CMG CLINICAL DIRECTORS CONFERENCE 2017cmgevents.ie/wp-content/uploads/2017/06/Jack-Nagle-Clinical... · CMG CLINICAL DIRECTORS CONFERENCE 2017 Managing Poor Performance & Supporting

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CMG CLINICAL DIRECTORS CONFERENCE 2017

Managing Poor Performance & Supporting those in Difficulty

Dr Jack P NagleCEO, Alpha

Learning Aims

• Performance Management

• Recognising early signs

• Improvement programs

• Best practice & evaluation

• Managing the budget & resources

Context

Private Providers

HospitalsPrimary Care

Residential Care

Context

Clinical Strategy & Programmes

• National Clinical Programmes (31)

• Integrated Care programmes

– Patient Flow

– Older People

– Children

– Maternity Care

– Prevention & Mngt of Chronic Diseases

Clinical Governance

Standards - Quality v Compliance…

‘BE QUALITY RATHER THAN COMPLIANCE DRIVEN’

Compliance will then follow…

CQCHIQA

Quality v Compliance• A Compliance focus is putting in sufficient effort to meet HIQA’s & Legal

minimum requirements.

• A Quality focus, on the other hand, is derived from a systematic continuous improvement process where management, resources and measurement systems are aligned and operated in such a way that continuous improvement and compliance is an inescapable outcome.

• An organisation will never achieve those benefits with a compliance-only approach.

• Continuous Improvement (CI) holds the key to not only compliance, but even more so to improved productivity and therefore increased profitability.

28-Jun-17 C. Alpha Healthcare Ltd 2006

Performance Managing Clinical Directors.

– Performance Management Vs Performance Measurement?

– How Has Performance Management Changed?

– Individual Appraisal Vs Joint Review

– Measuring Outputs Or Inputs & Processes

– Reward And Development

– Accountability And Autonomy

– The Role Of KPI’s

– Top Down And 360⁰ Feedback.


Performance Management Vs

Performance Measurement

C. Alpha Healthcare Ltd 2006 28-Jun-17


Individual Appraisal Vs Joint Review

Measuring Outputs Against Inputs/Process


The Results and Objectives

that are achieved.

The Skills, Competencies and Processes that achieve these results.


Professional-based to Service-based

Some Key Indicators

• Level of Complaints

• Level/Severity of Patient Safety

• Audit Results

• Staff Turnover/Recruitment/Retention

• Absence levels

‘Softer Issues’:

• Teamworking

• Conflicts

• Culture


Recognising Early Performance Signs

Checklist:

• Quantity of work,

• Quality of work,

• Absenteeism,

• Role as the centre of conflict,

• Dishonesty,

• Setting of unrealistic targets,

• Refusal to delegate,

• Slowness in taking decisions,

Ref: The management of Poor Performance – J Mayberry Postgrad Med 2007, checklist by Stewart & Stewart


Recognising Early Performance Signs

Recognising, understanding & addressing performance problems

Ref The Management of Poor Performance, J Mayberry, 2007

Recognising, understanding & addressing performance problems

Ref Recognising &addressing performance problems in healthcare organisations –DOH /UK 2006

Improvement Programs

• Agreement on the size of the problem

• Individual mentoring & support

• Development of learning plans

• Tutorials with experienced colleague

• In-house or external training

• Regular review of progress

• Good documentation of activities


Ref The Management of Poor Performance, J Mayberry, 2007


Ongoing Evaluation & Best Practice


Methods Of Ongoing Evaluation

1. Surveys – Staff and Service Users

2. Focus Groups – Multidisciplinary Team Groups

3. Working Groups

4. Appraisals

Best Practice


Peer Support Groups

• Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other.


Clinical Leadership Groups


Tips For More Effective Management

‒ Value Management As Well As Leadership

‒ Enable Reflective Learning

‒ Extend General Management Networks

‒ Clarity, Accuracy and Thoroughness In Communication

‒ Hire The Right People & Know Your Team


Value Management As Well As Leadership


Enable Reflective Learning


Extend General Management Networks


Communication Is Key


Hire The Right People

“It Wont Be Easy But It Will Be Worth It”


Leading The MDT To Assess & Improve Quality

‒ SWOT Analysis

‒ Formal Learning

‒ Myers Briggs

‒ Facilitating Clinical – Managerial relations


SWOT Analysis

Strengths, Weaknesses Opportunities, Threats

How do you learn ? e.g - Kolb’s Learning Style

© Alpha Primary Care Ltd 2010 28-Jun-17


TQM

Total Quality Management is a philosophy that enables the

management of people and business processes to ensure

complete customer satisfaction. It has been widely used in

industry to deliver huge benefits in customer service, efficiency

and cost reductions.

Myers Briggs Type Indicator


Facilitate Clinical–Managerial Relations


Providing Effective Feedback

• Whether you are providing feedback to an employee during a performance appraisal, disciplinary meeting or during the course of day to day business.

• Feedback is an opportunity, not a threat, feedback enables you to identify strengths & weaknesses, and to improve performance.


Factors affecting Quality of Heath Care Services

Ref the Kings Fund Survey of Medical Directors 2014

Managing The Clinical Directorate Budget/Finances/Resources

• Planning

• Financial allocation

• Expenditure Control

• Decision Timing

• Drivers For Change

• Distribution Of Power


Budgetary Considerations

Ref the Kings Fund Survey of Medical Directors 2014

Summary

• Performance Management v Measurement

• ‘Early signs’

• Improvement initiatives

• Best practice & evaluation

• Managing budget v resources v Quality of care

THANK YOU!

C. Alpha Healthcare Ltd 2006

• Founded Alpha 2003

• Prior – Senior Manager & Director Operations and Engineering roles

• Healthcare Business & Change Management experts

• Provides a suite of outsourced management services to healthcare professionals & providers

• Industry methodologies (TQM, LEAN, 6 Sigma) to deliver efficiency improvements

• Launched in the UK in 2010

• Worked more than 650 Clinicians & 125+ healthcare organisations –including DoH & HSE and CCGs & NHS in UK

Contact: [email protected]

Dr Jack Nagle - Background

Documents

CMG CLINICAL DIRECTORS CONFERENCE 2017cmgevents.ie/wp-content/uploads/2017/06/Jack-Nagle-Clinical... · CMG CLINICAL DIRECTORS CONFERENCE 2017 Managing Poor Performance & Supporting