6 Elements of Great
Management
Follow-Up to Staff Surveys
IPC3
Learning Session 2
Denver, Colorado
April 26-28, 2011
Objectives
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Using data from the staff satisfaction survey,
teams will identify one to two areas for
workforce development improvement.
Based on outcome data from the staff
satisfaction survey, teams will identify their
areas of strength, and share their successful
workforce strategies and ideas.
Additions to the Ring of Knowledge will be
compiled with ideas and successful strategies
to be available to all teams.
Great Management = Top Box
Staff Responses
1.
2.
3.
4.
5.
6.
I know exactly what is expected of me in my clinical
microsystem.
I have the materials and equipment I need to
accomplish my role in my clinical microsystem.
In my clinical microsystem, I always have the
opportunity to do what I do best every day.
In the past seven days, I have received recognition or
praise for doing good work.
My supervisor or someone in my clinical microsystem
truly cares about me as a person.
There is someone in my clinical microsystem who
always encourages my development.
The Basis for our survey
First Break All the Rules
Climbing to the Summit
Buckingham M, Coffman C (1999): First Break All
The Rules. New York, NY: Simon & Schuster.
BASED ON GALLUP SURVEY
RESULTS
Analysis to determine what differentiates
great organizations, great managers
 Gallup survey of 1,000,000 employees
over 35,000 organizations
 Goal: to find key quality of work life
characteristics that separate great
workplaces from terrible workplaces.
 12 questions separate high performers
from the low performers

Prioritization

Which two of your six staff survey questions
had the lowest percent Top Box score?
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
This information is available from your excel
spreadsheet, tiny graphs tab
Why two??
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If you are feeling overwhelmed by workforce
development needs.
Identifying only one or two areas to begin with give
you the opportunity for focused tests of change.
But, you wanna do more? Hey! Go for it!
Prioritization
Survey Question
1.
Know what is expected
2.
Materials and equip.
3.
Opportunity to do best
4.
Recognition past 7 days
5.
Someone cares
6.
Encourages
development
Number of Teams
with this Question
as a Priority
Discussion
Were there any surprises?
 Were suspicions confirmed?

Workforce Development
Staff Satisfaction
The CareSouth Carolina
Story
9
WAKE UP CALL!!!
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We’ve had 103% growth since 2000 (but don’t forget,
we’re a non-profit!)
Staff increased from 100 to 250
Had put a real strain on financial and administrative
infrastructure
Resulting in lots financial squeeze
And organizational stress!
We’ve been engaged in The Improvement Journey since
1999: BPHC and IHI
Doing it all! Diabetes, CVD, asthma, depression, access
and flow
But, it all took a toll: employee morale and energy
10
Staff Satisfaction Surveys 2006
We Tanked!!
11
Baseline Surveys
Six question survey done September
2006 for an IHI Office Practice IMPACT
team: We were the worse among all the
teams!
 Comments were right on target:
confusion around supervision,
expectations, communication
 All of which substantiated the previous all
staff survey done in August 2006.
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12
What did we do??
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Using previous IHI Workforce Development work
(see www.clinicalmicrosystem.org click on
toolkit) we began implementing a step by step
change package.
Based on First, Break all the Rules, by Marcus
Buckingham and Curt Coffman
Gallup survey of 1,000,000 employees over
35,000 organizations
Goal: to find key quality of work life
characteristics that separate great workplaces
13
from terrible workplaces.
The Beginning: What We Did
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Established a bi-monthly Staff Satisfaction
Improvement meeting for leadership staff to
develop action plans for “reaching the summit”.
Furnished leadership with the book, First,
Break All the Rules, expected them to read it!
“Caught up” on all performance evaluations
Announced the survey results (yuk!) and the
Quarterly Action Plan at the 11/30/06 quarterly
staff meeting. Plan to re-survey staff in
February and August 2007 with Action Plan
updates.
Transparency!
14
Action Plan 11/30/06
Clarity on every staff person’s direct
supervisor: list and organization chart
posted to the Virtual Office, updated
monthly. Except for Corporate Office
staff (AR, AP, IT), Facilities staff, ALL
other staff report directly to Site Manager
for operational issues and needs.
 Sounds simple and clear? We were
amazed by how much “assumption” had
been made about previous lines of
authority.
15
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Action Plan, con’t
Change in the roles and responsibilities of
Technical Supervisors to Technical Advisors
 Technical Advisors – training and advice to
line staff on technical aspects of the
position, in coordination with site manager.
All operational aspects handled by Site
Manager.
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Action Plan con’t
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All job descriptions revised to reflect job expectations in
terms of measurable system level key processes,
customizable per employee and linked to outcomes.
See handout sample
This tool became the performance evaluation and
competency assessment tool also!
All job descriptions were revised to clearly reflect the
employee’s direct supervisor,
Interviews with all staff conducted in order to negotiate
job expectations, clarify supervision, and identify any
needs for supplies and/or equipment, identify talents and
training needs.
Re-designed orientation to insure specific
responsibilities, mentoring, and follow-up
17
Then What?
Using the guidance from FBATR, we
began a systematic approach to
workforce development.
 We have adopted a change package
based on the book recommendations.
 We understand that this is not a journey
with an end…we have to keep our eyes
open, attentive to workforce needs and
issues. No More Sleeping!!!
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Change Package
The Change Concepts
1.

Create a work place that
allows employees to feel they
are making contribution.
Use employee’s talents
wisely
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Hire right
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Be clear headed
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Know how much of an
employee you can
change
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Know the difference
between talent, skills,
and knowledge;
which can be taught,
which to hire
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Interview with
questions that cut
through person trying
to impress and reveal
talents
What we are doing
 We are reviewing and revising
our interview and hiring
processes to “hire for talent”:
 Striving – what motivates
 Thinking – how the person
thinks
 Relating- the “who” of a
person
 We are using Personal Skills
Assessment tool in the Green
Book at
www.clinicalmicrosystem.org
to “get to know” current staff
 We have established and
implemented an Employee
Council with representation
from all sites. Council meets
monthly and has direct access
to Executive Leadership Team.
 All sites are expected to have
bi-monthly site meetings and
19
bi-monthly Lunch and Learns.
Change Package
What We are Doing
The Change Concept
Develop Employee
Recognition
2.
•
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Time is the currency
of motivation by
leadership
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Who you spend it
with, how you
spend it
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We have implemented
“Great Job” medallions:
10 coins to site manager, 5
to division managers,
monthly. Staff who receive
coin can redeem them for a
raffle ticket at the quarterly
staff meeting.
These awards are
combined with our
quarterly Innovator, Spirit,
Mission Cup, and Sterling
Awards, which are aligned
with our Strategic Plan
20
Change Package
The Change Concept
3.
Encourage Personal
Compassion for
employees
•
Encourage praise
and recognition
among staff
What we are doing
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We have reimplemented “Fun
Days” in addition to
Site Lunch and
Learns
Strengths based
profiles for staff:
www.authentichappiness.org
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Change Package
The Change Concept
4.
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Encourage staff and
professional
development
Development plan
for each staff
member
Performance
evaluations 2 X /
year instead of
annual
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What we are doing
Developed a training and
development plan for
each staff
Implementing bi-annual
evaluations instead of
annual, using the tool of
the combined job
description and
performance evaluation
Support SCPHCA staff
Retreats (i.e. front office)
22
Top Box Survey Scores
All Staff Surveys
70%
60%
50%
40%
30%
20%
10%
0%
Aug-06 Nov-06 Feb-07 Aug-07 May-08
23
Some more help from the
trenches!
Pinon
 Chinle
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Let’s Put Our Heads Together!
Ideas for Testing or the Ring of
Knowledge
1.
2.
3.
4.
5.
6.
I know exactly what is expected of me in my clinical
microsystem.
I have the materials and equipment I need to
accomplish my role in my clinical microsystem.
In my clinical microsystem, I always have the
opportunity to do what I do best every day.
In the past seven days, I have received recognition or
praise for doing good work.
My supervisor or someone in my clinical microsystem
truly cares about me as a person.
There is someone in my clinical microsystem who
always encourages my development.
1.
I know exactly what is expected of me
in my clinical microsystem.
IDEAS
2.
I have the materials and equipment I
need to accomplish my role in my clinical
microsystem.
IDEAS
3.
In my clinical microsystem, I always have
the opportunity to do what I do best every
day.
IDEAS
4.
In the past seven days, I have received
recognition or praise for doing good
work.
IDEAS
5.
My supervisor or someone in my clinical
microsystem truly cares about me as a
person.
IDEAS
6.
There is someone in my clinical
microsystem who always encourages my
development.
IDEAS
“Digest” and work on your Action
Plan
Take the remaining time in the session to
digest what you’ve heard,
 Talk through some ideas you’ve heard,
 Record your ideas and plans on the
Workforce Development Action Planning
Sheet
 Post the Action Planning Sheet with your
next team report
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