CORE Evidence-/based Regulation: A Regulatory Performance Measurement System

1. COREEvidence-/based Regulation: A Regulatory Performance Measurement System COREEvidence-/based Regulation: A Regulatory Performance Measurement System COREEvidence-/based Regulation: A Regulatory Performance Measurement System COREEvidence-/based Regulation: A Regulatory Performance Measurement System COREEvidence-/based Regulation: A Regulatory Performance Measurement System

2. C O R E ommitment to ngoing egulatory xcellence

3. ? Are there any differences in outcomes between using a nurse as an investigator vs. a non-nurse investigator?

4. ? What is your rate of completed investigations?

5. Good or Bad? It takes 10 days to process a license renewal

6. Finding the Evidence • "How are we doing?" • "Are we tracking the right measures?" • "How do we compare with others?" • "Are we making progress fast enough?" • "Are we using the best practices?"

7. Methodologies for Finding the Evidence Total Quality Management (TQM) Continuous Quality Improvement (CQI) Six Sigma Quality Control (QC) Performance Management System Management By Objectives (MBO) Balanced Scorecard

8. System of Performance Measurement

9. Performance Measurement • Why Measure Performance? The basic purpose of any measurement system is to provide feedback, relative to your goals, that increases your chances of achieving these goals efficiently and effectively. Measurement gains true value when used as the basis for timely decisions. • Measurement Is Not an Essence, but Improvement The purpose of measuring is not to know how your business is performing but to enable it to perform better. The ultimate aim of implementing a performance measurement system is to improve the performance of your organization. If you can get your performance measurement right, the data you generate will tell you where you are, how you are doing, and where you are going.

10. Listening to Mozart will increase infants IQ

11. Evidenced-based? Sample = 79 College Students Ideas need to be evaluated critically and examined for effectiveness

12. Steps To Achieving Regulatory Excellence Sharing findings Use evidence to make decisions. Actions How well have we done? (progress, accountability, quality) Analyze the Data Data collection techniques include screening records and reports, direct observation of behavior, face-to-face interviews, telephone interviews, and mail questionnaires Collect the Data Determine Measures/ Methods How will we measure our progress toward goal attainment? Identify data that is relevant, cost-effective to collect, and actionable What do we do? What are our resources? How are we organized? Identify Area of Study/Improvement Identify Roles/Mission

13. Goal To help State Boards of Nursing improve their management and service delivery

14. Why CORE? • What you don’t measure, doesn’t matter • What you don’t measure, you aren’t managing • What isn’t benchmarked, doesn’t improve

15. What is CORE? CORE is the process of being humble enough to admit that someone else is better at something, and wise enough to try to learn how to match and even surpass them at it.

16. CORE CORE is the continuous search for relevant best practices that lead to superior performance and stakeholder satisfaction, by measuring against and learning from other parts of the same organization or boards/companies recognized as leaders

17. Benchmarking = Innovation To Improve They Benchmarked Fast Changeover Racing Pit Crews HospitalAdmittance Hotel, Airline, Rental Car Shell Casing Manufacturing Lipstick Tube Manufacturing

18. CORE is a powerful tool for driving continual improvement. It delivers 3 critical inputs to improving quality and productivity: A comparison of board performance versus the "Best-in-Class” An understanding of how the “Best-in-Class” achieve superior performance levels Answers to how gaps can be closed between the organization and the “Best-in-Class”

19. CORE is… • A systematic and disciplined process of examining your own processes • Finding who is better or best: • In your own industry • Outside your industry • Domestic or foreign • Learning how they do it • Adapting it to your organization • Implementing it • Doing it continuously

20. CORE is Not • Going to meetings • Number crunching • Copying or catching up • Quick and easy • Scapegoating or blaming

22. How many hours of CE should be required? Hours Outcome

23. Proving Effects vs. Improving Results  Why did the chicken cross the road?” Measurement How fast did he go, how long did he take, and how many feathers did he lose along the way!”  Program Evaluation “Prove that the chicken got to the other side.” 

24. To help more families achieve the American Dream of homeownership.

26. The Basic CORE Process • Plan: Identify and understand your processes; identify benchmark process and indicator • Analyze: compare your organization to the benchmark indicator to identify performance gaps • Develop: develop goals and performance levels; develop clear action plan • Action: implement action plan • - Review: monitor results and adjust steps accordingly

27. The 7 main steps of CORE are: • Determining which functions to benchmark, • 2. Identifying the key performance variables to measure (critical success factors) for the business, • 3. Measuring your own business performance, • 4. Identifying reasons for performance differences, • 5. Identifying “BEST IN CLASS” in those fields, assessing and comparing their performance, • 6. Specifying programs and actions to close the gap, and • 7. Implementing and monitoring results.

28. Process Promising What makes the top performers perform at a higher level? Science Research Evidence Focus Groups Interviews Observation Best Practice

29. Pitfalls of Process: • Must prepare to perform benchmarking • 70% of all process improvement initiatives fail due to: lack of relevance, leadership, perseverance and planning. • - Typical blocks to success: no buy-in from management, no champion, wrong people involved, failure to consider stakeholders, too long or costly.

30. Benefits of Process • - Creates better understanding of current processes • and (potentially) improves those processes • A precise way to measure gaps in performance • Sets realistic performance goals and action plans • Brings innovative ideas and accelerates change • -Team building tool

31. Avoid these mistakes Mistake #1. Confusing CORE with participating in a survey. Mistake #2. Thinking there are pre-existing benchmarks" to be found. Mistake #3. Forgetting about service delivery and customer satisfaction. Mistake #4. The process is too large and complex to be manageable.

32. Avoid these mistakes Mistake #5. Confusing benchmarking with research. Mistake #6. Picking a topic that is too intangible and difficult to measure. Mistake #7. Not establishing the baseline. Mistake #8. Not researching benchmarking partners thoroughly.

34. Points to watch: • The most important issues may change with time.

36. Points to watch: • Don't try to benchmark too many things to begin with. Begin with the two or three highest priorities, then gradually add others as the first batch becomes part of your normal activities. • Don't waste time benchmarking things that are 'just nice to know'. • The more precisely you define what you want to measure, the more useful the information you gather will be.

37. More Precision • Q: Were you treated fairly? • OR Opportunity to make oral or written submissions to the board) The reasons for the board’s decisions are based on the facts of the case under consideration The person is told the reasons for the decision

39. Operational Excellence

40. 1. Functions to benchmark 2. Key performance variables 3. Measuring own performance 4. Identifying reasons for performance differences 5. Identifying “BEST IN CLASS” in those fields, assessing and comparing their performance, 6. Specifying programs and actions to close the gap 7. Implementing and monitoring results. Reason for the crushing defeat had to be found. A The "Continuous Improvement Team" was established The American Corporate Steering Committee immediately hired a consulting firm to do a study on the management structure. After some time and millions of dollars, the consulting firm concluded that too many people were steering and not enough were rowing. To prevent losing to the Japanese again, the American Team's management structure was totally reorganized to three Steering Directors, three Steering Managers, and two Steering Supervisors. Also a new performance system for the person rowing the boat was developed to give more incentive to work harder.Humiliated, the American corporation laid off the rower to "cut costs, sold all of the paddles, canceled all capital investments for new equipment, halted development of a new canoe, gave a "Superior Performance" award to the consulting firm, and distributed the money saved as bonuses to the senior executives.

41. Benefits of CORE • Provides objective measures • Sets higher goals • Convinces skeptics • Accelerates restructuring and change • Prevents reinventing the wheel • Makes implementation more likely • Improves productivity and quality

42. Common Problems • Identifying best processes to benchmark • Convincing process owners to benchmark- overcoming typical objections • Our situation is unique • Nonprofits are different • Finding out who’s good, better, best – and then contacting them • Facing confidentiality questions • Implementing based on the findings

43. The Search for Best Practices • Boards with high performance ratings are interviewed to discover • Practices common among boards with consistently high ratings • Differences from boards with lower ratings

44. Everyday Best Practice • Wash your hands after going to the bathroom • Use up-to-date, supported antivirus software • Exercise more and eat less

45. Practice

46. Best Practice

47. There are no best practices.

48. Better Practice

49. Best/Better Practices • Not always “best” – but “better,” “exemplary,” “successful,” “good,” • Solutions and approaches that achieve our objectives • What’s best in one setting is not necessarily best in another • Good methodology “triangulates” – uses various sources/judgments to arrive at a set of “best practices”

50. Guidelines • Demonstrated benefits • Creativity & Innovation • Transferability • Perishable/Timeliness • Credibility • Recognition • Process/Practice Focused