ViewPoints Blog

Sustaining next-level performance: Are you making progress?

Sep 26, 2017 10:22:11 AM
iVantage Health

In our 4-part blog series on integrated performance management, we’ve already tackled three questions:

- How am I performing?

- Where are my opportunities?

- How do I improve?

Today, I am excited to tackle the fourth essential question of hospital performance improvement, Am I improving?

Change is hard. And it’s even harder to make change stick. Many hospitals and health systems are full of well-intentioned initiatives that seem to work fine during the first few months of implementation but frequently lose their momentum and begin to drift back to the status quo. There are plenty of reasons this occurs when viewed from an organizational perspective: Overtaxed management bandwidth; uncoordinated functional initiatives; flavor of the month mentality; trial fatigue; doubts about need to change; or the human desire to relax immediately following the hard work of a new initiative, to name a few.

More tactically – other factors play a role:

  • Performance initiatives are too broad – and thus a level of accountability is hard to pinpoint or accomplish in the established timeline.
  • The performance improvement workflow is designed too narrowly around a specific set of individuals, limiting flexibility and creating an overspecialization that creates gaps when a single team member is absent. These gaps create inconsistency in the workflow delivery and uneven results.
  • The initiative to make a change isn’t moving the measures as expected. If it raises doubts that the initiative is effective, there’s unlikely to be much motivation to make a change.
  • Documentation of agreed upon goals is sporadic or inconsistent and the follow-up measurement is likewise uneven.

It’s also well known that to make change happen, system and facility leadership teams need to be able to manage, measure and make visible performance improvement activities to ensure progress towards improvement goals. Successful leaders must become experts at operating within two broad constructs – first, being able to articulate the desired intent/end state of an initiative, and second, creating the empowered conditions that allow for the initiative to happen. These two ideas mutually reinforce each other. A well-articulated and data-driven intent establishes a direction and conveys a clear image of the desired outcome. When this is done, it can be a powerful enable, particularly if clearly connected to the root cause and tied to accurate and transparent data – which also improves the speed in decision making, the completion of the work and the ability to generate measurable improvement.

Organizations are good at identifying and kicking off performance initiatives. And there are plenty of project management tools available in the marketplace to get those going. But they are typically managed in a variety of ways -- using a wide variety of tools, even within one organization. Monitoring and reporting on performance initiatives therefore becomes cumbersome and inefficient. Worse, it makes it difficult for senior leaders to assess whether the organization is making progress.  

I would propose that having the ability to seamlessly create project improvement initiatives directly from the core management workflow platform – where the data directly and transparently points to the improvements needed -  and then assign and track them to those responsible, will lead to more accountability throughout the organization. Bottom line, access to a sophisticated project management tool that is fully rooted in the core business data and enables you to kick start performance initiatives, drive change and accountability will accelerate execution and successfully reaching performance targets.

 As always, I look forward to questions and/or comments. Reach out to me at







Tags: Benchmarking, Analytics, Performance

Written by John Whittlesey

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