1. The Complimentary Toolbox for Practice Improvement

2. Disclosures
Nothing to disclose

3. Welcome & Introductions
Who are we?
Who is in the room?
What are you interested in hearing about today?

4. Objectives:
Apply matrix principles to conversations about practice change
Explain how relational coordination is essential to improving task integration
Demonstrate how lean tools reduce waste, increase value, and support practice change
Increase awareness of unconscious bias and the impact it has on relational systems.

5. Matrix Model of Communication
Matrix Leadership Institute
Boulder, Colorado
Amina Knowlan

6. Video Slide

7. Yarn Activity Break into 2 groups, form circles
Pick a person in your circle, name them, ask a curious question while tossing yarn to them
Receiver may answer (or not), then pick another person in circle and repeat process
Continue until everyone is included

8. Relationships = Connections

9. Activity Debrief Representation of communication patterns
Building “Ground of Health”
Investment in building strong connections
Safety net
Connections

10. Barriers to Strong Matrix
Lots of barriers realistically
Awareness
What do you bring to the table?
What experiences do others bring?
Choose your response, don’t react
Own it! Make deliberate decisions

11. What is Unconscious Bias?

12. Unconscious Bias Activity
Warmth and Competence Exercise
On a sheet of paper give each of the following pictures of 6 famous people a score for 1) warmth and 2) competence. Rate them using a 1 (lowest) to 5 (highest ) scoring scale.

13. Warmth and Competence Exercise1 2 3 4 5 6

14. Unconscious Bias Pause…..
What are some biases we may encounter in our own healthcare environment?
Pause…..
Recognize that everyone has biases
Recognize our own biases
Resources - IAT

15. Summary/Debrief Remember what it looks and feels like to pause:
Stop and listen
Acknowledge your own reaction
Actively Listen
Seek to understand other possible interpretations
Engage in an empowering and affirming manner
Collaborate
Make it Happen

16. Relational Coordination
Communicating and relating for the purpose to accomplish a job together as a team.

17. Relational Coordination Survey
Validated tool to ground the relational issues more concretely to the work or task at hand.
7 Dimensions of an effective team:
Frequent Communication
Timely Communication
Accurate Communication
Problem Solving
Shared Goals
Shared Knowledge of one another’s roles
Mutual Respect

18. Family Practice Average 3.62
RC Dimension
Family Practice
Average
Frequent
Communication
4.11
Timely
3.71
Accurate
3.72
Problem-Solving
3.18
Shared Goals
3.76
Shared Knowledge
3.29
Mutual Respect
3.57
Relational Coordination
3.62
is Moderate
<3.5 is Weak
> 4.0 is Strong

19. 9 Months later… RC Dimension Family Practice Average Frequent
Communication
4.11
Timely
3.71
Accurate
3.72
Problem-Solving
3.18
Shared Goals
3.76
Shared Knowledge
3.29
Mutual Respect
3.57
Relational Coordination
3.62
9 Months later…
is Moderate
<3.5 is Weak
> 4.0 is Strong
RC Dimension
Family Practice
Average
Frequent
Communication
4.22
Timely
3.89
Accurate
Problem-Solving
3.73
Shared Goals
3.98
Shared Knowledge
3.53
Mutual Respect
3.97
Relational Coordination
Between Workgroups
Mean Min Max
Relational Coordination
Frequent Communication
Timely Communication
Accurate Communication
Problem-Solving
Communication
Shared Goals
Shared Knowledge
Mutual Respect

20. LEAN Thinking “LEAN” –eliminate waste, increase value.
NOT a quick fix, problem solving through continuous improvement- a culture

21. Lean Strategies to Achieve “Flow”
Standard Work
Process Mapping
Problem Solving using A3s
Daily Management System
Huddles
Daily Metrics

23. Lean Activity One Piece Flow versus Batching
We need 2 groups of 5 people.
Facing back to back.
Timer for each group.

24. Indirect Work throughout the day
Urgent
Flow Station
Inbox
Phone Note
Document Visit
CPO Test result
Non-Urgent Flow Station Inbox

25. Complimentary Toolbox Summary
Matrix Model of Communication
Strengthen the network of relationships
Relational Coordination
Communicating and Relating for the purpose of a task
Unconscious Bias
Recognize bias and implement strategies
Lean
Culture of Continuous Improvement

26. Please evaluate this session at: stfm.org/sessionevaluation