eliminating missed hpv vaccination opportunities: one performance improvement at a time toolkit...
TRANSCRIPT
Eliminating Missed HPV Vaccination Opportunities: One Performance Improvement At A Time
Toolkit
Antonia BlinnMassachusetts League of Community Health Centers
Action plan (WWW)What:Action/Commitment
Who:Responsibility
By When:Deadline
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Chaos becomes clear.Chaos becomes clear.
A simple method to visually display the various steps, events, and operations that constitute a process.
What is Process Mapping?
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When to Utilize Process Mapping?
Process mapping is used to:• gain agreement on the scope of the project• better understand the process to be improved• reveal unnecessary, complex, and redundant
steps in a process• compare actual processes against the
expected process• identify steps where additional data can be
collected
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Perceptions of a Process
What we think it looks like:
What we wish it would look like:
Do not jump to “What we wish it would look like”Do not jump to “What we wish it would look like”
What it actually looks like:
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1. Form the appropriate team, gather materials (banner paper, Post-It® notes, markers, dots) and find a wall space large enough to accommodate the completed map.
2. Define the process to be reviewed. Name it. Agree on the process start and end. The start and end should match the scope of the project written in the charter.
3. Determine how complex and detailed of a map you will need to give you what you want.
4. Assign symbols:
- Rectangle for steps- Oval for start and stop- Diamond for decision
Steps to Develop a Process Map
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5. Identify the process steps Start by rapidly writing process steps on Post-It® notes and
placing them on the paper.
Write large with one process step or item per Post-It® note.
Don’t worry about order, don’t worry about priorities, just list them!
6. Now sequence the steps - arrange the steps the way work is currently done and draw arrows.
7. Validate the map to ensure it represents the situation as it really is today. Change the process map to correspond with the physical process.
Steps to Develop a Process Map (continued)
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Validate the Process Map1. Are the process steps identified correctly?
2. Is every feedback loop closed?
3. Does every arrow have a beginning and ending point?
4. Is there more than one arrow from an activity box? Perhaps it should be a diamond.
5. Is there anything missing?
6. Do the workers who do the process every day agree that the map reflects reality?
7. Ask the questions:• What happens if…?• What could go wrong?• Who…?• How…?• When…?
8. Update the map
Walk through the actual process with the entire team.
Walk through the actual process with the entire team.
TaskTaskDirectionDirection
StartEndStartEnd
Automated System Answers
Automated System Answers
PatientCalls
PatientCalls
Touch-Tone
Phone?
PatientChooses Routing Option
PatientChooses Routing Option
Call Placed In Queue,On Hold
Call EndsCall EndsCall Gets Routed To
Voice-Activated System
Patient Waits?
SchedulerAnswerPhones
ReviewOr Decision
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Change the process map to match the
actual process.
Change the process map to match the
actual process.
Example: Process Map
TaskTaskDirectionDirection
StartEndStartEnd
ReviewOr
Decision
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Baseline Patient Contact Information Collection Process
What is Change Acceleration Process(CAP)?
A good technical solution is simply not enough for success
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Changing Systems & Structures
CurrentState
TransitionState
ImprovedState
Creating a Shared Need
Shaping a Vision
Mobilizing Commitment
Making Change Last
Monitoring Progress
Leading Change
Change Acceleration Process
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Leading Change
Having a sponsor/champion and team members who demonstrate visible, active, public commitment and support of the change.
Creating A Shared Need
The reason to change, whether driven by threat or opportunity, is instilled within the organization and widely shared through data, demonstration or demand. The need for change must exceed its resistance.
Shaping A Vision
The desired outcome of change is clear, legitimate, widely understood and shared; the vision is shaped in behavioral terms.
Mobilizing Commitment
There is a strong commitment from constituents to invest in the change, make it work, and demand and receive management attention; Constituents agree to change their own actions and behaviors to support the change.
Making Change Last
Once change is started, it endures, and learnings are transferred throughout the organization. Change is integrated with other key initiatives; early wins are encouraged to build momentum for the change.
Monitoring Progress
Progress is real; benchmarks set and realized; indicators established to guarantee accountability.
Changing Systems And Structures
Making sure that the management practices (Staffing, Development, Rewards, Measures, Communication, Organizational Design, and Information Technology Systems) are used to complement and reinforce change
Change Acceleration Process
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Mobilizing Commitment: Why is this Important?Understanding the key stakeholders whose support and commitment will “make or break” the change effort
Key difference between success and failureMobilizing the Commitment of Key Stakeholders
is Essential to the Success of the Change
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Mobilizing Commitment Tool:
Stakeholder Analysis
Used For: Identifying stakeholders and understanding resistance
Developing strategy to eliminate or lessen resistance
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Name(Key
Stakeholders)
Issues / Concerns “Wins” Influence
StrategyStr
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Ag
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Mod
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Ag
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Neu
tral
Mod
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Su
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ive
Str
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Su
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ive
Mobilizing CommitmentStakeholder analysis & resistance tool
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Shaping a Vision Tool:
Elevator Speech
Used For:Clearly and simply stating the need for change and describing the future state
Rallying the support and commitment of key stakeholders
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Elevator Speech
Simple 4-part formula for your elevator speech:
“What our effort is about . . . .”
“Why it is important to do . . . .”
“What success will look like . . . .”
“What we need from you . . . .”
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Stakeholders Message Media Who When/Where(inform,
persuade, influence)
•(written, newsletter, bulletin board, senior leader memo, events, meeting one-on-one, department meeting, all staff mtg., offsite meeting
Which team
member?Dates/Times
Announce theProject
Shaping the vision
Mobilizing Commitment (what’s in it for this group/individual)
Begin to monitor progress
Changing Systems & Structures
Communication Plan
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Resources and Contact InformationMassachusetts League of Community Health Centers
– Antonia Blinn– [email protected]
HPV Initiative (Join or get on list serve)– Allison Hackbarth– [email protected]
MA Chapter of American Academy of Pediatrics (MCAAP)– Cynthia McReynolds– [email protected]
MCAAP Website has quick links to key HPV materials:
http://mcaap.org/immunization-hpv/21