project echo qi: managing up - enhancing your relationship with leaders

Welcome to Project ECHO Quality ImprovementWe will begin momentarily.

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Welcome!Project ECHO Quality Improvement

Presented by the Weitzman Institute, a division of Community Health Center, Inc.

Session 2: Managing Up – Enhancing Your Relationship with Leaders

May 18, 2016

Faculty• Presenters

– Daren Anderson, MD, Director, Chief Quality Officer

– Wanda Montalvo, PhD RN, Associate Director

• Panelists– Patti Feeney, MS, QI Education Manager

– Tierney Giannotti, MPA, QI Data Analyst

– Mark Splaine, MD, MS, Director of Education

– Deb Ward, RN, Senior Quality Improvement Manager3

Community Health Center, Inc.

Foundational Pillars Clinical Excellence Research & Development Training the Next Generation

CHC Profile: Founding Year - 1972 200+ delivery sites 130k patients

Project ECHO QI SessionsMay 18, 2016 Managing Up – Enhancing Your Relationship with Leaders

June 8, 2016Buy-In – Gaining Support for Your Project

June 29, 2016Communicating & Advocating Using Data

July 20, 2016Plan-Do-Study-Act Cycles – Getting the Most from Your Tests of Change

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To register visit: http://weitzmaninstitute.org/clinics/qualityimprovement

• The Weitzman Institute Online Learning Network is free and available to anyone interested in the session materials

• We have posted many resources and answered questions from our session on April 28th on “Developing Your Professional Presence”

• Recording and slides are available after each session by clicking on the following link:

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Online Resources

http://moodle.weitzmaninstitute.org/course/view.php?id=16

• Functions we will use in this session – Chat, polling, Q & A

• Live tweet us @CHCProjectECHO and #QIECHO

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Get the Most out of Zoom

Lower right hand corner of screen

• A little bit more about Zoom functions we will use

– Polling – we will ask you a specific multiple choice question and you will answer on your screen

– Chat – you can use this function to offer comments and send messages to us during the session

– Q & A – use this function for questions you would like us to address

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Get the Most out of Zoom

Learning Objectives• Understand common challenges when working

with leaders on a QI effort• Review and discuss effective strategies when

communicating with leaders• Consider approaches to developing yourself as a

leader

Managing Up: Five Tips for Communicating with Leadership

The Leadership Perspective• Leaders are very busy• Leaders are balancing many competing

priorities• Leaders are thinking strategically• Leaders are responsible for financial as well as

clinical outcomes• Leaders prefer data over anecdote to make

decisions

• Key Stakeholder in the dark

• Lost in the details

• Lack of alignment

• Unconvincing Results

Pitfalls when communicating with leadership

Some examples of when working with leaders didn’t go so well…

When communicating with leaders:

1. Be sure that you have evaluated the impact of your project on various stakeholders and communicated with each of them

Know Your Stakeholders• Projects often fail when key stakeholders are:

– unaware, unsupportive, unengaged• Projects can fail when we don’t properly

anticipate the impact of a change

Identify all the key stakeholders before initiating your project:

• Who will need to be actively involved?• Who might be impacted?• Who might be threatened by the changes

brought about by your project?• Don’t forget IT, HR, Finance!

Stakeholder AnalysisStakeholder Strongly

againstModerately

againstNeutral Moderately

supportiveStrongly

supportive

Not all stakeholders need to be “strongly supportive” for successful change

Communication PlanAudience Objectives Message(s) Media &

MethodsTiming &

FrequencyWho/When

Where

When communicating with leaders:

2a. Establish a regular communication process with the senior leaders/sponsor

2b. Know your topic: be able to speak about it succinctly and clearly

Project / Program: Project XYZ Date: 5/5/2016

A. Key Project / Program Metrics -Enroll xx patients into the program

A. Key Upcoming Event(s) or Milestone(s) 1. Continuation of weekly project touch base meetings 2. Testing of system 3. Staff training 4. Launch!- May 31st

C. Highlight / Lowlights / Risks / Opportunities

Lowlights Highlights 1. The training will likely have to take place on 2

or 3 different days to accommodate all of the sites. It seems that a single training with all 6 intervention sites is not possible.

1. Teams worked together to devise a strategy that will eventually eliminate the needs for individual patient referrals

2. Integration is largely complete and testing has begun

Risks Opportunities 1. Patient recruitment- how will our patient

population receive this intervention? Will they engage at all?

2.

1. We will learn a lot about the potential of email to engage patients. We will see how many have email addresses shared with the agency as well as how many are correct.

2.

Elevator speech

Elevator Speech (at the Wall)

Imagine a chance meeting of a project team member and a key stakeholder in an empty elevator with 90 seconds to rideDescribe the need for change and the vision of the new state, as one might respond to the question, “Why are we doing this project?” by addressing the following elements:

Problem / issueBenefitWhere we areWhat others can do

Team members practice this “speech” so they can convey a uniform message to others

Communicate Clearly and Succinctly

When communicating with leaders:

3. Be able to demonstrate how your project aligns with core agency goals and objectives

When communicating with leaders:

4. Understand the impact on finance as well as on staff and patients

When communicating with leaders:5. Use data to make your case

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Example: Same Day Access Clinic

The Problem:• Too many patients being diverted to urgent

care due to filled schedules

The solution:• Test an in-house urgent care clinic

Strategic alignment:

• The team aligned their project with key agency goals:– improve patient satisfaction– reduce ER utilization

The Team Used Data to Demonstrate Results

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Number of Days worked and patients seen by week

Days workedPatients seen

Week

Top Diagnoses

Diagnoses TotalURI 110Pain 66Rash 53Allergic rhinitis 43Dysuria 37Diarrhea 29Asthma 29Hypertension 9Depression 5Diabetes 8Alcoholism & Other Drug Abuse 5COPD 2Tobacco Abuse 2Well Child Visit 1

Tue, May 1

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Thu, June 04

Thu, June 11

Mon, June 22

Fri, Ju

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Thu, Jul 2

Thu, Jul 9

Wed, Jul 1

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Fri, Ju

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Thu, Aug 6

Wed, Aug 19

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Completed Sick Visit Provider Appointments May 12-September 4, 2015

Completed ApptsBreak EvenRolling Average

Attention to ROI:

Developing as a Leader

Survey Results (n=52)

Question Disagree Neutral AgreeI spend a lot of time at work developing connections with others

8% 19% 73%

I always seem to instinctively know the right thing to say or do to influence others 21% 52% 27%

I have a large network of colleagues, able to call on for support to get things done 23% 38% 39%

Map it Out• Set your goals

– Be clear about whom you need to influence and what you want to accomplish

• Identify benefits and challenges– Find common ground and anticipate the

challenge, should you tap relationships ?

Make it Happen• Pick the right time and place• Establish Rapport

– Connect with the person you are attempting to influence

• Set the Stage– Describe situation, be factual, watch for reactions

as you share• Leverage Agreement

– Capitalize on something you agree on, next steps might as simple as a PDSA CYCLE

Developing Political Skill• Think before you speak• Practice influence• Socially astute• Be sincere, professional integrity and authenticity

are crucial• Knowledge expert has authority

– Messenger is the persuader and not necessarily the message

• Network, network, network

Let’s Answer Your Questions

Bibliography• Some references that have been helpful

to us….

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Additional Resources

Weitzman Institute offers a range of additional QI training resources and opportunities. If you’d like to learn more, please contact QIecho@chc1.com

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Slides and recording of today’s session:http://moodle.weitzmaninstitute.org/course/view.php?id=16

Project ECHO Clinics

RemindersSign up for our next session in this series:Buy-In – Gaining Support for Your Project

Wednesday, June 8th from 12-1p.m. EDT

Complete our post-session survey!

Sign up at http://weitzmaninstitute.org/clinics/qualityimprovement

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