1. Florida STAR Peer Mentor Training November 15-16, 2012 Angie Maldonado
Process Improvement Coach
Reduce Waiting & No-Shows  Increase Admissions & Continuation
This product was supported by the Florida Department of Children and Families
Substance Abuse and Mental Health Program Office funding.

2. Peer Mentor
Plays a critical role in the development of Florida’s performance improvement system

3. Criteria to Become a Peer Mentor
Complete Specific Training
Plan Do Study Act (PDSA) 101
How to Lead A Change Team
Advanced Data collection and Analysis
Making the Business Case
Have Experience
Leading a change team
Implementing change cycles
Failures/Challenging change cycles
Characteristics
Energetic
Positive

4. Peer Mentors
Key Roles
Use their experience and expertise to provide in person, telephone and online technical assistance to STAR participants
Identify promising process improvement strategies, tools, and products to be disseminated throughout the state
Participate in and assist in expanding the peer learning network
Provide training and share knowledge

5. Peer Mentor Role Reflections on Experiences as Peer Mentors
What worked?
What didn’t?

6. Peer Mentor Role Key Principle
Listen

7. Is direction needed? Teach the process (PDSA) Provide Ideas (tools)
Encourage brainstorming

8. Provider Project Set-up – Checklist for Peer Mentors
Review walk-through results
Create project charter
Confirm that Change Leader is appropriate and has time to devote to PI
Confirm that Change Team has been established
Involve Executive Sponsor and get sign off on Project Charter

9. Provider Project Set-up – Checklist for Peer Mentors
Review walk-through results
Assist to identify at least two salient findings
Assist to prioritize each one
Introduce nominal group technique (if needed)

10. Provider Project Set-up – Checklist for Peer Mentors
Create project charter (1st page of change project form)
Aim statement
Define measure and how data will be collected
Baseline data
Business case

11. Provider Project Set-up – Checklist for Peer Mentors
Confirm that Change Leader is…
Influential
Experienced
Knowledgeable
Has freed up enough time to devote to PI activities

12. Provider Project Set-up – Checklist for Peer Mentors
4. Confirm that Change Team has been established
No more than 7 people
If Change Leader is not clinical person, make sure to include clinician on team
Make sure to include someone who represents customer’s perspective
Plan frequency of team meetings, e.g. 1.5 hrs. every other week

13. Provider Project Set-up – Checklist for Peer Mentors
Involve Executive Sponsor
Ensure ES engaged in PI
Confirm that ES signed project charter
Confirm ES support and commitment to sustain changes that result in improvement
Establish communication flow with ES

14. PI Toolkit for Providers – Mentors offer, as needed
Nominal Group Process
Flowcharting
How to measure change
Next available appointment tracking/ graphing forms
No-show tracking/graphing forms
NIATx website - Promising Practices

15. PI Toolkit – Flowcharting
GOLDEN RULE: Focus on fixing system,
not individuals (no blame)
Step 1 Define objective (e.g. see all clients within 24 hours of 1st contact, increase retention from 1st contact to admission)
Step 2 Define process (e.g. admission process)
Step 3 Define first and last steps
Step 4 Quiet Time – Each person writes down current process steps (from customer’s perspective)
Step 5 As a group, note steps in process on yellow Post-its
Step 6 Review flowchart

16. PI Toolkit – Flowcharting
Step 7 Quiet Time – Each person uses red Post- its to identify and record bottlenecks/drop out points and blue Post-its to describe suggestions for process improvements
Step 8 Place blue and red Post-its on flowchart
Step 9 Review suggested changes
Step 10 Quiet time – Prioritize areas to focus on. Each participant picks three changes, based on ease of implementation and impact on objective. Use colored dots to mark on flowchart.
Step 11 Select changes to pilot test
Step 12 Discuss next steps

17. Peer Mentor Styles and Concepts
1. When to listen, when to tell
When in doubt, listen
Respect organizational lines of authority and roles

18. Peer Mentor Styles and Concepts
2. What to look for and listen for
What kind of organization are you working with?
Take the idea and run - Utopia
Take the idea and run in the wrong direction – Ask questions to make sure you understand why
Tell me what to do – Avoid this seduction/ dependence; find someone in the organization who can provide direction around improvement projects

19. Peer Mentor Styles and Concepts
3. When to add structure, when not to
Feel the rhythm; watch what happens when they run a few cycles
Great ideas, but trouble executing them – help develop a plan
Great at implementation, but not at generating ideas – teach them idea generation techniques, e.g. Nominal Group Technique; direct them to the NIATx website

20. What to watch for – Common Pitfalls
Too much, too quick
Not holding people accountable
Multiple changes made simultaneously
Improvements aren’t affecting bottom line
Waiting for aim measure results to see if there’s improvement
“No authority/control” to change cause of problem
Resistant staff

21. Project Monitoring/Reporting and Other Tasks
Bi-Annual Peer Mentor Report
Next Available Appointment Tracking
No-show Tracking

22. Support for Peer Mentors: Role of Peer Mentor vs. Coach
Total autonomy (the peer mentor acts as the coach and the coach reviews site activity without regular conversations);
Supervisory (Coach talks to Peer Mentor on a regular basis);
and/or
Collaborative (Peer Mentor does provider awareness building and provides some phone call assistance and Coach does majority of technical assistance).

23. Support for Peer Mentors
Monthly conference calls:
Within state
STAR-SI Peer Mentor Interest Circle Call

24. Support for Peer Mentors
Resources
Data
Change Ideas
NIATx website
Interest Circle Calls
State PI Coaches
Sheila Barbee
Rick Hankey
Angie Maldonado

25. Next Steps Call provider to arrange site visit Learning Session (TBD)
See Sample Initial Site Visit Agenda
Learning Session (TBD)

26. Feedback
What should we do differently in our next Peer Mentor training?
What should stay the same?

27. Have fun!