10- Fundamentals of Workflow Process Analysis and Redesign- Unit 7- Facilitating Meetings for...

8/10/2019 10- Fundamentals of Workflow Process Analysis and Redesign- Unit 7- Facilitating Meetings for Implementation Decisions

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Fundamentals of Workflow Process

Analysis and Redesign

Facilitating Meetings for

Implementation Decisions

This material Comp10_Unit7 was developed by Duke University, funded by the Department of Health and Human Services,

Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.



Facilitating Meetings forImplementation Decisions:

Learning Objectives

1. Describe major health care facility decisions in process redesign

that includes EHR technology

2. Draft an agenda and facilitation plan for a decision makingmeeting,

3. Prepare a presentation to communicate findings of a workflow

analysis or process redesign to health care facility decision

makers, and

4. Document those decisions that are made and actions identified in

a decision making meeting

5. Critique a decision making meeting agenda, facilitation plan or

scenario to identify problems and how they could have been

prevented

2Health IT Workforce Curriculum

Version 3.0/Spring 2012

Fundamentals of Workflow Process Analysis & Redesign

Facilitating Implementation Decisions Meeting



Major Decisions in EHR-relatedProcess Redesign

• Which processes to automate or redesign

• Which redesign option to implement

• EHR functionality requirements

• How candidate systems measure up against

requirements

• Process change and system implementationplans







Effective Meetings





“ A single effective meeting will substantially

change the capacity of a group to

achieve desired outcomes” (Bolea & Scott, 2012)

Effective meetings:

• Face the current reality and gap between “as is” and

“where we want to be”

• Identify unused potential to improve, and

• Commit to action / implementation plan



Health Care Decision-Making

In the health care field, the steps of making a

decision may be remembered with the mnemonic

BRAND, which includes

– Benefits of the action

– Risks of the action

– Alternatives of the prospective action

– Nothing: That is, doing nothing at all

– Decisions

(Wikipedia, 2012)



Fundamentals of Workflow Process Analysis & RedesignFacilitating Implementation Decisions Meeting



“BRAND” Change Matrix Template

PROCESS Benefits of the action

Risks of the

action

Alternatives of the

prospective

action

Nothing: doing nothing

at all

Decision

Process option 1:

Process option 2:

Process option 3:

7.1 Table Change Matrix Template (courtesy of Dr. Meredith Nahm,

2012)






Example Process RedesignMeeting Might Include

• Presentation of opportunities for redesign

• For each redesign opportunity:

─ Rationale for the change:

─ Pros and cons of each competing redesign options, or analysis of

multiple options to justify the chosen one

─ Cost assessment of making the change

─ Decision whether or not to move forward with the change,

─ if resources were limited, a priority for the change would be assigned.

• Review of approved changes and their priority

• Next steps






Meeting Purpose

• to “tee up” the key decisions along with the

information necessary to make them for the

decision makers• and ultimately, to obtain the decisions needed to

move the project toward successful completion.






Practice Workflow and InformationManagement Redesign Specialist’ s

Role (as Meeting Facilitator)• Facilitation

– Process of designing/running a successful meeting

• Practice Workflow and Information ManagementRedesign Specialist ’s role (as the facilitator) – Work with practice leadership to plan the agenda,

– Attend to meeting logistics

– Provide decision-making materials in advance

– Conduct, maybe facilitate, the meeting

– During the meeting, present or provide for presentation of decision-

making materials

– Gain agreement on next steps






Group Decision-Making Process

• Process resulting in the selection of a course of

action

• Results in a “choice”

• Systems

– Consensus

– Voting-based methods

•Majority required

• Plurality

– Dictatorship

(Wikipedia, 2012)

10Health IT Workforce CurriculumVersion 3.0/Spring 2012




Meeting Participants Role

• Work within the established ground rules

• Review decision-making material in advance – Notify the facilitator in advance if additional

information is needed

– Provide “reality checks”, i.e, question options,

rationale and assumptions used in cost/benefit

analysis

– Participate in decision-making

• Participate actively in the meeting• Complete action items and follow-up as needed





Key Elements of Success

• Involvement of key personnel – Have thought through potential solutions

– Results in ownership of ideas• Solutions

• Develops commitment for implementation

• Immediate focus on changes which will makethe greatest possible contribution toimprovement and “Meaningful Use”

• Initial implementation planning is begun in thenext steps debriefing wrap-up session at theconclusion of the decision-making meeting





Exercise

A Patient check-in (registration) is shown in a process diagram on thefollowing slide. Assume the practice leadership wishes to use

consensus among the practice manager, senior nurse, two physician

extenders and the two practice partners as the decision-making style.

Assume that resources are limited and the process changes will need

to be prioritized.

Review the diagram, pause the slides, and

1. Create a meeting agenda

2. List decision making materials needed to make decisions about the

process

Afterward, restart the slides and we will talk through the results.





New Patient Check-in: RedesignedProcess

7.2 Figure New Patient Check In. (eQHealth Solutions (formerly Louisiana Health Care

Review) and the Mississippi Regional Extension Center, 2012)





Example Topics for Agenda

• Introductions

• Goal of the meeting and expectedproducts

• Review of documentation of processanalysis and redesign

• Summary & next steps





Decision-Making Materials

• BRAND matrix

• Process diagram





Meeting Logistics

Making arrangements for the meeting

• Scheduling so that necessary decision makers can

attend

• Room size and layout

• Supplies

• Refreshments & breaks

• Travel time & parking

• Building access• Providing materials in advance such that participants

have time to review them





Conducting the Meeting

• Open the meeting by stating the meeting purpose

– “to make decisions on …”

• Review and follow the agenda

• Monitor the agenda / time

• Encourage participation from all attendees

• Help participants reach consensus

• Document decisions

• Document next steps and follow-up / action items





Documenting a Meeting

• Key information to be documented

– Approved / denied process changes

– Priorities for approved changes

– Chosen alternatives

• Next steps

• Action and follow-up items





Debriefing Wrap-up

• A wrap-up debriefing at the close of themeeting summarizes the decisions

• The purposes of the debriefing are: – To confirm agreement

– To agree on next steps to move forward withimplementing approved changes





Method Also Apples to the OtherTypes of EHR-related decision-

making meetings

• Which processes to automate or redesign

• Which redesign option to implement

• EHR functionality requirements

• How candidate systems measure up against

requirements

• Process change and system implementationplans





Facilitating Meetings forImplementation Decisions

Summary• Identified major types of EHR-related process

decisions

•Provided strategies, tools, and aids for planningand conducting a decision making meeting

• Provided tools for documenting decisions madeand actions identified in a decision-making

meeting• Identified professional development areas

related to planning and conducting meetings



F ilit ti M ti f



Facilitating Meetings forImplementation Decisions

ReferencesReferences

• Bolea, A., & Scott, B. (2010). Creating effective meetings. Retrieved 2011, from Business advisors.net:

http://business-advisors.net/files/dwnld/Creating_Effective_Meetings_a.pdf

• Group decision making. 2011. In Wikipedia.org. Retrieved December 21, 2011, from

http://en.wikipedia.org/wiki/Group_decision_making

Charts, Tables, Figures

7.1 Table: Courtesy of Dr. M Nahm, 2012.

7.2 Figure: Permission for use by eQHealth Solutions (formerly Louisiana Health Care Review) and the Mississippi

Regional Extension Center. 2012

23Health IT Workforce CurriculumVersion 3 0/Spring 2012




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