Identifying and Improving Process Effectiveness

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2009 -AHCA/NCAL- Identifying and Improving
Process Effectiveness

• Explain core competencies and key work
  processes , and the associated operational
  performance measures and outcomes these produce
  for tracking daily operations  

Ira M. Schoenberger, FACHCA Senior Administrator
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Baldrige Health Care Criteria Framework A
Systems Perspective- Core Competencies and Key
Work Processes

• While core competencies were introduced as an
  important concept in the 2007 Baldrige Criteria,
  their strategic significance was not fully
  exploited.
• The Criteria questions probe the relationship of
  your core competencies to your organizations
  mission, strategy, and sustainability.
• Is your organization competent in the areas that
  will deliver its sustainability?

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Baldrige Health Care Criteria Framework A
Systems Perspective- Core Competencies and Key
Work Processes

• Strategic advantages generally arise from either
  or both of two sources (1) core competencies,
  which focus on building and expanding on an
  organizations internal capabilities, and (2)
  strategically important external resources, which
  are shaped and leveraged through key external
  relationships and partnerships.
• Key Work Processes
• Your key work processes (6.1b1) are your most
  important internal value creation processes and
  might include health care service design and
  delivery, patient and stakeholder support, supply
  chain management, business, and support
  processes. Your key work processes are the
  processes that involve the majority of your
  organizations workforce and produce patient and
  stakeholder value.
• Key
• The term key refers to the major or most
  important elements or factors, those that are
  critical to achieving your intended outcome. The
  Baldrige Criteria, for example, refer to key
  challenges, key patient and stakeholder groups,
  key plans, key work processes, and key
  measuresthose that are most important to your
  organizations success. They are the essential
  elements for pursuing or monitoring a desired
  outcome.
• Your key work processes frequently relate to your
  core competencies, to the factors that determine
  your success relative to competitors and
  organizations offering similar health care
  services, and to the factors considered important
  for business growth by your senior leaders.

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Core Competencies

• The term core competencies refers to your
  organizations areas of greatest expertise.
• Your organizations core competencies are those
  strategically important capabilities that are
  central to fulfilling your mission or provide an
  advantage in your marketplace or service
  environment.
• Core competencies frequently are challenging for
  competitors or suppliers and partners to imitate,
  and they may provide a sustainable competitive
  advantage.
• Core competencies may involve unique service
  offerings, technology expertise, a marketplace
  niche, or a particular business acumen (e.g.,
  health care delivery start-ups).

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Mission

• The term mission refers to the overall function
  of an organization. The mission answers the
  question, What is this organization attempting
  to accomplish? The mission might define
  customers or markets served, distinctive or core
  competencies, or technologies used.

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Examples of Core Competencies

• The mission of the United States Air Force is to
  fly, fight and win in air, space and cyberspace.
  To achieve that mission, the Air Force has a
  vision of Global Vigilance, Reach and Power .
  That vision orbits around three core
  competencies Developing Airmen,
  Technology-to-Warfighting and Integrating
  Operations. Core competencies and distinctive ...

• Mercy Health Care System (MHS) core competencies
  are those areas of expertise that are critical to
  accomplishing the mission and vision. MHSs
  senior leaders determine and reaffirm
• MHSs core competencies as part of the mission
  and vision review during the SPP. MHSs core
  competencies include 1) partnering with
  physicians to create and maintain an effective
  integrated healthcare delivery system and 2)
  engaging employees and physicians using the
  Servant Leadership Philosophy and the COE model,
  which provide a balanced approach to patient
  focused care.
• The integrated delivery system model has enabled
  growth and diversification of business lines,
  supporting the ability to effectively coordinate
  quality healthcare delivery across the continuum
  of care and supporting the mission, to provide
  exceptional healthcare services resulting in
  healing in the broadest sense. Partnering with
  physicians supports a collaborative focus on
  quality healthcare services and information
  sharing across the four core services. The
  integrated delivery model supports coordinated
  transitions between departments, providers, and
  care settings to ensure .

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Heritage Hall East Mission

• It is the purpose of HHE to improve the lives we
  touch through the delivery of high quality health
  care and everyday compassion. The vision of HHE
  is to set the standard in nursing and
  rehabilitative care through clinical excellence
  and responsiveness to the unique needs of every
  patient we care for. We will be the recognized
  leader in clinical quality and customer
  satisfaction in our marketplace. Our
  organizational culture is defined by our core
  belief that patients and residents are the center
  of our work. Our employees are the vital link
  between HHE and our patients and residents. They
  are the service we provide, the product we
  deliverthey are our most valuable resource.
  Achievement of our vision comes only through the
  talents and extraordinary dedication they bring
  with them every day of the year. Our core values
  revolve around excellence in patient/resident
  care and an energized culture of change and
  learning for our staffextending to the
  surrounding community. Our values include Care
  Compassion for every life we touch, Respect
  Appreciation for each other, Teamwork Enjoyment
  in working together, Focus Discipline on
  improving the quality of care, Creativity
  Innovation to develop effective solutions and
  Honesty Integrity in all dealings. The
  organization deploys these values through 1)
  innovative approaches for resident empowerment,
  2) a highly participative management
  approachwhich includes all levels of the
  organization, and 3) a coordinated focus on
  personal learning and career mobility. Our
  mission is conveyed to our residents, families
  and staff on an ongoing basis via written
  communication and direct contact. Our residents
  and families are informed and educated on our
  philosophy and mission prior to admission i.e. in
  the hospital or home, during the admission
  process and on an ongoing basis at care plan
  meetings, resident counsel meetings, and family
  meetings. All contract workers are orientated to
  our mission statement and expectations.

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Examples of Mercy Health System core competencies
and key processes
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Operationalized-
Mission
Core Competencies
Business
Skilled and Satisfied Staff
Clinical
Customer Satisfaction
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Health Care Core Competencies based on their
Mission and Vision statement and Core
values. The focus is on Clinical, Business,
Skilled and and Satisfied Staff Staff Excellence,
and Customer Excellence.
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Examples of Key Health Care
Process from HHE Step 3- Key services and their
major processes are determined through market
need and evaluated against regulatory agencies
that govern each process. The center is licensed
as a skilled nursing facility to meet the
needs of long-term care residents and short stay
patients from our referral basis. We design
our services around our stakeholders requirements
keeping in mind our strategic objectives.. If
we adhere to our key processes we provide
delivers our core competencies and our strategic
objectives clinical excellence, excellence in
customer care, staff excellence and business
excellence By measuring our results and using our
CQI process we continually improve our health
care outcomes.
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Sample of Trended Scorecard
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Sample of Performance Score Board
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Baldridge CriteriaHow do you design your work
systems?

• How do you design your work systems?
• Describe HOW your organization determines its
  CORE COMPETENCIES and designs its WORK SYSTEMS
  and KEY PROCESSES to deliver VALUE to PATIENTS
  and other CUSTOMERS, prepare for potential
  emergencies, and achieve organizational success
  and SUSTAINABILITY.
• Within your response, include answers to the
  following questions
• 6.1a. CORE COMPETENCIES
• a(1) HOW does your organization determine its
  CORE COMPETENCIES?
• What are your organizations CORE COMPETENCIES
  and how do they relate to your MISSION,
  competitive or collaborative environment, and
  ACTION PLANS?
• a(2) HOW do you design and INNOVATE your overall
  WORK SYSTEMS?
• HOW do you decide which PROCESSES within your
  overall WORK SYSTEMS will be internal to your
  organization (your KEY work PROCESSES) and which
  will use external resources?
• 6.1b. Work PROCESS Design
• b(1) What are your organizations KEY work
  PROCESSES?
• HOW do these KEY work PROCESSES relate to your
  CORE COMPETENCIES?
• HOW do these PROCESSES contribute to delivering
  VALUE to PATIENTS and other CUSTOMERS,
  organizational success, and SUSTAINABILITY?
• b(2) HOW do you determine KEY work PROCESS
  requirements, incorporating input from PATIENTS,
  other CUSTOMERS, suppliers, PARTNERS, and
  COLLABORATORS, as appropriate?
• What are the KEY requirements for these
  PROCESSES?
• b(3) HOW do you design and INNOVATE your work
  PROCESSES to meet all the KEY requirements?
• HOW do you incorporate new technology,
  organizational knowledge, and the potential need
  for agility into the design of these PROCESSES?
• HOW do you incorporate health care outcomes,
  CYCLE TIME, PRODUCTIVITY, cost control, and other
  efficiency and EFFECTIVENESS factors into the
  design of these PROCESSES?

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Resources

• AHCA/NCAL Quality Award program requirements and
  application information (www.ahcancal.org).
• Baldrige National Quality Program To order a
  free copy of the Baldrige Health Care Criteria
  for Performance ExcellenceTel
  301-975-2036Website www.baldrige.nist.gov.

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More Resources

• Books available at www.ahcapublications.org
• Conducting Satisfaction-Based Customer Surveys A
  Guidebook for Long Term Care Providers by Vivian
  Tellis-Nayak, Ph.D.
• Continuous Quality Improvement Using the
  Regulatory Framework by Barbara Baylis
• Developing a Quality Management System The
  Foundation for Performance Excellence in Long
  Term Care by Bernie Dana
• Quality Management Integration in Long-Term Care
  Guidelines for Excellence by Maryjane Bradley and
  Nancy Thompson

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Questions ????For more information...

• Please contact
• Ira M. Schoenberger, FACHCA
• Senior Administrator
• Heritage Hall West/Genesis Health Care
• 61 Cooper Street
• Agawam, Massachusetts 01001
• 413-821-0750
• ira.schoenberger_at_genesishcc.com