Hospice & Staff Retention: Part 5, Performance

“Efficiency is doing things right. Effectiveness is doing the right things.” — Peter Drucker

Reducing turnover and retaining your hospice staff is a critical element to your agency’s success. Reducing turnover impacts your agency’s ability to deliver consistent care with familiar faces which affects patients, referrals, CHAPS reporting, business operations, and much more. Performance, having well developed processes that create operational excellence and help in achieving goals and creating innovation is one of the puzzle pieces in developing a workplace where team members are committed and motivated.

7 Elements of Staff Retention

1. Alignment: Company’s purpose or mission, the company values & direction. Click here to read Part 1. Alignment
2. Coaching: Company leadership care about employee concerns, provide assistance as needed, and encourage development. Click here to read Part 2. Coaching
3. Connection: Employees feel appreciated, their work is meaningful maximizing their potential and information is transparent.
4. Engagement: Team members feel the work is challenging & productive and that they want to do their best. Click here to read Part 3, Connection & Engagement
5. Leadership: Team members feel confidence in their company’s leadership & management. Click here to read Part 4, Leadership
6. Performance: Well developed processes that are flexible, achieving goals, innovation, leadership that is involved in operations.
7. The Basics: Pay, benefits, training, expectations. “People work for money but go the extra mile for recognition, praise and rewards.” – Dale Carnegie

Performance Goals

Developing clear goals for performance can be a confusing rabbit-hole of options. It’s important to cut through all the possibilities to determine not just if something is a good idea or good goal, but if it’s the right good idea and right good goal for your agency.

• Increased Productivity: Hospice is a service-based industry. Every hospice agency has multiple value streams that are organized into growing your census and driving hospice care. These streams can be broken into three buckets:

1. Generating Referrals: Branding & marketing services & products, sales team, processing referrals.
2. Patient Care: The work of delivering & documenting hospice care by your clinical team – from admission through bereavement
3. Third-party products & services: Meds, DME, Other supplies, hardware & software partners

The common goal of performance is to increase the effectiveness and productivity of these value streams within your agency. The benefits of an enhanced performance strategy is that by honing in on any given value stream your agency will grow with improved staff efficiency and higher service levels through streamlined and flexible processes.

• Improved Service: Both as a result of increased productivity and as a goal in it’s own right, improving the quality of your agency’s services can improve staff dedication & motivation as well as impacting referrals, CHAPS reporting, & more. Especially in the highly regulated hospice industry where agency’s are certified and audited by government agencies and accreditation services, there can be significant consequences for sub-par services – for both patient-care and as it relates to government oversight.  A focus on service quality is one that should be ongoing working towards continuous improvement.

The Workback Method to Achieve Performance Goals

“We have a strategic plan. It’s called doing things.” —  Herb Kelleher 

The workback method enables you to examine any given value stream within one of the three buckets of your performance goals in a clear articulate manner to achieve greater performance. Once your clear on where you are, start at the end – where do you want to be. When you know where you want to be workback from there what needs to happen 3 months before, 6 months before, a year before and so on  until you reach where you are today to clearly lay out the steps, and missteps, on the way to achieving your goal.

1. List and details the existing process & current results of a value stream
2. Detail what the desired outcome looks like – where do you want to be (by a certain date 1 year, 3 years, 5 years)
3. Identify the difference between where you are and where you want to be
4. Work backwards by date (by year, by quarters) and list the milestones at each stage which will lead to your desired outcome
5. What needs to happen. Develop the pieces of the process that needs to happen as it relates to that milestone working backwards to the current date & process.

A Workback Plan to Increase Referrals

“Once you have mastered time, you will understand how true it is that most people overestimate what they can accomplish in a year – and underestimate what they can achieve in a decade!” — Tony Robbins

Examining referrals as one value stream which can have performance improved, the 1st step in the assessment is understanding where you are now & your current results. Start by listing your assets and achievements:

1. List and details the existing process & current results of a value stream:

• What is your brand and does it align with your mission & values?
• What marketing collaterals do your marketers have to work with?
• What is the monthly average of referrals for each sales team member?
• Where do those referrals come from (by type of organization, role of referrer within org, geographic breakdown)?
• What is the sales process for different account types?
• What prevents more referrals now?

2. Detail what the desired outcome looks like by a certain date: 

By listing your current assets you may find that your goal isn’t just ‘more referrals.’ Get granular with your goals and list them with as much specificity and detail as you can. Get the information down and edit later as needed.

Your goal may include a specific number for average referrals but it may also be to have new referrals from previously untapped sources. or more of a specific type of referral. Or more referrals from certain types of facilities.

3. Identify the difference between where you are and where you want to be

Show your math! Make sure the numbers you want your sales team members to hit is reasonable & achievable and based on a thoughtful assessment. There is a line between motivation employees or simply treating them like machines with targets created on a whim. Creating goals that are not tethered to a plan is a surefire way to disengage your team. Even worse, holding people accountable for not meeting unrealistic expectations when the numbers were simply pulled out of a hat can create negative feelings that can be toxic to a team environment.

Unreasonable expectations are a fast track to creating unmotivated and frustrated employees. If you’re going to create a quota and a work-back plan, show them where the numbers come from and how & why they’re achievable.

4. Work backwards by date (by year, by quarters) and list the milestones at each stage which will lead to your (achievable) desired outcome

Your assessment and asset list comes heavily into play here and in point 5. If at the end of one year the goal is for a salesperson in your agency to average about 50% more referrals per month than today what would that look like. If the salesperson is averaging 20 referrals a month they would need to have 30 in the 12th month of the plan, 26 ending the quarter before that, 22-24 the quarter before that and 20-22 the quarter before that.

Is that growth achievable? It may be appropriate for a salesperson with a core competency in hospitals and cancer clinics, but perhaps not for your salesperson working on small Medicaid facilities over a larger geographic region.

5. What needs to happen. Develop the pieces of the process that needs to happen as it relates to that milestone working backwards to the current date & process. 

This element of the workback plan is where processes are created that develop into Performance: Well developed processes that are flexible, achieving goals, innovation, leadership that is involved in operations.

Coupled with the list of assets and your assessment, understanding roadblocks, what has prevented this goal from already being achieved, is critically important. These stumbling blocks may require leadership and innovation in terms of allocating resources, aligning branding & marketing with your mission and values, developing sales coaching and other development skills and more.

To achieve an average of 30 referrals a month at the end of the next 12 months, does your salesperson need more time i.e.: fewer non-sales related job functions? Specific marketing materials to speak to their referral types? More budgetary decision making freedom to develop events? Closer alignment with the clinical team to create additional care service offerings? An improved on-call service? A streamlined admission process? Easier access to patient oversight and reports?

A workback plan for any one value stream is a jumping off point that while intended to improve the performance and develop achievable goals in the particular track, can have wide ranging impact across your agency.

When your team members see that leadership is focused on developing well-developed and thoughtful processes that is also based on their needs and knowledge, and that these plans are designed to meet achievable goals and are flexible and innovative with involved leadership, the results will flow directly to performance. In many cases these performance objectives are measurable, such as average referral numbers, CHAPS scores, purchasing efficiencies, and other strategic objectives. However, the impact of performance as a key element appears in harder to measure, but deeply impactful areas such as the dedication and motivation they inspire in your team members. All these elements flow from your commitment to your mission and values; to quote Seth Godin, “You don’t need a new plan for next year. You need a commitment.”

The EMR and billing tools your team uses needs to be powerful, flexible and aligned with delivering operational excellence for your team.

Book your demo & find out more about the Hospice EMR built from the ground up for teams like yours!

Check Out More Hospice Tools Insights!   Book Your Hospice Tools Demo Today!