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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
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Process Improvement
Current ProcessWho does
what?How?
Process Redesign
Who could/should do
it?How?
EMRHow can lists of patients due for
screening be generated?
Measurement
Is a change an improvement?
TEAMFacilitation
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What factors can prevent “buy-in” from all team members when planning
an improvement?
Buy-inx
Patients
Procedures
Providers/Team
Policies
Places/Equipment
Cause/Effect Diagram (also known as Fishbone or Ishikawa)
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Facilitator Wisdom
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
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Facilitator Wisdom
Without a visible
sponsor, the change will seem optional.
- Silversin
• Leadership is key
• Improved buy-in
• Clear direction
• Quicker decisions
• Less dependence on facilitator
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Leadership
Clinic Lead
• Physician/Provider Lead
• Office Manager, or
• Clinic owner
Improvement Lead
• Team member• Physician/
Provider Lead• Office Manager,
or• Clinic owner
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Identifying the Improvement Lead
• Interested• Involved• Keen• Organized• Comfortable leading• Communicates well
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Facilitator Wisdom
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 GlanceQI Guide IHI Open School (QI102)
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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”
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Facilitator Wisdom
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 meetingsQI Guide
IHI Open School (QI105)
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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