1. Building your team: First things
January 30, 2017
Day 1
Building your team: First things
Phyllis Virgil

2. Session Handouts
Working Agreement = D

3. Session Objectives Revolutionary Common Sense
Identify early team tasks that will pay off dividends
Discuss the use of working agreements to help to clarify roles and responsibilities
List the four essential norms for team success
Recognize the importance of healthy ground rules
Describe successful team building exercises
Revolutionary Common Sense

4. Session Agenda Building Your Team
Topic
Time
Definitions and Aim
5 minutes
Early Team Tasks
25 minutes
Reaching Working Agreements
20 minutes
Creating Healthy Group Norms
Building Team Relationships

5. Team versus Group? Distinguishing factors: Commitment Purpose
Relationship
A healthy team has CPR— Commitment, Purpose, and Relationships. The group must be clear on its aim/goals, committed to the project, and attend to the needs of its people.
Commitment to value of the team -- realize working together is better than working alone...
Clarity and Constancy of Purpose (aka AIM) – know what they are doing and why
Relational, they attend to the needs of group and its members.
Have HEALTHY CPR
Commitment to value of the team --
Common Purpose (aka AIM)
Interdependent – realize working together is better than working alone
CARE
Commitment
Attitude
Relationship
Empathy
Source: M. K. Key for TIPQC (Tennessee Initiative for Perinatal Quality Care)

6. A high performing team is...
A cohesive group. With a common Aim. Who work well together. To get things done.
© 2016 Phyllis M. Virgil, PMV Consulting
Source: Phyllis M. Virgil,

7. Coach Role is Essential to Team Building
Coach Aim:
Transfer Knowledge and Skill
Achieve self sufficiency
Time
Coach Involvement
Low
High
New Team
Mature Team
From Bob’s 2015 ELFT slide deck: ELFT IC Day 1A-Introductions_ver4 AB& RL adds
Also in my Source: Phyllis M. Virgil, Team Training Presentation, 2012, as well as many personal contracting sessions from 1990 onward
Graphic Source: Executive Learning , Team Training Materials
Content Source: John S. Dowd, Courses in Continual Improvement
Help Teams Set up for success and become self sufficient, in Improvement Science and Team Work
Transfer knowledge and skill....
Graphic Source: Executive Learning , Team Training Materials
Content Source: John S. Dowd, Courses in Continual Improvement

8. From Bob’s 2015 ELFT slide deck: ELFT IC Day 1A-Introductions_ver4 AB& RL adds
Source:
Image Source: The Red Fairy Project

9. Early Team Tasks Select a table facilitator
Create an affinity diagram of early team tasks (10”)
Use sticky notes to quickly identify early team tasks - one idea per note (do this silently)
Post ideas on your flip charts, organize them into like categories, then label your groupings with a title that represents the category
Be prepared to report out to the larger group (5”)
Debrief... Ask tables to report out their major categories... Karen to create master list... Start with table one... Next table anything to add that is different... Keep going until all ideas are up there...
Volunteer to take photo and send to me at

10. Tending to Early Team Tasks
Pays Off Dividends
Progress curve
Amount of Work
Team Progress
Amount of work put in the beginning pays off dividends in the end..
The beginning can be frustrating: You’re doing so much work and yet it doesn’t feel like you’re making progress. We know progress brings joy at work (Amiable’s progress principle), so the beginning is often challenging
Time >>>>>

11. Early Team Tasks – Peter Scholtes List
Team Building & Development Objectives
Reaching agreements between the team members, coach and leader about their working relationship, roles and responsibilities.
Setting Team Ground Rules and defining key processes such as decision making
Getting to know each other -- interests, experience, capabilities and contributions
Understanding and adopting effective meeting and decision making processes
Educational Objectives
Understanding and embracing the teams charter and purpose.
Exploring and embracing the Model for Improvement and basic improvement tools
Understanding and embracing team meeting structure, process and tools
Project Objectives
Selecting and orienting members to the mission of the team and a basic roadmap
Understanding the scope, boundaries and area of focus
Defining and understanding customers or target population
Developing a team Aim Statement
Identifying resources and obtaining commitments
Beginning a storybook and storyboard
Source: The Team Handbook, Peter R. Scholtes, et. al., Joiner Associates, Inc, 1988, page 4-15.
As presented in Phyllis M. Virgil, Team Training Presentation, 2012
Adapted from: The Team Handbook, Peter R. Scholtes, et. al., Joiner Associates, Inc, 1988, page 4-15 as presented by Phyllis M. Virgil

12. First Things, A Deeper Dive...
Adapted from Phyllis M. Virgil, Diveheart Strategic Quality Planning Retreat, 2009

13. Identify Team Leadership
The Team Leader should ideally be process owner (person able to directly authorize and sustain changes), they are responsible for running the team, leading meetings, and ensuring results. Be sure to have an Executive Sponsor who takes responsibility for the overall success of the project , assists in removing barriers, links the project to senior management, and champions the project. The Improvement Coach will support the leader and team with help in learning and applying QI concepts and tools and facilitating group processes. The aim of the coach also will be build capacity for team and leader self-sufficiency overtime in both running teams and making improvements.
Source: Phyllis M. Virgil and Karen Baldoza, for ICP Spring 2016
Source: Phyllis M. Virgil and Karen Baldoza

14. Develop Draft Roadmap
Contra Costa Regional Medical Center, BH-PC Collaborative
Activity
2rd Qtr
3th Qtr
4st Qtr 4 5 6 7 8 9 10 11 12
Aim and Goals
Team Infrastructure
Develop Measures
Initiate 1st PDSA
ID High Priority Areas
ID Change Strategy & Ideas
Run PDSA Projects
Source: Phyllis M. Virgil for Contra Costa Regional Medical Center, BH-PC Collaborative. 2015
Develop Task List for yourself and preliminary roadmap for your team
Source: Phyllis M. Virgil for Contra Costa Regional Medical Center, BH-PC Collaborative

15. Craft a Prelimary Aim
Every system must have an aim. Without an aim that is clear to all there is no system. - W. Edwards Deming, Out of the Crisis Corollary 1: Every team must have an aim. Without an aim there is no team. Corollary 2: Determination without destination leads to disaster.
Source: Phyllis Virgil, Strategic Quality Planning Retreat, 2008
Original Slide Created 1998, Phyllis Virgil, Corollary 1 & 2 adapted from 2008 PMV materials on strategic quality planning
Key Point: A system is a network of interdependent components working together toward a common aim. Without a common aim among the components, you don’t have a system.
Source: Phyllis M. Virgil

16. Select Team Members Review the project aim
What is the process of focus (boundaries, scope, major steps)
Who is involved (persons who supply the process, work within it, manage it, or receive the benefits of it)
Select a cross-section of this group
Cover skills and knowledge base needed, and
Function and role needed (managers, administrators, point-of- service staff)
Be sure to include those who work in the process
Developed by Phyllis Virgil and Karen Baldoza for ICP Feb 2016
When selecting and recruiting team members:
Review the project aim
Consider the process(es) that relate(s) to your aim
What process will be affected by the improvement efforts? (boundaries? scope?)
Who are the people who supply the process, work within it, manage it, or receive the benefits of it?
Select a cross-section of this group
Be sure to include members directly involved in the process of focus
Cover skills and knowledge base needed, and
Function and role needed (managers, administrators, point- of-service staff)
There may be one or more people on the team with each kind of expertise, or one person may have expertise in more than one area
Best is to have an intact team... Not cross functional... Functional is best!!!! When lesarning
Source: Phyllis Virgil and Karen Baldoza

17. Selecting Team Members (cont.)
There may be one or more people on the team with each kind of expertise
Or one person may have expertise in more than one area
Don’t forget you can have just in time guests, as needed
Also, some members may come and go during different phases of the improvement process
Developed by Phyllis Virgil and Karen Baldoza for ICP Feb 2016
When selecting and recruiting team members:
Review the project aim
Consider the process(es) that relate(s) to your aim
What process will be affected by the improvement efforts? (boundaries? scope?)
Who are the people who supply the process, work within it, manage it, or receive the benefits of it?
Select a cross-section of this group
Be sure to include members directly involved in the process of focus
Cover skills and knowledge base needed, and
Function and role needed (managers, administrators, point- of-service staff)
There may be one or more people on the team with each kind of expertise, or one person may have expertise in more than one area
Best is to have an intact team... Not cross functional... Functional is best!!!! When lesarning
Source: Phyllis M. Virgil and Karen Baldoza

18. Team Member Matrix Skills, Knowledge Function, Role Bob Sam Pat Tom
Sue
Process Knowledge
QI Skills
Owner
Technical Expertise
Management
Supplier ?
Customer?
Front Line/Point of Service
etc...
Source: Phyllis M. Virgil, Team Training, 2012
Process Knowledge Team, Idea Team, Implementation Team.... Just in time team members...
IA/Staff/Front line leader – 3 Action Squad team – works too!!! Test it, may work! Let us know. Bare bones --
Source: Phyllis M. Virgil

19. Reach Working Agreements
With your leader
and
With your team
Source: The Role of Contracting in Quality Improvement,, by M.K. Key, Ph.D. Quality Matters, October, 1992, Page 22,
Got From From Bob -- Day 3B-ELFT IC WS2 effective mtgs ver5
Usually, as the process improvement effort begins, the team leader and coach negotiate who will take responsibility for leading meetings based on the experience and skill level of the team leader.
If the team leader has never led a team before, it is likely that the coach will model skills by leading the initial team meetings.
On the other hand, if the team leader has previous team leadership experience or has possibly been developed as a coach, then he or she will be able to lead the meetings from the start.
Article Source: The Role of Contracting in Quality Improvement,, by M.K. Key, Ph.D. Quality Matters, October, 1992, Page 22
Graphic Source: Executive Learning , Team Training Materials
Source: The Role of Contracting in Quality Improvement,, by M.K. Key, Ph.D. Quality Matters, October, 1992, Page 22, as outlined by Executive Learning Inc.

20. Working Agreements... (aka Contracts)
Explicit, though probably unwritten, agreements between two parties (Coach/Leader, Coach/Team).
Working agreements specify:
1. Who the client is (remember we are all customers of each other)
2. The aim and objectives of the relationship
3. The roles and responsibilities of each
4. Any other ground rules for the relationship
If broken provides opportunity to reflect, learn and rework as needed.
From Bob -- Day 3B-ELFT IC WS2 effective mtgs ver5
SOURCE: The Role of Contracting in Quality Improvement,, by M.K. Key, Ph.D. Quality Matters, October, 1992, Page 22,
Content Source: The Role of Contracting in Quality Improvement,, by M.K. Key, Ph.D. Quality Matters, October, 1992, Page 22, as outlined by Executive Learning Inc.
Graphic Source: Executive Learning , Team Training Materials

21. Working Agreement Handout
Definition of working agreement
Purpose of agreements
How to conduct a session
Pointers for successful agreements
Pitfalls of making agreements
Coaching Tasks Inside meetings
Coaching Tasks Outside meeting
From Bob -- Day 3B-ELFT IC WS2 effective mtgs ver5

22. Coach/Leader Agreements Simulated Pair Share
1. Skim the coach/leader agreement handout. Highlight those items that you feel are most important to discuss in a coach/leader working agreement session. (5 minutes)
2. Simulate a working agreement meeting (5 minutes):
Find a partner – one is the “team leader” and one is “coach” Simulate a meeting to develop your “Working Agreement”. Include:
The aim the relationship
The roles and responsibilities of the both parties
Any other ground rules for the relationship
Be prepared to share significant learnings or insights with the large group
Adapted from: The Role of Contracting in Quality Improvement,, by M.K. Key, Ph.D. Quality Matters, October, 1992, Page 22, as outlined by Executive Learning Inc.
Adapted from: The Role of Contracting in Quality Improvement,, by M.K. Key, Ph.D. Quality Matters, October, 1992, Page 22, as outlined by Executive Learning Inc.

23. The Perfect Team - Google's “Project Aristotle”
After looking at 180 groups for more than a year to find the anatomy of the perfect team, Google’s researchers found:
Success was NOT related to “personality type, skills, talent, or background, etc. The “who did not matter...
Instead they found understanding and influencing group norms were the keys to team success.
Specifically, successful teams had norms that allowed members to:
Be Heard / Be Understood / Be Known / Be Safe
Source: What Google Learned From Its Quest to Build the Perfect Team , New York Times Magazine February. 25, 2016, as presented by Phyllis M. Virgil, Feb, 2016
Help the leader and coach manage behavior of the team memebers... Big tool for mamangin particularly important to cross functional teams
Guests... What do you do when person another department not go or – all ironed out before hand, need permission to come to meeting
Source: What Google Learned From Its Quest to Build the Perfect Team , New York Times Magazine February. 25, 2016, as presented by Phyllis M. Virgil

24. Establish Healthy Norms
Ground Rules make explicit those norms the group wants to establish regarding expectations and behaviors in their improvement journey, both in and outside of their meetings.
They help to establish a culture of collaboration and respect.
Are the team members explicit “working agreements”.
Are best recorded in a manner where all can view them.
Source: Phyllis M. Virgil, Team Training, 2012
Help the leader and coach manage behavior of the team members... Big tool for managing particularly important to cross functional teams
Guests... What do you do when person another department not go or – all ironed out before hand, need permission to come to meeting
Source: Phyllis M. Virgil

25. Ground Rules Tips from the Trade
Ground rules are made, owned and used by the team
Best to develop in the first few meetings
Ground rules should be specific enough so all understand
Should be used for improvement not punishment
The coach is not the ground rule cop, but does help point out violations
Are the teams “working agreement”, use PDSA to review and revise
Remember “Project Aristotle”, ground rules should help remember:
Be heard, Be understood, Be known, Be safe
Source: John S. Dowd, Courses in Continual Improvement
Ground rules are made, owned and used by the team
They should be developed by the team in its the first few meetings
Ground rules should be specific, not general so team members understand what is expected
The team needs to agree about how ground rules will be used
The coach is not the ground rule cop, but does need to point out violations
Ground rules should be reviewed periodically, they are the teams “working agreement and should be redrafted as needed
Use PDSA to review and revise
Trick is to develop useful and productive norms in the beginning
Remember “Project Aristotle” – be heard, be understood, be known, be safe
Source: John S. Dowd, Consultant in Continual Improvement

26. Rules of Engagement, Community Health Center of Buffalo
Effective Meeting Tips, Adopted by CHCB, November 2016
From Lavonne Ansari, MD
Submitted by Lavonne Ansari, Medical Director, Community Health Center of Buffalo, NY, ICP Fall 2016

27. Here are basic ground rules from this morning:
So what do you think?
Anything you would add?
The group will help enforce the ground rules during the workshop.
Here are some from our first offering
Only one person speaks at a time.
Stay on topic.
No side conversations.
Confidential issues will remain in the room.
Respect others’ points of view.

28. Build Team Relationships
Being known is key to team performance...
Google Project Aristotle
Warm-ups
Check-ins
Source: What Google Learned From Its Quest to Build the Perfect Team, New York Times Magazine February. 25, 2016, as presented by Phyllis M. Virgil, 2/16
Check-in Photo Credit: Bill and Jami in Wiki Ed team meeting 2,
Team Names = First Blood, Q Potty Team, Round em Up
Particularly important in beginning... Begin with ice breakers, then go to check in...good early one... To get
Energizer Bunny Hot Air Balloon, larger than the Statue of Liberty. Colorado Balloon Classic in Colorado Springs, CO at Memorial Park.
Date 6 September 2009, 08:22
Ice Breaker was Bob’s photo
Coffee cup =
Checkin labeled non commercial resuse on google... Site =
Energizers
Source: What Google Learned From Its Quest to Build the Perfect Team , New York Times Magazine February. 25, 2016.
Photo Credits: Communication4Health, Pixabay, Flickr,-everly and Pack, Wiki Education Foundation

29. Ice Breakers, Warm-ups, Energizers, Check-ins...
Meeting openers like ice-breakers, warm-ups and check-ins help team members to clear their minds, break away from their previous work, develop team spirit, think creatively and focus on the task at hand.
Effective Meeting Openers
Relevant to the group or topic
Engaging and/or fun
Have an element of self disclosure
Warm-ups
Energizers
Check-ins
© 2016 Phyllis M. Virgil, PMV Consulting
Source: Phyllis M. Virgil, Diveheart Strategic Planning Retreat, 2008
Ice Breaker Suzanne Vander Wekken
Coffee cup =
Energizer Bunny = Beverly and Pack
Checkin labeled non commercial resuse on google... Site =
Source: Phyllis M. Virgil
Photo Credits: Communication4Health, Pixabay, Flickr,-everly and Pack, Wiki Education Foundation
Source: Phyllis M. Virgil, Diveheart Strategic Quality Planning Retreat, 2008

30. Warm-ups, Ice-breakers, Energizers, Check-Ins
Google it....
Energizers
Source: Phyllis M. Virgil, Diveheart Strategic Planning Retreat, 2008
Ice Breaker Suzanne Vander Wekken
Coffee cup =
Energizer Bunny = Beverly and Pack
Checkin labeled non commercial resuse on google... Site =
Photo Credits: Communication4Health, Pixabay, Flickr-Beverly and Pack, Wiki Education Foundation

31. Warm-ups: ICP All Stars
Share your favorite Warm-up
Short Name
Instructions
Your contact info
Send to Linson who will add to ICP favorites list:
Energizers
Source: Phyllis M. Virgil, for ICP F16
Google labels photos as Noncommercial Use.
Source: Phyllis M. Virgil, Diveheart Strategic Planning Retreat, 2008
Ice Breaker Suzanne Vander Wekken
Coffee cup =
Energizer Bunny = Beverly and Pack
Checkin labeled non commercial resuse on google... Site =
Source: Phyllis M. Virgil
Photo Credits: Communication4Health, Pixabay, Flickr, Beverly and Pack, Wiki Education Foundation

32. Example from Wave 2
Team Line Up Submitted by Kathryn McDaniel Wave 2 Fall 16 One of the easiest/quickest, but still effective ice breaker's I've been a part of is a 'superlative' one. You pick a category and the members of the group have to line up in order of that category. If you have multiple teams, the one to do it the fastest wins. eg: Shortest to tallest, distance traveled closest to furthest, birth date by month and day January to December, # of letters in first and last name shortest to longest, etc

33. In Summary... Attending to early team tasks will pay off dividends
Forming working agreements with your leader and team helps to clarify roles and responsibilities
Having healthy norms and ground rules are essential for high performing teams
Getting to know each other enhances team performance, use team building exercises to develop relationships
Created by Phyllis Virgil
Being present -- is an essential skill for team coaching
Attend to early team tasks -- Up front there are many early team tasks to tend to
Form working agreements – with your leader and your team
Get to know each other -- ice breakers, Warm-ups, and Check-ins can help your team bond
Have healthy group norms – walk the talk and talk the walk –
Be There is an essential skill for team coaching
Up front there are many early team tasks to tend to
Contracting, pre-briefing and debriefing
Ice Breakers, Warm-ups, Check-ins can help your team bond
Group norms are key to teamness – Ground rules
Source: Phyllis Virgil

34. Additional Resources

35. Evaluating your Team’s Effectiveness!
Exercise #4
Evaluating your Team’s Effectiveness!
Date of assessment: _________________
All too often team leaders and members THINK they are functioning at a high level.
A primary role for an Improvement Coach, therefore, is to continuously assess if the team is in fact functioning efficiently and effectively or if it is drifting into the land of incompetency.
This assessment tool provides a quick and easy way for an Improvement Coach to evaluate a team’s ability to achieve its desired outcomes.
Conduct this assessment at least three times during the life of the team.
Source: Executive Learning , Team Training Materials
From Bob ELTF Slide Deck -- Day 3B-ELFT IC WS2 effective mtgs ver5
Here is a team assessment questionnaire that you can use to evaluate how well your team is functioning as a cohesive group that works well together to achieve its aim... Ideas on where may need shoring up...
Source: Executive Learning Inc., Team Training Materials

36. Break