Published on February 25, 2014
Maximizing Your Team’s Creative Potential Quality Forum 2014 Melissa Crump and Katie Procter
What is your pet peeve in your improvement work and why?
Speed Networking – Why start this way? What did you notice? •Liberates participation immediately for everyone provided the questions are engaging!! •Attracts deeper engagement around your questions •Invites stories to deepen as they are repeated •Emphasizes the power of loose connections in relationships •Gets you energized and engaged quickly
SPEED Networking – keys to success •Introduction – very brief but important in the case of a potentially reluctant audience •Questions are simple but must matter to participants inviting engagement AND be reflective with what do you want them to explore together •Standing up and milling around across the room
•Done in pairs as strangers for 2 minutes each (total 4 minutes per pair timed by facilitator) •Encouraging new connections with fast pace •Not 1, Not 2, but 3 rounds •If you choose to share output in a group share back, do it carefully and preserve confidentiality
IDENTIFYING YOUR PROBLEM SETTING YOUR GOAL(S) CREATING AN AIM STATEMENT AND “HOW-TO” MEASURES
I want to make a change/improvement
• Building blocks for change • Leadership support • Infrastructure to support and sustain the change
The Whirlwind (AKA the everyday STUFF)
Being successful in the whirlwind • • • • Team focus on no more that 3 goals at a time 1 to 2 goals are optimal You want to apply more energy against goals Humans are hardwired to do one thing at a time with excellence
There will always be more good ideas then there are capacity to execute
How to choose your goals • Either from within the whirlwind (badly broken and need fixing) Or • A key element of your care delivery that isn't being addressed or delivered.
Getting to the heart of the problem • We don’t spend enough time on the study • If we don’t get to the heart of the problem we jump to solutions
Sometimes more money, more people and more time is not the answer
People are not the problem...the problem is in the process or system
Research your problem • Speak with people (getting staff involved from the beginning) • Observe the environment • Process map/value stream map • Spagetti diagram
Getting to the heart of the problem) • May be based on a problem (Root cause analysis) – 5 whys process map form/Ishikawa Diagram
Reminder • If at the end of your research (5 whys, cause/effect diagram, etc) your problem is a person…dig deeper…find the process error
Where to start? Rank ideas (potential goals by impact)
Choosing your Goals
Rules to creating successful Goals • No team focuses on more than 2 goals • The battle you choose must win the war (your goal must somehow impact the strategic direction of the organization) • Senior Leaders must define the strategic direction of the organization but must allow the units to define their goals • Your goal must have a finish line (x to y by when)
How to choose your goals • Ask: – What is most important? – If every other area of our organizations/unit remained at its current level of performance, what is the one area where change would have the greatest impact? – What are the greatest strengths of the team that can leverage the overall goal – What are the areas that the team needs to improve on
How to pick your goal • • • • • • Does it align with the organizations goals Is it measurable Is it worth measuring Is it ongoing process or “once done” Who owns the results Who owns the games
Executing your goal
Creating an Innovative culture • Cadence of accountability allow release of creativity • Weekly meetings encourage experimentation of new ideas, problem solving, shared learning • Forum for engagement • Brings out the best thinking in each team member
Goal session Toolbox • • • • • Speed networking Triz 25 get your 10 Discovery action dialogue (DAD) Discussion
Goal Sessions (weekly meetings) • Cadence of accountability (weekly meetings) – Same day – Same time • No longer than 30 mins • Accountability – making commitment to the team that impacts the goal
Goal session • Report on commitments • Review of scoreboard (Review success and challenges) • Plan (commitments for the next week, clearing the path for success) Commitments Plan Scoreboard Goal
Keeping score • Everyone must know the score • People do not engage if they don’t know the score • Keeping score drives engagement
Creating your scoreboard • Ask: – Is it simple? – Is it visible to the team? (visibility drives accountability) – Are your measures visible (team needs to see they are impacting the goal) – Can you see if you are winning or losing? (Enable you to see where you are now and where you should be now)
Scoreboard Staff scoreboard • Simple • Visible Leader scoreboard • Full of data • complex
Accountable, Engaged, Innovative Community
CREATING A GOOD STORYBOARD
A good storyboard…. • • • • Simple Visible Engaging Has a score?? (remember we are trying to win a race)
DISCOVERY & ACTION DIALOGUES A TOOL FOR GETTING STARTED WITH CONVERSATIONS
What is a Discovery & Action Dialogue? • Discover what people are already doing that works Positive Deviants
What is a Discovery & Action Dialogue? • Discover what people are already doing that works Positive Deviants • These deviants face the same restrictions as everyone else but find their own solutions Hidden and untapped solutions
What is a Discovery & Action Dialogue? • Discover what people are already doing that works Positive Deviants • These deviants face the same restrictions as everyone else but find their own solutions Hidden and untapped solutions • They gain support as colleagues see the solutions working and then adapt the new thinking/behaving Momentum spreads
The “DAD”: 6 Questions 1. What do you know about (the problem) / how do you know when it’s present? 2. What do YOU do about it? 3. What are the BARRIERS that prevent you from doing (the right thing/process) 100% of the time? 4. Who are the Positive Deviants that are overcoming these barriers? 5. WHO ELSE needs to be part of this conversation? (“Don’t decide about me without me.”) How do we invite them to join the action? 6. What other ideas do you have? Any volunteers?
The Details … Q1: How do you know when a resident is on inappropriate antipsychotics? (the problem is present) • Affirm that we all have existing knowledge of the problem • Provide opportunities to get questions on the table
The Details … Q2: How do YOU contribute to reducing inappropriate antipsychotic use? (solving the problem) • Focus on personal practices, NOT on what other people don’t do • Amplify / confirm the participant’s knowledge of effective practices
The Details … Q3: What prevents you from doing this or taking these actions all the time? • Identify real barriers and constraints • Ask: What prevents you? vs Why don’t you?
The Details … Q4: Is there anyone you know who • Establish that getting around barriers is possible is able to frequently address BPSD without inappropriate • Identify the existing-butmedications? uncommon successful strategies (solve the problem, overcome barriers)
The Details … Q5: Do you have any ideas? • Identify the supports that make the desired behaviour more likely • Provide an opportunity for participants to generate and share new ideas for enabling the desired behavior
The Details … Q6: What needs to be done to make it happen? Any volunteers? • Identify action steps, target dates & feedback loops for metrics • Invite volunteers for each action step (capture ideas that don’t yet have an identified action plan or volunteer)
The Details … Q7: Who else needs to be involved? • Who else can we bring in? • Widen the circle of people involved in discovering solutions, drawing in unusual suspects
Getting Started with a DAD • What is the problem you are going to talk about? – Inappropriate antipsychotics? – BPSD? – Culture? – Care Planning? • How will you get people to come? • When will you hold the meeting or meetings? • How will you follow-up with the information you learn?
Arranging Space & Materials for the Conversation (this is perfect for Huddles) • Where? When? With Whom?
Arranging Space & Materials for the Conversation • Where? When? With Whom? • Have someone else record the responses so you can facilitate
Arranging Space & Materials for the Conversation • Where? When? With Whom? • Have someone else record the responses so you can facilitate • Room set-up: – Chairs in a circle OR standing around a flip chart
Arranging Space & Materials for the Conversation • Where? When? With Whom? • Have someone else record the responses so you can facilitate • Room set-up: – Chairs in a circle OR standing around a flip chart • 5 – 15 people with diverse roles and experience is an asset, although one-on-one can be powerful too!
Everyone Who Touches the Resident Can Participate • Everyone interested in solving the problem
Everyone Who Touches the Resident Can Participate • Everyone interested in solving the problem • Look to your process map!
Everyone Who Touches the Resident Can Participate • Everyone interested in solving the problem • Look to your process map! • Multiple disciplines and different roles
Everyone Who Touches the Resident Can Participate • • • • Everyone interested in solving the problem Look to your process map! Multiple disciplines and different roles Who else? – Residents – Families – Volunteers
Everyone Who Touches the Resident Can Participate • • • • Everyone interested in solving the problem Look to your process map! Multiple disciplines and different roles Who else? – Residents – Families – Volunteers • Make sure everyone has an equal opportunity to participate
Facilitator “Do” Guidelines • Start with the purpose “We are here to _______________!” • “Give” the questions to the group, then wait at least 20 seconds for a response Sing Happy Birthday to yourself • Encourage quiet people to talk
Facilitator “Do” Guidelines How do you handle cynical responses? “If I understand you correctly, no one has ever done this successfully or well.” “What would you do if there was an opportunity for change?” “Can you please re-frame what you just said with a question beginning with ‘what’ or ‘how’? Include some kind of action.
More “Do’s” • Work through all or some of the questions without worrying about the order AND/OR • Follow the conversation with other questions
More “Do’s” • Work through all or some of the questions without worrying about the order AND/OR • Follow the conversation with other questions • Keep respect at the forefront of the conversation
More “Do’s” • Work through all or some of the questions without worrying about the order AND/OR • Follow the conversation with other questions • Keep respect at the forefront of the conversation • Have someone record responses on flip charts
Facilitator “Don’t” Guidelines • Don’t answer questions that haven’t been asked directly to you Even then, ask the group members to provide an answer (they are the wise ones who will have the answers) • Don’t miss opportunities to “catch butterflies” Record ideas that got missed in the conversation
More “Don’ts” • Don’t continue the conversation when others need to be present -“Nothing about me without me!” Invite them to the next dialogue
More “Don’ts” • Don’t continue the conversation when others need to be present -“Nothing about me without me!” Invite them to the next dialogue • Avoid responding positively or negatively to contributions You might ask, “How/What do others think or feel about this suggestion?”
General Tips & Traps • Hold the dialogue out in the open • Make impromptu invitations as you enter the area • Create an “informal climate”, starting with introductions and a story if appropriate • Maintain eye contact and sit with the group (not higher or far away)
General Tips & Traps • Talk less than participants, and encourage everyone to share stories and “sift” for action opportunities • Draw out stories that help people make a leap of understanding from a small example of behavior change to a larger shift in values and/or resource sharing • Demonstrate genuine curiosity in everyone’s offerings without answering the questions yourself
WILL GET YOU CROWD SOURCING
What is an idea that you have that might influence a behavior shift with a group of clinicians in your working environment/project? What would be your first step/PDSA towards that goal. Write your idea and your first step on the ONE SIDE of the recipe card on your tables. NO NAMES BE REALISTIC WRITE LEGIBLY
•5 rounds of 20 seconds each •Pass cards around while moving around the room – do not look at the cards while doing so! • •At the end of each round (bells), read the idea on the front of the card •If you get the same card switch it off with someone immediately •Rate the idea from 0 – 5 ( 0 being the lowest and 5 being the highest rating •At the end of the 5 rounds you will have 5 numbers on the back of the card that will total something out of 25 •Add the numbers
What is made possible? • A large crowd can generate and sort their bold ideas for action in 20 minutes or less!! • Helps spread innovations • Helps people to notice patterns in what emerges • Helps you to prioritize your work depending on how you set up your question or what you want the team to work out
• Innovations are owned and more likely to endure • Sparks synergy and coherence in diversity (difference) • Gives novice innovators and quiet ones a bold voice
Ideas for where to use • Prioritizing ideas and bringing coherence after a meeting • For illuminating bold ideas at the start of a conference or task force meeting
Variations • Ask “If you could un-make one decision that is holding us back, what would it be? What is your first step to un-make it?” • Ask “What courageous conversation are we not having? What first step could spark our courage?” • Ask “What do you hope can happen for us in the future? What practical first step can you take now to tip the balance in this direction?”
• What priority should we be taking with our work? • You can write the work already identified by the team (say from a TRIZ) on the cards and have the group prioritize where to start. Keep knocking off the top 5 or 10 as you can re-do the exercise until you are complete.
Thank you!! Katie Procter firstname.lastname@example.org Melissa Crump
Storyboard template Title Page
Anecdote • The story that will pull at heart strings
Background • What does the research/evidence telling you about your work? Data? Hard facts? Numbers? Costs?
Aim of Your Project
Results so Far
Next Steps: Future Focus
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