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Quality and Organizational Performance Management: An Integrated Approach

Quality and Organizational Performance Management: An Integrated Approach. Gregory Richards, MBA, Ph.D, FCMC Professor of Performance Management May 7, 2010. Agenda. Our research Concept of a “performance management framework”. Where do quality initiatives fit?

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Quality and Organizational Performance Management: An Integrated Approach

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  1. Quality and Organizational Performance Management: An Integrated Approach Gregory Richards, MBA, Ph.D, FCMC Professor of Performance Management May 7, 2010

  2. Agenda Our research Concept of a “performance management framework”. Where do quality initiatives fit? Technical issues: data, information, analytics The human component 2

  3. Our Research • Multiple case studies (private and public sector) • Large scale survey (338 private sector, 80 public sector) • Experimental: decision modelling/data modelling • “Participant” observation specific to health care: • Montfort • The Ottawa Hospital • University of Pittsburg Medical Centre

  4. Performance Management Frameworks “Organizational capital” created by a managerial process that: Clarifies expected outcomes: what, who and how Reviews key measures on a regular basis Focuses on process improvement, especially in service organizations Closes the loop between outcomes and processes 4

  5. The PM framework is based on a “model” of success • Variations of success models: • “Theory” of the business (Drucker) • Value-based management (Porter) • Causal modelling (Ittner and Larcker) • Strategy mapping (Kaplan and Norton) 5

  6. Planning for Success: A simple logic model Inputs activities outputs outcomes 6

  7. “Theory of Change” & Logic Models Theory of Change: understanding outcomes Strategies Outcomes/Impact Targeted -improved quality of life -reduced cost of health care -healthier communities -early intervention and education -rapid care and issue resolution -continuous learning Logic model: “service” strategy Inputs activities outputs outcomes -# issues resolved -response time Patient satisfaction Performance Indicators: # staff available -# of visits -time per visit 7

  8. Example of a Logic Model from MOH-LTC 8

  9. "In God we trust, all others bring data." W. Edwards Deming DATA, INFORMATION, ANALYTICS

  10. Applying “Managerial” Analytics: Step 1: Modelling decisions Organization’s reputation Patient satisfaction Patient well being improves Patients visit the centre Develop service processes and procedures Service and Access Presumed key success factor Translated into a service standard 10

  11. Step 2: understand relationships "Without a standard there is no logical basis for making a decision or taking action."Joseph M. Juran 11

  12. Outcome of the analysis • Chi-Square test of independence = 42.9, df=2; p<.0001 • Conclusion: Our service standard of 2 hours does make a difference to patient satisfaction. • From analysis to action: • What is our cost for maintaining this standard? • How much of a difference does it make? • Is a 2-hour wait time important for all patients? • How can we ensure consistency? 12

  13. "If you can't describe what you are doing as a process, you don't know what you are doing." W. Edwards Deming WHERE QUALITY & “LEAN” FITS: IMPROVING PROCESSES

  14. Reducing wait time is a process-level issue < 2 hours Reception Assignment Treatment Discharge -Capacity -Flow -Value added versus Non-value added time -Consistency 14

  15. The personal side of organizational performance 15

  16. Individual Aspects • 95% of performance is related to systems and processes, not to individual effort* • “Systems and processes” are full of people 16 *Joel Barker

  17. Inverted “U”: motivation versus performance Engagement reduces uncertainty, builds ownership, develops a sense of of control and self-efficacy. Allows a “right shift” along this graph so that higher targets can be set and met. The use of LEAN techniques is a powerful way of engaging staff! 17

  18. Conclusions High performance in complex environments depends on strategic clarity which brings focus, consistency and continuous improvement. Causal planning is one way of creating clarity: works from the patient backwards; represents hypotheses about how value is delivered. Measures are used to test hypotheses and to point to core processes that need to be examined. Don’t forget the human component: the organization should value excellence and accountability but also engagement and support. LEAN processes are exceptional ways of engaging staff. 18

  19. Gregory Richards, MBA, Ph.D, FCMC Professor of Performance Management 613-562-5800 x 2611 richards@telfer.uottawa.ca École de gestion Telfer Université d’Ottawa 55 Laurier Avenue Ottawa ON K1N 6N5 Tél. : (613) 562-5731 Télec. : (613) 562-5164 www.gestion.uottawa.ca Telfer School of Management University of Ottawa 55 Ave Laurier Ottawa ON K1N 6N5 Tel.: (613) 562-5731 Fax: (613) 562-5164 www.management.uottawa.ca

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