Leading Quality Improvement - IHI Home...

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Leading Quality Improvement

Essentials for ManagersLesson 1: Know Yourself

January 24, 2016

These presenters have

nothing to disclose

Janet Porter, PhDDave Munch, MDKathy Duncan, RN

Today’s Host2

Rebecca Goldberg, Project Coordinator, Institute for

Healthcare Improvement (IHI), coordinates multiple

projects focused on increasing value in health care by

improving quality and reducing costs. Currently,

Rebecca’s primary responsibility is coordinating and

hosting IHI’s Expeditions, monthly virtual support

programs focused on specific topic areas. Rebecca is a

recent graduate of Georgetown University in

Washington, D.C., where she obtained her Bachelor of

Science degree in human science with a minor in public

health.

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Audio Broadcast3

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Chat

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Example: Sam Jones, Midwest Health

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LQI Structure

9 Lessons in the program

– Each lesson is composed of:

1. Preparation work on the Learning Management System (videos,

articles, case studies, and an assignment)

2. A coaching call for that Lesson (WebEx call with faculty)

– Lesson preparation work opens two weeks before the lesson’s

coaching call (Lesson 2 pre-work will open after this call)

– While you complete your preparation activities, please feel free

to email the listserv, [email protected], or the Lesson

faculty with questions

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Faculty10

Janet Porter, MBA, PhD, serves as consultant to

hospitals and physician practices for Stroudwater

Associates where she is a Principal and a member of the

Board of Directors.

Dr. Porter served as the Chief Operating Officer of Dana-

Farber Cancer Institute; the Associate Dean of Executive

Education at the University of North Carolina’s School of

Public Health; the Interim CEO of the Association of

University Programs in Health Administration (AUPHA);

and the Vice President, and then COO, of Nationwide

Children’s Hospital in Columbus, Ohio. She teaches at

University of Miami, Ohio State University, University of

North Carolina and Harvard. She currently serves on the

AARP Board of Directors. Dr. Porter received her BS and

MHA from Ohio State University, and her MBA and PhD in

health care strategy from the University of Minnesota.

mailto:[email protected]

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Faculty11

Kathy D. Duncan, RN, faculty, Institute for Healthcare

Improvement (IHI), directs IHI Expeditions and manages IHI's

work in rural settings. Previously, she provided spread expertise to

Project JOINTS, co-led the 5 Million Lives Campaign National

Field Team, and was faculty for the Improving Outcomes for High

Risk and Critically Ill Patients Innovation Community. She also

served as the content lead for the Campaign's Prevention of

Pressure Ulcers and Deployment of Rapid Response Teams

areas. She is a member of the Scientific Advisory Board for the

AHA NRCPR, NQF's Coordination of Care Advisory Panel, and

NDNQI's Pressure Ulcer Advisory Committee. Prior to joining IHI,

Ms. Duncan led initiatives to decrease ICU mortality and morbidity

as the director of critical care for a large community hospital.

Faculty12

David Munch, MD, Senior Vice President and Chief Clinical

Officer, Healthcare Performance Partners, leads the

organization’s clinical and Lean Healthcare engagements. He

previously served as Chief Clinical and Quality Officer at

Exempla Lutheran Medical Center, where he led their Lean

Production applications for more than five years, resulting in

substantial improvements in both clinical and non-clinical

processes. Dr. Munch has been a frequent speaker on

leadership effectiveness and Lean transformation for a number

of health care organizations, including The University of

Rochester Medical Center, Yale-New Haven Health System,

Tulane University Medical Center, Pittsburgh Regional Health

Initiative, Institute for Clinical Systems Improvement, and the

Voluntary Hospital Association. He served on the Agency for

Healthcare Research and Quality's High Reliability Advisory

Group, and he has an extensive background in hospital

operations, health plan governance, physician organization

governance, and clinical practice in Internal Medicine.

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Today’s Agenda13

Ground Rules & Introductions

Action Period Assignment

Know Yourself

Lesson 2 Preparation

Ground Rules14

We learn from one another – “All teach, all learn”

Why reinvent the wheel? - Steal shamelessly

This is a transparent learning environment

All ideas/feedback are welcome and encouraged!

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15

Chat

15

What is your goal for participating

in this program?


LQI Objectives

At the end of the program, participants will be able to:

Describe the skills, tools, and resources needed by

a middle manager to lead quality improvement

efforts in their local settings

Demonstrate how to link department-level

improvement activities to the organization’s goals

and overall strategic plan

List at least three ways middle managers can be

successful in partnering with front-line staff in quality

improvement activities

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LQI Lessons

Lesson 1 – Know Yourself, Janet Porter

Lesson 2 – Managing Time and Attention, Kathy Duncan

Lesson 3 – Practice Improvement Essentials, Kathy Duncan

Lesson 4 – Coach Your Team, Dave Munch

Lesson 5 – Patient and Family Engagement, Janet Porter

Lesson 6 – Problem Solving in a Culture of Safety, Dave Munch

Lesson 7 – Managing Systems and Connections, Dave Munch

Lesson 8 – Empower Teams to Engage in Improvement, Janet Porter

Lesson 9 – Identify & Spread Successful Improvement, Kathy Duncan

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Today’s Agenda18



Know Yourself


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Please complete the Managers Self Assessment.

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Manager Self-Assessment Results20

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Today’s Agenda21



Know Yourself

Know Your Change Style

Know Your Influence Style

Know Your Work Style


Personal Preference or Inclination

1. Find a pen or pencil and a piece of paper.

2. Quickly sign your name the way you typically sign a

check or other document.

3. Move your pen or pencil to your other hand and sign

your name again.

S-1

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23

Chat

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How would you describe your

experience writing with your

non-dominant hand?


Embracing Change

Everyone thinks of changing the world, but no one thinks

of changing himself.

– Leo Tolstoy

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Self-Assessments

Provide insight into your own style

Provide a framework for thinking about other’s styles

Answer with your first instinct, don’t over-think your

answer

Truest results is when you answer as you really are – not

as you want others to see you

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27

Poll

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Please indicate for the poll

whether your change style is to

be a conserver, pragmatist or

originator


When Facing Change Conservers

Generally appear deliberate, disciplined, and organized - Focused

Prefer clearly defined structure

Start with traditional ideas when problem solving

Don’t like surprises and uncertainty

“May appear” cautious and inflexible

Focus on details and implementation

Value tradition and best practices

Are convergent thinkers

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May appear unorganized, undisciplined,

unconventional and spontaneous – React in the

moment

Challenge existing structure

Dismiss traditional ideas when problem solving

Enjoy risk and uncertainty

“May appear” impractical and miss important details

Appear systemic in their thinking

Can dismiss established practices with little regard

Are divergent thinkers

When Facing Change Originators

Generally appear practical, agreeable, and flexible

Value change that produces readily visible benefits

More interested in functionality than tradition or novelty

Operate as mediators and catalysts for understanding

Are open to both sides of an argument

Take more of a middle-of-the-road approach

Appear more team oriented to their co-workers

When Facing Change Pragmatists

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31

Chat

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Were you surprised at your

style? What do you find

challenging about working with

others of different styles?


For Dealing with Conservers

Consider at least three alternatives before making a decision.

Remember to pay attention to the wider ramifications of problems in addition to present realities.

Think of the “big picture” consequences of actions. Ask others to explain them if necessary.

Specify a time frame in which the decision will be made or the action taken.

Identify no more than three or four criteria for making the decision.

Write a list of advantages for taking more of an originator-type approach in a given situation.

Write a description of a desired future outcome in positive and global terms.

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Wait a day before taking action.

Identify and try to understand at least five facts related to the situation, problem, or decision.

Explore and understand what is already working in the current situation.

Learn to give up on an impractical idea.

Attempt to clearly understand the impact of the decision or action on at least two other people.

Write a list of advantages for taking more of a conserver-type approach.

Make a list of relevant facts and details.

Learn to screen activities rather than attempting all that is initially appealing.

For Dealing with Originators

Specify a period of time in which to consider alternatives prior to

committing to a solution.

When dealing with strong conservers or originators, ask

exploratory questions about emotional responses to a situation,

for example,

How do you feel about this? How would you like things to be?

Identify a person you suspect to be a strong conserver and a

person you believe to be a strong originator - ask their opinions.

Identify decision criteria and apply the criteria to each possible

solution.

Identify specific questions to ask conservers and originators.

For Dealing with Pragmatists

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Consult with a person you believe to have a change style different from yours before proceeding.

Make efforts to understand the perspectives of those with styles other than your own.

Imagine putting on a hat of another style.

Solicit feedback and suggestions.

Step back and be aware of your initial reaction in a situation, especially when you are aware of having an emotional response.

In General

Today’s Agenda36



Know Yourself





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37

Chat

37 Please send your message to All Participants


whether your influence style is

primarily asserting, rationalizing,

bridging, inspiring or negotiating.

©2011 Discovery Learning, Inc. All Rights Reserved.

You look for compromises and make concessions to reach outcomes that satisfy your greater interest.

You put forward your ideas and offer logical, rational reasons to convince others of your point of view.

You insist that your ideas are heard and considered and you challenge the ideas of others.

You advocate your position and encourage others with a sense of shared purpose and exciting possibilities.

You build relationships and connect with others through listening, understanding and building coalitions.

Influence Styles

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39

Chat


What style would you never

think to use to influence

others?

To Influence Effectively

Understand key stakeholders/team members influencing style For large groups, have data AND a story AND a vision AND “what’s in it for me?” AND alignment with policyUnderstand and personally align to the organization’s direction and priorities Understand and personally align to the culture and values Take action even if you don’t have the authority over resources Build confidence through proven executionDemonstrate concern for others as well as self

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Today’s Agenda41



Know Yourself





42

Chat



whether your work style is

primarily to be analytical,

driver, amiable or

expressive.

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Work Styles 43

A - Analytical• Cautious decisions

• Likes structure• Prefers to work alone

• Likes data, facts

C – Amiable• Slow at taking action

• Likes working with others• Supports and listens to others

• Works slowly, cohesively

B – Driver• Action oriented

• Likes control• Freedom to manage self, others

• Works quickly

D- Expressive• Spontaneous actions, risks

• Likes new ideas• Works quickly with excitement• Not good with follow-through

For Dealing with Those

with A Different Work Style

Be aware of your own style

Pay attention to others work styles

Have teams take the work style inventory to understand

each other’s style and contribution

On a team, think about how to leverage the style of team

members for optimal utility (For example, have the

analytic collect data)

Play to people’s strengths

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45

Chat


How do you think your work style influences the way you

work with others?

Know Yourself through Reflection

The more you know yourself, the

better you will work with others


more likely you are to select

organizations, teams, jobs that

are a fit for you


more likely you are to be

satisfied, engaged with your work

Reflect, reflect, reflect

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Closing Poll

How useful was this lesson on a scale from 1-5?

Given today's topic, what would you like to learn more

about?

Any other comments on today's lesson?

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1 2 3 4 5

Not Useful Somewhat Useful

Very Useful

LQI Communications

• All sessions are recorded

• Pre-work materials are located in LMS

• Listserv address for session communications:

[email protected]

• To add colleagues, email us at [email protected]

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Lesson 249

Tuesday, February 7, 1 PM ET

Managing Time and Attention

Kathy Duncan, RNDirector

Institute for Healthcare Improvement

Sneak Peak: LMS Pre-work - Lesson 2 Assignment50

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Thank You!51

Rebecca Goldberg

[email protected]

Please let us know if you have any questions or

feedback following today’s LQI Coaching Call.


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