Engagement Education Session #2Creating Powerful Action Plans

October/November, 2014

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II. Select 2 survey items on which to focusa) One Q12 item that is most negatively impacting patient or team

member safety in your areab) 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 itemsa) Need/Rationaleb) Current Conditionc) Target Condition and Reasoningd) Action Plan

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

2007 2008 2009 2010 2011 2012 2013 20140

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

3.79 3.82 3.87 3.83 3.78 3.92 3.84 3.91

29th 35th Percentile

Our Engagement Journey

Gallup Health Care ClientsAdena Health System Hendrick Health System

Adventist Health System Henry Ford Health System

Alegent Health Hospital for Special Surgery

Borgess Health Alliance Intermountain Healthcare

Aultman Health Foundation Lakeland Regional Medical Center

Baptist Health Loma Linda University Medical Center

Baptist Health South Florida MemorialCare

Bon Secours Health System Inc. MultiCare Health System

CentraCare Health System Parrish Medical Center

Cleveland Clinic Foundation Self Regional Healthcare

Commonwealth Health Corporation Sisters of Mercy Health System

Hawaii Pacific Health System Vanguard Health Systems

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

% o

f W

ork

gro

up

s

0%

25%

50%

75%

100%

35%26%

22%17%

2014= <3.76 3.76-<4.11 4.11-<4.45 4.45+

n= 130 113 95 86 56 73 39 55

n 113n 86 n 73 n 55

Despite those efforts61% of our workgroups are in

the bottom two quartiles

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% o

f W

ork

gro

up

s

0%

25%

50%

75%

100%

35%26%

22%17%

2014= <3.76 3.76-<4.11 4.11-<4.45 4.45+

n= 130 113 95 86 56 73 39 55

n 2907n 1729 n 1347

n 475

4636 team members are in the bottom half

4636 1822

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Note: Percentiles based on Gallup’s 2014 Q12 Healthcare Workgroup Level Database

Radiology

Health Care Specialist

Nursing

Labs

Administrative

Pharmacy

Facilities and Trade

Allied Health

Finance

Computing

Management

0.00 1.00 2.00 3.00 4.00 5.00

3.68

3.71

3.78

3.87

3.88

3.90

4.02

4.02

4.23

4.24

4.3971st 307 0.09

60th 211 0.07

59th 262 0.01

43rd 630 0.15

43rd 324 0.11

34th 188 -0.05

33rd 933 0.02

32nd 222 0.04

26th 1,912 0.10

22nd 696 0.11

20th 152 0.04

2014 Percentile

2014n Size

YOY Change

2014 Medical CenterGrandMean: 3.91Percentile: 35th

8 out of 11 job families are in the bottom half

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…

Hope is not a strategy to solve a problem…

neither is a survey

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

2014 Q12 Results

Q12 Items

Medical Center 2014 Mean(n=6,235)

2014 Percentile Ranking Change

Opportunities to learn and grow 4.01 40th +0.11

Progress in last six months 3.78 31st +0.21

Best friend 3.62 34th +0.13

Coworkers committed to quality 4.09 37th +0.08

Mission/Purpose of organization 3.99 30th +0.11

My opinions count 3.62 38th +0.10

Encourages development 3.89 39th +0.08

Supervisor/Someone at work cares 4.10 35th +0.04

Recognition last seven days 3.51 36th +0.02

Do what I do best every day 4.03 34th +0.03

Materials and equipment 3.92 33rd +0.03

I know what is expected of me at work 4.39 32nd +0.00

Note: Percentiles based on Gallup’s 2014 Q12 Healthcare Workgroup Level Database

Q12 Items

Medical Center 2014 Mean(n=6,235)

2014 Percentile Ranking Change

Do what I do best every day 4.03 34th +0.03

Materials and equipment 3.92 33rd +0.03

I know what is expected of me at work 4.39 32nd +0.00

Note: Percentiles based on Gallup’s 2014 Q12 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

1. Need/ Rationale 3. Target Condition

4. Reasoning

2. Current Condition 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.

Action Plan:Know what’s expected

5. Action Plan – Requesting time offWhat Who When Outcome

Determine various ways team members currently request time off

Mary 2 week period Clear illustration of current practices

Evaluate the current practice which meets the needs of the department and team member

Mary & Steve 1 week period 1st draft of time off request process

Review 1st draft with team members in team meeting

Manager December Team Meeting

Approval of time off process

Implement new process All team members By January 1, 2015 All team members request time off using same process

Explore additional areas where team members may not have clarity

All team members By April 1, 2015 Increased understanding of team member expectations

1. Need/ Rationale 3. Target Condition

4. Reasoning

2. Current Condition 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.

Action Plan:Materials & Equipment

5. Action Plan – Locating needed suppliesWhat Who When Outcome

Sort out unnecessary items, keep items based on frequency of use

Rick, Julia and Tami 2 week period Segregate and eliminate supplies

Arrange items so they can be found quickly

Rick & Julia 2 week period Organize and rearrange

Visually sweep area after use and clean any mess

All team members December Team Meeting Daily cleanup process

Standardize cleanup activities so that these actions are specific and easy to perform

All team members By December 1, 2014 Constant 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 members By January 1, 2015 Achieve habitual compliance

1. Need/ Rationale 3. Target Condition

4. Reasoning

2. Current Condition 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.

Action Plan:Do what I do best

5. Action Plan – Leveraging strengths

What Who When OutcomeCreate a tool to gather professional interests and strengths

Sara 1 week period Learn what inspires team members to do their best work

Complete tool All team members 2 week period Clear list of professional interests/ strengths

Review list Manager 1 week period Develop follow up questions to gain clarity from each team member

Conduct follow up meetings with each team member

Manager & team members

By January 15, 2015 All 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, 2015 Each team member sets 1 goal/task that aligns with their strength

Entering Action Plans via Gallup Online

Handout

Gallup OnlineImpact Plan Section

Utilizing A3 problem solving

methodology prepares you for

Action Plan submission

Turn to page 7

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

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

CAR

E

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

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

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

Previously we viewed & discussed 2 videos

http://www.youtube.com/watch?v=y4nwoZ02AJM http://www.youtube.com/watch?v=gZ3wxgog4nc

3 are busting their butts 5 are looking at the scenery

And 2 are trying to sink the boat

Engaged Disengaged

Actively Disengaged

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Imagine your team members are more like crew members

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

• 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

• 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

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

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

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

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?

• 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

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.

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

Handout

Handout

Compilation of Best Practices

Uteam Resources

Handout

Action Plan Reflection

Complete

this handout

Coming up…

Enrollment in Education Session #3 will begin in January via the Learning Management System

Oct/Nov 2014 MC Management Education #2 – Creating Powerful Action Plans

Feb/Mar 2015 MC Management Education #3 – Reviewing Plans & Sharing Key Learnings

May 2015 Health System Census Survey