By Amy Mervak

Michigan Kata Practitioner DayJune 16, 2016

Using Small Opportunites to Grow Big Skills

We take care of people who are dying, and their families.

Physical

Emotional

Spiritual

2

3

What the Improvement Kata and Coaching Kata are About to Us

Priorities

Weekly Leadership Meetings

StoryboardsFocused on individual priorities

Alignment

4

StoryboardsFocused on

strategicpriorities

Competent/Proficient

Venue

Learner

Coach

2nd

Coach

Novice

Gemba Walk

(often)

Weekly Challenges Meeting

(None)

Competent +

5

Kata Practice as of March 2016

Serving More in our Community

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Improving Staff Communication

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Decreasing Costs while Improving Quality of Life

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Spreading Scientific Thinking

Periodic improvement Daily improvement

QI staff leading

Eliminate waste(what CAN we improve?)

Group learners & coaches

Move From To

Middle leadership leading

Strategic objective(what MUST we improve?)

Individual coach/learner relationships

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COACHING

FREQUENTPRACTICE

MASTERY

STARTERKATA

Corrective feedbackTo ensure the Learner practices the rightpatterns

Interest, motivation, enthusiasm (growing self efficacy)"I'm getting better at this"

Structured routinesfor beginners

To practicefundamentals

A little every day

Ingredients for Acquiring New Skills

Think of sports and music. With the following ingredients you can acquire new skills & habits

Mike Rother – Toyota Kata 10

Itʼs practice designed specifically to improve performance over time.

Itʼs practice that involves continual evaluation of your weaknesses and targeting specific weaknesses, rather than repeatedly doing what you already know how to do.

Itʼs practice that requires a coach. Observation and specific feedback on your current performance is critical to understanding what to work on and acquiring new skill.

Itʼs practice where you donʼt move on to the next part of the routine youʼre trying to learn until you master the part youʼre currently working on.

DELIBERATE, or MINDFUL PRACTICE

By Mike Rother 11

Competent/Proficient

Venue

Learner

Coach

2nd

Coach

Novice

Gemba Walk

(sometimes)

Weekly Challenges Meeting

(None)

Competent +

Limits

People

Time

Expertise

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Spreading Scientific Thinking

Move Toward

Limits

People

Time

Expertise

13

Obstacles

Limits can spur creativity!

Coaching Kata Proficiency AssessmentBy Yvonne Muir, Jennifer Ayers & Julie Simmons

Stage Level Characteristics Autonomy

3Expert • Intuitive grasp of coaching based on deep, practiced understanding

•Direct, yet supportive

•Coaching conversations are natural; learner doesn't notice being coached

•Sought after for coaching advice

2nd Coach

needed

occasionally

2Proficient •Clear perception of learnerʼs gaps or weaknesses

•Uses coaching to guide: adapts to the situation, asks meaningful questions

•Ability to assess learners preferred learning style (auditory, visual, kinesthetic)

•2nd Coach capability

2nd Coach

needed

periodically

Competent •Capable of sensing learners uncertainty level and knowledge threshold

•Consistently coaches learner with a repeatable pattern

•Coaching embedded in normal daily work

1Advanced Beginner

•Narrow "development perception"; recognizes need for 2nd coach

•Becoming comfortable providing feedback to learner

•Beginning to observe and listen more (vs. talk and advise)

•Asks some probing questions to gain insight

Must have a

proficient 2nd

Coach at each

coaching cycle

Novice •Rigidity in asking questions / uses closed ended questions

•Lack of discipline to follow a pattern and recognize its importance

•Focuses on results (command and control)

•Not able to hear and identify when learner has hit a Threshold of Knowledge

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The Coaching Kata

Card is downloadable at:http://www-personal.umich.edu/~mrother/KATA_Files/5Q_Card.pdf

By Mike Rother 15

Clarifying Questions

What regulatory guidance do we need to be aware of?

What thought process are staff using to make decisions (what CAN'T be observed)?

Can you show EMR data that supports that?

Is the process variable by day? Staff? Type of patient?

Any EMR or IT system limitations?

Are we within caseload expectations? Visit frequency expectations?

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5 Questions - Modified

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Modified Questions

What's the goal?

What's happening now?

What are some potential solutions?

Of those, which is the best?

What's getting in the way?

When will you know the result?

--------------------------------------------------

How did it go?

What did you learn? (used sometimes)

Target Condition: By 6/16, I will be confident in using the modified 5 questions in a 1-to-1 structured conversation

“There are more opportunities to coach than I realized.”

“She makes good decisions. I need to let her talk first. We’ve developed a process.”

“Oh my gosh, it's happening. I'm starting to use the questions!”

“I'm more aware and am taking a breath before deciding to coach or direct.” Date Confidence

4/21 Low

5/5 Low

5/10 Low *

5/16 65% *

6/7 85% ** Coaching Cycles between Learner and Coach are of higher quality and more efficient.

Peer Coaching

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Peer Coaching

• 2nd Coach is a must

• Experienced how it felt to be the Learner at the same time

• Novices progressed to Advanced Beginners fairly quickly

• Gave me 2nd Coach practice

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What we’ve learned (so far)

The IK/CK Experimenting Record

20Form is downloadable at: http://www-personal.umich.edu/~mrother/KATA_Files/5Q_Card.pdf

Complete 1-to-1 Coaching Cycles at the Weekly Meeting

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Describe gaps. Recommend

actions. in TC form.

Describe gaps. Recommend

actions.in TC form.

Bring Kata to Existing Work Patterns

Conduct environmental scan; review key metrics

Set Annual Compliance

Plan priorities

Design Audit approach

(incl. outcome measures)

Conduct audit

Address gaps or choose

not to

Experiment - Bring Kata to compliance

Conduct environmental scan; review key metrics

Set Annual Compliance

Plan priorities

+Process Analysis

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Practice on small things.

It can turn into big insights.