FORGE AHEAD Program Transformation of Indigenous Primary Healthcare Delivery : Community-driven Innovations and Strategic Scale-up Toolkits Module 4: Facilitation

Facilitation in FORGE AHEAD 3 key roles as a Community Facilitator in FORGE AHEAD To provide leadership, guidance and organization To keep the teams on track and meeting their objectives Record and track the teams history, progress, ideas and PDSA’s Each of these three points will be discussed, and then we will suggest possible tools to help you fulfill these roles

1) Leadership You will provide direction to the group by helping the team establish what should be done, and how they can do it Where possible, encourage the team members to take on key responsibilities/tasks, and delegate tasks. Organize the team meetings, and develop an agenda to guide the meetings

1. Leadership Tool: Meeting Agenda Use the Meeting Agenda template, or adjust the template to create an agenda that works for your teams. Write meeting minutes to document areas covered, decisions, and action items. Key components of an agenda: date, who attended, regrets, topics, decisions, and actions items (what needs to be done and who is going to do it). Discuss the agenda at your first meeting so everyone agrees with a process for establishing and recording the minutes. Book the meetings in advance if you can, to ensure meetings can take place (eg, 10am every Monday for 30 minutes)

1. Leadership Tool: Meeting Agenda If writing meeting minutes is time consuming: Delegate to another team member Document the key components only (date, attendees, topics, decisions, actions) Sending meeting minutes to Western: You do not have to type them out You can also send a quick email to just let us know the key components of the meeting Copy us on emails to your team members Identify the meeting objective and the key points you will cover The team should acknowledge their acceptance of the agenda, or make suggestions for changes

1. Leadership Tool: Meeting Agenda Identify the meeting objective and the key points you will cover The team should acknowledge their acceptance of the agenda, or make suggestions for changes Assign any duties/work to individual team members (eg, who will lead a discussion on a topic, who will report on a PDSA, or who will record notes, who will lead the meeting, etc) Set up during initial organizational meeting with each team to ease your workload

1. Leadership Tool: Tips for Booking Meetings Use Doodle polls to organize meetings to fit everyone's schedules (go to doodle.com) Use huddles as well as meetings when schedules do not allow for regular meetings – KEY TO KEEP ACTIVITIES MOVING! Book regular meetings for the long term (eg, Monday 10am every week or every other week to ensure time is dedicated for meetings) Hold meetings even if every person is not available for every meeting Have team members call in to a speaker phone if they cannot make it in person Hold a short meeting if that is all that is available at any given time

1. Leadership Tool: Team Guidelines Propose a list of team guidelines (eg, everyone will respect others that are talking, do not use cell phones during a meeting, etc) This should happen at the first meeting, or early on in the program Provide an opportunity for the group to delete, add, or adjust any guidelines The team then needs to agree about the rules as a basis for participation in the team, this could be confirmed in an email to all team members The guidelines can be posted in the meeting room as a reminder of the teams vision and shared values

2) Meeting Team Objectives Guide teams down the plan outlined in the agenda If a meeting or a discussion goes off topic, bring them back to their plan Help to ensure the team is meeting their objectives and completing important milestones Have some ideas about how to prompt discussion Provide encouragement, motivation and enthusiasm to keep the team engaged and positive

2. Meeting Team Objectives Tool: Prompt Discussion Come prepared to meetings with specific questions for the team Brainstorm ideas to prompt discussion If discussion is repetitive, summarize the points made and then attempt to broaden the discussion, or summarize and move the group onto the next item on the agenda

2. Meeting Team Objectives Tool: Agenda Use the agenda to guide the discussion, and manage time Use the meeting objective to refocus the group if they are not following the objectives Remind the group if they are running behind on time, or how much time they have left in the meeting If the group is not following the objectives, but the discussion is important, or there are important ideas or suggestions being made, write them down in a ‘parking lot’, and then come back to them at a later time The bottom of the agenda can be used to assign tasks or duties to team members. This will help to ensure that team members are aware of their responsibilities, and to help ensure tasks or tests are done on time You could send a quick email after the meeting to team members of the action items and who is responsible for each action item

3) Keep Records Keep records, or ensure the team keeps records of what you have done, and any major decisions you have made Records can be used so the group does not repeat anything it has already done Records can be used to show what the team has done and has accomplished, which can be used as motivation Records can remind groups of why decisions were made, or what the key points where that led to a team decision

3. Keep Records Tools: Minutes of Meetings The agenda template can be easily converted into a minutes of the meeting once the meeting has taken place Assign someone the duty of writing down notes for the development of the agenda. With the notes, it should only take 5 minutes to create an agenda Take a photo of notes from a white board/flip chart as a quick way to record the minutes of the meeting The minutes should only contain key points, and can be recorded as bullet points. Eg, what the key discussions were, what key factors led to a decision, what PDSA’s were done since the last meeting, and what PDSA’s will the team try next. The minutes should also record next steps, and the tasks each person is responsible for, and when the task or test should be completed by The minutes will be sent to the Western team, but they should also be used by the team to track their progress and decisions

Scenarios The following are a number of issues that may arise when you are facilitating your teams. Read through the following scenarios, and discuss how you would respond, and why you would respond in that way.

Scenario 1 One person in the clinical team is quiet and a little shy. While he does contribute to discussions and work, the majority of discussions are shaped by the other four team participants. You think that you may need to change the format of the meeting to use the experience and perspectives of this person. What are your next steps?

Scenario 2 The progress in your community team has been really good, but it is very difficult to organize everybody's schedule to meet regularly. This has now started to slow down the progress the team has been making. What are you next steps?

Scenario 3 Someone consistently gives negative comments. Just now, he rolls his eyes and says under his breath “what a waste of time!”, and you feel you need to act. What are your next steps?

Scenario 4 After a few meetings, the doctor on the team gets frustrated with the quality improvement initiatives because she is already very busy and she cannot give enough of her time to the QI work. She suggests that the rest of the team continue, and simply says she doesn’t have enough time. What are your next steps?

Previous Challenges Have you encountered any challenges in any experiences when you have been facilitating? What were they? How did you respond? And now as you reflect upon this experience, would you respond to it differently? If so how and why?

The Key Roles for Community Facilitators As a community facilitator you will need to: Provide information and advice about the program, such as how to create PDSA’s Motivate and encourage teams to keep going, even if things get tough Help organize your teams, particularly through team meetings Support your teams to overcome challenges Help ensure the teams achieve their goals and milestones. The teams will need to be continuously moving forward in order to be successful Although conducting the improvements are the responsibility of the teams, you will play a very important role in helping them to be successful