welcome back, warm up, questions from day 1 -...
TRANSCRIPT
Welcome back, warm up, questions from Day 1Improvement Coach Professional Development Program
Workshop 2, Day 2
March 14, 2017
Karen Baldoza
Workshop 2: Day 2 overview
Time Agenda Item
7:00 AM Breakfast available
8:00 AM
10:00 AM Break
• Welcome back, warm up, questions from day 1
• Coaching to learn (One-on-one leadership coaching)
• Developing change ideas: Change packages
• Breakouts: WIP presentations round 2
12:00 PM Lunch
1:00 PM
3:00 PM Break
• The art of coaching: Coaching practice round 1 breakouts
• Visual displays of data
• Open space
• Day 2 debrief and assignments
5:00 PM Adjourn
Optional – Individual consultations
Coaching to Learn: One on One Leadership Coaching
Phyllis Virgil
Improvement Coach Professional Development Program
Wave 3, Workshop 2
March 14, 2017Day 2
Created by Phyllis M. Virgil
Session Objectives
• Review the basic building blocks of connecting and
coaching to learn.
• Practice key skills associated with the art of coaching
questioning, exploration, understanding, and the ability
to elicit insight (3 rounds of paired coaching)
• Obtain insight on one key issue or problem you are
currently working on.
Phyllis M. Virgil, PMV Consulting, LLC
Session agenda
Topic Min
Introduction 10
Meet, Greet and Gathering Skills (5, 5/5) 15
Questioning, Exploration and Inquiry Skills (10, 10/10) 30
Skills for Understanding and Insight (10, 5/5) 20
Reflection and Wrap-up 15
Phyllis M. Virgil, PMV Consulting, LLC
Coaching to Learn
Requires:Choosing the right attitude,
and sending the right signals.
In order to get people to talk,
and keep them talking.
So we can gather the story,
to elicit their insights
and offer our own.
Adapted from Boothman, Levine and Gladwell by Phyllis M. Virgil, PMV Consulting, LLC
Photo Credit: MS Word
First Things…
Write down one key problem or difficult situation that is complex in nature, currently unresolved and weighing on your mind.
Can be any issue (project related or not, professional or personal), which you are willing to openly share and to work on...
Phyllis M. Virgil, PMV Consulting, LLC
Clip Art Credit:: MS Word
When Coaching Others:
First Attend to the Person
Then to the Problem
Adapted from How to Connect in Healthcare in 90 Seconds or Less by Nicolas Boothman by Phyllis M. Virgil
Clip Art Credit:: MS Word
Recognize the Importance of Trust
People must trust you, before they will hear you.
Adapted from How to Connect in Healthcare in 90 Seconds or Less by Nicolas Boothman by Phyllis M. Virgil
Building the Cycle of Trust
Practice Open Communication
COMMUNICATION
Open
Closed
Trust
Collaboration
Mistrust
Fear
Competition
Learning
No Learning
@Phyllis M. Virgil
Adapted from The Fifth Discipline by Peter Senge
The coaching kick off...
When connecting as a coach we need to:
• Choose the right attitude
• Send the right signals
• Get people talking
11
Adapted from How to Connect in Healthcare in 90 Seconds or Less by Nicolas Boothman by Phyllis M. Virgil
Choose the Right Attitude
• Attitudes are infectious.
• Drive behavior.
• Open not closed.
• Can make or break a coaching session.
• Be genuine.
• Charming not alarming.
• Mend moodiness before meeting.
Adapted from How to Connect in Healthcare in 90 Seconds or Less by Nicolas Boothman by Phyllis M. Virgil
Clip Art Credit:: MS Word
Send the Right Signals
• Recognize the importance of nonverbal
communication
• The three must’s of body language:
1. Look them in the
2. Warm smile
3. Point your towards them
• Coordinate (synchronize) posture and tone
Adapted from How to Connect in Healthcare in 90 Seconds or Less by Nicolas Boothman by Phyllis M. Virgil
Clip Art Credit:: MS Word
Get People Talking
Begin with an open statement:
• Comment on location or occasion
Follow by an open ended question
• What / Why / How
Avoid closed questions:
• Are You? / Have You / Do You?
• (can soften with respect or a smile)
Adapted from How to Connect in Healthcare in 90 Seconds or Less by Nicolas Boothman by Phyllis M. Virgil
Clip Art Credit:: MS Word
Round One Coaching Exercise (10 minutes)
Choose a partner -- someone close by, like to get to know better
ID roles Coach/Client (birthday closest to today = client)
Work on problem/issue you wrote down...
Meet and greet your client remembering to:
• Choose the right attitude
• Send the right signals
• Get them talking
Coach works to connect to person and their problem, do not provide
solutions only questions and understanding
5 minute round then switch roles coach/client (I will call time)
Phyllis M. Virgil, PMV Consulting, LLC
Clip Art Credit:: MS Word
Keep them Talking By providing feedback:
• Eye contact
• Open body language
• An occasional nod of the head
• Short words of encouragement
By throwing the ball back in their court:
• Follow-up questions – tell, explain, describe
• Appeal to senses – how does that sound, what do you see, how did you feel....
• Active listening paired with reflective feedback
Adapted from How to Connect in Healthcare in 90 Seconds or Less by Nicolas Boothman by Phyllis M. Virgil
Clip Art Credit:: MS Word
Gather the Story
• Recognize the importance of story
• Contains seeds of insight
• Treat it as a treasure
• Have a genuine concern
• Feedback to reflect back
• Take a spirit of inquiry
• Probe to discover meaning
• Practice the art of listening
Adapted From: Getting to Resolution: Turning Conflict into Collaboration by Stewart Levine, by Phyllis M. Virgil
Clip Art Credit:: MS Word
An effective listener is...
Intuitive
Open
Perceptive
Unpresuming
Source: Phyllis M. Virgil, PMV Consulting, LLC
Clip Art Credit:: MS Word
Practice the Art of Questioning
To help your client:
• Find Clarity
• Explore Emotions
• Develop Strategies
• Take Action
Source: Coaching with a Full Deck by Dr. Anne Power
Coaching With a Full Deck
The card questions are organized as follows:
Finding Clarity – Diamonds
Exploring Emotions – Hearts
Developing Strategy – Clubs
Taking Action - Spades
Start by seeing if there
is a suit that captures
the problem or issue.
Stay within that suit.
Organized in terms of
complexity # low to high
If the problem or issues
cuts across all suits
then shuffle the deck
and pick at random
Source: Coaching with a Full Deck by Dr. Anne Power, [email protected]
Round Two Coaching Exercise (20 minutes)
Continue your coaching conversation:
• Keep your client talking
• Gather their story
Use coaching cards to stimulate questions
Coach ONLY asks questions
Do not make judgments, provide advice or direction
10 minute round then switch roles coach/client
(I will call time)
Phyllis M. Virgil, PMV Consulting, LLC
Clip Art Credit:: MS Word
Continue the Exploration
Take a Spirit of Inquiry & Attitude of Discovery
• Genuine desire to understand
• Suspend your judgments. assumptions and conclusions
• Search behind statements and positions
• Dig deeper, play detective
• Probe to discover meaning
Source: Phyllis M. Virgil, PMV Consulting, LLC
Clip Art Credit:: MS Word
Elicit Insights (not answers)
Be present
In the moment
Forget your preconceptions
Be a blank slate
Feel way to findings
Ask for permission
Trust and test your intuition
Maintain detachment
Elicit their insight and offer your own
Adapted from Blink - The Power of Thinking Without Thinking by Malcolm Gladwell by Phyllis M. Virgil
Clip Art Credit:: MS Word
Use The Power of Blink
Blink: The Power of Thinking Without Thinking,
by Malcolm Gladwell
Rapid cognition operates very effectively:
1. First meet a person/situation
2. Times of crisis and quick decisions making
3. Complex situations…
Silent mental valet
Occurs in an instant
Skill that can be developed
Adapted from Blink - The Power of Thinking Without Thinking by Malcolm Gladwell by Phyllis M. Virgil
Clip Art Credit:: MS Word
Round Three Coaching Exercise (10 minutes)
Continue your coaching conversation:
• To elicit their insights
• And offer your own
5 minute coaching round then switch roles client/coach
(I will call time)
Phyllis M. Virgil, PMV Consulting, LLC
Clip Art Credit:: MS Word
Coaching to learn requires a shift...
From: “How do I get
this person, this
team to do xyz?”
To: “How do I help this
person or team discover
their own way and their
own solutions
Source: Jane Taylor
This means an effective Coach…
Asks questions
Stimulates the imagination
Challenges ways of thinking
Validates and supports
Shows patience and compassion
Helps their client discover their own solutions, develop their own plans and put them into action
Source: Jane Taylor
A Final Thought
There is nothing as rewarding as watching your client (team/leader)
wake up to their own insights and answers...
Conversation with John S. Dowd
on the art of coaching
Interview with John S. Dowd, Consultant in Continual Improvement by Phyllis M. Virgil
Reflections
What insights did you get from this exercise?
What hit you most powerfully about your coaches help?
What might you take home or do differently now?
Phyllis M. Virgil, PMV Consulting, LLC
Clip Art Credit:: MS Word
Appreciate, Adjourn
What words of gratitude would you like to share
with your coach?
Source: Phyllis M. Virgil, Coach Training
Appendices
A. Coaching Skill Sets
B. Coaching Tips
C. How can a coach help?
D. Why this Matters
E. Emotional Intelligence (EI)
F. Approaches to Improvement
G. The Importance of Story
H. Elicit Definition
I. Additional Resources
Personal CompetenceSelf-Awareness; emotional awareness
accurate self assessmentself-confidence
Self-Regulation: self controltrustworthinessconscientiousnessadaptabilityinnovation
Self-Motivation: achievement drivecommitmentinitiativeoptimism
Social CompetenceSocial Awareness: empathy; serviced
developing othersleveraging diversitypolitical awareness
Social Skills: influence communicationleadershipchange catalystconflict managementbuilding bondscollaboration and cooperationteam capabilities
Appendix A
Coaching Skill Sets
• Evaluate yourself in
light of these
characteristics.
• Which areas do you
do well?
• Which areas do you
need to work on?
Adapted From: Daniel Goleman,
Emotional Intelligence, 1995 by
Jane Taylor.
Appendix B
Coaching Tips
√ Articulate: succinctly describe what is going on; share observations without judgment
√ Clarify: Here’s what I’m hearing. . . . Is that right?
√ Acknowledge: strengths and weaknesses
√ Show curiosity: “I wonder . . .” leads to discovery
√ Help team gather information: What topics will you include in the report? What data would help us understand more?
√ Help team develop accountability: What will you do? When will you do it? And, how will we know?
Appendix C
How can a coach help?
Coach helps the team or leader identify issues, barriers, struggles,
areas to understand, test and improve
Listen first —don’t offer own valuable experience, when need to - ask
permission
Ask penetrating questions
Reflect back and then ask, “is this the case?”
Avoid the temptation to:
Share your story - unless you are asked
Give advice - unless you are advising
Source: Jane Taylor
Appendix D
Emotional Intelligence- Why it Matters
50% of work satisfaction is determined by the relationship a worker has with… his/her boss.
Emotional Intelligence (EI) is a prerequisite for effective leadership across disciplines.
EI requires a high level of self-mastery and people skills; ability to put yourself into the positions of others.
Adapted From: Daniel Goleman, Emotional Intelligence, 1995 by Jane Taylor
• Signals of Lower EI• All or nothing thinking
• Overgeneralization
• Excessive worrying
• Worrying as magical thinking
• Disqualifying the position
• Jumping to negative conclusions
• “Should” statements
• Labeling & mislabeling
• Personalization
• Stonewalling
• Criticism; contempt
Appendix EEmotional Intelligence (EI)
• Develop EI by:• Take time for mindfulness
• Be “present
• Recognize and name emotions
• ID the causes of feelings
• Differentiate having the emotion and doing something about it
• Learn optimism to challenge distortion - Martin Seligman
• Learn distraction techniques
• Listen to voice of experience
• Develop Listening skills
Adapted From: Daniel Goleman, Emotional Intelligence, 1995 by Jane Taylor
Consultant Mentor Coach• ‘Expert’ view• Tells you what to do
• Developmental view• Mentor shows
• Results view• Coach asks
questions
• Looks backwards on the data to make conclusions
• Where are you right now?
• No firm action plan
• Forward looking only
• Client does the work based on the ‘expert’ advice
• Client observes• Discusses issues
and topics• Process is
developmental
• Client acts and reflects
• Action orientation• PDSA testing• Coach holds client
accountable
Source: Jane Taylor
Appendix F
Approaches to Improvement
Appendix G
The Importance of Story
When we haven’t the time to Listen to each other’s story, we seek out experts to teach us how to live… The less time we spend together at the kitchen table, the more how to books appear… Because we have stopped listening to each other, we may even have forgotten how to listen, and stopped learning how to recognize meaning.
Levine, Getting to Resolution
Levine, Getting to Resolution
Appendix H
Elicit Definition
• evoke or draw out (a response, answer, or fact) from someone in reaction to one's own actions or questions.
• draw forth (something that is latent or potential) into existence.
• synonyms: obtain, draw out, extract, bring out, evoke, call forth, bring forth, induce, prompt, generate, engender, trigger, provoke;
Appendix I
Additional References
Immunity to Change. Robert Kegan, Lisa Lahey.
Emotional Intelligence. Daniel Goldman
Social Intelligence. Daniel Goldman
Learned Optimism. Martin Seligman
Co-active Coaching. Laura Whitworth, Karen Kimsey-House
Executive Coaching with Backbone & Heart. Mary Beth O’Neill
Robert Putnam’s dissertation (Harvard)
Action Inquiry: The Secret of Timely and Transforming Leadership. William Torbert
Compiled by Jane Taylor
Break
Developing Change Ideas: Change PackagesWilliam Peters
Improvement Coach Professional Development Program
Wave 3, Workshop 2
March 14th, 2017Day 2
Question 3 of the Model for Improvement
What are we trying toaccomplish?
How will we know that achange is an improvement?
What change can we make thatwill result in improvement?
Model for Improvement
PlanAct
DoStudy
Source: Associates for Process Improvement
Here we are looking at
a set of changes “pre-
packaged” for ease of
use and rapid
effectiveness:
CHANGE PACKAGES
Question 3 of the Model for Improvement
• A collection of good ideas ready for use
• Tests of change, known to bring about improvement
• Proved ideas
• Based in research (might include level of evidence)
• Clinical guidelines
• Experience
• Usually organized around a
model or framework
• Where do they come from?
What are we trying toaccomplish?
How will we know that achange is an improvement?
What change can we make thatwill result in improvement?
Model for Improvement
PlanAct
DoStudy
The lifecycle of testing changes45
How we come up with changes46
Packaging Effective
Changes
Change Package
- Change 1
- Change 2
- Change 3
- Change 4
- Change x …
How we come up with changes, cont’d
• It is the ideas that lead to improvement that are
singled out to be incorporated into a “Change
Package”
• Changes that lead to improvement after
implementation are the kind of changes we need
to think about spreading!
• Rapid Response Teams, or Early Warning
Systems, I’ve seen as some of the most
effective
47
Some well known change packages
• RRT, or Rapid Response Teams
• QEWS, or “Qatar Early Warning System”
• VAP, or Ventilated Associated Pneumonia
• CLABSI, or Central Line Associated Bloodborn…
• Pressure Ulcer Prevention Bundle
• VTE High Risk Bundle
• Any one have one they know about?
48
Example 1: The Package49
Example 1: The Breakdown50
Example 1: Let’s dive in one51
Example 1: Detail52
Example 1: Measurement Detail53
Example 2: The Package54
Example 2: The Breakdown55
Example 2: Let’s dive in one56
Example 2: Detail57
Example 2: Measurement Detail58
Summary
• Not a “one size fits all” mentality
• Only package and spread proven ideas
• Your team could be forming one now? Anyone?
• Typical parts of a change package:
– Driver Diagram detailing change package overview
– Table detailing each of the individual parts
– Table operationally defining the measures needed
• The completed product should be able to be implemented by a 3rd party with limited input, it’s almost a “standalone” product
59
Breakouts
Lunch
The Art of Coaching Set-upPhyllis Virgil
Improvement Coach Professional Development Program
Wave 3, Workshop 2
March 13, 2017Day 2
The Art of Coaching…
Image by Margaret Riegel, Margaret Riegel Il lustrations, NYC commissioned by the New York State Department of
Health AIDS Institute National Quality Center. Funded through a cooperative agreement with the Health Resources
and Services Administration HIV/AIDS Bureau..
Session Objectives
• Using an assigned case scenario, demonstrate
improvement coaching skill by role playing a
coach/client interaction.
• Apply improvement and coaching knowledge to
provide feedback to coach/client role-plays.
The Art of Coaching
The coaching case scenarios have been designed to provide a forum to practice and receive feedback on the art of coaching thru role playing
This exercise will be held twice, giving each person the chance to play the role of coach & client
Note there is no one right answer to any of the scenarios, so please develop your case scenario given your best understanding and expertise.
Feel free to add any additional context to your scenario.
Role Play Process
Role playing scenarios will be conducted in 3 breakout rooms
with 8-9 scenarios per breakout.
Setup: (1 minute)
• Organize your references, flipchart or other resources
• Tells us the situation or build the situation into the role playing scenario
Role play the scenario (5 minutes)
• After your brief introduction enact your coach/client role play
• May use any supporting materials or props you want (flip chart, texts, tool box, etc)
Feedback from colleagues (4 minute rapid round robin)
Went well, will take home
Other ideas and things to consider
Agenda and LogisticsCoaching Scenario Role Play
Tues and Wed 1-3 pm Start Minutes
Break Out Room Introduction 1:00 5
Role Play (10 min each Total) 1:05 90
Insights & Learnings (record on flip chart) 2:35 10
Break 2:45 15
Key Learning Report Outs (Main Room) 3:00 15
Coaching Case Scenarios
Paired Sign Up Coach/Client
We need 2 names in each cell – Coach & Client.
You must keep the same partner for round two, but trade roles for your second case.
This means your names must appear twice on the sign up flipchart:
1. Tuesday (1-12)
2. Wednesday (13-24)
Coaching Case Scenario
Paired Sign-up
Break Out # Room __________
Round ONE: Tuesday 1:00-3:00
1 2 3 4 5 6
7 8 9 10 11 12
Round TWO: Wednesday 1:00-3:00
13 14 15 16 17 18
19 20 21 22 23 24
Case Scenarios (pick up at sign-up station)
ROUND ONE (Tuesday)
1. Aim Statement for Hand-Off Team
2. Cardiology Staffing Data
3. The Stalled Primary Care Team
4. Fetal Risk Management Data
5. Aim Statement for Healthy Habits
6. The Dysfunctional Waste Reduction Team
7. Intent to Automate
8. The Confused Family Involvement Team
9. Difficulty moving to testing
10. Learning with Data Over Time
11. Shooting for the Stars
12. Friends... Building Capacity and Capability
ROUND TWO (Wednesday)
13. Adverse Drug Events (ADE) Aim Statement
14. The Struggling Team
15. Ventilator Associated Pneumonia (VAP) Data
16. The Stuck Team
17. Childhood Obesity Data Collection
18. The Enthusiastic Medication Advising Team
19. No More Razors Team
20. The Results Driven Leader
21. Temperatures Rising
22. What Do We Do With This Data?
23. Community Coalition All Talk, No Action
24. Time to Spread?
Break
70
Debrief Coaching Practice: Report out key learnings
71
The Visual Display of DataWilliam Peters
Improvement Coach Professional Development ProgramWave 3, Workshop 2
March 14th, 2017Day 2
Why graphical displays of data?
Data Set 1 Data Set 2 Data Set 3 Data Set 4
X Y X Y X Y X Y
10.00 8.04 10.00 9.14 10.00 7.46 8.00 6.58
8.00 6.95 8.00 8.14 8.00 6.77 8.00 5.76
13.00 7.58 13.00 8.74 13.00 12.74 8.00 7.71
9.00 8.81 9.00 8.77 9.00 7.11 8.00 8.84
11.00 8.33 11.00 9.26 11.00 7.81 8.00 8.47
14.00 9.96 14.00 8.10 14.00 8.84 8.00 7.04
6.00 7.24 6.00 6.13 6.00 6.08 8.00 5.25
4.00 4.26 4.00 3.10 4.00 5.39 19.00 12.50
12.00 10.84 12.00 9.13 12.00 8.15 8.00 5.56
7.00 4.82 7.00 7.26 7.00 6.42 8.00 7.91
5.00 5.68 5.00 4.74 5.00 5.73 8.00 6.89
Average
9.0
Average
7.5
Average
9.0
Average
7.5
Average
9.0
Average
7.5
Average
9.0
Average
7.5
Statistical summary of four data sets
• Each data set has 11 data points for variables X and Y
• Each data set has the same averages for the Xs (9.0) for the and Ys (7.5)
• Each data set has the same correlation coefficient for X and Y (r = .86)
• Each data set has the same least squares regression equation
( Y = 3.0 + .5X with r2 = .667 and the standard error = 1.24)
So, do you conclude that the four data sets are the same
or different?
They all produce the same results.
Look at the scatterplots produced by these four data sets
on the next page.
What conclusions do you make now?
Scatter plots of Anscombe’s four data sets
Scatterplot for Data Set 1
0
5
10
15
0 5 10 15 20
X values
Y v
alu
es
Scatterplot for Data Set 2
0
5
10
15
0 5 10 15 20
X values
Y v
lau
es
Scatterplot for Data Set 3
0
5
10
15
0 5
10
15
20
X vlaue
Y v
alu
e
Scatterplot for data Set 4
0
5
10
15
0 5
10
15
20
X vlaues
Y v
lau
es
Five basic types of data display
Plot data over time
Plot data showing a distribution
Plot data showing relationships
Plot data as locations
Plot data showing multiple measures
What graphic tools are associated with each type
of data display listed above?
• Overall Objective of a chart or graph: To communicate information about the issue of interest
while minimizing the amount of ink and white space on the chart!
• Chart titles
• 1st line of title: Organization
• 2nd line of title: name of the specific measure (e.g., Inpatient Falls Rate)
• 3rd line of title: date of data sequence shown on the chart (e.g., 2016/01 – 2016/12)
• Clearly label the X and Y axes (clear wording as well as appropriate font size)
• Scale the Y axis to allow for future data points and don’t rely on auto scaling
• Avoid vertical and horizontal grid lines on charts, especially on control charts (sometimes grid lines help for reference on scatter diagrams but grid lines need to be lighter than other
axes)
• When presenting percent or rate charts it is helpful to show the numerators and
denominators in a data table on the top or bottom of the chart
• If you are going to show the raw data on each point on the chart make sure that it does not
make the chart confusing and too busy
• If a control chart is being made make sure to identify the type of chart, CL and UCL/LCL
• Annotate the charts to show changes and when they were implemented
• Partition the control chart (i.e., freeze the control limits) to show changes
Checklist for Making Good Graphics
Edward R. Tufte
• “The Leonardo da Vinci of
data” –New York Times
• Professor Emeritus at Yale
• Author and publisher of
7 books
• Received 40 awards for
content and design
• Provides practical design principles for graphical
excellence
“The least ink to present the greatest amount of
information in the smallest space.”
XYZ
Time on Diversion
Example: CMS/HQA Core Measures
(Perfect Care Bundles – all aspects of a bundle must be
met in order to receive credit)
Better than or Equal to State Average
Worse than State Average
Legend
#1: Reported
“Patient/Visitor/Other” Incidents
4th Quarter - October 1, 2005 – December 31, 2005 Total Incidents = 230
1st Quarter – January 1, 2006 - March 31, 2006 Total incident = 331
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
Re
po
rte
d In
cid
en
ts
4th Q 2005 46 49 32 9 17
1st Q 2006 69 56 40 32 8
Fall Delay in Treatment Pollicy ProcessHospital Acquired Pressure
UlcersEquipment Failure
Tufte’s classic works
The Visual Display of Quantitative Information.
Graphics Press, Cheshire, CT, 1983.
Envisioning Information. Graphics Press,
Cheshire, CT, 1990.
Visual Explanations. Graphics Press, Cheshire,
CT, 1997.
This graphic shows six variables simultaneously: the size of the army, its location on a two-dimensional surface, direction of the army’s movement, and temperature on various dates during
the retreat from Moscow.
422,000 men
started the
journey to
Moscow
10,000 men made
it back to Poland
From: The Visual Display of Quantitative Information by E. Tufte, Graphic Press, Cheshire, CT, 1983, page 40.
IH: 23-4
Tufte (page 40)
concludes that this
map “may well be
the best statistical
graphic ever
drawn.”
Charles Joseph Minard’s dramatic account of Napoleon's Russian campaign of 1812 (drawn in 1861)
100,000 men
arrived in Moscow
In September of 1854 Dr. John
Snow used a dot (or location) map
to plot the location of deaths due to
cholera in central London. The red
dots indicate the location of water
pumps. The black bars indicate the
total number of deaths in the area.
Snow observed that the deaths due
to cholera occurred primarily around
the Broad Street water pump. He
had the handle of the contaminated
pump removed thus ending the
cholera epidemic that claimed over
500 lives.
Broad Street
neighborhood
From: Visual and Statistical Thinking: Displays of Evidence
for Making Decisions by E. Tufte, Graphic Press, Cheshire,
CT, 1997.
Graphical Excellence Summarized
Substance and integrity• Provide important information, never mislead by way we scale,
sample, frequency
Statistics
Design principles• use the least ink to present the greatest amount of information
in the smallest space
First and foremost: visual displays of data (i.e. run chart) are there to learn from, not talk about!
Chart serve as a basis for action, not just for looking cool
On run charts, include the op-def and a SME interpretation
Open SpaceKaren Baldoza
Improvement Coach Professional Development ProgramWave 3, Workshop 2
March 14th, 2017Day 2
Day 2 debrief and assignmentsImprovement Coach Professional Development Program
Workshop 2, Day 2
March 14, 2017
Karen Baldoza