Performance Management

Healthcare performance management

VOICE Clinics provides managers a safe way to confront behaviors without dictating.
—Orthopedic Practice Leader


Performance Management and Value Based Purchasing

Medicare is now withholding a portion of its reimbursements based on hospitals’ HCAHPS patient satisfaction scores. The average hospital is expected to lose $1 million a year (Data Advantage).

In response, many hospitals are conducting service training and manager coaching programs to improve their HCAHPS scores. Most or all of these programs are either simplistic, overly-scripted and rigid, not relevant to internal and external service, or don't link the learned skills to job standards that are role-modeled and coached to by managers. See Competitive Comparisons.

What’s missing in Studer and other healthcare service programs

Studer's AIDET is a set of basic greeting and departure steps that are relevant to only some patient-facing jobs. VOICE Clinics cover these skills and go way beyond to include demonstrating Patient Experience Ownership; asking, listening, and responding to the complete Patient's VOICE; handling tough challenges like complaints and saying no; using proven skills to reduce re-admittances, errors, and rework; and working as a team to improve quality and maximize all Medicare pay-for-performance measures. Plus Studer imposes scripts whereas VOICE Clinics engages employees to speak from their Authentic VOICE and to create their own personal scripts (reviewed by managers) to demonstrate the skills and standards.

More importantly, Studer and other manager-only programs like Crucial Confrontations can create employee-manager conflict because:

  • They fail to specify consistent house-wide standards for all hospital employees
  • They fail to provide comprehensive evidence-based skills for achieving the standards
  • They fail to provide in-depth skills-training in the skills and standards
  • They fail to train managers to “walk-the-talk” or role-model the skills and standards
  • They fail  to train managers how to train their employees in the skills

CLICK Here to see how VOICE Clinics "Hardwire" Collaborative HealthCare

What’s missing in Press Ganey surveys

More than half the hospitals in the US use Press Ganey patient survey services. VOICE Clinics take the next step for Press Ganey users and guarantees 80 percentile scores on their patient satisfaction index (or 5 percentile points more if already above 80 percentile). Here's how:

  • VOICE Clinics provide the teamwork and collaboration standards as well as Press Ganey service standards
  • VOICE Clinics provides the skills and the skills training to achieve the standards
  • VOICE Clinics train managers to role-model and train employees in the skills and standards
  • VOICE Clinics implement an accountability, coaching, and reward system to reinforce the skills and standards

hospital service trainingThe Accountability mechanism helps managers know how their people are internalizing the skills back on the job.
Co-director of Food and Nutrition Services

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VOICE Clinics as validated performance management

Hospitals need a strong validated performance management program that develops and promotes talented committed employees; and that re-directs and re-engages poor performing and poorly committed employees to either demonstrate the skills and standards or to seek more appropriate jobs.  Here’s how:

  • The Clinics’ skills and standards are based on extensive evidence-based research
  • Clinics use managers and directors as Leaders (trainers) for delivering the standards and skills across the entire organization
  • As Clinic Leaders, managers don’t impose the skills, they provide learning opportunities for employees to discover, acquire, and practice them
  • All managers attend the VOICE Clinics as participants and learn the skills as role-models on a shared learning curve with their employees
  • The Clinics introduce the skills and standards (not the managers), which employees and managers together interpret, apply, and commit to as partners
  • The Clinics imbed observation, feedback, and coaching skills in each Clinic’s activities to give employees and managers the skills to learn from each other
  • The Clinics implement an Accountability Process for employees and managers to document and help each other achieve and surpass the standards
  • The Clinics provide the learning platform to introduce new local and house-wide standards and the learning opportunities to achieve them

VOICE establishes clear lines of control and accountability

Healthcare organizations often have unclear reporting relationships and too expanded lines of control (too many employees reporting to the same manager). The process of implementing and conducting VOICE Clinics and the built-in Accountability Process establishes clear lines of control and reporting, as well as the performance management process for operationalizing the lines of control. Specifically:

  • Before VOICE is implemented, department heads as VOICE Leaders select and notify their local VOICE Coaches and Master Coaches and assign employees to them
  • VOICE Coaches announce the VOICE program to their assigned employees
  • Between Clinics, employees submit their VOICE Standards Accountability Forms (SAFs) to their assigned VOICE Coaches
  • VOICE Coaches score, feedback, and coach their employees on their VOICE SAFs
  • VOICE Coaches track, post, and report their employees' SAF scores up to their Master Coaches, then to their VOICE Leaders, then on to the VOICE Program Manager, then on to the VOICE Sponsor (C-Level Executive)
  • The VOICE Documented Coaching System using the 100 VOICE Standards continues ongoing after all the VOICE Clinics to ensure ongoing employee performance observations, assessments, feedback, coaching, tracking, and reporting.