Chapter 2 – Maturity Assessment PDF

## CHAPTER 2: MATURITY ASSESSMENT ### 2.1 INTRODUCTION This chapter contains the maturity assessment for Building a Daily Management System. In essence, it tells the story of the journey that must be travelled in each module to become a company that applies leading practice in terms of continuous improvement. ### 2.2 MATURITY LEVELS The term 'maturity level' is used to describe the level of performance in relation to best practice. There are five levels of a company's maturity, which can be described as follows: - Novice - Learning - Competent - Sophisticated - World-class ### LEVEL 1: NOVICE A novice company is 'just in business'. Its performance signifies the lowest possible score and it is characterised by no clear management system and a very traditional style of thinking. - People on all levels use phrases such as: 'We have no time for this' and 'this is the way it has always been done'. - Each set of operations begins with instructions given by a superior. - Despite the intent being otherwise, there is little evidence (in terms of the management systems in place) that managers care how well each team member performs the assigned tasks. - Team members sometimes receive contradictory instructions from their seniors and look for reasons to avoid challenging assignments, rather than striving to achieve them. - Front-line managers and team members have little idea of what is going on in other parts of the company. As a result, there is duplication of effort and misalignment. - There is a tendency among front-line team members to avoid highlighting problem areas and risks. This is due to being afraid of being blamed for what is wrong rather than being encouraged to participate in ensuring the root causes are understood, and in the identification and implementation of improvements. ### LEVEL 2: LEARNING During the learning phase, improvement efforts have started with a single focus or they have undertaken a range of unrelated initiatives. - People use phrases such as: 'We have never thought about it this way!' and, 'Why don't they try it and then we (managers) will support them?' - The organogram is clearly defined and the span of control is one person managing between 8 and 12 team members in a high routine work type environment. - Each person's range of responsibilities is clearly defined and employees have a positive attitude about following instructions. - People from every level feel free to contribute ideas. - The values of the company are clearly expressed. ### LEVEL 3: COMPETENT Reaching competence means that people have started to buy into the concepts and principles of world-class thinking pertaining to continuous improvement of the work environment. The principles are applied on a broad scale in the company and positive results are being achieved with significant improvements in productivity, cost, quality, delivery and client relations through energised people. The culture of the company has started to change and 'the way we do things around here' has improved for the better. - Top management objectives are clearly described at each level of the company. - The objectives are broken down into more specific objectives at each successive level. - Performance-driven teams are well established with visual management boards to show the specific objectives of each department, section and team. - Managers at each level monitor progress towards objectives. - Managers at each level follow a supportive coaching style when assisting and giving feedback to teams on a daily basis. ### LEVEL 4: SOPHISTICATED Sophistication is characterised by a style of working that reflects classical performance-driven teams. Management levels work cooperatively in setting objectives and coordinate their effort to achieve common goals. - Company-wide and cross-functional teamwork is established with departments and teams that assist each other spontaneously, when necessary. - Information flows freely and communication is transparent between different levels in the company. - End-to-end processes are managed and all modules of Mediclinic Continuous Improvement are implemented to a level 3.5. - Multi-level meetings are held to clarify company strategy and to review the past year's progress. The company strives to achieve at least 80% of the targets by the mid-term meeting. - **Team members**: - Consistently start continuous improvement activities - Apply root cause analysis to determine root causes of sub-optimal performance - Have a systems-based approach ### LEVEL 5: WORLD-CLASS A world-class company embraces change and is fully prepared to deal with changing conditions in the pursuit of its goals. The company is a true leader in its field and is highly flexible, reliable, innovative, productive and competitive. It is able to adapt to the external environment and continuously improves itself to meet ever changing client requirements, demands and expectations. - Executives and first-line managers feel that they have the same objectives and these objectives are spelled out as measurable targets. - First-line team members have a qualitative and quantitative understanding of the impact of their daily work and improvement thereof on the company's goals. - The company encourages top-down and bottom-up teamwork. - Each person is encouraged to improve his or her abilities, and the entire company has a cooperative 'all for one and one for all' spirit. - At least 80% of the goals are achieved by the mid-term multi-level meeting and 100% is achieved by the year-end multi-level meeting. - Continuous improvement activities extend beyond operations to include corporate office departments. ## MATURITY ASSESSMENT | LEVEL NO. | EVALUATION CRITERIA | Points 0 to 5 | |---|---|---| | 1 | The organisation's hierarchical structure is optimal, and it is clearly defined. 1.1 The structure supports the business objectives, e.g. key departments have managers and team leaders 1.2 Each team understands and has access to their own organogram 1.3 Roles and responsibilities are clearly defined between people and jobs (e.g. this would include clarity of roles for PN, EN, ENA and care worker in a nursing unit) 1.4 No one-on-one reporting structure is evident 1.5 There are not too many layers, and team sizes and span of control are appropriate. Span of control is 1 person manages 6-12 people | | | 2 | Everybody is clear about reporting relationships, and it is adhered to. 2.1 Each person follows the chain of command, e.g. not skipping a hierarchical level on the organogram 2.2 Top-down communication and prioritisation follows the hierarchical structure 2.3 Bottom-up reporting of progress, issues, performance and problems are performed appropriately 2.4 Ad-hoc reporting, e.g. project progress reviews, is done according to predetermined reporting relationships, e.g. project team 2.5 Everybody follows the reporting relationships | | | 2 | Goal alignment is effectively done. 3.1 Corporate goals and objectives are defined and available for the line manager 3.2 Company/departmental goals and objectives are broken down to each successive level, from senior manager, to manager, to team leader and to individuals 3.3 A balanced scorecard structure is used for the company/department goals and objectives 3.4 Each line manager has contracted with subordinates on a set of KPIs and has a weighted average percentage linked to the KPIs and performance standards per KPI defined based on the performance rating scale of 1-7 3.5 All employees in the company have a balanced scorecard performance contract as per 3.4 | | | 4 | Visual management is established in team meeting areas. 4.1 Teams set up a team meeting place with a visual scorecard of goals and objectives in balanced scorecard clusters. The clusters are defined as Client/Quality, Finance, Process and People 4.2 The visual graphs contain a KPI, target and actual performance against the target 4.3 The visual graphs contain a balanced mix of daily, weekly, monthly and yearly information 4.4 The visual management is kept updated daily by responsible persons 4.5 The visual management graphs contain an action plan on how to improve performance against KPI | | | 5 | Performance-driven teams are established as the foundation for performance reviews. 5.1 A team meeting (called 'huddle') is held to discuss team performance using the visual management graphs. This is done complementary to patient handovers 5.2 The meetings follow a set agenda and minutes are kept of important decisions 5.3 Chairing the meeting is rotated among team members 5.4 Team members are actively engaged in the meetings, can explain the graphs appropriately and improvement ideas have started from team members 5.5 At the start of every work day or shift, or during the work day, the team leader conducts a brief and focused meeting with the team | | | 6 | Managers show a real interest in individual employee performance and development. 6.1 Informal coaching is done in scheduled intervals through the start of Gemba walks 6.2 A supportive leadership style is demonstrated by following the formal performance management process 6.3 KPIs are contracted at least yearly through balanced scorecard KPIs 6.4 A skills gap analysis is performed for all employees 6.5 Personal development plans exist for all | | | 7 | A recognition culture is established. 7.1 Criteria for recognition is defined 7.2 Monthly formal recognition is applied in the team, e.g. worker of the month, and visually displayed 7.3 The applause system is used by team members, managers and team leaders under the 'people' applause system with a formal recognition system, e.g. department with most applauses logged 7.4 Management formally recognises the use of the applause system 7.5 Record is kept of monthly employee recognition awards and a formal yearly recognition ceremony is held based on these records | | | 8 | Performance-driven teams with visual management boards are well established in all departments. Action plans with responsible people and timelines to improve are in place. 8.1 Available action plans are appropriately linked to KPIs and are applied to the balanced scorecard clusters 8.2 All tasks on the action plan have specific people allocated to it and target dates for completion 8.3 Responsibility for managing the action plans are shared between team members 8.4 Progress review on the action plans are conducted and implemented 8.5 Action plans are derived from evidence of analysis of the performance trends | | | 9 | The structure to review goal achievement is well established. 9.1 A daily management system is established in the organisation, Level 1 (team meet daily at start of work, e.g. 07:00), Level 2 (department meets daily, e.g. 08:00) and Level 3 (hospital management meet daily, e.g. at 09:00) 9.2 Management meetings to manage KPI trends are established Level 1 (team, weekly), Level 2 (department, weekly, monthly) and Level 3 (hospital, monthly quarterly) meetings are conducted 9.3 Set agendas are followed and accurate minutes are kept, meetings start on time and meetings have a set time limit that is not exceeded 9.4 Past and current performance on KPIs, problem areas are reviewed and possible solutions are generated 9.5 Regular project progress reviews are conducted 9.6 Department KPI feedback and project reviews form the basis for performance management discussions | | | 10 | Managers regularly conduct balanced scorecard performance management discussions with subordinates. 10.1 A balanced scorecard review sheet, including goals and performance ratings per KPI, is used to review performance 10.2 Managers have a formal performance discussion at least twice per year with immediate subordinates 10.3 A balanced scorecard review sheet has weighted goals and performance ratings are done per predefined standards per KPI according to a rating scale of 1-7 10.4 Managers have a one-on-one discussion once a month with immediate subordinates 10.5 The balanced scorecard rating is linked to a performance bonus | | | 11 | Managers regularly conduct Gemba walks and coach for improvement. 11.1 A Gemba roster is used by team leaders and managers 11.2 The Gemba walks are scheduled with an intent, e.g. 5S, waste, complaints, process improvement, visual management, and make use of a Gemba template to make notes 11.3 Evidence is available of Gemba walks conducted according to the scheduled roster 11.4 Evidence is available that coaching was conducted during the Gemba walks 11.5 Evidence is available of actions drawn up after Gemba walks for the manager conducting the Gemba walks | | | 12 | Each department and team conducts their own continuous improvement maturity assessments. 12.1 The Mediclinic continuous improvement maturity assessments are available and known to all 12.2 A round-robin roster is used to schedule internal maturity assessments, i.e. Department A assesses Department C, etc. 12.3 At least once a quarter the internal assessments are conducted using the round-robin roster 12.4 The results of the maturity assessments are used to draw up actions for improvement 12.5 The results of the maturity assessments are used to recognise line managers| | | 13 | Leader standard work (LSW) is documented and performed. 13.1 Team leaders and managers have drawn up LSW to include all routine work activities in daily, weekly, monthly, six-monthly and yearly activities Examples are Kronos time sheets, staff planning, daily huddles, Gemba walks, project meetings and more. These would include continuous improvement activities as well 13.2 LSW is scheduled and tracked 13.3 Record is kept of improvement actions derived from LSW activities, e.g. Kronos improvements 13.4 While LSW is performed, coaching opportunities are identified and evidence is available that coaching was performed 13.5 LSW is performed actively on all management levels in the department | | | 14 | Service Level Agreements (SLAs) are established. 14.1 The department has drawn up some SLAs with other departments and/or some external suppliers. Measurable performance criteria have been included 14.2 These SLAs are measured and included in the balanced scorecard 14.3 Two times per year, meetings are conducted to discuss SLAs and performance between departments and action plans are derived from these meetings 14.4 SLAs are updated once a year based on the previous year's performance 14.5 The department has drawn up SLAs with all client departments and all external suppliers on-site | | | 15 | Regular multi-level meetings (MLMs) are held. 15.1 Senior management conduct MLMs to review the business and to plan improvement at least once (preferably two times) per year 15.2 MLMs communicate the strategic objectives and business goal achievement (KPI achievement) for the past year as well as the year ahead 15.3 A representative sample of team members attend the MLM 15.4 For preparation for the MLM, all managers draw up high-level action plans on how to achieve the business objectives 15.5 Managers present their action plans to achieve the company objectives at the MLM | | | 16 | People engagement is evident in ideas implementation. 16.1 People engagement is evident by the number of ideas for improvement that spontaneously surface in teams 16.2 Ideas and innovation are a result of updating of graphs by team members, chairing of huddle meetings, up-to-date completion of Gallop action plans, team participation in A3 projects, etc. 16.3 There is evidence of high motivation of team members, through the dynamic huddles, meaning the whole team frequently participates in huddle discussions of the visual graphs, daily operational issues, problems identified from longer-term trends, solutions and idea generation 16.4 A departmental idea management system is functioning whereby ideas are logged, evaluated, feedback given, and if approved, ideas are implemented 16.5 There is a formal company system, whereby big ideas that require money resources are elevated to management and evaluated for approval. Ideas are shared on a company platform for all to be informed | | | 17 | The Mediclinic continuous improvement programme has been extended to 100% affiliated companies and suppliers on-site. 17.1 All affiliated companies to be included in the CI process on-site, have been identified. These would include catering, coffee shop, cleaning, parking, security, etc. The focus is on affiliated companies and suppliers, which are essential in terms of the full value chain performance and patient experience on-site 17.2 A continuous improvement plan is drawn up with each affiliated company 17.3 Affiliated companies are trained in the CI modules 17.4 Affiliated companies draw up action plans for CI implementation in the affiliated companies 17.5 Affiliated companies are included in the two times-per-year external maturity assessments | | | 18 | At the mid-year and year-end, at least 80% of the stretched goals in the organisation's balanced scorecard goals are achieved. Goal achievement is measured for all performance areas and colour evaluation (green, yellow and red) is used to visualise gaps. Green > 80% of stretched target; yellow < 80% and red < 50%. The whole department implements all the CI modules trained so far to Level 3 maturity assessment Only continue if all items above have been completed | | | 19 | Balanced scorecard stretched goals are 100% accomplished by the year-end. Goals are 100% accomplished by the department across all balanced scorecard clusters | | | 20 | There is a focus on yearly plans and objectives, but there is also a clear understanding of the longer term. There is a thorough understanding of the longer- term vision, strategy and objectives by all employees, throughout the department and teams. Long-term plans include three- to five-year plans and goals to implement strategy. The company has developed characteristics to enable instant adjustments to external and market changes and can meet these adjusted goals immediately | | ### POINTS | | 0 | 1-15 | 16-30 | 31-50 | 51-65 | 66-75 | 76-85 | 86-95 | 96-100 | |---|---|---|---|---|---|---|---|---|---| | LEVEL | | 1.5 | 2 | 2.5 | 3 | 3.5 | 4 | 4.5 | 5 | ### 5 - Fully meets requirements - Does not meet the standard ## ACTIVITY 2 1. Describe in your own words what the purpose of the maturity assessment is? 2. How often should an internal maturity assessment be conducted? 3. How would you use the results of the maturity assessment? - Internal (i.e. within the team): - External (i.e. outside the team):

Chapter 2 – Maturity Assessment PDF

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