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BALANCED MEASURES STUDY
Dept. of VA (VHA)
Goalsharing Program
Veterans Integrated Service Network 2

SITE: Department of Veterans Affairs
VISN 2 – Upstate New York
DATE: May 13, 1999
TIME: 10:30 – 11:30 AM
PARTICIPANTS: Harry Ray, VISN 2 Buffalo, NY – Goalsharing Program Manager
NPR members: Betsy Currie, Amy Hertz, Curt Marshall

OVERVIEW:

Goalsharing is an incentive awards program set up at the 5 VA Medical Centers that comprise VISN 2 in Upstate NY. The purpose is to unify all employees in the accomplishment of the primary goals within the Network/VISN. It requires teamwork, pride in service, better communication and higher quality service. VISN 2 believes it is the first federal entity that has adopted "Goalsharing".

The goals established for FY99 are arrayed in a Balanced Scorecard/matrix approach: (see attachment 1). The three features of Goalsharing are Network focussed with medical center support; long-term in scope, so it avoids the "quick fix" mentality’ improvement oriented, emphasizing progress from good to better to best. Annual targets toward continuous improvements are a major part of the Goalsharing effort. The goals are:

• Cost per patient
• Increase in Veteran Patients above the National Average
• Cost Savings and Revenue Generating Improvement
• Increase MCCF (Medical Care Cost Funds) in
• Customer Service

Goalsharing is considered the 3^rd generation of Gainsharing because of its focus on outcomes, future oriented but based on a business model. It has a definite term (goals set for 1 year), but is based on continuous improvement and is inclusive of all employees.

Goalsharing was created as an outgrowth of VISN 2 receiving a low ranking in customer service on a national survey. The problem needed to "be fixed". The Goalsharing program provides a very clear sense of goals, involved all levels of employees in the development (thru a catch-ball process), and is "in the line of sight with front line employees".

In its second year of operation, the program has proved to be highly successful. It has improved performance in a declining environment (ongoing RIFs, $15 million shortfall in VISN budget). Customer Service scores have brought the VISN up to # 6 in the nation, compared to being in the bottom third. Last year, each employee in the VISN received on average a $100 cash incentive award coupled with a signed letter of appreciation from the Network Director that outlined the improvements within the VISN as a result of each employee’s involvement in the process.

ESTABLISHING A BALANCED SET OF MEASURES:

• Establishment of the measures was a grass roots effort, then bubbled up to management for finalizing the network goals determining the goals
• Measures are set for the Network and then for each of the 5 Medical Centers.

ACCOUNTABILITY:

• For FY99, the awards will be split 60% for Network and 40% for Medical Center. The top awards will be $150 for the Network accomplishments and $100 for the local contributions to the Network goals. The Network goals must reach a bronze level before the local incentives will be awarded in that goal category.
• Accountability is throughout the network. Resource sharing is used and intra-network tiger teams were formed to help the network reach the goals.

DATA COLLECTION AND REPORTING:

• Each VAMC provides a monthly status report in the form of a scoreboard or matrix

EVALUATING AND UTILIZING AND REPORTING TO CUSTOMERS AND STAKEHOLDERS:

• The Network Goalsharing Committee reviews the monthly reports, publishes the results and notifies employees via newsletters and electronic media. Goalsharing results are posted in areas around the medical center.
• Incentive awards are announced at the holiday party in December and are posted on Pay Period 1.

BEST PRACTICES:

• Developed a Goalsharing Pamphlet that defines each goal and identifies the impact of the goal. It also provides a template for developing an action plan in support of the goals
• Benchmarked with Corning Glass (who has been using Goalsharing for over 10 years)
• Legal authority under OPM to use the Incentive Awards Program (as a result of the Reinvention efforts)
• In compliance with VA’s Rewards & Recognition Handbook
• Personal letter from the Director at the end of the year

LESSONS LEARNED:

• Communicate/Publicity efforts are critical. They use logos (Olympic Themes based on the bronze, silver, and gold award levels), buttons, learning center for each goal (passport booklet gets stamped when they move from center/goal to the next
• All goal levels are stretch goals – wanted to push for performance improvement
• Action Learning (applied learning) is used to align efforts in support of the Goals throughout the year. Example: A CQI and Goalsharing Workshop resulted in $29K in savings from one class (Scissors Award) conducted for employee volunteers after hours. Creative Problem Solving and Goalsharing was conducted at the mid-point of the program this year to identify barriers and to establish action plans for mid-course corrections. We used The Osborn Parnes Creative Problem Solving process to turn ideas into innovative concepts and action plans.

ATTACHMENT 1
VA HEALTHCARE NETWORK
UPSTATE NEW YORK
FY99 GOALS