Most hospices get an additional 5% of NPR profit after doing a Model Workshop or doing the Model very well based on the workbooks and other materials. However, some hospices have attained 30%! Of course, the Model is more than money as it impacts how each visit and phone interaction is done. But the money results are so easy to quantify! Obviously, part of a dramatic financial improvement is dependent upon “where” a hospice is positioned before its great transition. If things are bad, it is easier to score big quickly. But if a hospice can go from average at a 5% margin to 15%…that is impressive. What explains this great variance?
Let’s revisit the factors of profitability in the MVI world.
The Main Factors of Profitability
1. The CEO
3. Monthly Benchmarking
4. Your Model
6. The CFO
7. Compensation Systems
Most of the time, we can link the lack of phenomenal results to the lack of Accountability. Stated another way, a hospice will only be as profitable as the effectiveness of its accountability system. During the workshop, especially the workshops as of the last year, standards are addressed with great force with very precise financial standards being established before I leave. Behavior standards take a bit more time and need to be seriously contemplated by a CEO. However, even these are becoming quite easy to standardize during the workshop.
If your hospice is not getting great results from its Model implementation, I would highly encourage that you refer back to the November 2013 FlashPage where we hit Accountability with force. (Click here to read it on-line.) The executive summary here is that if you base most of your accountability on the personal inspection of work or the supervision of managers, you have an inherently WEAK accountability system. Structures that are not dependent upon the presence or energy levels of the managers are needed.
Accountability is the difference between making things real in organizations or efforts being a joke or a waste. It kills me when I do a workshop and a team member says “Nothing will happen here…we have weak leaders.” Weak translates into non-enforcement of standards, a lack of holding people accountable. Accountability involves standing for something and not letting anyone do anything that is outside of your standards. This involves relatively immediate rewards and consequences based on the standards. Most people have no problem giving rewards, but don’t like to address non-standard performance. There must be some pain involved with ANY performance or behavior that does not meet your hospice’s standards. My favorite ways to beef up accountability involve the paycheck and the public posting of performance. I am not afraid to whack a person’s pay or shame a person if he or she chooses to deviate from standards. Failure to address non-standard performance or behavior makes standards meaningless. Standards are the basis of all People Development and Accountability. In fact, there can be no meaningful discussion of accountability without clear standards. The structures of accountability save you every time! Don’t depend solely on managers to hold people accountable. Do it structurally!
Your objective friend,