IMPORTANCE OF GOALS SETTING IN ORGANIZATION Goal setting is a skill that is so often overlooked by home business owners. Unfortunately, it is a vitally important skill when beginning your home business. If you don't have goals then you really have no idea where your business is going. But that isn't even the main reason you need goals. Goal setting is one of the most important skills you can cultivate as a home business owner. Make a list of long and short-term goals. Write the list down and make 12 copies. Then, make a list of the things you need to be doing in your business in order to achieve these goals. Be specific and be aggressive when setting your goals and determining what action is required on your part in order to achieve these goals. Now, address 12 envelopes to yourself and set these in your files just as bills to be paid each month. Open these each month and measure how much you have achieved the last month and where you see room for improvement. If you aren't making the progress you should be, consider what should be changed in order to initiate the changes you need to make. Goal Setting Guidelines 1. Your goal must be conceivable. You must be able to imagine, conceptualize and understand the goal or desired result. Top athletes practice visualizing step- by-step actual success in their sports competition. By visualizing your success in great detail, you are conditioning your mind and preparing yourself to achieve your desired success. 2. Make your goal believable. Your goal should be consistent with your personal values system, and you must believe you can reach the goal. It is critically important that you believe in yourself. You must see yourself with the goal in hand. 3. Your goal must be achievable. You must have the mental and physical capacity to reach the goal. It would, however, be important for your goal to cause you to stretch beyond normal self-imposed limits. You will find a goal that causes you to stretch and grow will be the goal that gives you the most satisfaction. Don't be afraid to challenge yourself to go beyond old limits! 4. Make your goal measurable. Deciding to do better than last year or to be happy gives you no standard by which you can measure progress. Be sure to relate your goal to quantity, percentage increases, dollar volume, time or distance. This will allow you to measure your progress. 5. Your goal should be controllable. This means you must be able to achieve the goal yourself, or gain the willing cooperation of others to reach the goal. This emphasizes the importance of building team spirit. If you can have no control over the outcome of an event, it's not realistic to set a goal in this area. It would be like gambling in Las Vegas. Without a proven system that beats the odds, lack of control will lead to frustration - and cost you a lot of money! 6. be sure you have singleness of purpose. Make sure your goal is not in conflict with other areas of your life. For instance, if you decide to travel extensively in your business or work 80 to 90 hours per week, this will interfere with your personal or family relationships. The travel and long hours could lead to poor health or family discord. Some goals become mutually exclusive and create conflict with other goals. To be a competitive tri-athlete you must train for four to six or more hours daily. That leaves little time from career and family. You must then decide what is most important. Be sure to set priorities so you can focus on what is truly important; not just urgent. Too often we spend our time putting out brush fires. We handle daily crises instead of dealing with top-priority activities, which will contribute to reaching the goal. Personally Paying the Price Why should you write down your goal? A written goal represents a real commitment. Without a commitment, a goal is only a dream. A dream is something we would like to have happen, but are unwilling to pay the price to make it happen. Any worthwhile goal has its price! That price may be confronting a personal fear or investing a certain amount of time and effort. Whatever the goal is, if it's worthwhile, you can bet there will be a price for achieving it. One way to motivate yourself to pay the price is to create a reward for reaching your goal. That reward can be a vacation or time off work, a nice dinner, a bottle of wine or time spent with friends. If you select a reward, you can focus on the reward rather than fear of failure in striving for the goal. If reaching the goal requires performing some tedious or boring tasks, having a reward in mind will give you something positive to focus on. Think about the fun just around the bend. Fear versus Reward Motivation A few years ago I attended a National Speakers Association annual convention in San Francisco. In addition to the many career-related activities, they offered a 10-kilometer run for NSA members. It was part of a total fitness program of aerobics, jogging and calisthenics available to us. I signed up for the competitive run, which went through the streets of San Francisco early on a Sunday morning. Since I'd been both running and bicycling, I considered myself to be in excellent physical shape. I really want to win at anything I do, and I'm quite a determined competitor. As the start of the race approached, I began to scope out the competition. As each runner entered the starting area, I'd say to myself: "He's too heavy; he can't be very fast," or "She looks like the woman who beat me in the Milwaukee race." As I compared myself to others, I made judgments about who would be the toughest competition during the race. I forgot that my former manager in Oakland, California had said I should never compare myself to others. He said that I would always end up with an inflated ego or be very discouraged! The starting time quickly approached. I didn't know my way around the city. I'd have to follow other people or be guided by the race committee. Because this was the first event conducted by the race committee, there would probably be a few glitches. I scanned the crowd once again for the fastest looking runner. My eyes fixed on the most obvious leader. He was a young, broad-shouldered, muscular man. Dressed in running clothes that gave him an experienced look, he also wore a gray plastic inflatable helmet with huge horns. He looked like Mercury, the fleet-footed runner. We crowded to the starting line. I felt my heart pound. My nerves were keen; my muscles twitched. The starter's gun went off, and 50 runners bolted down the street, leaving the hotel behind. Just as I had imagined, Mercury Man sprinted to the front of the pack. He was setting a blistering pace - for me, at least! I decided to fall in behind him and let him set the pace for the event. Five or six of us started to pull away from the rest of the runners. It was clear that I was with the die-hard runners. I thought about my motivations. Why was I in this race? Could I win? What would it mean to me if I did? The answers came back quickly. This race was no different for me than most events in my life. I really like to win; I really hate to lose! I was going to tough it out, however tough the competition became. No matter what the cost. My pride was at stake. Middle-age or not, I would compete like a true athlete. I would give my absolute best. I refused to quit despite the pain and shortness of breath. I said affirmations over and over to block out thoughts of failure. Fear and Failure Some game plan. I didn't know the race route. I hadn't run for several weeks. I was following a guy wearing inflatable horns. My heart was pounding so hard, I thought it would come right out of my chest. My legs and lungs were burning. I was pushing myself harder than I could remember. By now, Mercury Man had reached the halfway point, and he was headed back to the finish line. Someone was calling out times as we passed the 5 kilometer (3.1 mile) mark. I heard him call "19.10," as I passed. That was about a minute and one-half faster than I had ever run the same distance! No wonder I felt so tired and sore. The fatigue began to take its toll. I began to think about the other runners. I was in second place. Could I catch Mercury Man? Could I possibly hold my lead over the other runners? I became paranoid. Footsteps. Footsteps. I kept hearing footsteps. They sounded closer and closer. I just knew the other runners were gaining on me. Instead of focusing on the lead runner (about 100 yards ahead of me), I worried about the runners behind me. I wanted to stay out in front, but I had already taken myself beyond my limits of endurance. My legs were burning incessantly now. My lungs begged me to slow down, but no, I had to keep pushing on. The fear of being caught became an obsession. I couldn't put the other runners out of my mind. I wanted to turn around to look at them, but I was afraid of losing my footing and falling on the uneven Embarcadero. Could I hold this pace and perhaps even challenge Mercury Man? Was he tiring, too? Would I be able to catch him? What about the others? Would they work as a group to catch me, then leave me behind as a fallen foe? Footsteps. Footsteps. They sounded closer. I finally forced myself to change my pace enough to glance backwards over my shoulder. I was at least 100 yards ahead of the pursuit group. Could I hold this pace? As I turned to face forward again, Mercury Man had disappeared! He had made a turn following the unmarked route. I ran straight ahead, fearful that he had simply sprinted beyond my sight. I continued to run, by now numb to the pain. I was determined to finish this race at the best pace of my life. But, after about five more minutes, I knew that I was lost! I spent the next 30 minutes trying to find my way back to the hotel. My own course took me to areas of San Francisco that are not on the tour maps. Now I was afraid of being mugged, or worse. I was either too stubborn or too afraid to ask local residents for help. When I finally did build up the courage to ask, I was sent in two different directions. Now I was tired, angry, frustrated, embarrassed and lost! About an hour after the start of the race, I found the hotel. My aching legs carried me up the red-carpeted stairs. I re-joined the group of runners as they gulped down refreshments. Several people asked me what had happened. They said, "Bruce, you were so far ahead of us, we thought we'd never catch you! What happened?" In total embarrassment, I admitted that I'd become lost. I told a few people that 10 kilometers wasn't enough challenge, so I thought I'd run a few extra. That event provided a great learning experience: I had let fear destroy my singleness of purpose. I had taken my eyes off the goal and worried about other people behind me. Have you ever done the same? Have you worried so much about your performance that you performed poorly? Have you let fear prevent you from trying a new job, a difficult sale or some new experience? I really wanted to win that race but not enough to learn the race course and commit it to memory. I wanted to win, but my fear of losing held me back. How do these goal-setting guidelines relate to your goal and your performance? What does success mean to you? To some people, success means a great deal of money or financial independence. To others, it means recognition for a job well done. To others still, success may mean freedom from worry or strife. What does success mean to you? Bettie B. Young’s offers additional suggestions when selecting and striving towards personal and corporate goals: 1.Select a goal for the right reason. Choose a goal that makes you happy, not because it makes your boss or your spouse happy. Be sure that reaching your goal will help satisfy your needs. 2. Keep a copy of your goal plan in sight and refer to it often. This will help you concentrate on results, rather than on activities. It will also provide a constant reminder and help motivate you to the goal. 3. while approaching the completion of a major goal, begin formulating another important goal. Goals are like foundation-building blocks. Each goal provides the strength and direction necessary to help you attain the next highest goal. Every time you attain a goal you gain personal pride and self esteem. This increased confidence and more positive attitude will enable you to more eagerly approach your next challenge or opportunity. How do you see unexpected road blocks on the path to each of your goals? Do you perceive each road block as a problem? Do you see it as an opportunity to test your skills and to learn? My running experience taught me I must learn from each setback. It's usually easier to quit than it is to go on. By forcing yourself to persist until you reach your goal, you build greater character. By building your character and adding in persistence, tenacity and determination, you can reach any worthwhile goal. Go for it! Goal Setting Importance of Goals An important step in health information technology (HIT) strategic planning is to establish specific, measurable goals that are communicated to all. Specific goals play an important part of many of the aspects of planning, selecting, implementing, and realizing benefits of HIT. HIT Goals . . . Writing Goals Writing effective goals is not easy. Many organizations recognize the importance of SMART goals. The acronym has taken on many meanings to fit specific organizations’ needs. Specific. Goals should identify who, what, where, when, and why. They should be well defined and clear to anyone that has a basic knowledge of the workings of your organization. Some also suggest that the goals not only need to be Significant enough to make the investment in achieving the goal but Stretching for the organization to push itself to continuously strive for improvement. Measurable. “If you can’t measure it, you can’t Manage it” is a well-known business mantra. Goals should answer the questions how much and how many, so you can determine when a goal has been accomplished. To be measurable, goals must contain specific Metrics, be Meaningful, and Motivational. Attainable and Agreed upon. Although the most common citations of SMART goals refer to the need to develop attitudes, abilities, skills, and financial capacity to reach the goals being set; gaining consensus on Acceptable goals and commitment to Achieving the goals is critical as well. Goals need to be Action-oriented if they are going to guide your organization to success. Realistic, Relevant, Reasonable, Rewarding, and Result-oriented. Goals must reflect the availability of resources, knowledge, and time so they can be achieved. Set the bar high enough to be meaningful in light of the investment made to Reach the results. Timely and Tangible/Trackable. Allow enough time for staff to acquire and learn to use HIT in support of achieving goals, but too much time so as to suggest that the goal is not important or meaningful for your organization. Specific metrics enable the goal to be tangible and for your organization to track its accomplishment. If a goal is achieved within the timeframe established, celebrate it. If not accomplished, carry out an analysis of why it has not been achieved. Template for Writing and Tracking Goals Your health care delivery organization may be concerned about writing SMART goals because you do not have baseline data, or because you fear results will be difficult to achieve. These issues are actually a part of the problem—not a reason for inaction. The adage “you can’t manage what you can’t measure” is true in health care organizations and reflects one of the main reasons for pay-for-performance. If baseline data are not available to your managers, now is the time to start collecting data for the most important functions. Even for difficult measure, you can estimate baseline data or paint scenarios. Cultivating a culture of quality measurement, reporting, and improvement is often more important than implementing the HIT. Engaging your end users in setting expectations, providing the commitment and support to achieving the expectations, and then measuring, reporting, and celebrating success is essential. Use the template below to help write your goal statements. Start out with a general statement, such as the example in the column Objective. As you dissect the goal to determine how HIT can help you achieve it, you will be describing the intended action. Identify the sources of data and which application within the HIT will enable you to make improvements. Define the metrics so you have a clear understanding what data to collect. Record your current baseline data. Then set your goal by summarizing the improvement you think can be made within a realistic timeframe using the new HIT or EHR application. You might also want to record the rationale for setting the goal and any obstacles to achieving it that you see. An obstacle may be that the pharmacy you work with is not yet up on e-prescribing so you may not be able to fully achieve your goal until they adopt the technology. Finally, use a table like the one below to record results periodically until the target date for achieving your goal is reached. If you wait until the targeted time, you will not know whether you are on course to meet the goal and you will not be able to implement corrective action to meet your deadline. While the deadlines are self-imposed, timeliness is a key motivator. In the example in the template below, the goal to “eliminate ADE…” may sound impossible, but the organization that set this goal expected to achieve it, and got very close within the first six months of implementing an e-prescribing system. In some cases, the goal may be set for you by regulation or contract, such as in the second example. Describing the rationale/obstacles may help you communicate the importance of the goal and find ways to overcome the obstacles. Record the results regularly. Template with Samples for Writing Goals Objective Intended Source of Application Metrics Baseline Goal Rationale/ Results Action Data Obstacles Prevent Check for Drug e-Rx # ADE 53 ADE Eliminat Patient 98% over- or single, knowledg due to due to e ADE safety within 6 under- daily, e base over- or over- or due to initiatives months dosing cumulativ under- under- over- or adverse e dosing dosing under- drug overdosin per per year dosing events g year within 1 (ADE) year of adopting CPOE Reduce # Notify MD MD calls Login # 50% of Reduce The Joint Month 1 of on login to to nurses Screen charts charts # charts Commission check unsigned sign VO who enter wo/VO w/VO requirement <10% verbal into CPOE signed unsigne Month 2 orders within d within check (VO) 24 hrs 24 hrs to Physician <8% <5% at adoption of any time CPOE must using an be required alert at MD login Resources for Goals Identifying all the goals for a given HIT project may take some time. To help structure your goals, consider the major functions your organization performs. The following table lists many of these functions in hospitals, clinics, and health information exchanges (HIE). Knowing how the clinic captures information gives you a better understanding how it is shared through HIE and suports the continuum of care. Add to or delete as your functional descriptions vary. Focus on the functions that need HIT support. HIT Related Functions Hospital Functions Clinic Functions HIE Functions Patient identification, record location Pre-visit patient registration, Patient identification, (MPI), admission/discharge/transfer, appointment scheduling, patient record location patient access, utilization review, identification/ registration, insurance insurance verification verification, chart preparation Health maintenance/preventative services reminders, chronic care registry alerts and call-back lists Automated self-history by patient or Automated self-history by patient or Personal health records caregiver/personal health record caregiver/personal health record information retrieval, pre-admission information retrieval, standing orders testing for advance diagnostic studies Consent management Consent management Nurse staffing, triage, bed control, Manage workflow and wait times census Nursing assessment and clinical Patient intake (reason for visit, vital pathways signs) History and physical examination, Validate patient history, physical Data collection diagnostic studies review, previous examination, diagnostic studies admission review, referring review, previous visits review, physician information review referring physician and patient- supplied information review Problem list management Problem list management Medication reconciliation Medication reconciliation Care planning, clinical decision Care planning, clinical decision Data mining making, clinical practice guidelines, making, clinical practice guidelines, documentation at the point of care documentation at the point of care, level of service (E&M) coding Provider order entry for: nursing Provider order entry: internal office Data transmission services, medications, procedures, tasking, diagnostic studies, surgery, therapies, diagnostic studies, referrals, admissions; prescription consultations writing Diagnostic studies operations: anatomical pathology, blood bank, lab, microbiology, radiology and other imaging (picture archiving and communication system [PACS]) Diagnostic studies results retrieval Diagnostic studies results retrieval and management and management Medication administration Operating room management Patient monitoring and care charting Medical devices information capture Medical devices information capture and display and display Care coordination/scheduling across Care coordination/scheduling across sites of care: triage, ED, ICU, sites of care: hospital admission, long surgery, recovery, step down, term care/home care, referrals to specialty areas, long term care, specialists behavioral health care, home care, assisted living, migrant care Care communication, continuity of Care communication, continuity of Release of information, Hospital Functions Clinic Functions HIE Functions care, discharge instructions, health care, medication instructions, health health education education education Charge capture/coding Charge capture Purchasing, pay-for- performance Quality measurement, reporting, and Quality measurement, reporting, and Quality improvement, improvement; revenue cycle improvement; revenue cycle public health reporting, management, general accounting; management, productivity, general population health, bio- supply chain management; human accounting; supplies management; surveillance resources human resources Patient follow up; prescription refills Health information management and Health information management and document archiving; release of document archiving; release of information; privacy and security, information; privacy and security, including data breach notification including data breach notification Setting Goals The process of setting goals helps individuals understand the capabilities of HIT and builds interest. Once written, the goals form the basis for a performance-based request for proposal (RFP). The RFP is written to ensure that the application has all the functions needed to achieve the goals. In the example of verbal orders, the hospital would seek a verbal order alert at the time a physician logs in. During the selection process, evaluate whether products truly can help achieve your goals. Ask your references or those you visit about how well the HIT has accomplished the outcomes that interest you. If a product is generally supportive of your goals but lacks one function, you can identify that function in the contract as something that must be addressed by a certain date. Once you start the implementation process, your goals serve as the starting point for training and testing scenarios. For example, exactly how the computerized physician order entry (CPOE) will help reduce over- and under-dosing can be explained during training and testing. As a drug is entered into the CPOE system, it can be checked against previous orders to ensure that the drug or like drug has not already been ordered. Clinical decision support built into the CPOE that compares a drug entered with a drug knowledge base and other characteristics of the patient can recommend whether the dose is too much or too little. Once implemented, the CPOE can generate reports on the number of times a potential adverse drug event was avoided, and the quality committee or risk manager can track the number of times actual adverse drug events occurred.
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