BRADFORD: There is a demonstrable ROI from this in healthcare. Healthcare has been remiss in [not] requiring demonstrated ROI of the input into human capital. As you're able to demonstrate that, you can demonstrate the cost of a poor successor or the cost of turning over a great performer. We created what we call learning group fellowships, and we take these learning groups and we put them to work on really tough problems. It's cross-functional and multi-level—there's everything from a manager to an executive VP in these learning groups. Through them, we get some of the best innovations, some of the best ideas, and some of the largest return on small investments that you can imagine.
HEALTHLEADERS: It's a different kind of investment, isn't it? You're investing in people and it takes them a while to internalize some of the things that you're teaching.
BRADFORD: Our senior leadership team now clamors to get their ideas and projects put before these learning groups because they've seen the results that have been yielded through their work. They spend six to nine months on this. They do large presentations back to the senior group and to each other. We had one working on medication safety, for example. We all know what a big issue that is in our industry. Not only was there a huge ROI, but we think we saved lives. We've been doing this for almost four years and we've only lost one person out of about 120 people that have participated in the program.
SMITH: We believe experiential learning is important and a worthy investment. Another key to retention and engagement is knowing that leadership cares about me as an individual and wants to develop me. That can have immediate and long-term benefits. So a change in policy to focus more on succession planning and leadership development within the institution, especially when it's performed internally, will generate an immediate spike in engagement.
DEBORD: We created probably about 50 performance improvement teams, maybe more, where we took the director of a function, say the lab, to look at lab within our region. What contracts do we have? What processes can we change? We found a lot of success in that. And one of the things we found as we were doing it is that some people needed some more training. Healthcare reform is coming and it's going to be even more critical for all of us to be as efficient as we can, so we'll have a lot more of those teams over time.
ZAMAN: We've done similar types of things. We call them RPI initiatives where we've taken some of our strong leaders as well as frontline staff and put them through a fairly strenuous educational program to help them understand the dynamics of how to do an assessment, create an action plan based on the data, and then implement and see it come to fruition. We're working collaboratively with the learning organizations in our community. For example, we've started to retool some of the basic core competencies at the nursing schools. Practically, that took the form of a partnership in that last year they're in school. There is a tremendous amount of orientation for people who we've already tapped—who we know are coming into our system. What it's also done is create a yearlong residency program, which we're now expanding outside of nursing into allied fields, so that short-term immediate need that we had has now turned into a long-term investment and it's paying us top dollars on the type of talent that we're getting in. Our turnover rate is less than 8%, which is huge in today's world. Our vacancy rate is at less than 4% right now. So we're in a good position to fill hard-to-fill positions that are the most critical to us.
HEALTHLEADERS: Have any of you reached a place where succession planning is part of the performance appraisal?
BRADFORD: We track metrics on performance, but every director in the organization has a goal for that and we have a performance dashboard that has many metrics. So by virtue of that, they have to participate actively in the succession-planning process, and it's become interesting to watch the commitment and behavior. It's the old saying: What you measure gets managed.
DEBORD: We don't have anything specific in our actual performance evaluations; however, we always recommend and teach that, as part of the evaluation process, our leaders discuss the career goals and plans of the individuals who we're developing. Succession planning and leadership development were key components of our last three-year strategic plan whereby each entity had to create an entity-specific business plan to help meet the objectives of the system plan. And a lot of those things from those business plans were then incorporated into the leaders' evaluation tools as far as action items that they had to be working on to help achieve goals.
HEALTHLEADERS: Many of you have mentioned mentoring. Have you ever had indications from senior leaders that they are insecure about mentoring younger groups for fear of training their replacements?
ZAMAN: People were very suspicious when we moved to everybody having an assessment. At that point we were going through affirmative action initiatives. One of the first jobs I had was to re-create our affirmative action plan. Part of it was how we looked at people who were getting promoted and how we developed them. We still have that age-old problem where a manager has a department with two or three top performers. They don't want them to go anywhere. They really depend on them to help their department run. We're getting better about it. The yearlong leadership essentials program that everyone has to engage in now has been a key culture change for us. Over the next couple of years as we continue to evolve and focus on change, we'll become very good at it because we are beginning to take a little pride in our internal ability to develop leaders.
HEALTHLEADERS: How do you go about matching people with mentors?
BRADFORD: We have a profile on everyone, and it's not only that the potential mentor is strong in the areas where we have deficiencies with the potential person to be mentored; it also can be how they translate that into actionable steps in success, whether they've been trained, and whether they actually want to mentor.
DEBORD: It's critical that you have somebody who's really willing to spend the time because you don't want them forced into a situation. It's also critical that you have somebody who's aligned with the values of the organization and who truly is passionate about that.
ZAMAN: We take them through a formal mentoring program. The criteria are their willingness to commit the time and whether they really have the time. Recently we've changed things a little so that a person can have up to two mentors. So in our Emerging Leader program, you could have a mentor coach who looks at it from an organizational perspective, has that type of a background, and really is invested in where we are strategically. And then we have the person within the department who really is a mentor and not a direct report.