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A key performance indicator (KPI) is a management tool.  Key performance indicators are not goals. KPIs are measures used to gage the progress or advancement toward the organizations’ purpose; its mission, operational or department goals, and strategic goals. Key performance indicators, when not linked to the organizations purpose, can lead to perverse incentives and unintended consequences as a result of people not understanding the real purpose behind the measures or working to manipulate the specific measurements at the expense of the actual quality or value of their work.   In other words, Leadership must precede Management. Although in some instances organizations use qualitative indicators, the best, most precise KPIs are quantitative indicators that are both specific and measurable, they can be represented with a number, or a simple yes/no statement and therefore are not subject to human interpretation and disagreement. The most powerful KPIs are quantitative. Many organizations use process indicators that measure compliance with, or the efficiency, or effectiveness of a process. Process indicators can be very informative and powerful if used in conjunction with or in the context of outcome indicators that reflect the outcome or results. Measuring results is the only real gage of effectiveness, and informs users of their progress toward the organizations mission, departmental goals and strategic goals. Measuring only process goals may feel safer to some because people can be assured that “I am doing it right” but only outcome measures really inform users as to whether they are “getting the job done.” Any initiative to develop effective KPIs should always begin with outcome measures. There are 2 distinct types of outcome indicators: lagging indicators and leading indicators: Lagging indicators measure the ultimate success or failure of the goal post hoc, or after the conclusion of activities. Leading indicators measure the potential success or failure well in advance of the ultimate (lagging) outcome measure. In addition, input indicators that measure the amount of resources consumed during the generation of the outcome are critical in ensuring that an activity, process or project is sustainable. Once the categories of KPIs have been established, future targets must be declared. Targeted KPIs have a timeframe in the future. They can be 5 years, 1 year, quarterly, monthly, weekly… even hourly. In order for KPIs to be effective, one individual must promise to be accountable for ensuring that the future targeted KPI is achieved.

Disruptive forces are reshaping our economy. Responding quickly and effectively with innovative solutions is crucial for survival. Yet, implanting innovation into organizational DNA remains elusive. Many approaches have been attempted to foster innovation but fall short of resolving the innovation dilemma. To do so, requires; 1) an understanding of the root cause barriers to innovation and 2) a comprehensive approach to creating a culture that fosters innovation. If humans operated like computers with the simple logic of binary code, no barriers to innovation would exist. We are not rational beings however, we are emotional beings with the capacity for rational thought. Our emotional mind, which controls most of our perceptions, is a-rational. That is, it is without reason, as opposed to irrational, or unreasonable. At times this unconscious, arational response serves our purpose, at other times it’s counterproductive. Our emotional mind resists change, as it is always looking to past experiences to inform our present actions. The specific reasons each of us resists change are, of course, individualized, however most people share: 1) The fear of failure. 2) The fear of the unknown. 3) The fear that our creative idea will be rejected by others. 4) Our propensity to believe that we are “right” and any other viewpoint is “wrong". In order to engage in real innovation, one must become aware of the presence of these unconscious beliefs, suspend them, and consciously engage the executive center of the brain. Thinking is volitional as opposed to emotion which is involuntary and automatic. Therefore it requires a great deal of conscious effort and will. Thus, if we are to innovate, we must learn to govern our unconscious emotional reactions with our conscious thoughts. If you are looking to develop an innovation embracing culture you must nurture the following attributes: Team members have a conscious awareness of their unconscious emotional proclivities, and reactions. Team members are united by a consciously generated, emotionally compelling shared purpose that is superior to their individual agendas. This emotional force counteracts unconscious barriers. Personal accountability for measurable outcomes motivates the development of innovative processes, products and services. Team members do what they say they will do, even when barriers arise. Open communication is utilized, unimpeded by organizational rank. Confronting difficult issues is accepted as a necessary and integral part of the creative process, and is conducted in a manner that strengthens interpersonal relationships. We refer to such a culture as intrapreneurial. "An intrapreneur is a person who takes the direct responsibility and commensurate authority to organize and manage an enterprise, within a larger organization." The distinguishing characteristic essential to intrapreneurship is the voluntary taking of initiative and risks associated with generating the outcomes of the enterprise. Those organization’s that consciously, methodically develop an intrapreneurial culture will have the greatest opportunity to survive the forces of entropy in an ever changing world. #Intraprenuer #Entraprenuership #Business #accountability

Each of my clients in the health-care industry has their own specialty: behavioral health, primary care, etc. One commitment they all share? To improve the health and wellness of individuals. The ACA and the intended transformation of the health care system that it seeks to produce, provide a unique opportunity to fulfill on that mission. In order to take advantage of the opportunity, all health care organizations must make fundamental shifts in the services that are provided, the manner in which they are provided, and the way that that business is conducted and managed. These changes will necessitate a significant culture shift in our organizations. We all know health-care spending in the United States is sky high. We spend over $7,000 per person — by far the most of any country in the world. Yet, our “healthy life expectancy” ranks at the 32nd in the world at 79.9 years. Certainly, the health-care system is expensive, but that is not what is killing us. We live in a culture that promotes unhealthy behaviors: 32.2 % of men and 35.5% of women in our country are obese, and 12.3% of our people ages 20 – 79 have diabetes. Most health care experts agree that as much as 80% of health-care costs are spent as a result of five behavioral, lifestyle issues: poor diet, lack of exercise, substance abuse, smoking and stress. It is generally understood that our health care costs are so high because our lifestyles are so unhealthy. If we are to improve the health status of the population we serve, the root-cause lifestyle issues outlined above must be addressed. Until now, under the existing fee for service model — which is designed to treat the diseases caused by these unhealthy lifestyle factors — addressing the root causes has been financially unviable. The ACA seeks to change that fundamental discrepancy by shifting from a fee-for-service model to a pay-forperformance model. Performance will ultimately be measured based on the measurable health outcomes of the people served, in aggregate. This funding change will be made gradually over the next 10 years, and in order to operate in this new environment, several seismic shifts must be made: Shift from disease treatment to prevention and wellness. The service offering must be expanded to include services that support people in changing their behaviors and lifestyle factors. We must not only educate, but inspire them to want to make the changes. A whole new model of “change management” for individuals needs to be developed and implemented, and it must be done in time to experiment and ensure it produces results before the funding scheme changes. Shift from compliance to personal commitment. In the current system, people are responsible for complying with mandated protocols established by funders. If the organization is to educate and inspire people to want to change behaviors and adopt healthy habits, each employee must be driven by their personal commitment to improve their patients’ lives. The leadership of our organizations must create this environment of inspired, engaged employees throughout. Shift to personal responsibility/accountability for patient outcomes. If the organization is to be accountable for outcomes, that accountability must “drill down” and reside with each person within the organization. Everyone must be clear about how their work contributes to patient outcomes. There must be Key performance indicators in place for each employee to measure their contribution against an agreed upon standard. Shift to a Learning Organization. In order to create this new organization, leadership must be equipped with the necessary mindset, skills, and tools to become transformational leaders. We must develop: The ability to drive employee engagement with inspirational leadership. A culture of integrity; where we make promises for results (outcomes) and deliver (do what we say we will do). A culture of demand for personal growth. Each employee will need to learn new approaches and methods to accomplish their jobs. In order for them to make the change they must seek out, and be receptive to learning. They must “ask” for coaching and training. If organizations are successful in executing the shifts outlined above, the potential to impact the wellness of ever increasing numbers of people in a financially sustainable manner is great. If these shifts are not made successfully, the organization risks falling short of being able to improve the health and wellness of individuals’— and the organizations very survival may be threatened. #healthcare #wellbeing #prevention #budget