Appreciative Inquiry

Gabrielle Campbell Julie Haizlip, M.D. Jennifer M. Schlener Jeannette M. Shorey, II, M.D. Penny Williamson, ScD November 5, 2011

• Welcome! (9:00 a.m.)

• What is Appreciative Inquiry (AI)? (9:00-9:10 a.m.)

• Three Examples of AI (9:10-9:25 a.m.)

• The AI Experience (9:25-10:20 a.m.)

• Reflection on the AI Process (10:20-10:30 a.m.)

Our Time Together

“Appreciative Inquiry is the cooperative search for the best in people, their organizations, and the world around them. It involves systematic discovery of what gives a system „life‟ when it is most effective and capable in economic, ecological, and human terms. AI involves the art and practice of asking questions that strengthen a system‟s capacity to heighten positive potential. It mobilizes inquiry through crafting an “unconditional positive question‟ often involving hundreds or sometimes thousands of people.”

Cooperrider, D.L. & Whitney, D., “Appreciative Inquiry: A positive revolution in change.” In P. Holman & T. Devane (eds.), The Change Handbook, Berrett-Koehler Publishers, Inc., pages 245-263.

What is Appreciative Inquiry?

• AAMC (Gabrielle Campbell)

• University of Arkansas for Medical Sciences College of Medicine (Jan Shorey, M.D.)

• University of Virginia Center for Appreciative Practice (Julie Haizlip, M.D.)

3 Examples of AI-In-Action

• AAMC (Gabrielle Campbell)

3 Examples of AI-In-Action

Series of small group conversational brainstorms

AAMC Internal Optimization

Brainstorm Goals

Engage staff across units & levels to highlight areas of potential optimization by harnessing their operational experience and creativity;

Identify options for further exploration of optimization & resource realignment; and

Provide the output to leadership for possible integration into the budget submission process

Process

Brainstorm Series

Analysis “Deeper

Dive” Leadership Prioritization

Op

tim

iza

tio

n

Questions

Imagine that the work you do could be cleared of any obstacles so that you would be free to work at maximum efficiency and effectiveness, both within your unit and across AAMC.

What would it take to get there?

What can you do to help in

achieving transformation of AAMC?

What stands in your

way when you have a

great idea?

What will get you the

furthest the fastest?

Outcomes

• Series 1: 123 participants /8 discussion groups

• Series 2: 120 participants /10 discussion groups

• „Deeper Dive‟ of 90 staff

Crystallized themes

Engaged staff

Engaged, excited staff

Feedback of “feeling heard” & “part of the conversation”

But:

Bandwidth challenge to keep momentum, meet

expectations, and communicate

• AAMC (Gabrielle Campbell)

• University of Arkansas for Medical Sciences College of Medicine (Jan Shorey, M.D.)

3 Examples of AI-In-Action

“Appreciative” Exit Interviews

How can we learn, in some depth, why faculty members choose to leave our college of medicine?

• 7 questions guide these conversations that are conducted by either the Associate Dean or the Director of Faculty Affairs.

• Confidentiality is assured in terms of de-identifying specific remarks when preparing summary reports for the Dean and Department Chairs.

• Notes are taken during each interview, with synoptic remarks entered into a secure database.

7 Questions

1, What does your Department/COM/UAMS do best as an institution for its faculty members?

2. How could we improve, and better support the faculty?

3, What was the best or the most positive thing that happened to you during your time here as a faculty member?

4. Is there a person, or group of people you would like to mention as having made a big difference to you here in your time on the faculty?

5. In recruiting faculty to the COM/UAMS – what should we emphasize? What are the greatest strengths that should be noted about working here?

6. Are there things I haven‟t asked about that you would like to share about your experiences at COM/UAMS?

7. Will you share with me explicitly why you are leaving? Going to what kind of position, where?

Our Findings About This Appreciative

Approach

• Initial surprise

• Small minority goes “right for the negative”

• Vast majority tell detailed stories of their best experiences, their treasured colleagues, and the strengths of our institution

• (almost) Everyone has people they want to acknowledge as having made a positive difference in their careers and lives

• Most offer thoughtful suggestions for how things should be improved

Value Of Appreciative Approach To

Exit Interviews Over 7 Years

• “Witnessing”

• “Someone in the Dean‟s Office has heard me – and took notes”

• Very stable information about the best of our school and community:

Collaborative and collegial place

Little Rock is great place to live & raise a family!

Great benefits package

• Challenge: time-consuming qualitative data analysis

Summary

• We have found that beginning with appreciative language – asking questions in the positive – invites our participants to take a broad view, to access their full capacity to reflect on their experiences.

• They share both the good and the not so good.

• They feel heard.

• AAMC (Gabrielle Campbell)

• University of Arkansas for Medical Sciences College of Medicine (Jan Shorey, M.D.)

• University of Virginia Center for Appreciative Practice (Julie Haizlip, M.D.)

3 Examples of AI-In-Action

UVA Center for Appreciative

Practice

• Joint venture of SOM, SON, Medical Center & Physician Practice Plan (UPG)

• Build a more collaborative culture

• Worked with over 40 groups

• Administrative

• Education

• Clinical Care

UVA Inpatient Psychiatry

• Concerns:

• Transitions from inpatient to outpatient care – discharge planning

• Staff morale

• “Don‟t want patients to fall thru the cracks”

Goals of Summit

• Improved transitioning of patients between hospital and community

• Relationship building with community service providers

• Incorporation of clients into planning

Building Bridges

• Discovery

• “Tell me about a time when you were especially proud of the quality of care you or others provided during a patient‟s transition.”

• Dream

• What does the ideal transition look like?

Building Bridges

Outcomes

• Improved relationships

• “It was great to put a face to the person I‟ve worked with for 12 years.”

• Increased awareness of existing services

• Realization of shared vision of ideal care

• Consumers impressed by commitment of providers

• Shared desire to reduce stigma

The AI Experience –

The Question

Think of a particular time (a brief or longer event) when you were able to make optimal use of all healthcare personnel (i.e., the right people in the right roles providing the safest and most efficient care). What did it look like?

The AI Experience –

The Question

Think of a particular time (a brief or longer event) when you were able to make optimal use of all healthcare personnel (i.e., the right people in the right roles providing the safest and most efficient care). What did it look like?

• Please tell your story to a partner at your table.

• What was it about you that contributed? What unique skills did you bring to the situation?

• What did others contribute?

• What about the context (strategy, venue, time) impacted the situation?

The Shared AI Experience

The following slides are the pictures/diagrams, designed by each table, depict the themes of the individual stories shared in response to the question, “Think of a particular time (a brief or longer event) when you were able to make optimal use of all healthcare personnel (i.e., the right people in the right roles providing the safest and most efficient care). What did it look like?”

Reflections on Today’s

Experience

Please take a moment to jot down your own thoughts and then consider sharing with our entire group.

Thank you!

A list of AI resources is included in your packet.

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