unity is strength presentation handout
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4/25/2014
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Unity is Strength: The Power of Collaboration
Kevin Warren
President/CEO Texas Health Care Association
Melody Malone, PT, CPHQ, MHA Quality Improvement Consultant
TMF Health Quality Institute
Objectives
At the conclusion of the session, participants should be able to:
Recognize the benefits of forming coalitions for a common purpose.
Apply a plan to form a successful coalition.
Form project teams focused on achieving specific outcomes.
Implement a project team focused on achieving a specific outcome.
Our Process…Today
Project Team Specific
Process
Purpose Players
Community Focus
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Benefits
Resource Sharing
Knowledge / Expertise
Community Presence and Trust
Opportunities for community cohesion
Shared Responsibility (and Risk)
Collective Leverage / Bargaining
Mitigate “Group Think”
“Knowledge is of two kinds. We know a subject ourselves, or we know where we can find information upon it.” Samuel Johnson, 1775
What’s the Goal?
Improvement of some components, processes, or outcomes?
OR
Complete system transformation to ensure success every time?
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Purpose(s) of External Coalition Building?
Census Growth?
Clinical Improvement?
Reducing Rehospitalizations?
Specialized service delivery?
Staff retention/recruitment?
Policy development?
Community Involvement / Outreach?
Determining the Need (“Reflection”) Consider This…
Organizational Description: Environment, Service Offerings, workforce profile, Assets, Regulatory Requirements, M/V
Key Customers: Their requirements and how do you know?
Competitive Environment: Organizational Position, Success Factors, Data Sources
Strategic Planning: Your Strategic Challenges / Advantages and why are they important?
Performance Improvement: How do you measure success/opportunity? Source: AHCA/NCAL National Quality Award
Bronze Application Criteria
Being Effective
Be specific (purpose, timeline, structure)
Have a Plan
Make it Measurable
Take Ownership
Open Communication
Feedback
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“What endures is your effect on other people and the kind of world, organization and culture that you've helped to create.”
Jeffrey Pfeffer
Stanford University
Building organizational momentum through
meaningful relationships with front-line staff as daily problem solvers
What we want is to:
Maximize efficiency and effectiveness
Retain staff
Ensure that employees are fully engaged on a daily basis
Avoid harm
Be successful
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Questions:
When did you learn how to be on a team?
• Red Rover, Red Rover
• Sports
• School
•Did everyone pull their weight?
More Questions:
Do you have teamwork now?
• On the floor?
• In a QI team/PIP team?
• In your leadership team?
More Questions:
What’s the barrier to teamwork?
• Hierarchy
• Language
• Education/knowledge (formal/informal)
• Shared purpose
• Hidden agendas
• Turnover
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First Things First
We have to create a culture of teamwork.
Let’s watch a movie
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So…
How easy is it to connect to:
• Individuals
Empathy
Fuels connection
Perspective taking
Staying out of judgment
Recognizing emotion in others and communicating that
Empathy
Feeling WITH people
A vulnerable choice
I have to connect within myself to a similar experience
– Dr. Brené Brown
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So…
How easy is it to connect to:
• Individuals
• Teams
Culture of Teamwork
To be understood, you must first understand
Investing Inside the Nursing Home Walls
First Things First
Create a culture of teamwork
• We can’t eat our young – use empathy
• We have to break down barriers
• We have to forgive
• We have to ask for forgiveness
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Successful QI Project Teams
Need an organizational culture of quality
Need a shared mental model
Have accountability
Have a blame-free environment
Blame-Free Environment
Human error is not the cause of accidents, it is a symptom of deeper trouble.
Human error is not random.
Human error is not the conclusion of an investigation, it is the beginning.
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Human Factors
“Human Factors” is about how features of our tools, tasks and work environments continually influence what we do and how we do it.
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Three Categories of Performance Gaps
The plan itself was inadequate to achieve desired outcome (planning error).
The plan is not executed properly (execution error).
There was a deliberate departure from “safe” practice (violation).
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Moving to a team culture
Fuel connections – empathy
Grow knowledge, skills and abilities
Develop a shared mental model
Be a learning organization
Coach and mentor daily
One caution!
Avoid Group Think
• Desire for harmony or conformity in the group results in an irrational or dysfunctional decision-making outcome.
Watch out for:
• Suppression of individual opinions, and
• Creative thought
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Team Process
Team Members
Cognitions
Knowledge
“Think”
Behaviors
Skills
“Do”
Attitudes
Affect
“Feel”
Team Conflict
Is it a bad thing?
NO!
Constructive conflict is a component of high-functioning teams
Resolving Team Conflict
Understand and appreciate various viewpoints
Acknowledge the conflict
Discuss the impact
Agree to a cooperative process
Agree to communicate
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The Social Age
Requires us to be:
More strategic
More creative and innovative
More solutions-oriented
And, do it faster!
PIP Team Charter
Serves as a catalyst
Gives direction to the team
Gives protection the team needs to succeed
Communicates to non-team members what is going on
PIP Team Charter
Brings the team together for a common:
• Mission
• Scope of operation
• Objectives
• Timeframe
• Consequences
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PIP Team Charter
Project Name:
Team Leader:
Team Members (resident/family included?):
Aim Statement:
Sponsor:
Frequency of reports:
Timelines/deadlines:
Other (Resource limitations?):
Let’s Build a Team
Let’s Build an Action Period
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“It's not whether your glass is empty or full, it's what you do with it that really matters.”
– Sue Nelson Buckley
About TMF
TMF Health Quality Institute focuses on improving lives by improving the quality of health care through contracts with federal, state and local governments, as well as private organizations. For more than 40 years, TMF has helped health care providers and practitioners in a variety of settings improve care for their patients.
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About the QIO Program
Leading rapid, large-scale change in health quality:
Goals are bolder.
The patient is at the center.
All improvers are welcome.
Everyone teaches and learns.
Greater value is fostered.
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Contact
Melody Malone, PT, CPHQ, MHA
Quality Improvement Consultant
TMF Health Quality Institute
214-632-2238
Melody.malone@hcqis.org
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Patient Safety: Nursing Home Team
nhnetwork@tmf.org
1-866-439-5863
http://texasqio.tmf.org
This material was prepared by TMF Health Quality Institute, the Medicare Quality Improvement
Organization for Texas, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 10SOW-TX-C7-14-52
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