1

Facilitation Skills for ASaP

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

3

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

4

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)

5

How can these factors be avoided/solved?

6

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

7

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

8

Leadership

Clinic Lead

• 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

10

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)

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”

12

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)

13

Improvement Board

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