Utah Association of Local Health Departments

Utah Association of Local Health Departments
Train-the-Trainer Workshop October 19 and 20, 2011

Workshop Overview Welcome Remarks Introductions Why are we here? Expectations

Innovative Solutions. Measurable Results.
…PHF Mission: We improve the public’s health by strengthening the quality and performance of public health practice Innovative Solutions. Measurable Results. 3

Brainstorming 5 minutes individually, write down:
What issues have arisen around implementing or setting up a QI training session? Volunteer ideas as scribe writes Build on listed ideas Add new thoughts as they occur Debrief to whole group Grace

Soft skills as well as hard skills
Coaching QI Teams Teams don’t use tools in a vacuum Soft skills as well as hard skills © PHF 2009

The purpose of coaching QI Teams is to:
Build a partnership between the coach, team leader, and team members Help the team move to a higher level of achievement Help the team overcome obstacles Help the team navigate a politically sensitive situation Provide training or problem solving assistance

Coaching QI Teams Building a partnership between the coach, team leader, and team members is effective when there are: Agreed upon ground rules Clear expectations Specific time frames Established goals and measures of success

Some Issues That Could Arise:
Coach groups into teams Clarify objectives and goals Dissolve hidden agendas Move to commitment & accountability Move from hoping to acting Generate efficiency Model success of other high performing teams Share values & vision of the organization Overcome frustration & failure Keep them going Give recognition

The Five Dysfunctions of a Team
The Role of the Coach Inattention to… Results Confront Difficult Issues Avoidance of… Accountability Focus on Collective Outcomes Lack of… Commitment Force Clarity and Closure Fear of… Conflict Demand Debate Absence of… Trust Be Vulnerable P. Lencioni 2005 © PHF 2009

Coaching QI Teams The goal is to build a culture of commitment and accountability

What is Coaching? Establish trust Build rapport and open communication
Clarify key roles and responsibilities Establish goals and an effective personal development plan Create and implement a mentoring agreement

Coaching Exercise, #1 Break into teams of five each List out the elements you would want in a coach Identify the top three elements you would consider most important for a successful coaching intervention. Debrief

First Rule of Coaching Start where your client “is” and not where you think he should be or where you are.

Second Rule of Coaching
Confirm readiness: Is the client receptive to coaching? Do they want to be coached? Have they requested coaching or been told to get it? What do they expect to get from coaching?

Third Rule of Coaching Set Expectations: Establish goals Intent is to help, not run the team Build trust – who do you have to report your results to – make it clear Establish when and where coaching will take place

Fourth Rule of Coaching
Observe The Team: Identify destructive behaviors Document specific incidences Document their strengths and weaknesses Understand what they think is blocking or hindering their progress

Fifth Rule of Coaching Develop an Improvement Plan:
Describe observed team behaviors and the impacts; both good and bad Review causes that lead to bad outcomes for the team Set realistic change expectations Build the plan around their strengths Describe specific corrective actions to overcome weaknesses Indicate any training that may be required and how they can obtain it.

Sixth Rule of Coaching Confidentiality: What you observe, recommend, or help the team with stays in “Vegas” If you must report your finding to some one higher in the organization let the team know at the outset

Seventh Rule of Coaching
Follow-Up: Set a time to follow-up with the team to see if progress has been made Ask them to send you brief updates on a regular basis – what is and is not working

Coaching Exercise #2 Choose a partner for this exercise. You will practice coaching techniques. Look at the three most important elements for a successful coaching intervention each of you chose during exercise 1. Choose one element to practice with your partner. You can each choose a different element. Continued…

Coaching Exercise #2 The first “coachee” sets up the situation in which the “coach” will provide support. The coach LISTENS to the “coachee” to understand their coaching need. The coach then explores different approaches (DO NOT TELL) to that scenario with the “coachee.” Take no longer than 5 minutes for the exchange. Take two minutes for the “coachee” to express observations of the helpfulness of the coaching. Swap roles and repeat with the second partner.

Summary Coaching Fundamentals: LISTEN EMPATHIZE (not sympathize) ASK DON’T TELL

Team # 1 QI Tool

Team Analysis and Decision Making

Problem Solving vs. Decision Making
Whenever teams encounter a problem, we are involved in decision making. We are involved in decision making even when there is NOT a problem. Quality Improvement is about process, not only the outcome of our processes (W. Edwards Deming)

Improvement versus Redesign for QI
Analysis is for more than just solving problems. Dr. Juran’s Trilogy of Quality Planning, Quality Control, and Quality Improvement encourages us to design processes from the beginning to be effective and efficient. It is less costly to plan quality into a product or service before implementing (Act) than after valuable resources are expended in piloting or complete rollout has occurred. This chart identifies both a problem solving situation and an opportunity to redesign a process that is within control limits. Teams can use the QI tools for both of these situations.

The Basic Feedback Loop
Decision making is a result of effective analysis. This simple feedback loop shows the comparison of the current state performance of a process (1), with the future state desired process outcomes (3), through a sensor, or metrics tool (2). The analysis of the comparison drives the actuator or decision function (4) for action or maintenance of the current process (5). The PDCA and SDCA cycles described in our earlier QI training in September are the vehicle Public Health Departments have adopted initially to drive the continuous improvement of our organizations.

Align Quality Improvement Measures
Act Do Check/ Study Plan Three steps for generating data for analysis and decision making: Assessing: Identifying, defining, prioritizing – Plan Analyzing: Examining and investigating – Do and Check Answering: Finding solutions - Act Performance Measurement Systems are created to maintain and improve the output and outcomes of our PH processes. As we map each core process with the HD, one of the critical steps is establishing measures that clearly align the process with the key priorities of the Health Department. Remember the training we participated in last month. Fully a third of those two days was dedicated to measures, data gathering and analysis.

In Reality; There Are Two Qualities
A product or service – Attribute Quality What you deliver to the client A management tool – Method Quality What do you do internally to deliver the product or service to the client? How does the service you provide support the critical goals of your Department? The PDCA cycle and the 7 basic Quality tools not only help us meet our commitments to our clients and stakeholders (effectiveness). They also help us be more efficient with the resources we have available to us to do our jobs. We participate in improvement team activities for both internal and external customers. The three areas of measures we discussed in our initial quality training – process, capacity, and outcomes – are applicable to our internal processes and also the client facing processes that our communities see. We all work in Quality. We all work to improve the department. Quality isn’t about titles or departments, It’s about methods and their impact on individuals, our communities and how well we use our resources.

Analyzing Goals and Measures of Success
Activity preparation: What organizational goals do you have in common with others in this session? Focus on the most operational goals possible for this activity Group in teams of 4 or 5 who have at least 3 common goals. Decision Making and Analysis is a vehicle for identifying and supporting the critical goals of the organization; whether they are internal or external. QI means constantly monitoring the effectiveness and efficiency of our processes so we can create and sustain organizational excellence.

What and How How You Do It Wrong Right Right Things RTW RTR % % What You Do Wrong Things WTW WTR % %

RTR Analysis and Decision Making
15 Minutes: Using the RTR matrix handout, identify: Which of the identified goals are the right or wrong priorities based on your most critical stakeholder needs? Which actions taken to meet the identified goals are either the right or wrong ones to successfully meet those goals? Share your RTR observations

Team # 2 QI Tool

Listening and Communicating
A good coach is an outstanding listener and effective communicator

Listening and Communications
Communications is a two-way process Speaker has to accurately convey their thoughts to the listener The listener must make sure they understand the message This seems simple enough

When the message understood by the listener matches the message intended by the speaker we have successful communications Whenever we communicate there are two basic factors at work: Ideas Feelings

Ideas – thought process which contains the concept we are attempting to communicate Feelings – emotions associated with the concepts we are communicating

An Idea-feeling relationship is in balance most of the time During stressful situations the feel factor will take over and distort the message Stressful situations require an emphasis on effective listening

Ideas Ideas Feelings Feelings Normal Stressful

Class Exercise Break into teams of two each and sit back to back One person faces the screen; the other makes sure you cannot see the screen The person facing the screen must instruct the person sitting behind them to draw the figure to be shown You have 3 minutes Quick debrief – what happened and why

Class Exercise

Class Exercise Now turn and face each other
One person faces the screen; the other makes sure you cannot see the screen The person facing the screen must instruct the person sitting in front of them to draw the figure to be shown You have 3 minutes Quick debrief – what happened and why

Class Exercise

What Happened and Why?

Cues of Communications: Verbal Vocal Visual

Cues of Communications:
Verbal: What we say and our choice of words Big versus little words no slang Speak from our experience which may not be your listener’s experience - disconnect

Cues of Communications:
Vocal – how we say it – tone, pitch, volume, inflection Volume – too soft suggests uncertainty Pitch – high pitch suggests excitement or nervousness Tone – may suggest skepticism or disagreement Inflection – upward pitch at the end of a sentence may make a statement sound like a question

Listening and Communication
Research indicates that: 50% of our communications comes from body language 43% from tone of voice 7% from the actual words we speak

Every Body’s Talking A way to read emotions not put into words
Nonverbal speak loudly – sometimes louder than words Watch your intended message recipient or audience for these clues Washington Post, Section F 1, June 24, 2008

Three types of listening: Passive listening Acknowledgement response Active listening

Three types of listening
Passive listening: Listener may or may not be paying attention No response to spoken words – silence Limited or no body movement Voice can whine

Acknowledgement response: Listener hears and understands Response acknowledges message Direct eye contact Body movement – gestures of acknowledgement

Active Listening: Listener uses feedback Listener tries to gain additional information Eye contact Positive body gestures

Active Listening Know the purpose Pay attention Interpret Evaluate Respond

Remember The busy employee spends
50% of their time listening to people and still does not remember half of what is said We forget 1/3 to 1/2 of what we hear within one to eight hours We forget an additional 25% in the next 48 hours We forget more in the first eight hours than in the next six months

We ignore, forget, distort, and/or misunderstand 75% of what we hear
Remember We ignore, forget, distort, and/or misunderstand 75% of what we hear

Listening Is A Skill Find areas of interest – worth of the message – match your experiences Judge the content not the delivery Hold your fire – listen to the content, not the hot button words – do not jump in right away – over stimulated Listen for ideas or facts that are interesting Be flexible and open minded

Listening Is A Skill Work at listening – be prepared physically
Resist distractions Exercise your mind Keep your mind open – do not go to the deaf spot Capitalize on thought speed

Communications Model M S C N R Message Channel Source Noise Receiver
Feedback

Summary We need to make sure we keep our listener(s) fully engaged or they will drift off Use visuals, exercises, handouts, etc. to fill in the voids that words cannot possible do

Research indicates that we can: Speak at 100 words per minute
Summary Research indicates that we can: Speak at 100 words per minute Hear at 200 words per minute Think at 600 words per minute

Team # 3 QI Tool

Being an Effective Team QI Team Building
The following material is from the text “Growing Teams” by G. Fetteroll, G. Hoffherr, and J. Moran, Goal/QPC, 1993

16 Guidelines For Teams To Work Effectively
Establish goals and objectives all team members accept Let each team define its own standards of performance Allow members to disagree in a constructive way to resolve problems Review past actions when making plans for the future Make decisions by consensus Remain cohesive and maintain a sense of unity Strive for synergy Develop a comfortable working atmosphere Use physical space that is conducive to the team process

16 Guidelines For Teams To Work Effectively
Listen to each other and provide useful feedback Use constructive criticism to facilitate group interaction Allow members to express their ideas fully and frankly Recognize individuals for the contribution they make within the team Assist members when it ensures successful completion of team goals Highly value creative approaches to problems Incorporate flexibility in the team’s thoughts and action

Roles and Responsibilities
Sponsor: Set improvement project goal Select the team leader Participate with the team leader to select team members Remove barriers Empower Monitor Review progress Help implement final improvement

Facilitator: Keep the team on track Train if needed Assist the team leader Help overcome negative behaviors Impartial observer – give the team constructive feedback

Team Leader: Conducts the meetings Prepares agendas Participates actively in the team meetings Represents the team to management Follows up on action items between meetings Secures needed resources for the team

Team Members: Give your undivided attention Take responsibility for comprehending Listen to understand rather than to refute Control your emotions Listen for the main ideas, not the details Put your mind to work

Teaming “I not only use all the brains that I have, but all that I can borrow.” Woodrow Wilson

How to Build a Strong Performing
TEAM © PHF 2009

Starting Teams Develop: Team charter Ground rules
Measures of team progress

Selecting Team Members
“Hire for attitude, train for skills Skunk works Softball at recess Conscripted Volunteer ….

Maintaining Teams Agree on the improvement model to use.
Use proven methods based on data and knowledge. Manage team dynamics.

Essential Team Characteristics

Team Roles & Responsibilities
The Public Health Quality Improvement Handbook Table 21.1 (Handout) 15 minutes: Review the Team Roles and Responsibilities Discuss: Why so many different “positions?” Which are hard? Which are easy? Why? Be prepared to share your observations with the group © PHF 2009

4 Stages of Team Development
Storming Forming

Achieving long-lasting success using teams.
COMMUNICATE!! © PHF 2009

The Team Leader as Coach
Reinforce Request Information Resources Responsibility Role Repeat "6 R's"

Dealing with “Difficult” People
Reserve judgment Concentrate on the act not the person Get their perspective Maintain your own self worth React only to the current situation © PHF 2009

What if the difficult person
is me? © PHF 2009

Don’t Nag Be direct Ban blaming Stay focused Negotiate
Realign priorities Say less Let it go © PHF 2009

Receiving Criticism Put your shields up Act like a coffee filter
Pretend you’re Sherlock Holmes Say “you’re right” © PHF 2009

When You Disagree Hearing is not listening
Acknowledging is not agreeing Acknowledging is not yielding © PHF 2009

Leading Effective Meetings
Preparation. Use an agenda, distribute early. Fill key meeting roles. Facilitator Timekeeper Scribe Involve participants actively. Take and distribute minutes.

Build a Loyalty Action Plan
Hear Clarify Dialogue Gain agreement Summarize Act/follow-up Hand off © PHF 2009

Establish an Effective Team
RACI Charting

Topics We Will Cover What is Responsibility Charting
When do you use Responsibility Charting Key Definitions The Four-Step Process for Responsibility Charting Tips for Analyzing a Responsibility Chart

Objectives Describe the need for and benefits of having clearly defined roles and responsibilities within teams Analyze and develop an effective RACI chart

So What is RACI Charting?
A systematic and participative technique to: Identify all functions (activities, tasks, and decisions) that have to be accomplished for effective operation Clarify roles and individual levels of participation in relation to each function Develop best methods for individuals to fill these roles RACI charts are used in many situations to clarify roles and responsibilities. For example: After an event when the flow of work has been changed and the tasks have been modified or operations simplified. Gathering current state data on an operation to show where there are overlaps of responsibilities. Creating a future state for an operation or department with the new roles and responsibilities clearly stated. HR departments can use the output of a new RACI chart to define the job responsibilities of positions.

Increased productivity through well defined accountability
Therefore, with clear roles and responsibilities we should expect to see... Increased productivity through well defined accountability Increased capacity by eliminating overlaps and redundancies Less confusion/misunderstandings by encouraging teamwork Streamlined work process by eliminating unnecessary interfaces and assigning ‘accountability’ where it belongs Improved team effectiveness by allowing disciplines to cooperate and share responsibility Some of the benefits of RACI charts.

Unclear roles and responsibilities result in comments like these…
“My team leader always overrules my recommendations whenever he/she wants” “The approval process for even the simplest item takes so long today” “It seems every department has someone putting together a spreadsheet on the same data” “Things are always slipping through the cracks” “I have the responsibility, but not the authority, to get the job done” We know none of these problems occur in our organization?! Clear roles and responsibilities can be identified through RACI charting

RESPONSIBLE: Do The Job. Execute.
R: Responsible A: Accountable C: Consult I: Inform These are the individuals who actually complete the task or activity and are responsible for action and/or implementation. Responsibility is often shared, with each individual’s degree of responsibility determined by the individual with the “A”. More than one person can be responsible for doing a job or task. The “A” can also have an “R”

ACCOUNTABLE: Make the decision. Take ultimate ownership.
R: Responsible A: Accountable C: Consult I: Inform This is the individual who carries the “yes” or “no” authority and has full veto power for an activity. It is important to clarify the levels of accountability and to distinguish between management accountability and operational accountability. Only one “A” can be assigned to a task or activity and authority must accompany accountability. The person with the “A” is the “go to” person if something is wrong, or, if going right, to recognize the efforts of the individual and the team they supervise. The “A” person is “where the buck stops” (quoting former President Harry Truman). Q: How many A’s should each task have? A: Every task must have one and only one ‘A’.

CONSULT: Communication before. In the loop.
R: Responsible A: Accountable C: Consult I: Inform These are the individuals who must be consulted prior to a final decision or action. “Consult” implies two-way communication. The “C” person does not do the work, but must be consulted before it is implemented. This implies ownership of the activities and some measure of accountability although not formally. Only use a ‘C’ when the individual must be consulted. If consulting is optional, omit the ‘C’.

INFORM: Need to know. Do not change the decision.
R: Responsible A: Accountable C: Consult I: Inform These are the individuals who need to be informed after a decision or action is taken because they, in turn, may take action or make a decision based on the output. “Inform” is FYI and implies only one-way communication. These are the people we “cc:” on our s. Try to reduce the number to a minimum of only those who actually need to know. Q? How much time do you spend every day deleting s without even reading them? Q? Do you know individuals who “group cc:” to a fault? When we construct a RACI chart we need to be aware of the overuse of the “I”

The output RACI Matrix can initially look quite complex
Roles of Participants Decisions or Activities But it really isn’t. The following slides tell the story. RACI’s provide lots of information in a very simple format

RACI Chart for Validating Open Position
See for the Grading sub process next page R = Responsible (execute) A = Accountable (Yes or No) C = Consulted before I = Informed After

RACI Chart for the grading/regrading
R = Responsible (execute) A = Accountable (Yes or No) C = Consulted before I = Informed After

Determine the activities Prepare a list of functional roles
The 4–Step Process Determine the activities Prepare a list of functional roles Develop the RACI chart Get feedback and buy-in (validate) Activities along the “Y” axis from top to bottom; Roles on the top in the “X” orientation, usually with the highest ranking person to the left, moving “down” the org chart to the right. Don’t use people’s names on the chart – people move from job to job. Use the position or title.

Guidelines for developing a RACI Chart (to-be)
Remember new ‘culture’ philosophy when defining roles and responsibilities: Eliminate “checkers checking checkers” Encourage teamwork 100% accuracy is not always required Place ‘accountability’ (A) and ‘responsibility’ (R) at the lowest feasible level There can be only one accountability per activity Authority must accompany accountability Minimize the number of ‘consults’ (C) and ‘informs’ (I) All roles and responsibilities must be documented and communicated (use team charter) First fill in the Rs – who does the work. Then fill in the As – those with the ultimate authority. Remember only one A per task. A position can have both the A and the R Try to place the A at the lowest reasonable level to minimize excessive sign-offs and levels of approval. It may mean we have to create templates and guidelines with limits of authority to insure small decisions can be made without too many approval levels.

Obtain Feedback and “Buy–In”
The RACI chart is shown to people that represent the functional roles on the chart These individuals are asked for their input, and the RACI chart is revised as appropriate The RACI chart may be validated in conjunction with the other products generated by the QI teams This is the validation process – our sanity check before implementing the changes.

Common Errors ‘RACI’ everything (instead of thinking about what is value-added) Do not take into account that people are trying to justify their jobs Do not eliminate the "coordinators & consolidators" Do not use enough ‘action’ verbs in constructing the “Activities” list Do not understand it will change Do not consider "interface" issues Learn about it in training and think they can do it without practice RACI everything – sometimes it is simple enough to avoid doing a RACI – only use it if it adds value to the process, not just to do it.

Let’s see what we know True False
1. If you have an "R“ (to someone else's "A") it becomes your "A“ in most cases. 2. If you have the "A" that means you have no constraints or limits in your decisions…for that task. 3. To ensure good communication in an organization, we should encourage many "consults" and "informs" on a task. 4. It is quite common to see the VP in an area have the "Accountability" for a task, and an Operator to have the "R," so we should be okay with that. 5. The structure of RACI allows even the most recent of Core / Process team members to successfully complete it. 6. RACI is interesting as an exercise, but it doesn't help to eliminate the "non value-added" work/functions. 7. When in doubt, give the "A" to the highest ranking individual in the room. False False – still have to work within the constraints of the business – not a free for all. False – not many – enough to cover the necessary bases. Too much red tape False – Just because the VP is in the line up for a series of tasks, doesn’t mean he/she will always have the a False – needs training and practice! Easy to describe more difficult to implement False - False – Strive to push the Accountability as low into the organization as possible

Team # 4 QI Tool

Getting Teams Started and Keeping Them Going

Before the first team meeting, the Team Leader should:
Review the team charter and direction with the Team Sponsor* Clarify roles Draft a plan Identify pertinent existing data Set meeting logistics Draft an agenda * Some organizations and Sponsors develop the team charter before the team comes together. Others see value in having team members define their own charter for greater empowerment.

Create and Maintain a Team Charter
A Team Charter provides the initial focus for a quality improvement project. This is an example of a simple team charter. This document should be drafted as one of the first activities when a team is created. The Team Charter is a living document and should be reviewed and modified to reflect the progress of the team through the different phases of the project.

Goals for the first few meetings:
Build relationships: Get to know each other Learn to work as a team Work out decision making issues Set ground rules Understand the project: Review the charter Develop a work plan Identify stakeholders Learn new tools and skills: The scientific approach (PDCA) Team behavioral skills Basic quality tools

The Team Meeting Cycle Conduct the Meeting
Design the Meeting Develop the agenda Design the format Conduct the Meeting Agenda review Discuss items ID follow-up actions Evaluate the meeting Carry out between meeting assignments Collect information needed to design the next meeting

Team # 5 & 6 QI Tools

Q&A On Using Individual QI Tools

Outstanding Issues

Wrap-up Day 1

Review of Day 1 Comments Questions Suggestions Scan agenda for Day 2

Communicating Team Progress

Follow the Communication Plan in your Team Charter
Internal team communications according to ground rules (informal) Tollgate reviews with Sponsor, process owner and Senior Management (formal) Involvement of key stakeholders (formal and informal) Effective project management tools: (formal) Project deadlines, action items and tracker Gantt chart Meeting minutes

What is a Tollgate Review
A Tollgate Review, as the name indicates, is like a checkpoint in an improvement project where the various team members meet with the Team Sponsor to determine whether the work has been performed as indicated in the project plan and whether the objectives planned have been achieved.

Tollgate Review Tools The diagram below indicates how a tollgate review is carried out at the end of each stage. When the goals have not been met, activities within the stage need to be re-visited. For example, Check Sheets, Project Deliverables Document and List of Milestones. Plan Tollgate Review Do Check Act Standardize Read more:

Tollgate Preparation To ensure successful tollgate review outcome, it is important to conduct pre-review groundwork. This may involve the following: Ensuring all required attendees are informed of the review. Blocking time in everyone’s work-day for the duration of the review. Preparing a suitable presentation consisting of check sheets, milestone lists, etc. for review. Creating a structured agenda for the presentation. Read more:

Set project deadlines Build individual task lists Milestones Assignments Measures Accountability Final outcomes

Gantt Charts A Gantt chart is a matrix diagram
The vertical axis lists all the tasks to be performed for a project Each row contains a single task identification The horizontal axis is headed by columns indicating estimated task duration in hours, days, weeks, months, etc. , skill level needed to perform the task, and the name of the person assigned to the task, followed by one column for each period in the project's duration. 128

Gantt Chart Henry L. Gantt – WWI
Franklin Arsenal 1910 Progress Chart Work planned and accomplished are shown in the same space Emphasizes work movement through time Deals with plans and progress Helps identify and eliminate obstacles The Gantt Chart – William Clark, The Ronald Press Co, NY 1922 131

Use Of Gantt Charts Establish order of tasks:
Sequential and Parallel Identify resources requirements Timing of resource needs Identify the critical path Monitor the project “On-Time” Schedule Alerts where remedial action is required

Traffic Light Gantt Chart
Task: City of XYZ HD 29-Feb 7-Mar 14-Mar 21-Mar 28-Mar Finalize assessment analysis X Gain consensus on priorities Identify comm. with elected off. Plan PHF consultant visit Set agenda and travel schedule City HD/PHF PI meeting On Schedule Watch Late or at Risk Use Excel to build it Helps make projections on potential progress highlights potential problems Very Visual 133

Communication Activity
Time allotted: 20 minutes In your QI teams, identify: Team Sponsor Process Owner Key Stakeholders Core team members Draft a timeline for communicating team progress with each of the above individuals. Identify the communication subject and choose either formal or informal format. Be prepared to share your thoughts with others.

Team # 7 QI Tool

Analyzing Your Training Audience

Audience Analysis Definition: Study that describes the nature of the worker or students. Who are they? What do they already know? Are they confident? Have they volunteered to participate? How many are in the target population? Are they local or remote? What kinds of technology support are available to them? Are their managers interested in this topic? Are their managers supportive of their career growth?

Analyzing the training needs
Definition: Study to design and develop instructional and informational programs and materials. After the performance analysis has determined that training or informational materials are indeed appropriate Needs assessments involve: Subject matter study Audience analysis Determination of prerequisite skills and attitudes Error and work product examination Resolution of disagreements among experts Definition of the details that drive training approaches

Activity: Describe your audience
Time allotted: 15 minutes Assume that you have been asked to facilitate an improvement project in your own local HD Answer as best you can the questions on the audience analysis slide using your HD colleagues as the “target population.” How would you estimate the skill and attitude level of your LHD colleagues in QI tools and techniques? Entry, Working Knowledge, Advanced? Be prepared to share your assumptions with the class.

Team # 8 QI Tool

Building the agenda and materials exercise
Time allotted: 40 minutes Using all the materials and activity output from the last session and this session: Draft an agenda for training your Health Department on QI tools and techniques. List the materials you will use to introduce and reinforce the lessons you share with the students. Be prepared to share your agenda items and material suggestions with your class mates.

Project Presentations 1-8
AIM statement SIPOC + CM Flowchart Cause & Effect Measures of Current State Areas for Improvement Timeline Next steps: Current Activities If done: Outcomes Lessons Learned

What happens next & Adjourn

Contact Information Jack Moran T: – 0560 Grace Duffy T: cell

Organizational Wisdom on Improvement and Change
Understand the history behind the current culture. Don’t tamper with systems, improve them. Be prepared to listen and observe. Involve everyone affected by the change in making it.

Utah Association of Local Health Departments

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