelow Research Study 8/08
Before HML, N=26; After HML, N=25 for Retaining High Performers
Before HML, N=25; After HML, N=25 for Further Developing Middle Performers
Before HML, N=25, After HML, N=25 for Moving Out Low Performers
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highmiddlelow® Affects Our Patients
• highmiddlelow® conversations result in a more engaged workforce
• High engagement leads to reduced turnover and fewer workarounds
These factors combined makes a SAFER
environment for our patients!
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Employee Turnover Impacts Patient Care
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We have learned that the
reluctance to address low/subpar performance keep an
organization from being the
best.
Quint Studer
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Performance Curve
L
M
H
8%
58%
34%
Low
Performer
Middle/Solid
Performer
High
Performer
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Who’s Who?
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Who Are You Spending Time With?
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Clinical
HIGH
Customer
Staff
Growth
•Manager Evaluation
(Annual)
•Scorecard
Financial
PERFORMANCE
RESULTS
Out
MIDDLE
Different Seat
LOW
Out
Standards of Behavior
Manager Evaluation (Annual)
Customer Evaluations
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Definition of High Performer








Definition
Comes to work on time
Good attitude
Problem solves
You relax when they are scheduled
Good influence
Use of peer interviews
Pillar ownership
Brings solutions
H
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.
Professionalism
Teamwork
Knowledge & Competence
Eager to change for the good of the organization. Strives for
continuous professional development.
Communication
Consistently communicates organizational information. Does
not create we/they. Provides frequent feedback to staff.
Safety Awareness
Demonstrates the behaviors of safety awareness in all
aspects of work.
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How do you treat your High Performers?
• Ignore them?
• Say thank you?
• Give them more work?
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Ignore them? High Performers:
• 47% are actively looking for another job, resumes,
internet search and interviews:
– Lack of recognition
– Feeling under rewarded
– Are the most unhappy
– Even when unemployment is Exceeding,
have a pent-up demand to leave
• 55% said they were never or rarely thanked
by their boss
Leadership IQ,, Fall 2006
Maritz Incentives, St.. Louis 2003
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Goal with High Performers
• Re-recruit
• Recognize
• Retain
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Definition of Middle/Solid Performer







Definition
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
M
Solid
Professionalism
Usually adheres to policies concerning breaks, personal phone calls,
leaving the work area, and other absences from work.
Teamwork
Committed to improving performance of their team and
organization. May require coaching to fully execute.
Knowledge & Competence
Invested in own professional developments. May require some
coaching to fully execute.
Communication
Usually communicates organizational information.
Occasionally uses we/they language. Provides some feedback
to staff.
Demonstrates the behaviors of safety awareness in all
aspects of work.
Safety Awareness
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Goal with Middle (Solid) Performers
• Reassure
• Re-recruit
• Develop
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Who, me?
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Definition of Low Performer






Definition
Points out problems in a negative way
Positions leadership poorly
Master of “We/They”
Passive aggressive
Thinks they will outlast the leader
Says manager is the problem
L
Professionalism
Does not communicate effectively about absences from work.
Handles personal phone calls in a manner that interferes with
work. Breaks last longer than allowed.
Teamwork
Demonstrates little commitment to their team and the
organization.
Knowledge & Competence
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 we/they culture. Does not provide
feedback.
Performs work with little regard to the behaviors of
safety awareness.
Communication
Safety Awareness
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Goal with Low Performer – Up or Out
• Improve, OR
• De-select
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Phases of Skill and Change – Individual
Even with positive change, there is resistance
Unconsciously
skilled
Consciously
skilled
Consciously
unskilled
Unconsciously
unskilled
Source: Abraham Maslow; 1940; “Four Stages for Learning Any New Skill””; Gordon Training International by Noel Burch; 1970
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Thank you!
Lynne Cunningham
Lynne@studergroup.com
916.847.6026