“Faced with the choice between changing one’s mind and proving that there is no need to do so, almost everyone gets busy on the proof.” — John Kenneth Galbraith

Most executive teams have started down the path of determining what infrastructure they need to work in a contracting environment focused on value and performance (for this month’s coverage of that, see Working With Health Plans—The 7-Part Checklist). But there is a parallel development path that is needed—moving to a more data-driven culture that is compatible with the emerging value-based landscape. So how do you know if your culture is headed in the right direction. There are five indicators (see Is Your Culture Performance-Driven? Take The Test) that should be on your blueprint:

  1. Abundant practical metrics
  2. Committed leadership
  3. Knowledgeable staff
  4. Staff accountability
  5. Performance recognition

Abundant practical metrics—Metrics are the currency for showing value to health plans, and delivering actionable insights for performance improvement. If an organization hasn’t invested in data collection and management, that is step one. When that is in place, sharing data through management dashboards is the only way to evolve from data collection to data-informed decisionmaking (see Performance Management Needs Performance-Driven Leaders). There are three basic steps in best practice performance management:

  1. The selection of optimal organizational key performance indicators (KPIs)
  2. The creation of KPI data reporting tools for managers
  3. The adoption of an organizational process to use KPI metrics in performance improvement

This gives a performance culture the ability to track performance trends, compare operating units, benchmark the competition, and predict performance problems (see Best Practice Performance Management—The Key To Sustainability & Success).

Committed leadership—Understanding how to align organizational culture with payer expectations rests on the shoulders of leadership. The language of performance must be clearly communicated and embodied by top executives and then taught to staff and the board. This education should give employees an increased sense of urgency about their performance, and if done correctly, it will lead to staff identifying new sources of value for consumers and payers alike (see How To Retrain Managers For Data-Driven Performance Management?).

The work of Patrick Lencioni (see The Advantage: Why Organizational Health Trumps Everything Else In Business) offers an extremely valuable framework for leadership to work within, including:

  1. Build a cohesive team
  2. Create clarity among your team members
  3. Over communicate that clarity
  4. Reinforce clarity

Leaders can enhance their organization’s culture by making a point of creating the culture expectations, making those expectations a priority, and then reflecting that priority at every level of the organization.

Knowledgeable staff—Leadership is paramount, but a lot rides on staff understanding strategic communications coming from the c-suite. At every opportunity, staff must demonstrate its understanding and use of data. Your staff will be “performance educated” when they cease to be strictly process driven, and use the data at hand to be value driven. To facilitate this, leadership must commit resources to education, training, and targeted coaching (see 4 Keys To Make New Tech Work), with a focus on three elements.

  1. Create a comprehensive plan informed by the overall performance strategy and with defined roles.
  2. Assign a project manager who is responsible for oversight and intervention during poor performance.
  3. Hire the “right” people and give them the “right” tools to communicate the requisite information.

Step one is to ask yourself a series of questions. Is your team the right team? What is your team’s performance IQ? Can your team connect the dots to deliver on a metrics-based strategy? The answers you find must all be in the affirmative.

Staff accountability—Leadership needs to enact clear team member accountability for specific performance metrics coupled with real-time performance feedback at all levels of the organization. Becoming truly performance driven demands accountability for individual performance and the outcomes that arise from that performance.

Just remember, if everyone doesn’t know what measures reflect their job performance and how they can improve that performance, they can’t be held accountable. The executive team must know, collect, review, and share all the metrics as a standard way of managing if staff is to perform.

Performance recognition—One of the best tools for driving staff to seek better education and embrace accountability is to build a system of performance recognition and celebration. A performance-driven organization can only know it’s making progress if leadership is transparent about staff progress. Recognize the great performers celebrate outcomes, share the process that got them there, and record the successes.

For more on building an organizational culture, as well as a performance-driven culture, check out these resources from the OPEN MINDS Industry Library:

  1. Culture Will Trump Strategy Every Time
  2. Creating A Culture Where Metrics-Based Management Can Succeed
  3. Two Uses Of Metrics-Based Management – Strategy & Business Process Management
  4. Optimizing Your Operations With Analytics, Performance Measurement & Metrics-Based Management
  5. Integrating Predictive Analytics Into Clinical Practice For Improved Outcomes & Financial Performance
  6. Performance Measurement & Value-Based Payment In Medicare & Medicaid: An Executive Update
  7. The Continuum Of Change Management
  8. How To Tackle Performance-Based Compensation
  9. What Do Today’s Leaders Think About Managing Change?
  10. Creating and Leading A Team in Times of Change

Ultimately, performance culture is just like your strategic planning, budgeting, and service line launches—it simply won’t “just happen.” Take time to deliberately build it.

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