Traditional approaches to financial performance have focused on increasing revenue and reducing costs. However, in order to do either, physician groups are now focusing on developing a team culture with a coordinated approach to performance improvement. While revenue and costs are still an important foundation in achieving financial performance, creating a culture of performance excellence is the basis for building that groundwork.

Creating a shared vision and strategy for the organization is the first and most important step in creating a culture of performance excellence. In order for business leaders to expect excellence, they must first determine what excellence is, then communicate, communicate, communicate! It is meaningless to create a vision and strategy if the entire organization does not know what it is or if they lack the buy in to work towards it. Once the strategy and vision are created and shared with everyone in the organization, it is essential to continuously measure and monitor the organization’s progress towards its goals. Throughout this process, the organization can create a culture of performance excellence by:

Making the data transparent

Sharing data using a web based Business Performance Management (BPM) system is the easiest way to ensure that current performance is being measured against organizational goals. By pushing performance information to all levels of the organization, you can ensure that there is a constant focus on the ultimate vision and mission of the organization

Define what to measure

Measurements should be selected based on their relevancy to the larger organizational objectives and be reliable enough to accurately measure performance. There is nothing worse to morale than reacting to measurements that are neither applicable to the organization and current business environment nor are accurate measures of performance. Key metrics that are commonly measured and often sited by MGMA as measures of better performing groups include measures of financial performance such as Cash Collections, Accounts Receivable > 90 days (or A/R greater than 120 days), total gross charges

Combine data to include organization wide metrics

Metrics should be universal enough to focus on broad organizational goals as well as include specific metrics that are relevant to individual departments and job functions. This will ensure that each department is held accountable to achieve measures that will drive the success of the entire organization. Using a BPM system will allow users “immediate” feedback relative to their performance and provide and opportunity to affect change when it matters.

Highlighting “wins”

In addition to communicating opportunities for improvement, it is imperative that organizations also communicate the areas of success with the organization. By sharing the good news, teams become more receptive to constructive criticism
and are more willing to focus on performance improvement proactively so that they can be recognized for accomplishment rather than opportunity.

Continuously assess performance and adjust targets / goals

Using data, leaders can continuously review operational performance and ensure that performance is meeting the set targets. In addition, a regular review and adjustment of goals will continuously challenge the teams to always perform better. When one milestone is reached, leaders should celebrate the success then challenge the teams to raise the bar. Most importantly, however, leaders must ensure these new standards are communicated regularly throughout the organization.

Ensuring accountability for Excellence

Tantamount to developing a culture of performance excellence is holding teams accountable for excellence. In order to continuously drive performance up, operational leaders must expect excellence from their teams, and expect it always. Excellence can not be something that happens on Monday or during October but should be a standard that is ingrained in the culture of the organization everyday.

It’s All About Will

The ability to improve performance starts with the will to want to achieve a higher standard. Even if organizational leaders communicate vision, strategy and current operational performance, the teams inherently have to have the desire and tools necessary to be successful. Organizational leaders can help their teams make the connection between organizational goals and performance excellence by giving them access to tools that will help them manage performance. By having access to performance measures and drill down data, teams can use these performance measures to understand and improve the process. They can use data to analyze performance indicators and trends as well as drill down into the root causes of negative performance trends. Additionally, teams should be encouraged to take action to improve performance while balancing business and customer objectives. Finally, organizational leaders should hold team members accountable to execute change initiatives and maintain performance levels.

Tracey B. Lewis, MPH
Independent Health Care Consultant

Tracey Lewis is currently a Black Belt with the Performance Excellence Department of New York Presbyterian Hospital in New York City. Her past experiences include working as a consultant for the Healthcare practices of both Arthur Andersen Business Consulting and Cap Gemini Ernst and Young. During this time, Tracey was engaged to assist clients with their Revenue Cycle Re-designs including implementing benchmarks and best practice process flows to optimize both efficiency and revenue. Following her consulting experiences, Tracey was a Manager of Analytics and then the Director of Productivity and Quality for Tenet Health System, Dallas TX.
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