Communicating QI to Staff

Sun, 07/19/2015 - 19:56 -- gkroberts

I'm sure many of you can relate to this. I recently lead a QI project meeting with individuals that were taking the comments personally, which lead to bashing one another. The meeting's atmosphere was so tense that it could be cut with a knife.

Because I was anticipating this, I tried prepping by meeting with a few key individuals to make sure I was understanding their perspectives, which helped me facilitate as a neutral party. It also helped to start the meeting introducing QI and the purpose of the meeting. I know some of the frustration is just something we need to work through as a team. But does anyone have any tips on how to better neutralize a tense QI situation and make everyone more comfortable?

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prusso's picture
Submitted by prusso on

 

Sounds like they didn't allow it to be a safe environment!  maybe by trying again to make it clear that  QI is about a system or process improvement - the system is broke, not the individuals in the system.   That QI is not about blame - people are working in a process that needs to be changed.   If they're resistant to change, that's another story! 

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prusso's picture
Submitted by prusso on

 

Sounds like they didn't allow it to be a safe environment!  maybe by trying again to make it clear that  QI is about a system or process improvement - the system is broke, not the individuals in the system.   That QI is not about blame - people are working in a process that needs to be changed.   If they're resistant to change, that's another story! 

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Submitted by Mary Ann on

I am pretty new at this but I start every QI project off by thanking the individual who brought the project forward and acknowlege that the process can feel like you are bearing your soul.  I compare it having your mother (or mother in law) come into your home and clean your refrigerator or put your laundry away (stay out of my messy drawers!).    

Setting the ground rules immediately stating that we are looking at process only, the minute it get's personal we refocus.  I try to include positive staff only - at least for the early projects.  I don't think involvement in QI projects is a way to win over the "non-believers". They may bring too much negativity with them and hinder rather than help. 

This is just a newbie's opinion.     

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Submitted by SharitaHill on

As Pam advised, make sure they understand that this is completely about processes not people and make that one of your ground rules.  'What is said here stays here' like Vegas.  We had a similar issue when our Revenue Collection Team began meeting but this became one of our ground rules & it has worked out very well for us.  Also, remember they won't begin trusting each other immediately it may take some time.  And, sometimes they need to get the frustration out so that they can move forward together....it's part of the storming piece of this process.  Our facilitator continues to remind it's not about people but about processes anytime that someone would attempt to say anything that could be taken as 'finger pointing' or blame.  Sometimes it just takes the consistent reminder to keep those that continue to blame on track with blaming the processes and not the people in the room. 

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Sharita Hill
Business Analyst
Oklahoma State Department of Health
Protective Health Administration

Submitted by gkroberts on

Pam, Mary, and Sharita, thank you ladies! You are all right that its important to constantly remind the room that this is a safe zone and to keep focus on the process. I will be more conscious of verbalizing this.

Each QI project team has different dynamics and its important to design the meeting by keeping this in mind. I think the reason this meeting was more difficult than a normal QI meeting is because this project is more of an executive level project, and includes a department of 3 individuals (1 executive level, and 2 new staff). Since the 2 staff members are new, we had to include all 3 in order to get all of the process details. The problem arose because the executive leader is resistant to change and hindered the 2 staff members from voicing their opinions. Usually I ask the executive leadership to not attend the QI meetings to allow their staff to speak freely, but I "cc" them on all meeting materials and minutes to keep them in the loop. Perhaps I need to do that this time as well.

Since most of our projects are submitted anonymously, we try not to investiage who submitted it but encourage involvement from anyone interested.

 

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Gurleen Roberts, MPH
Director of Quality Management
Cobb & Douglas Public Health
Marietta, GA
gurleen.roberts@dph.ga.gov

cgizzi's picture
Submitted by cgizzi on


The comments here are all great.

One thing I have found helpful is to have the agreed-upon ground rules on the wall (e.g. on post-it easel pad paper) everytime the team meets. It's an easy way to quickly remind people at the beginning of each meeting what they previously agreed on. You could also ask team members at the end of a meeting to do a silent "self-assessment" and briefly reflect on how well they followed the ground rules. (Sometimes this helps team members be more self-aware about their own participation, but it doesn't always reach everyone.)

Good luck!

Cindan Gizzi, MPH

Public Health Centers for Excellence

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Submitted by gkroberts on

Thanks, Cindan! I really like your suggestion, especially for those individuals that are visual learners. I will use this at our next meeting.

UPDATE: We had our second meeting with this same group, and I started the meeting off reminding everyone about focusing on the process, and repeated this anytime the conversation headed towards blame. This really did help keep the environment comfortable and focused.

This meeting might also have been smoother since everyone had a chance to get their frustrations out at the first meeting. Another thing that helped was that I created a "swim-lane" diagram in efforts to provide a visual of the process and the individuals involved. This helped the project team see exactly who is involved in each step, and that this process requires teamwork; thus, reinforcing that we need to focus on the steps and not the people.

Thank you all for your input and support!

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Gurleen Roberts, MPH
Director of Quality Management
Cobb & Douglas Public Health
Marietta, GA
gurleen.roberts@dph.ga.gov

Submitted by tkane on

I think this discussion thread highlights a few prerequisite soft skills or competencies for agency QI leaders. 

I recently developed a training in the LHD setting related to 'competencies for QI leaders in public health'. The session targeted "QI champions & coaches" and focused on a number of important competencies for public health QI Leaders including: 1) Facilitation skills & 2) Effective meeting management & 3) Team development.

Below are a couple of helpful resources that I came across while developing the course content. 

Team development - Our public health QI friends Jack Moran and Sonja Armbruster wrote an article - "The 4 stages of team development: Where are you?" - that was published to the web in 2013. The article provides an overview of the 4 stages of team development (Forming, Storming, Norming, Performing) and includes a "Teamwork Observation Checklist" to help you "observe a team to determine how they are maturing, where some problems might exits, and some tips to overcome them."

http://www.processexcellencenetwork.com/lean-six-sigma-business-transfor...

Facilitation skills - The Community Tool Box is a free, online resource for those working to build healthier communities and bring about social change. Their mission is to promote community health and development by connecting people, ideas, and resources. The CTB has a section called Developing Facilitation Skills (link below). 

http://ctb.ku.edu/en/table-of-contents/leadership/group-facilitation/fac...

Effective meeting management - The Holden Leadership Center at the University of Oregon website features some great resources under the "Leadership Skills" tab.

http://leadership.uoregon.edu/resources/exercises_tips/skills/running_ef...

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Submitted by gkroberts on

Ty, I just read all three of those articles and they were fantastic! I especially liked the Team Development and Facilitation Skills articles. I think individuals at all QI levels could benefit from this information. Thank you for sharing! Would it be possible for you to share the training that you developed? Or this topic could be done as a PHQIX webinar.. :)

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Gurleen Roberts, MPH
Director of Quality Management
Cobb & Douglas Public Health
Marietta, GA
gurleen.roberts@dph.ga.gov