1. Facilitation Skills for ASaP 1 Improvement Facilitator Training Session 2

2. Objectives Understand how effective facilitation is key to guiding teams in improvement Review certain tools and techniques for effective improvement facilitation Become more familiar with the ‘Facilitation at a Glance’ and ‘QI Guide’ reference tools 2

3. 3 Process Improvement Current Process Who does what? How? Process Redesign Who could/should do it? How? EMR How can lists of patients due for screening be generated? Measurement Is a change an improvement? TEAM Facilitation

4. What factors can prevent “buy-in” from all team members when planning an improvement? 4 Buy-in x Patients Procedures Providers/Team Policies Places/Equipment Cause/Effect Diagram (also known as Fishbone or Ishikawa)

5. How can these factors be avoided/solved? 5

6. Facilitator Wisdom 6 The people who do the work need to change the work. Improved buy-in Ownership of improvement work Enhanced understanding of others’ roles Better solutions Less dependence on facilitator

7. Facilitator Wisdom 7 Without a visible sponsor, the change will seem optional. - Silversin Leadership is key Improved buy-in Clear direction Quicker decisions Less dependence on facilitator

8. Leadership 8 Clinic Lead Physician/Provider Lead Office Manager, or Clinic owner Clinic Lead Physician/Provider Lead Office Manager, or Clinic owner Improvement Lead Team member Physician/Provider Lead Office Manager, or Clinic owner Improvement Lead Team member Physician/Provider Lead Office Manager, or Clinic owner

9. Identifying the Improvement Lead Interested Involved Keen Organized Comfortable leading Communicates well 9

10. Facilitator Wisdom 10 The best way to get a good idea is to get lots of ideas. - Linus Pauling Brainstorming (162) Cause & Effect (12, 29, 170) Defect Check Sheet (26) 5 Whys (31) Other options (153-94) Facilitation at a Glance QI Guide IHI Open School (QI102)

11. Ensuring All Voices Are Heard Facilitation at a Glance (pgs 135-52) Establish meeting guidelines/norms Ensure participants understand purpose of meeting/decision Create “buy-in” – What’s in it for us? Our patients? Use break-out groups and post-its for idea generating Body language – “traffic cop” 11

12. Facilitator Wisdom 12 You can have brilliant ideas, but if you can't get them across, your ideas won't get you anywhere. — Lee Iacocca COMMUNICATION QI Guide (pgs 18-19, 35) Improvement Team Communication – Huddles Clinic Team Communication – Improvement Board – Team meetings QI Guide IHI Open School (QI105)

13. Improvement Board 13 QI Guide (35) IHI Open School (QI201) Run chart? Process maps?

14. Summary Facilitation is critical to success with improvement work The team must do and own the work Leadership is key for team participation and progress For meetings, especially when redesigning screening processes, facilitation tools and techniques can help ensure that all voices are heard Ongoing communication between the improvement team and also to the greater clinic team is important Helpful tools and techniques are detailed in the QI Guide (binder) and Facilitation at a Glance 14