1. OneCF LLC2 May 4, 2015 3:30-5pm Phone Number: (866) 537-0817

2. OneCF LLC2 Teams, Coaches & Leaders Team & CoachLeaders Boston Children’s Hospital/JudyKate, Leah, Greg, Ahmet Columbia NYC/LaCreciaEmily,Claire, Hossein, Shirley Nationwide Columbus Ohio/Suzanne John, Terri, Karen, Deanne, Judy Rush Chicago Illinois/Staci Robert, Jenifer, Girish, Kathryn University of Missouri Columbia/Bob Jim, Connie, Natalie, Joe University of North Carolina/Randy Sheree, Jennifer, Magee, James

3. Agenda May 4, 2015 3:30PM Welcome and check-in 3:40PM RC Survey Review and Schedule 3:50PM Progress Reports (3-minute per site) 4:10PM Obeya Room and Measurement Homework review 4:15 PM OneCF LLC2 Site Visit to Minnesota 4:55PM Summary, questions, adjourn -3-

4. OneCF LLC2 OneCF PediatricsInpatientSpecialtiesAdult Exacerbations? Hospitalization Baby Care Lung Transplant Mental Health Reproduction CFRD Pedi-Adult Transition Aim: Assess and develop a CF care center that provides seamless care from the time of diagnosis through advanced care. This includes a focus on integrated care, smooth transitions (pediatric to adult), warm handoffs and transfers, and improvement of mesosystem care such as referral to specialists (e.g. Endo, GI, ENT, Psych) and inpatient care. 1.Baseline assessments 2.Improvement fundamentals 3.Everyone’s first focus: Pedi to adult transition 4.All teach, all learn -4- Diagnoses Advanced Care

5. Teams, Coaching and Leadership LeadershipTeams & Coaches Expectations 5Ps/performa nce Anticipate & assist with data Regular meetings- Provide time & space PDSA Rapid Tests of change with measures Sustain Inspire, Know & Tell Stories -5-

6. OneCF Center LLC2 Overall Aim: Assess and develop a CF care center that provides seamless care from the time of diagnosis through advanced care. This collaborative will focus on integrated care, smooth transitions (pediatric to adult), warm handoffs and transfers, and improvement of mesosystem care such as referral to specialists (e.g. Endo, GI, ENT, Psych) and inpatient care. -6-

7. Leadership of Health Care Quality and Improvement Development Program Overall Aim: Assess and develop personal and team leadership skills and abilities to lead quality and improvement as part of CF Pediatric, Adult and OneCF leadership team. Create conditions for successful improvement -7-

8. Relational Coordination Calendar DateTopic Tuesday, May 5RC survey will be sent out by Saleema Moore Tuesday, May 19Deadline to complete RC survey Wednesday, June 10RC reports distributed and discussed with leaders, coaches and team members at Minnesota Benchmarking Site meeting

9. Relational Coordination Survey Leaders: Create the conditions to ensure the RC surveys are completed Team members: Please remind everyone about the survey -9- 1 Poll

10. -10- Progress Reports- 3 minutes each Any challenges? How are you engaging people with CF and families in “co-production” of care in your OneCF Center?

11. Obeya Room Room with a view Aim: Effective solutions and actions that can be developed and implemented quickly. Increase coordination Multidisciplinary and person with CF and family members Dedicated time and space to coordinate and problem-solve Minimize organizational barriers -11-

12. Materials to Include Registry data 5Ps Value Stream Map and data Detailed “Hand off” flowchart and data -12-

13. Obeya Room -13-

14. Obeya Room “The Big Room”

15. Obeya Room

16. Jack D. Gorvoy Obeya Room Aim: We created a web- based gathering place to store and create tools that would improve the transition process from the pediatric to adult CF center

17. VSM focus on Transition to Adult Nationwide Children’s

18. Measurement Homework Brant has reviewed and posted comments to guide your work Leaders and coaches will discuss in next session -18-

19. Calendar Change The OneCF LLC2 team and leader Adobe Connect June 1 st will not be held. –Minneapolis Minnesota June 8-10 Monday, June 8 th Coaches @ 3pm –OneCF LLC2 Leaders @ 5pm –OneCF LLC2 ALL @ 6:30pm (includes dinner) –Please make your hotel reservat -19-

20. Minnesota Agenda https://www.surveymonkey.com/s/DV62RFG https://www.surveymonkey.com/s/DV62RFG -20- M ONDAY, J UNE 8, 2015 2:00–7:00 p.m. RegistrationSocial West, Pinnacle Ballroom 3:00–4:30 p.m.OneCF LLC2 Coach meetingInventor 1 Room Coaches 5:00–6:00 p.m.OneCF LLC2 Leaders and Coaches meeting Inventor 3 Room Leaders & Coaches 6:30 p.m.DINNERPinnacle Ballroom 6:45 p.m.Welcome from University of MN Executive Leader Welcome from University of MN CF TeamJordan Dunitz, MD Terri Laguna, MD, MSCS Sandy McAllister, RN Carlye Tomczyk RN, MSN, CPNP 7:00 p.m.Overview of CF Foundation Quality Improvement InitiativePaula Lomas, MAS, RN, CCRP 7:15 p.m.Overview of University of MN CF CenterJordan Dunitz, MD 7:30 p.m.BREAK 7:45 p.m. OneCF Team Reports including Obeya Rooms, All Value Steam Mapping on Poster board stands: 3 sites (15 minutes each) 8:30 p.m. BREAK 8:45 p.m. OneCF Team Reports including Obeya Rooms, All Value Steam Mapping on Poster board stands: 3 sites (15 minutes each) 9:30 p.m.ADJOURN

21. Next Activities Continue to meet weekly: Team and Coach –Leader and Coach meet regularly Review Task book on OneCF LLC2 website (prepare for Minnesota–June 8 to 10, 2015) Available Wednesday May 5, 5pm ET. –Reading, videos, resources –Preview the Minnesota CF Center website, annual report, maps and other relevant materials -21-

22. Minnesota Taskbook -22- To help you prepare for the Minneapolis Minnesota meeting, please review and complete the following Task Book. 1.Bring your value stream map including cycle time and information flows 2. Bring your Obeya Room example or pictures 3. Prepare a 7 minute PowerPoint presentation updating the Value Stream map, detailed “hand off” flowchart and where you have found improvement opportunities in the process. 4. Please practice the 7 minute presentation to ensure you don’t exceed 10 minutes (5 minute Q&A) 5. Review the OneCF LLC2 Minnesota agenda and pre-meeting materials: Observation worksheet and Fresh Eyes document 6.Post Site visit check list and materials: Thank yous, debrief with CF Center, Executive summary for your organization leadership and CFF. 7. Review these QuIRK modules on the website: #7 & #8 9. Review the following measurement modules on the website: #5, #6 & #7 10. Read Quality by Design chapters: 23 11. Read Difficult Conversations: 4, 5, 6, 7, 8, 9 If you have not registered for the Minnesota meeting: https://www.surveymonkey.com/s/MY5DV6Q https://www.surveymonkey.com/s/MY5DV6Q

23. Thank You See you in Minnesota! -23- www.clinicalmicrosystem.org Please complete the Survey Monkey listed in the chat box.