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2013 Performance Culture Assessment & Culture of Safety Survey Results Meeting and Discussion Guide with Action Steps for Leaders KentuckyOne is committed to sharing the results of the annual Performance Culture Assessment (PCA) and Culture of Safety surveys with employees. Please ensure that you share overall results for your facility and/or for your area with your employees by August 16, 2013. The meeting and discussion guide below will help you shape your conversation with your employees. It contains a sample meeting agenda, sample action steps that you can take after you meet with employees, and information on how to read the PCA results reports. Index for this Guide Meeting Guide Page 3 Things to Know about the PCA and Culture of Safety Survey Page 4 This Year’s KentuckyOne Results Page 5 Our Area’s Progress Page 6 Employees’ Discussion Page 7 Next Steps Page 9 Action Items for Leaders Page 9 Sample Meeting Agenda Page 10 How to Read Your Results Page 11 Appendix A: How to Build Engagement Page 14 Appendix B: Tips to Turn Survey Results into Employee Performance Page 18 Appendix C: Avoid Common Mistakes Page 21 Appendix D: Culture Advancement Planning Documentation Page 23

Meeting Guide Meeting Logistics:

Plan for an initial meeting with adequate time to share PCA and Culture of Safety survey

results and have an employee discussion. o Review the options in this guide for structuring your employee discussion. o A draft agenda has been included and may help with meeting structure.

Establish guidelines (ground rules) for a good discussion:

I want to share with you the results of the Performance Culture Assessment (PCA) survey and the Culture of Safety survey.

I’d like us to agree to some guidelines (ground rules) for a good discussion:

Participation is encouraged. Give your honest opinions while being supportive of your coworkers. Listen to others without being judgmental or defensive. Focus on what we can do together to improve. Ask questions as needed. Understand ideas may need to be prioritized as some may take more time to

implement than others.

Introduction:

As you know, all employees were asked to complete the PCA survey and the Culture of Safety survey. The survey is designed to help us create a workplace in which we can all thrive.

Participation in the PCA for all of KentuckyOne was 65%, and for all of CHI was 73%. Participation in the Culture of Safety survey for all of KentuckyOne was 39%.

Our final participation rate was ____% for the facility.

Our final participation rate was ___% for our department.

Thanks to all those who completed surveys.

I’ll share the PCA results and the Culture of Safety survey results for the facility and/or for our area. Then, we’ll have time to discuss what you think about the results and how we can improve. I’ll also talk about why the feedback you give me today will be helpful.

Things to know about the PCA:

The Performance Culture Assessment (PCA) is a survey designed to gain feedback from all employees on their workplace experiences. Because it serves as a guide for making improvements within KentuckyOne, taking the survey is an easy way for all of us to contribute towards cultivating a workplace in which our people thrive.

The PCA evaluates progress toward specific goals, which include achieving a high-performance workforce culture, high employee engagement and leadership effectiveness. Leaders are expected to achieve year-over-year improvement by identifying appropriate culture advancement plans, and implementing those plans.

Individual employee responses are confidential. No one from CHI or KentuckyOne is able to view survey responses from individual employees. All responses are managed by our partner in the survey, HealthStream Research.

We all own these results and have a responsibility to make this the best place to work possible.

You’ll be asked to complete the PCA again in spring 2014.

Things to know about the Culture of Safety survey:

The Culture of Safety survey gathers the opinion of employees on twelve domains concerning patient safety issues and error/event reporting.

The Culture of Safety survey will be administered again in 2015 (timeframe to be determined).

This year’s results:

Remind employees that while PCA and Culture of Safety scores are a useful way to measure progress toward our goals, even greater value lies in how the scores identify areas for improvement in the workplace and in leadership effectiveness. Acting on these opportunities helps make KentuckyOne a great place to work.

Among all KentuckyOne employees who completed the survey:

We were 62% positive on the leadership effectiveness index

We were 77.5% positive on the employee engagement index

We were 71.5% positive on the high performance culture index

We received 53.3% on overall patient safety culture

We received 65% on frequency of events reported

We received 53.5% on the overall perception of patient safety

Our Facility’s progress:

Share PCA and Culture of Safety survey results for your facility. Provide a copy of the report or summarize the results.

Things for the facility to celebrate:

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Things the facility should continue to focus on: (Year over year improvement is expected)

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Our area’s progress:

Share PCA and Culture of Safety survey results for your area. Provide a copy of the report or summarize the results.

Discuss the questions your group wants to improve and develop a culture advancement plan that includes the actions needed to increase next year’s scores.

Discuss survey questions as needed. For example, remind employees that “my manager” refers to their direct supervisor and “leadership” refers to their work group’s most senior leader.

Things for our area to celebrate:

Identify items for your area to celebrate. Ask your employees how they’d like to celebrate.

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________ Things for our area to continue to focus on:

Identify items for your area to celebrate. Ask your employees how they’d like to celebrate.

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Employee Discussion - Share your thoughts:

Below are options for facilitating this conversation. If you would like to talk through any of the suggestions for facilitating discussion, please contact your Human Resources representative.

1. Share the results with your group, give your employees questions to think about and come back the following week to discuss answers/solutions to these questions.

2. Divide your employees into small groups, discuss certain questions and report out potential solutions.

3. Discuss survey with your group and get real time feedback about solutions in a large group.

4. Write questions on a flipchart and then leave the room so your staff can talk about possible solutions. Identify a time limit and designate someone to record the answers before you leave the room. Ask the group to share the collective answers when you return. You may want to consider a neutral facilitator for this discussion.

Possible Discussion Questions, depending on the format you select to seek their input

Ask employees to share their overall thoughts about the PCA results. Are the results what they expected? What surprises them?

Choose specific questions to discuss. These could be questions that received low scores, questions identified as high priority on the Priority Analysis, and/or questions you and your employees can most easily take action on.

Here are some questions you can ask to get a discussion started based on the results for your area: (pick 2 or 3 for focus)

What are we doing well as a team, and what do we want to make sure we keep doing?

What needs to change to make us more effective as a team?

What’s getting in the way of _____? (feeling a sense of accomplishment; conflicts being managed; understanding how you contribute to KYOne)

What would be different if____? (we could consistently meet customer expectations; managers recognized good work; leadership modeled our values)

What would happen if ___? (leadership communicated a clear plan; leadership modeled our values; managers recognized good work)

What should we keep doing; start doing; and stop doing?

What happens to employees’ input:

Describe how your facility manages the wrap up of employee feedback from departmental meetings. Who it goes to and how it is managed: i.e. department leaders review with their employees and report up to the facility leader; facility leaders review feedback with their leader. KYOne PCA and Culture of Safety Survey process for 2013

KYOne as an organization will select employee focus groups to provide input on what to celebrate and what opportunities for improvement can be made. These groups will meet twice a year to provide input.

Each facility/entity will review their PCA and Culture of Safety results and determine what to celebrate and what opportunities for improvement can be made. These will be reviewed regularly at leadership meetings.

Each department leader will share feedback from their employees with their respective leaders and finalize a Culture Advancement Plan. These plans will be reviewed regularly at department meetings and reviewed with the leadership team in November and February.

Closing thoughts:

End on time.

Summarize the discussion.

Thank you for your participation.

Action Steps for Leaders Report employees’ input: Summarize employees’ input by August 16, 2013 and share it with your supervisor. Develop your goal(s) for improvement and a corresponding culture advancement plan: Based on your discussion with employees, develop a goal(s) for improvement and identify action steps that will lead to year-over-year improvement in your work.

o The action steps can be specific to you and your work group, and can include things that you will work on with other leaders within your group.

o See the attached SMART Goals document, which can also be found in the Leadership Development Community on Inside CHI: http://collab.catholichealth.net/gm/document-1.9.625508/Smart%20Goals.doc

What will happen in the future: As KYOne continues to refine the PCA process and the organizational talent management program, you will see more alignment of the PCA, leadership effectiveness review and the success management tools. These tools are designed to work together to help KYOne achieve its strategic plan.

Performance Culture Assessment and Culture of Safety Results Meeting Agenda

[Insert Date and Time] Materials: Have a copy of the PCA and Culture of Safety survey

results for each employee Reflection Establish Guidelines (Ground Rules) Introduction Results How Our Team Performed Team Discussion Next Steps Adjourn

How to read the PCA results report If your work group had at least 5 respondents, your report will be for your department. If your department had less than 5 respondents, your report will be for your facility.

Strength of correlation to “I am proud to be part of this organization”

Percentage of people in your area who scored a 5

Number of people in your area who answered the question

Percentage of people across CHI who scored a 5

Percentage of groups across CHI your area scored higher than

Percentage of people in your area who scored a 4 or 5

Themes show results for the groups of questions designed to measure leadership effectiveness, employee engagement and high-performance workforce culture.

Percentage of people in your area who scored a 4 or 5 for leadership effectiveness

Percentage of people in your area who scored a 4 or 5 for employee engagement

Percentage of people in your area who scored a 4 or 5 for high-performance workforce culture

The Priority Analysis is designed to identify the questions upon which improvement activities should be focused.

If you do not have a priority analysis (because your group is less than 30) you will still have instructions for how to determine items of focus on your PCA results.

High priority questions received the lowest scores from your employees and have the strongest relationship to the statement “I am proud to be a part of this organization”

Medium priority questions have room for improvement, but are less important than those identified as high priorities

Low priority questions either received high scores from your employees or have a weak relationship to the statement “I am proud to be a part of this organization”

Appendix A

How to Build Engagement [2]

1. Let Values Guide You o Show that you value team member ideas and opinions o Be a values-driven role model for the team to follow o Discuss the values, talk about what they mean, address violations, and practice

them

2. Communicate Your Commitment o Be conscious of non-verbal communication; body language and tone of voice o Be a good person reader; pay attention to jokes/cartoons at desks o Share information in a timely manner, share how team can apply the information,

and reinforce key points at all times o Provide timely responses to questions and concerns o Ask for others to participate in communication, listen carefully to their opinions,

and do not reprimand the messengers o Be “in the moment” with your employees; short instances of silence/think time is

encouraged

3. Focus on Relationships o Build consensus and support with team o Help them develop and provide periodic feedback on performance and behavior o Seek out and nurture committed relationships; capture “a few of their favorite

things” o Give them credit and spread out the high-profile assignments o Socialize; consider sponsoring family-inclusive events and activities

4. Concentrate on Change o Embrace the change yourself and develop a relationship with those initiating

change o Share what you know and involve them in planning; include when, how, and who

is affected o Connect the change back to the team and organization’s mission o Talk with employees about previous changes, equip them to succeed, and

observe behaviors of employees to ensure they are “on board” It may help to enlist a “change champion”

o Probe employees to discuss their obstacles and objections to change o Avoid using negative phrases. For example, “That will never work”… “The old

way was good enough”… etc. o Allow some time to accept the change

5. Create an Empowering Environment o Set clear expectations; reassure employees they are important and jobs come

with accountability to achieve desired results o Make them experts and create an “Expert Directory” of people and their skills o Develop and use your employees’ talents; discuss and document employees’

career aspirations

o Encourage pride in belonging to this organization o Encourage a culture of laughter within your team o Ask for employees to identify problems AND offer solutions o Look, listen for, and reinforce positive attitudes and behaviors o Delegate responsibility and authority; consider expanding purchasing authority o Give employees some autonomy on how to get their jobs done

6. Recognize What You Want More of o Understand the difference between recognition and reward; one is restricted by a

budget and one can be given at will o The entire team is responsible for recognizing any individual’s positive

contribution to organizational goals o Recognition is best received right after the desired behavior if you want that

behavior to be repeated o Say thank you to show appreciation… and do it sincerely o Make sure that you know your individuals’ preference for recognition and match it o Keep a log of the recognition to ensure you aren’t being biased. You can also

use a bulletin board for the team members to record their recognition efforts o Apply a personal touch; celebrate important dates such as birthdays, births,

weddings, etc.

7. Help Everyone Learn and Grow o Embrace and participate in learning efforts, showing that you value learning and

growth o Give ongoing feedback to support learning o Get them involved with a mentor o Mix it up, get creative with the vehicles in which you deliver the training o Continuously develop your team facilitated by creating personal development

plans that can include goals and ongoing training activities o Reinforce employees to apply what they learned to the job; help them learn from

mistakes and successes; teach individuals how to teach others “in-house”

8. Investigate and Keep Track of Engagement o Watch what the employees carry, does anything have the company logo

on it? o Feel the emotions of the team; listen to what people are saying; pay

attention to their behaviors at work o Check that job-skills appropriately fit for each member o Do they volunteer/ participate in optional events o Ask an outsider to observe and evaluate the team o Check for referrals. How many team members refer potential candidates

to open positions?

Characteristics of an Engaged Healthcare Employee [2, 7]

More productive More focused on their patients' care and treatment Safer, stay with their employers longer, and set a positive example of

engagement for others throughout the organization More profitable for a provider than disengaged employees Recommend the organization to others who are seeking employment Demonstrate a “can do” attitude instead of complacency Offer each other help without being asked Volunteer for special assignments and task forces Participate at meetings rather than merely attend them

Appendix B

Tips to Turn Survey Results into Increased Employee Performance [2, 6]

1. Provide Timely Feedback: Acknowledge you heard what employees said and confirm that their input was unfiltered and unedited. This will have a positive impact on future engagement.

2. Report the Results: Reward employees for their participation by sharing a summary of the results. This tells the employee that "we heard, and we care."

3. Take Time to “Digest” the Results: Ask yourself what was a surprise? What was expected? What was high or lower than you thought? Ask your employees and compare your answers.

4. Start With What is Working: Discuss the highest scores or the biggest improvements to understand what strategies worked well. Replicate the results in places in need of improvement.

5. Teach Engagement: The more employees and managers understand the relationship of engagement to business metrics, the more likely they are to see value in this process.

6. Go After What is Doable: Focus efforts on what you can fix or change. Identify problem areas that you and the team can actually control. This should also be true when developing a culture advancement plan.

7. Decide and Focus on One to Two Drivers. Make sure that the engagement driver(s) chosen have both a high opportunity for improvement and high impact on engagement.

8. Brainstorm Ideas: Ask the employees to provide potential solutions to the problems/concerns that were identified.

9. Culture Advancement Plan at All Levels: Every manager needs to meet with his or her direct reports to discuss the results for the team and set improvement goals. Employees need to be engaged in the culture advancement planning process to bring about change.

10. Take Action to the Top: Employees will be more likely to participate the next time if they see that the executive team used their feedback to make changes and improvements in the organization.

11. Communicate Actions: As an organization, be sure to let your employees know what you plan to do based on this year’s results and make sure to follow through on it. Communicate this throughout the year so that the process maintains momentum when the next survey begins.

12. Hold Managers Accountable: Require a team culture advancement plan from each manager and monitor progress by incorporating these plans into their yearly performance review goals.

Transition Initiatives

Execute Smooth Hand-Offs: If you move to a different department make sure to share all commitments made from the culture advancement plan by yourself and the team. Share all past reports all the way up to the most recent data and relay best practices.

Update Joining Members: Share the survey data and resulting culture advancement plan with incoming employees.

Appendix C

Avoid Common Mistakes [2, 8] Mistakes Often Made in Engagement Feedback

Make sure the chosen culture advancement plan is actionable

Best benchmark is knowing where you are and where you want to be

Transparency is key

Don’t look for the quick fix

Follow-up on results

Make this a continuous event

These Behaviors Hurt Engagement

Minimizing leader visibility and accessibility

Responding to questions with “I’ll get back to you”- but never follow up

Creating a “fuzzy” strategy and plan of action

Having unclear roles and responsibilities

Blaming and shaming people for mistakes

Focusing on WIFB (What’s In It For The Business)

Surveying people but taking no action on the feedback

Making people feel they can easily be replaced

Creating extended periods of working/life imbalance

Talking in codes and using acronyms that many do not understand

Brushing off business losses and mistakes

Criticizing and degrading your competitors

Conducing long death by PowerPoint meetings

Cutting corners and undercutting people

Micro-managing

Continuing to have employees perform menial tasks after the special cost-cutting

efforts

Compromising standards for health and safety

Appendix D

CULTURE ADVANCEMENT PLAN Goal

1. ACTIVITIES 2. TIMELINE 3. RESOURCES 4. BARRIERS 5. EXPECTED OUTCOMES

SELECT ONE GOAL PER FACILITY AND UP TO THREE GOALS PER DEPARTMENT. INCLUDE BOTH PCA AND SAFETY ISSUES WHEN DETERMINING GOALS.

THIS IS HOW PROGRESS WILL BE MEASURED:

HOW WILL THE BARRIERS BE ADDRESSED?

FOLLOW-UP MEETING SCHEDULED FOR: November__ 2013 and February __ 2014

Implement the Culture Advancement Plan To stay focused and motivated, monitor progress and seek support from all! Getting everyone involved in the developmental efforts will enhance the commitment to the goal. It is also an effective way to engage all to make the culture advancement plan work.

Keep the plan visible by communicating often with the entire organization

Share with all how they can help the facility/region succeed

Ask about progress to continuously monitor

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