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 3: Buy-In – Gaining support for your projectJune 8, 2016

Faculty• Presenter– Patti Feeney, MS, QI Education Manager

• Panelists– Daren Anderson, MD, Director, Chief Quality Officer

– Charise Corsino, MA, Program Manager, Nurse Practitioner Residency Program

– 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 SessionsJune 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 previous sessions on our online site.

• 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

Learning Objectives • Review strategies to help gain support • Connect with roles and departments to gain

buy-in• Learn how to use tools that will provide

structure to communicate

Core TopicsThree categories to engageUnderstanding peopleChange Management

The ToolsStakeholder AnalysisPrioritizing StakeholdersG.R.P.ICommunication Plan

Question:Which roles do you have the most challenge

gaining buy-in?

Introduction of Example:

Centralized Call Queue

CHC receptionists handle approximately 828,000 calls per year across 210 service locations. Patients tell us they wait too long to reach us and staff tell us that the workload is uneven.

By redesigning our intake, scheduling and greeting system, standardizing our call process and centralizing our call queue we will improve our service level, provide a consistent patient experience whenever and wherever they access our system, and balance the receptionist’s workload.

We have assembled a collaborative team from across CHC representing all disciplines to build a comprehensive plan to roll this out by April 15th.

Centralized Call Queue Elevator Speech:

Perspectives & Perceptions

Leadership

Stakeholder

Team

Three Categories: Leadership, Stakeholders & Team

Leadership• Know your topic & align with org goals• Early adopters and stakeholder analysis• Evaluate data

Project Roles Sets direction/deliverables/expected results Assigns resources and removes barriers Supports the team through the team leader

Sponsor/champion

Team leader

Team members

Accountable for team’s results Focused on objectives

Empowered and engaged to make decisions Implement specific actions Based on complementary expertise and

skills, not availability

Coach/facilitator Process expert and consultant for the team

Team Designo Work closely with a team sponsor

Present data and information Identify team members Identify team leader Review project charter Timeline & Milestones

The stakeholder Analysis

Who does the process touch?

Early Adopters & Stakeholder Analysis

1. Brainstorm all individuals and roles • Affected by a change• Influence or power• General interest

Roles

Chief Executive Officer

Nurses

Providers

Patients

Chief Medical Officer

Medical Assistants

Receptionists

Managers

Chief Nursing Officer

Finance

Human Resources

Medical Records

Stakeholder Strongly Supportive

Moderately Supportive Neutral (3) Moderately

AgainstStrongly Against

Sr. Leadership C Site Directiors C Med Providers D C BH Providers D C Dental Providers C Receptionist D COffice Managers C Medical Assistants C Nurses C Patients C Patient Accounts C Access to Care C IT C HR C OSMD D C

Call Queue Stakeholder Analysis example

Question:Have you ever forgotten a stakeholder?

Talk with Stakeholders• Financial or emotional interest (positive or negative)?• Motivation?• What information do they want from you?• Mode of communication?• Current opinion?• Who influences their opinions?(Maybe these become important stakeholders as well)• If not positive, what will help to gain support?• If not easily swayed, how will you manage their opposition?• Who else might be influenced by their opinions? (Maybe these become important stakeholders as well)

Early Adopters & Stakeholder Analysis

2. Prioritize Stakeholders• Influence or power• Interest• Level of interaction

fully engage Don’t over communicate & bore them

adequately informassure no major issuesVERY helpful people!

Don’t over communicate & bore them

ReceptionistsPatients

CMO/CNO

CEO

CEOMedical Assts

Medical Records Providers

Prioritizing Stakeholders Example

Nurses

Evaluate Data3. Look at all data available now & future• Measure baseline data• Display and communicate• What metrics are & will be available?

Call Queue Example:Baseline data: 1700 calls dropped/abandoned per weekUn-scanned lab workCentralized Call Queue: <100 dropped

0 1 2 3 4 5 6 7 8 9 10

G(Goals)

Purpose & OutcomesWe understand and agree on our project mission andthe desired outcome (vision)Customer & NeedsWe know who the project stakeholders are, what theyrequire, and why this project is really needed.Goals & DeliverablesWe have identified specific, measurable & prioritizedproject goals & deliverables linked to our business goals.Project Scope DefinitionWe understand/agree on what is in/out of our projectscope & tasks. The project scope is “set.”

R(Roles)

Roles & ResponsibilitiesWe have defined & agreed on our roles, responsibilities, required skills & resources for the project team.Authority & AutonomyOur team is clear on the degree of authority/empowerment we have to meet our project mission.

P(Processes)

Critical Success FactorsWe know & are focusing on the key factors needed tomeet the project goals & missionPlans & ActivitiesWe have an effective game plan to follow that includes the right tasks; clearly defined/assigned.Monitoring & MeasuresWe have an effective monitoring process & specificmetrics linked to progress & goals.Schedule/MilestonesWe have defined our project schedule and know what the key phases & milestones are.

I(Interpersonal)

Team “Operating Agreement”We have shared expectations, agreed & followedguidelines for how our team works together.Interpersonal/TeamWe have the necessary relationships, trust, openness,participation & behaviors for a healthy & productive

Goals, Roles, Processes, Interpersonal

0 1 2 3 4 5 6 7 8 9 10

G(Goals)

Purpose & OutcomesWe understand and agree on our project mission andthe desired outcome (vision)

2 5 2 1

Customer & NeedsWe know who the project stakeholders are, what theyrequire, and why this project is really needed.

4 6

Goals & DeliverablesWe have identified specific, measurable & prioritizedproject goals & deliverables linked to our business goals.

7 3

Project Scope DefinitionWe understand/agree on what is in/out of our projectscope & tasks. The project scope is “set.”

4 5 1

GRPI Scoring:

10 Team MembersPurpose & Outcomes : 68/10 = 6.8Customer & Needs: 76/10 = 7.6

Scale 0-10

G Purpose & Outcomes

6.2(Goals) We understand and agree on our project mission and the desired outcome (vision)

Customer & Needs

4.3 We know who the project stakeholders are, what they require, and why this project is really needed.

Goals & Deliverables

5.3 We have identified specific, measurable & prioritized project goals & deliverables linked to our business goals.

Project Scope Definition

4.6 We understand/agree on what is in/out of our project scope & tasks. The project scope is “set.”

R Roles & Responsibilities

5.2(Roles) We have defined & agreed on our roles, responsibilities, required skills & resources for

the project team.

Authority & Autonomy

2.9 Our team is clear on the degree of authority/ empowerment we have to meet our project mission.

P Critical Success Factors

5.3(Processes) We know & are focusing on the key factors needed to meet the project goals & mission

Plans & Activities

3.8 We have an effective game plan to follow that includes the right tasks; clearly defined/assigned.

Monitoring & Measures

3.5 We have an effective monitoring process & specific metrics linked to progress & goals.

Schedule/Milestones

4.3 We have defined our project schedule and know what the key phases & milestones are.

I Team “Operating Agreement”

4.4(Interpersonal) We have shared expectations, agreed & followed guidelines for how our team works

together.

Interpersonal/Team

4.2 We have the necessary relationships, trust, openness, participation & behaviors for a healthy & productive

Centralized Call Queue GRPI Example:

Common Responses to Change

• This seems like more work and I don’t have time for what I do now!

• We’ve tried new systems and processes before and it didn’t work

• This is how we’ve always done it

• This change is going to eliminate my job

Jason Clarke Director of Minds at Work - Author & Well-known speaker

“Very often we think they don’t like the idea, what they are really worried about is the journey to the idea.”

A BKnown

StructuredProvenFamiliar

UnknownUnstructured

UnprovenUncertain

FailureLoss

RejectionRiskFear

AnxietyConfusion

WasteBlameChange

Audience Objectives Message(s) Media & Methods Timing & Frequency Who/ WhenWhere

Extended Sub Groups email 3/1/2013 Fred Jones

Access to Care Lunch with Fred Jones

Agency-Wide email 3/9/2013 Fred Jones Town Hall Meeting 4/5/2013 Fred/Sally/Rita

Sr. Leadership

Site Directors

Med Providers

The goal of the smart scheduling plan is to address the # 1 concern of our pts; wait time. The plan is also aimed to standardized schedules, & training. ATC will be trained to schedule initial appts. Centricity schedules will be blocked.

Medical Provider Site Meetings 3/15/2013 OSMDs to Providers

BH Providers

Dental Providers

Office Managers tied to meetings with Receptionists - breakfast

Receptionist (64) Leaders - 7 Receptionists to breakfast - discussion A Friday morning breakfast Sr. Leadership

Medical Assistants

Nurse Managers email/weekly meeting 3/8/2013 Nancy Smith

Nurses email 3/8/2013 Nancy Smith

Call Pool Nurses Special lunch - discussion Nancy Smith

Patients

Patient Accounts

Access to Care

IT

HR

Finance Meeting ? CFO/Jane Doe

OSMD OSMD Meeting 3/27/2013 Mary Hart

Communication Plan

“The second day of the ‘revamped call queue’ was amazing and a little less frenetic than yesterday – Our patient service level numbers were the best in the history of the agency – 100% of calls handled – and service rate at 98%! We still are working on your feedback – much more fine tuning to be done.”

Tremendous Improvement Observations

Let’s Answer Your Questions

References• General Electric. (2012). Change Acceleration Process Training.

• PETERS, T. J., & WATERMAN, R. H. (1982). In search of excellence: lessons from America's best-run companies. New York, Harper & Row.

• MindTools.com. (2002). Stakeholder Analysis. [Online]. Available from: https://www.mindtools.com/pages/article/newPPM_07.htm#Interactive. [Accessed: March, 2013].

• Mindsatwork.com. (2010) Embracing Change. [Online]. Available from: http://www.mindsatwork.com.au/change-2/do-people-really-hate-change/. [Accessed: May, 2013].

• KEGAN, R., & LAHEY, L. L. (2009). Immunity to change: how to overcome it and unlock potential in yourself and your organization. Boston, Mass, Harvard Business Press.

• Kotter, J. P. Leading Change. Boston: Harvard Business School Press, 1996.

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:

Communicating and Advocating Using DataWednesday, June 29th from 12-1p.m. EDT

Complete our post-session survey!

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

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