UMMHC Management System
Updated 7/28/2017
Standard Work:
UMass Memorial Health Care
Management System
Version 7
December2016
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Table of Contents
1. Strategic Planning Overview .................................................................................................... 3
1.1 Strategic Plan .................................................................................................................................3
1.2 System Strategic Plan......................................................................................................................4
1.3 Local Strategic Plans .......................................................................................................................4
2. Strategic Execution, Alignment and Performance Measurement .............................................. 5
2.1 Strategic Execution, Alignment and Performance Measurement (System) ........................................4
2.2 Strategic Execution, Alignment and Performance Measurement (Local) ...........................................5
2.3 Strategic Execution, Alignment and Performance Measurement (Business Unit)...............................5
2.4 Responsibilities ..............................................................................................................................7
2.5 At-Risk Compensation.....................................................................................................................7
3. Operating Budget .................................................................................................................... 7
4. Business Development and Capital Investment ........................................................................ 8
5. System Development ............................................................................................................... 9
6. Development Activities ............................................................................................................ 9
Appendix: Key Acronyms ........................................................................................................... 10
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1. Strategic Planning
1.1 Strategic Planning Overview
All strategic planning efforts at UMMHC will follow our three step strategic planning process: 1) understand your
external and internal environment (environmental scanning and organizational strengths and weaknesses
assessment), 2) understand your strategic options (opportunity and threat analysis) and 3) decide what
opportunities you will take advantage of and what threats you will mitigate (Figure 1).
Continuous Environmental
Scanning and Reporting
Strengths
Weaknesses
ERM Risk
Survey
Opportunities
Selected Opportunities
Plans developed and executed
on by assigned senior leader
1
2
3 etc
Threats
Selected Threats
Mitigation plans developed and
executed by ERM committee
1
2
3 etc
Our strategic planning process, especially environmental scanning, should not be thought of as a discrete event
but rather a continuous process. Every member of the CEO core team should constantly be looking for and
brining forward changes in the external or internal environment that may impact our decisions about which
opportunities we take advantage of and/or which threats we mitigate. Key areas to constantly monitoring
include but is not limited to: changes in the regulatory environment, changes in the business model of health
care, by service/region market share data, current and future gaps in our workforce, emerging potentially
disruptive technologies and a continuous assessment of who our competitors are and their actual or likely
responses to our strategic actions. Environmental scanning should also include an in depth assessment of our
current performance with a specific emphasis on the quality and cost of the products and services we deliver,
patient and family experience with our services, our caregivers experience with delivering care and the
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profitability of each of our services. The environmental scan should be a continuous process that occurs
throughout the year. For example, as soon as any new legislation or regulation is passed an assessment of its
potential impact should be presented to the CEO core team.
At least annually through mechanism described in section 1.2 the CEO core team members will assess all
potential opportunities and threats and make specific decisions about which opportunities we will take
advantage of and which threats we will mitigate. Decisions about which threats we mitigate will be informed by
a yearly risk survey conducted by our enterprise risk management committee (ERM) which will also assist in
development and execution of annual threat mitigation plans.
1.2 System Strategic Plan
To align the efforts of the partner organizations, UMMHC and UMMS will engage in a joint strategic planning
effort and publish a high-level joint Strategic Plan approximately every 5 years.
In addition UMMHC will develop an independent and confidential health system component of the joint
strategic plan (System Strategic Plan). The System strategic plan will be updated at least quarterly with the
intentional goal of linking smart strategic choices to our fluid environment. The updates will include an updated
environmental scan as well as an intentional and deliberate review of actions and choices. The System strategic
plan will be maintained by the CEO and COS and will be disseminated to the Board of Trustees and System
senior leaders at least every six months or after any major change.
This System strategic plan will be informed by:






Competitive insights derived from weekly Core Team meetings and presentations
Board meetings and board strategy sessions (10 per year)
An annual core team strategic planning retreat
Executive Leadership Group (ELG) meetings (6 per year)
Mini-strategy retreats with System senior leadership (2 per year)
Topic specific strategic deep dives with frontline caregivers
1.3 Local Strategic Plans
Core Executives, defined as Entity Presidents, Community Hospitals/Community Entities and Division
40/Corporate Departments (Marketing, Human Resources, Administrative Services (CAO) and Administrative
and Financial Services (EVP/CFO) will develop local strategic plans aligned with the System strategic plan.
The local strategic plans will be reviewed and approved by the Core Team annually and local boards as
applicable. At least twice per year the Core Team will visit each entity and major department to discuss the
degree of alignment between the System strategic plan and local strategic activities and local performance. This
discussion should follow the Lean "catch ball" process which includes bi-directional feedback, shared decision
making and identification of clear tactic ownership (who, what and when). Example of “catch ball” information
flows follows.
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Additionally the Community Hospitals will have an additional layer of planning designed to integrate and
promote standardized practices. These plans are informed through the environmental scan, the UMMHC
process outlined above as well as Community Hospital/Community Entity Boards.
“Catch Ball” Information Flows
Status of Goal Success
Information, Updates, Barriers, Metrics
Managers
Directors
Executives
Caregivers
Leads
Supervisors
Coordinators
System
CEO
Core
Executives
Goals Defined, Metrics, KBI’s
Mentor, Coach, Resources
2. Strategic Execution, Alignment and Performance Measurement
2.1 Strategic Execution and Performance Measurement (System)
The System strategic plan will be broken down into no more than 10 strategic projects (A3) each owned by a
member of the Core Team. The A3 project owner is responsible for assembling an inclusive project team. The
project team, under the leadership of the project owner, is responsible for developing and executing a detailed
level tactical plan for each strategic project covering multi-year goals focused on the goals of the 5 year joint
strategic plan. This step links the short term performance with the longer term strategy.
The CEO will meet with each A3 project owner monthly for "catch ball" and follow the A3 meeting standard
work as listed on the meeting agenda including a review of project objectives and project milestones. Part of
the “catch ball” process will include a discussion of whether or not the project milestones have been achieved.
Each A3 will be reviewed at least bi-monthly with the Core Team (may be part of ELG presentations). It is the
responsibility of each of the Core Team members to be familiar with the System strategic plan and the
objectives of each of the System A3 strategic projects.
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The Core Team will, on a yearly basis, select the ten most important metrics to be tracked and posted in the
upcoming year (True North Metrics). The True North Metrics (TNM) should be selected based on achieving the
organization's mission and vision through the execution of the current System strategic plan.
In addition to TNM at each level in the organization, leadership is highly encouraged to select and measure
performance on 1-3 Key Behavioral Indicators (KBI). As we seek to align, enable and improve going forward, our
KBI are defined and measure leadership behaviors that are often focused on*:
1. Person centeredness-be consistently person centered in word and deed.
2. Front line engagement-be a regular, authentic presence at the front line and a visible champion of
improvement.
3. Relentless focus-remain focused on the vision and strategy.
4. Transparency-require transparency about results, progress, aims, and defects.
5. Boundarilessness- encourage and practice systems thinking and collaborations across boundaries.
*IHI High Impact Leadership: Improve Care, Improve the Health of Populations and Reduce Costs, 2016
A visual management system (Level 1 VMS) will be maintained at corporate headquarters and includes a posted
overview of the System strategic plan, 10 System A3s,an idea board and 10 TNM.
2.2 Strategic Execution and Performance Measurement (Local)
Each local strategic plan will be broken down into no more than 6 strategic projects each owned by a member of
the local senior leadership team. This local project owner is responsible for assembling an inclusive project
team. The project team, under the leadership of the local project owner, is responsible for developing and
executing a detailed level tactical plan for each strategic project (A3). The local project owner will meet with
each A3 sponsor regularly for "catch ball" as described above.
The local senior leadership of each entity/department will, on a yearly basis, select the 8 most important metrics
to be tracked and posted in the upcoming year. The local TNM should be selected based on achieving the
organization's mission and vision and primarily under local control coupled with execution of the current System
strategic plan and primarily under local control.
A local visual management system for each entity/department (Level II VMS) will be maintained at each entity
and department and include a posted overview of the local and System strategic plan, 6 A3s and 8 TNM.
2.3 Strategic Execution Performance Measurement (Business Unit Level)
Each business unit/department will, after consultation with local leadership, select 1-2 projects to work on for
the year and 2-4 TNM to that are primarily under their control and aligned with the entity, department, or
System TNM.
The unit based visual management system (Level III VMS) will consist of the 1-2 projects and 2-4 TNM, a huddle
board where ideas can be posted and their execution tracked. (See standard work for idea/huddle boards via
CITC).
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2.4 Responsibilities
Team Member
COS
Responsibilities (all follow the monthly process for review and performance
above)
Maintains the overall Level I VMS including a System strategy overview poster
board, 10 TNM, applicable KBI, 10 System A3, and an idea board
Core Team Members
Act as project owners for System A3 projects. Reporting bi-monthly at Core Team
using Core Team standard work. Members are responsible for understanding each
objective of each System A3. Through consensus, Core Team members will indicate
the status of both execution and confidence levels through their designation of
red/yellow/green.
Local Leadership
(Entity Presidents,
Major Depts, Corp
VP)
Maintains Level II VMS in their area(s) that will include 8 TNM, applicable KBI, 6 A3
(one quality and one service improvement), and an idea board. Note: Entity
presidents and major department leaders are responsible to assure that each
department/unit in their scope of responsibility has fully functioning Level III VMS
Business
Unit/Department
Maintain a Level III VMS that includes an idea board, 2-4 TNM, 1-2 A3, applicable
KBI and a celebration board. Each facilitate a weekly huddle around the idea board
and follow the standard work for huddles and idea board management
2.5 At-Risk Compensation
All at-risk compensation for Core Team members will be tied to System or approved entity-level TNM. All at-risk
compensation for entity presidents and vice presidents will be tied to System or local level TNM. Both require
approval by the Compensation Committee of the UMMHC/UMMMC Board of Trustees. At-risk compensation for
site leadership in community hospitals will follow the standard practices as outlined by HR.
3. Operating Budget
At the June meeting of the system board of trustees the EVP/CFO and CEO will seek approval of an operating
margin target for the forthcoming fiscal year. Once approved the EVP/CFO will set the entity-level targets,
excluding MSF and Division 40 for each entity.
In July, entity presidents will generate a budget to be approved by the EVP/CFO. Should agreement not be
reached by the entity presidents and EVP/CFO on the targets, the final decision will be made by the CEO with
the understanding that the System budget target is a zero sum gain.
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The entity presidents and department leaders are held responsible for budget adherence as they execute their
site specific strategic and operating plans. Should results (actual or forecasted) fall short of planned results, the
variance processes will be initiated. Specifically, entity CFOs will submit a recovery plan to the EVP/CFO by the
last day of the month following the actual or projected variance. Plans not approved by the EVP/CFO will be
brought to the entity president (and System CAO for Community Hospitals) and if not resolved to the CEO for
final modification and approval.
4. Business Development and Capital Investment
New business opportunities will regularly surface as a result of continuous environmental screening. Once
identified the new opportunity will be assigned a concept champion by the chief business development officer.
Decisions to move forward with a new business opportunity will be made by the CEO core team after the
concept champion has moved the business opportunity through the new business opportunity illustrated
below.
Strategic funding of aligned capital investments will be prioritized at both the System and site levels. Patient
safety, required regulatory, mission critical, quality and patient satisfaction-related, infrastructure maintenance,
improved access, and cost reduction factors will be taken into consideration.
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5. System Development
The Core Team will decide which services should be housed in the parent corporation (System). Criteria for
services to be housed in the centralized System include but are not limited to:

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
Elements of efficiency
Economies of scale
Effectiveness
System risk mitigation
System brand identity
Services currently meeting criteria include: IT, HR, community primary care, internal audit, compliance, risk,
legal services, communications and marketing, ventures, and administrative services (Finance).
The cost of System services and System level strategic investments will be allocated out to the entities as
determined by the EVP/CFO.
Annually a survey of entity presidents and their leadership teams about the value delivered by corporate
services will be conducted by the system COS and the results reviewed by the CEO core team.
The CEO and Core Team will all work to identify change efforts as early possible and seek to uncover unforeseen
consequences. Agreed-upon change efforts will be scheduled with Core Team. Listing of such efforts and
scheduling of same will be maintained in the CEO conference room.
Entities are encouraged to purchase services from one another using the required service level agreements
defining costs, expectations and deliverables. Entities are required to have service level agreements for
purchased services with the Medical Group.
The Medical Group will be the preferred source from which the member hospitals, CHL and the Medical Center
purchase physician services. With CEO approval and measurable benefit in cost or quality, entities are allowed
to purchase such services from other sources.
The Community Medical Group (CMG) will build the community primary care base for the System as directed by
the CEO and Core Team. Any loss occurring in CMG for primary care will be covered by the System and taxed out
to entities as determined by the EVP/CFO.
CMG will hire and maintain specialists only at the request of entity presidents or the CEO. Any loss from
specialists in CMG will be taxed back to the requesting entity or split between entities as defined by the
EVP/CFO.
Affiliate hospital relations will be managed by the office of the CEO in conjunction with the Chief Physician
Executive and the Office of Affiliate Relations. All communications with affiliate hospitals involving the Medical
Center, member hospitals, academic departments, and CMG must go through the Office of Affiliate Relations.
6. Development Activities
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All members of the leadership are expected to identify and cultivate potential donors including grateful patients.
At the Medical Center/Medical Group the Chancellor and CEO with input from the Medical Center and Medical
Group president and with the assistance of the joint development office, will:
 Set the development priorities for the organizations
 Determine the specific requests to be made of potential donors
 and control the spending of donated funds
At the Community Hospitals and at Community Health Links each entity president with input from the CEO and
CAO will:
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Set the development priorities for their organization
Determine the specific requests to be made of potential donors
and control the spending of donated funds
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Appendix: Key Acronyms
UMMHC
UMMS
TNM
VMS
A3
KBI
Level I
Level II
Level III
System
Local
UMass Memorial Health Care
UMass Medical School
True North Metrics
Visual Management System
Lean PM tool
Key Behavior Indicator
CEO and Core Team
Core Executives (Division 40, Entity Presidents, those who attend Core meeting
All other departments/units
All of UMMHC
Division 40, Community Hospitals, and other Entities
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