project echo qi: managing up - enhancing your relationship with leaders
TRANSCRIPT
Welcome to Project ECHO Quality ImprovementWe will begin momentarily.
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Use #QIECHO on Twitter
Send questions via Zoom Q&A or
Chat.
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 (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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Q1 2
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2Q 2
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75
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Perc
ent o
f Pat
ient
s Re
spon
ding
YE
S
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
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 160
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4 5 4 4 52
5 4 5 5 5 5 5 5 4 5
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5550
38
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27
69
29
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6357
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5862 62
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
2
Mon, May 1
8
Fri, M
ay 22
Fri, M
ay 29
Thu, June 04
Thu, June 11
Mon, June 22
Fri, Ju
ne 26
Thu, Jul 2
Thu, Jul 9
Wed, Jul 1
5
Tue, Jul 2
1
Mon, Jul 2
7
Fri, Ju
l 31
Thu, Aug 6
Wed, Aug 19
Wed, Aug 26
Tue, Sep 1
0
5
10
15
20
25
6
8
6
88
14
10
1211
18
9
1211
15
878
6
11
7
1111
16
11
161515
13
1010
7
4
8
6
15
78
15
10
44
14
9
15
6
12
1515
18
8
5
12
14
8
14
8
12
7
21
16
10
4
7
10
22
17
1312
19
13
11
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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 [email protected]
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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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