Pro’s and Con’s of using Performance Improvement Models and Frameworks

Webinar for Organizational Planning and Workplace Learning Program, Boise State University

April 6, 2017

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• Total Hip Arthroplasty and Total Knee Arthroplastyprocedures

• JV partnership with surgeons

• “Micro ASC” and surgical recovery facility

• Adults aged 45-64 (non-Medicare)

• Prospective, bundled fee revenue model

• Clinically and financially integrated

• Highly specialized, highly engineered and protocol driven

A HYPER-SPECIALIZED CARE DELIVERY MODEL

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Rick RummlerVice President, Process and Performance Management

Prior…

70’s: Praxis Corporation – Training materials administration

80’s: The Rummler Group – Operations manager

90’s: The Rummler-Brache Group and RBG Asia – Consultant

‘01-’16: Performance Design Lab – Partner

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Performance Improvement Models and Frameworks

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Two Types

I. Understand and Predict Performance

II. Guide Actions to Change Performance

Performance Improvement Key Success Factor

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KSF: Finding the right balance between scope of change and results

Balance Point Factors • Time window• Urgency• Resources available• Sponsor/Champion interest and

commitment

Strategies• Daisy chain (series of smaller

linked engagements)• Tap momentum for change

(align and raise understanding of the need)

• Whack-a-mole (opportunistic reputation building)

Performance Improvement Models and Frameworks

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Two Types

I. Understand and Predict Performance

II. Guide Actions to Change Performance

Understand and Predict Performance Models and Frameworks

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Provide a logic structure for:

• Defining and communicating the scope of engagements

• Analyzing and communicating current performance

• Designing and communicating future performance

× Project planning

Understand and Predict Performance Models and Frameworks

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Dr. Geary Rummler • Human Performance System• Nine Performance Variables• Organization as System / Anatomy of

Performance / Super-System• Business Process Framework• Value Creation Hierarchy• Effective Process Framework

Others• Gilbert’s Behavior Engineering Model• Weisbord’s Six-Box Model• Process Maturity Model• APQC’s Process Classification

Framework• Supply Chain Operations Reference• MIT’s Business Activity Model

Examples

Rummler & Brache’s Nine Performance Variables(a.k.a. Performance Variables Model, 9 Boxes Model)

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First appeared in Improving Performance, How to Manage the White Space on the Organization Chart, 1990 © Jossey-Bass, Inc.

Performance Levels

Performance Needs

Goals Design Management

Organization Level Organization Goals Organization Design Organization 

Management

Process Level Process Goals Process Design Process Management

Job/ Performer Level Job Goals Job Design Job Management

Rummler & Brache’s Nine Performance Variables

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The Three Levels of Performance Dimension• Systemic Views• Interdependent• Holistic in Combination

Performance Levels

Performance Needs

Goals Design Management

Organization Level Organization Goals Organization Design Organization 

Management

Process Level Process Goals Process Design Process Management

Job/ Performer Level Job Goals Job Design Job Management

Rummler & Brache’s Nine Performance Variables

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The Three Performance Needs Dimension• Determine Effectiveness

o Level specifico Leverages cause analysis experienceo Total performance system

Performance Levels

Performance Needs

Goals Design Management

Organization Level Organization Goals Organization Design Organization 

Management

Process Level Process Goals Process Design Process Management

Job/ Performer Level Job Goals Job Design Job Management

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Performance Levels

Performance NeedsGoals Design Management

Organization Level

Organization Goals• Has the organization’s strategy/direction been articulated and communicated?

• Does this strategy make sense, in terms of the external threats and opportunities and the internal strengths and weaknesses?

• Given this strategy, have the required outputs of theorganization and the level of performance expected from each output been determined and communicated?

Organization Design• Are all relevant functions in place?• Are all functions necessary?• Is the current flow of inputs and outputs between functions appropriate?

• Does the formal organization structure support the strategy and enhance the efficiency of the system?

Organization Management• Have appropriate functions goals been set?• Is relevant performance measured?• Are resources appropriately allocated?• Are the interfaces between functions being managed

Process Level

Process Goals• Are goals for key processes linked to customer / organization requirements?

Process Design• Is this the most efficient / effective process for accomplishing the Process Goals?

Process Management• Have appropriate process sub‐goals been set?• Is process performance managed?• Are sufficient resources allocated to each process?• Are the interfaces between process steps being managed?

Job / Performer Level

Job Goals• Are job outputs and standards linked to process requirements (which are in turn linked to customer and organization requirements)?

Job Design• Are process requirements reflected in the appropriate jobs?

• Are job steps in a logical sequence?• Have supportive policies and procedures been developed?

• Is the job environment ergonomically sound?

Job Management• Do the performers understand the Job Goals (outputs they are expected to produce and standards they are expected to meet)?

• Do the performers have sufficient resources, clear signals andpriorities and a logical Job Design?

• Are the performers required for achieving the Job Goals?• Do the performers have the necessary knowledge/ skills to achieve the Job Goals?

• If the performers are in an environment in which the five questions were answered “yes”, would they have the physical, mental, and emotional capacity to achieve the Job Goals?

Nine Performance Variables with Questions

Nine Performance Variables Use Scenarios

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Job/ Performer Performance Issues/Opportunities, e.g.:• Customer service representative retention/ turnover• Sales representative productivity• Project team effectiveness

Performance Levels

Performance Needs

Goals Design Management

Organization Level Organization Goals Organization Design Organization 

Management

Process Level Process Goals Process Design Process Management

Job/ Performer Level Job Goals Job Design Job Management

Nine Performance Variables Use Scenarios

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Process Performance Issues/Opportunities, e.g.:• Product development cycle time• New hire time to productivity • Facility tour scheduling and conduct

Performance Levels

Performance Needs

Goals Design Management

Organization Level Organization Goals Organization Design Organization 

Management

Process Level Process Goals Process Design Process Management

Job/ Performer Level Job Goals Job Design Job Management

Nine Performance Variables Use Scenarios

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Organization Performance Issues/Opportunities, e.g.:• Factory of the future design• Dutch Olympic swim team program design• Unit performance scoreboard design

Performance Levels

Performance Needs

Goals Design Management

Organization Level Organization Goals Organization Design Organization 

Management

Process Level Process Goals Process Design Process Management

Job/ Performer Level Job Goals Job Design Job Management

• What are the benefits of using performance improvement models, such as the Nine Performance Variables Model, as the basis for scoping and planning engagements?

• What are the pitfalls of using these models as the basis for scoping and planning engagements?

• We seldom have the opportunity to address all improvement needs (i.e., all dimensions of the Nine Performance Variables Model) in a single engagement:

o What risks does this create?o What strategies can be used to mitigate 

these risks?

Questions

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THANK YOU

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Contact: Rick@MuveHealth.com