Post on 28-Jun-2020
Bethany Rogers, BSN, RN, LSSMBB, CPHQ, CPHRM
Director of Performance Improvement, St. Luke’s Health System
Building Effective Teams and
Running Effective Meetings
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Objectives
Building an Effective Team
– The Seven Essential Team Functions
Leading an Efficient and Effective Meeting
– Understanding the Five Essential Meeting Roles
– The Kickoff Meeting
– The Three Meeting Phases
The 7-Step Meeting Process
– Facilitating Group Decision-Making
– Managing Group Dynamics
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Building an Effective Team
Ownership / Motivation
Content Expertise
Authority
Influence
Structure / Process
Accountability
Team Leadership
The team has collective responsibility
for the success or failure of the
project.
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Form Follows Function
Team members should be selected based on their ability to
fulfill one or more of these functions– Who is our LEADER?
Able to create energy and enthusiasm for the topic; able to get others to follow
– Who OWNS the outcome of this team’s efforts?
Motivated to see the project succeed, engaged in the work of improvement
– Who are our CONTENT EXPERTS?
Insight into actual workflows, barriers, competing priorities, etc.
– Who is our INFLUENCER?
Can persuade others to change behaviors
– Who will keep us ACCOUNTABLE to produce results?
Formal leader authorizing the team deployment resources
– Under whose AUTHORITY will we conduct tests of change? Who has the
AUTHORITY to enforce the standard, once set?
Formal leader who oversees workflows and has power to compel others to change
behaviors
– Who can help us succeed by providing STRUCTURE to our improvement
efforts?
Expert in evidence-based improvement science
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Essential and Distinctive
In the right quantities,
combining…
Flour Texture
Water Moisture
Salt Flavor
Time Lift
Heat Structure
…will produce a specific
and predictable outcome…
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Essential and Distinctive
In the right quantities,
combining…
Ownership / Motivation
Team Leadership
Accountability
Structure / Process
Influence
Authority
Content Expertise
…will produce a specific
and predictable outcome…
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Potential Sources
Frontline Staff (e.g., RN, CNA, tech,
physician, therapist,
EVS tech, etc.)
Unit Director PI Coordinator
Specialty
SMEs(e.g., IP, Educator,
Nurse Specialist,
Reg / Accred, etc.)
Team Leadership
Ownership /
Motivation
Content Expertise
Influence
Accountability
Authority
Structure / Process
= most effective = it could work = possible, but ill-advised
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Roles– Team roles and Meeting roles are frequently the same
…but they do not have to be the same
– Appreciate the value that each role brings to the meeting
Leader
Facilitator
Recorder
Timekeeper
Member(s)
Leading an Efficient & Effective Meeting
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Leader
– Sets the attitude, motivation, and effectiveness of the Team
– Has a communication plan with department leadership andfrontline staff
– Involves and engages stakeholders
– Retains records of the Team’s work
– Ensures that the work of the team moves forward during and between meetings
– Assigns and delegates the work of the Team to Team members and stakeholders
– Helps the Team resolve its problems, including going “up the chain”
Meeting Roles
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Facilitator
– Focuses more on the Team’s process than its product
– Guides the Team in selecting and using the most appropriate tools for process evaluation and improvement
– Monitors and manages group dynamics
– Assists and advises the Team Lead in structuring and breaking down tasks into reasonable portions
– Advises on, and teaches, data collection and analysis techniques
– Helps the Team with visual presentation of data and information
Meeting Roles
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Recorder
– Keeps a visual record of:
Important discussion points
Team decisions
Assignments (who, what, and by when)
Parking Lot items
Meeting Roles
What is the value of
a visual record?
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Timekeeper
– Monitors the team’s progress through the timed Agenda
– Notifies the Meeting Leader at 3, 1, and 0 minutes left
Interruption of discussion can be a challenge for some team
members – consider using non-verbal cues (holding up signs,
using an audible timer, or making hand gestures)
It is the Meeting Leader’s responsibility to ask the Team if they
would like to extend the discussion time on a particular topic,
and from what other topic they would like to remove equal time
Meeting Roles
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Team Member(s)
– Provide content expertise into the process or workflow
under review
All stakeholder roles should be generally
represented
– Build enthusiasm and engagement in the improvement
effort within the work area
– Serve as the “communication bridge” to others in their
same role
Meeting Roles As appropriate, the meeting Leader and Recorder
should participate in all of these functions, but
assignments should generally go to Team Members
who are NOT acting as meeting Leader or Recorder
Communication
Bridge
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The TEAM Leader doesn’t always have to be the
MEETING Leader
The meeting Facilitator may change as long as the
individuals have the skill set to fulfill the role
The Recorder role may rotate each meeting, or the
role may be shared
The Timekeeper role may rotate each meeting
The Team Member(s) may rotate on and off the
team, if approved by the TEAM Leader
Rotating Meeting Roles
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Ineffective Meetings
DYSFUNCTION DISENGAGEMENT
What are the Signs and Symptoms
of an ineffective meeting?
Uncontrolled, tangential discussion
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Ineffective MeetingsPeople don’t come at all
People don’t come prepared
for the discussion
On their phones (email,
texting)
Assignments are not done
Little forward movement,
despite significant resource
allocation
Effective meeting
skills can correct
the balance
Unclear / uncompellingpurpose
Starting late or going overtime
Unclear / misunderstood assignments
Repetitive discussion from one meeting to the
next
Uncontrolled, tangential discussion
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Define the project:– Problem statement, Aim statement, charter, etc.
– Parameters, scope, process start and end points
– Deliverables, goals, Critical to Quality (CTQ) characteristics
Define the team:– Team roles and stakeholder assessment
– Ground rules, meeting format, team member expectations
– Communication plan
Define the approach:– Outline the process (Lean, Six Sigma,
Microsystems, FOCUS PDSA, etc.)
– Plan the next meeting
Answer questions and reach agreement
The Kickoff Meeting
Fa
cili
tato
r
Le
ad
er
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Should generally cover:– How disagreement is handled
– How the team makes decisions
– Communication plan (high level)
– Behavior expectations
Timeliness / attendance
Completion of assignments
Engagement
Ground Rules
Common Ground Rules1. Start on time, end on time2. If you oppose, you must
propose3. Be present; excuse yourself
when interruptions are necessary
4. No “meetings after the meeting”
5. Team members support team decisions, regardless of personal opinion
What ground rules do you like to use?
Why do ground rules frequently fail?
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Voting
– Decision point: Simple majority? 2/3 majority? Unanimous? Multi-
voting?
– Voting membership: Quorum? Members present? Do all members
have a vote?
Consensus
– Does not mean all in agreement – means no strongly held
disagreement
– Establish safety for dissention: Give everyone a chance to express
their opinion
Leader (independent decision with group input)
– Must be established at the first as the decision-making mechanism
– Useful for controversial decisions
Decisions made at the meeting stand
– Must be brought back to the team for reconsideration if new information
surfaces
Facilitating Group Decision-Making
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Set the tone– Send out meeting materials in advance, so time at the
meeting can be spent on content rather than orientation
– Start on time and end on time
– Enforce your ground rules
Get it all on the table – Discuss and document assumptions and beliefs about the
process in question
– Establish safety and open communication
Create a shared vision– Identify measurable objectives and success factors
Keep the momentum– Schedule the first team meeting about a week after the kickoff
Tips for a Successful Kickoff Meeting
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The Three Meeting Phases
• Pre-Meeting1. Identify the AIM of the
upcoming meeting • Don’t ever have a meeting just
because it’s on the calendar
• Ensure that all stakeholders have been invited
2. Review assignments from the last meeting
• Is any follow up or loop-closing needed?
3. Create a timed Agenda
4. Share the Agenda with the Team
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The Three Meeting Phases
• Meeting (7-Step Meeting Process)
1. Clarify / agree upon Aim(s)• What we intend to accomplish with our
time
2. Review meeting roles• Leader, Facilitator, Recorder, Timekeeper
3. Review agenda• Determine or agree upon time allocations
for each agenda item
4. Work through agenda items• Keep active, visual meeting records
5. Review the meeting records• Make revisions
• Agree upon assignments
6. Plan the next meeting’s agenda• Aim(s) and agenda items
7. Evaluate the meeting• “Went Well / Next Time”
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The Three Meeting Phases
• Post-Meeting1. Communicate meeting
decisions to stakeholders
• Up Team Leader
• Across Team Members
2. Carry out Action Items
• Action Items drive meeting frequency
• “Working Teams” should meet frequently to drive forward movement
• “Reporting Teams” should meet based on cadence availability of new information
3. Identify new issues that need to be brought to the next meeting
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Action ItemsWho What When
Joe P.
Find
policy on
SAEs
Next
mtg
Sarah
H.
Find out
drsg par
level
Next
mtg
Meeting Records - Flipcharts
Discussion Record
Write highlights of
discussion, including
any decisions that were
made by the group
Parking Lot
Write down the
thoughts,
comments, or ideas that
people offer that don’t
directly relate to the
discussion at hand
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Meeting Records – Computer/Projector
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The Meeting Facilitator is
responsible for monitoring and
managing group dynamics– Supported by the Meeting Leader
Essential Tools for Managing
Group Dynamics:– Ground Rules document
– Parking Lot
– Aim Statement / charter, etc.
– Timed Agenda
– Meeting Evaluations
Managing Group Dynamics
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Attacks the product or the people
“This is stupid.”
“We’ve tried this before and it
didn’t work.”
“You’ll never get people to agree
to that.”
The Nay-Sayer
Management Strategies
• Remind the team of the
ground rules
• “We’re interested in your
improvement ideas”
• “How was this implemented
when it was done before?”
• “What were the lessons
learned last time, so we
don’t make the same
mistakes?”
• “How do you think we could
influence change with this
group?”
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Doesn’t want to be there
Attacks the process
“This is stupid.”
“Can’t we just skip this step?”
“Do we have to do this?”
“This is a waste of time.”
The Heckler
Management Strategies• “Tell me why you are frustrated
by this part of the process.”
• “Tell me why you find this hard.”
• “Tell me what part of the process is not working for you.”
• “Tell me why you are on this team.”
• Work with the Team Leader to reassess this person’s functional contribution to the team
– Are they a strong influencer?
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Dominates the conversation
Likes to hear the sound of their
own voice
Never shuts up
Doesn’t listen to what others
have to say
The Me Monster
Management Strategies• Structured conversation
– Round-robin for comments
– Written comments
– Timed comments
• Remind the team of the ground
rules
• Enforce the timed agenda
• Make them the Recorder
• “So, to sum up…”
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Does not speak up
Spends meeting time on mobile
device
May appear disengaged, or
may be highly engaged, but
silent
The Wallflower
Management Strategies
• “We haven’t heard from you
in a while – what are your
thoughts on X?”
• Structured conversation
– Round-robin for comments
– Written comments
– Timed comments
• Evaluate the safety of the
environment
• Control the Me Monsters –
Wallflowers don’t talk over
people
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Offers off-the-wall comments
Goes off on tangents in the
conversation
Ends up with a lot of
comments in the Parking Lot
The Space Cadet
Management Strategies
• “Tell me more about what
you’re thinking with that.”
• Reorient to the Aim of the
meeting
• Reorient to the scope of the
project
• Make them the Recorder
• If comments are disruptive,
consider using Structured
Conversation
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Jumps to solution
“All you need to do is X, and it’ll be no problem.”
“At my other hospital, we did it this way.”
Offers primarily “sucker solutions”
– New policy
– New form
– More staff
– Education
– Etc.
The Meddler
Management Strategies• Remind the team of the value
of following a structured improvement process in order to get lasting results
• Thank them for their suggestions, and let them know that we’ll need those when we get to the point of talking about change concepts
– Use the Parking Lot
• Reemphasize the need for data to inform our improvement efforts
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Handling Disagreements
Clarify – Try to identify the source of the assumption or belief that is driving the
opinion Query the participants about the accuracy of your perception of their belief
Identify how you can determine if the belief is valid
– Offer to restate the differing opinions Restating can give a participant insight into how their message is coming across
Restating can give a frustrated participant the sense that they are being heard
Redirect– Ask people to bring information / data to the next meeting for further
discussion
Reorient– Find common ground
Refer back to the Aim statement, problem statement, charter, etc.
If there is high emotion…– Take the discussion offline (eliminate the audience)
– Refer back to the team’s ground rules for behavior
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Questions and Answers