leading quality improvement -...
TRANSCRIPT
2/7/2017
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Leading Quality Improvement
Essentials for ManagersLesson 2: Managing Time and Attention
February 7, 2017
These presenters have
nothing to disclose
Janet Porter, PhDDave Munch, MDKathy Duncan, RN
Today’s Host2
Rebecca Goldberg, Project Coordinator, Institute for
Healthcare Improvement (IHI), coordinates multiple
projects focused on increasing value in health care by
improving quality and reducing costs. Currently,
Rebecca’s primary responsibility is coordinating and
hosting IHI’s Expeditions, monthly virtual support
programs focused on specific topic areas. Rebecca is a
recent graduate of Georgetown University in
Washington, D.C., where she obtained her Bachelor of
Science degree in human science with a minor in public
health.
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Audio Broadcast3
You will see a box
in the top left hand
corner labeled
“Audio broadcast.”
If you are able to
listen to the
program using the
speakers on your
computer, you
have connected to
the audio
broadcast.
Phone Connection (Preferred)4
To join by phone:
1) Click on the “Participants”
and “Chat” icon in the top,
right hand side of your
screen to open the
necessary panels
2) Click the button on
the right hand side of the
screen.
3) A pop-up box will appear
with the option “I will call
in.” Click that option.
4) Please dial the phone
number, the event
number and your attendee
ID to connect correctly .
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WebEx Quick Reference
• Please use chat to
“All Participants”
for questions
• For technology
issues only, please
chat to “Host”
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Enter Text
Select Chat recipient
Raise your hand
LQI Structure
• 9 Lessons in the program
– Each lesson is composed of:
– Preparation work on the Learning Management System (videos,
articles, case studies, and an assignment)
– A coaching call for that Lesson (WebEx call with faculty)
– Lesson preparation work opens two weeks before the lesson’s
coaching call (Lesson 2 pre-work will open after this call)
– While you complete your preparation activities, please feel free
to email the listserv, [email protected], or the Lesson faculty
with questions
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Lead Faculty7
Kathy D. Duncan, RN, faculty, Institute for Healthcare
Improvement (IHI), directs IHI Expeditions and manages IHI's
work in rural settings. Previously, she provided spread expertise to
Project JOINTS, co-led the 5 Million Lives Campaign National
Field Team, and was faculty for the Improving Outcomes for High
Risk and Critically Ill Patients Innovation Community. She also
served as the content lead for the Campaign's Prevention of
Pressure Ulcers and Deployment of Rapid Response Teams
areas. She is a member of the Scientific Advisory Board for the
AHA NRCPR, NQF's Coordination of Care Advisory Panel, and
NDNQI's Pressure Ulcer Advisory Committee. Prior to joining IHI,
Ms. Duncan led initiatives to decrease ICU mortality and morbidity
as the director of critical care for a large community hospital.
LQI Objectives
At the end of the program, participants will be able to:
Describe the skills, tools, and resources needed by
a middle manager to lead quality improvement
efforts in their local settings
Demonstrate how to link department-level
improvement activities to the organization’s goals
and overall strategic plan
List at least three ways middle managers can be
successful in partnering with front-line staff in quality
improvement activities
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LQI Lessons
Lesson 1 – Know Yourself, Janet Porter
Lesson 2 – Managing Time and Attention, Kathy Duncan
Lesson 3 – Practice Improvement Essentials, Kathy Duncan
Lesson 4 – Coach Your Team, Dave Munch
Lesson 5 – Patient Engagement, Janet Porter
Lesson 6 – Problem Solving in a Culture of Safety, Dave Munch
Lesson 7 – Managing Systems and Connections, Dave Munch
Lesson 8 – Empower Teams to Engage in Improvement, Janet Porter
Lesson 9 – Identify and Spread Successful Improvement, Kathy
Duncan
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Agenda
• Action Period Assignment
• Managing Time and Attention
• Provide a Framework for managing your time and attention
• Introduce a Time Study to better understand how you are
currently spending your time
• Discuss tools and tactics to accelerate your momentum and
maximize results
• Closing
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Assignment: Time Study
How are you spending time now?
• Track your time for 3 days and
categorize into the following
groups:
– Value Added: something that benefits
your customer
– Incidental: something that does not
provide value but is necessary.
– Waste: something deemed
unnecessary if everything was
working perfectly
Thanks! 12
Sue Ullrich Madeline Cohen
Jo Gilbert Dana Parker
Sadiqa Razzaqui Neelofur Babar
Gopa Green Tami Walker
Laurel Carpenter Marrissa Fermin Hunt
Darlene Tart Qalab Abbas
Christy Rieves Katherine Dokus
Norma Gomez Keira Hall
Karla Patricia PachecoAlvarado
Gina Johnson
Debra Rosen Lynn Todd
Christine Park Mary Noto
Diana Pontes Alexis Raimondi
Jo Gilbert Dana Palmer
Pheona Brown Tanvi Abhay Dandawate
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Darlene Tart13
Special Initiatives CoordinatorImmediate Office of the Regional Administrator – Region 3U.S. Department of Health and Human ServicesAdministration for Children and Families
Action Period Assignment
• I knew that as Risk Manager my days were mostly unplanned, but this really confirmed it!
• In light of that I need to better learn which “monkeys” are really mine and when not to take ownership.
• I am learning to not be a slave to technology and not feel compulsive about answering every e-mail right away but set time to check e-mail.
• I have always had an open door but when I really need to work on something without interruption I have learned to keep my door mostly shut, or ask people to return later to discuss non-emergent issues And not feel guilty!
Sue Ullrich, RN,
CPHRMDirector Quality, Risk and Care Management
Campbell County Health
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Assignment: Time Study
How are you spending time now?Value Added: something that benefits your customer
Examples of Value Added Time:
Assignment: Time Study
How are you spending time now?
– Incidental: something that does not provide value but is
necessary.
Examples of Incidental time:
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Assignment: Time Study
How are you spending time now?
Waste: something deemed unnecessary if everything was
working perfectly
Examples of Wasted Time:
Pointer Exercise18
Did you find the Time Log Activity Valuable? Place your pointer next to your answer – Chat in why you found it valuable or not
18 Find your pointer by clicking the marker icon in the top, left hand corner of
the WebEx and selecting the pointer. Click where you would like to place it.
Have not completed
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Rules for Managing Time
• Don’t waste it
• Let your customer determine
where you should spend your
time. What do they value?
• Align with your organizations
priorities
• Listen to your mind and body,
manage your energy
Poll Question
Based on your time study, how much time
was spent in waste?a) >5%
b) 6 to 15%
c) 16 to 25%
d) 26 to 35%
e) >36%
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Congruence?
• As a manager, list your
responsibilities in order of
importance.
• List your time studies in descending
order by amount of time spent per
category
– How do the lists compare?
– Is there congruence with respect to what
is more important and the amount of time
being spent on it?
– Where does performance improvement
rank with each list?
Poll Question:
What seems to be using more time than it should?a) Employee problems
b) Rework
c) Problems that you never get solved
d) Default to “I’ll do it myself”
e) Unsure of what is expected
f) Overwork of an assignment
g) Lack of personal experience or skill
???
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6 Tactics for Managing Time
1. Tackle Performance
Problems
2. Adopt a Standard Work
Mindset
3. Coach, Delegate, Evaluate,
Repeat
4. Manage your Energy
5. Get Organized
6. Break Tradition
#1 Tackle Performance Problems
• Define the problem in terms of the performance management system: Are these competency or behavioral issues?
• Develop a strategy with your HR partner
Be aware that performance problems are costing the whole team time and energy, not just you
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#2 Adopt a Standard Work Mindset
• Develop standard work for how
you manage
– What is the routine: daily, weekly,
monthly etc
• Standardize the common
processes in your area
– Use standard templates for as much
as possible
– Focus on the leading (process)
measures
– Coach your team to the standard work
behaviors
#2b Standard work – Calendar
Never start your day with a meeting – Start with Yourself
Schedule “Start Day” on Your Calendar– Review Schedule, Revise
– Plan One Day Ahead
Schedule “Organize” on Your Calendar – Send emails, gather, review files for key meetings
Be Clear About What Constitutes a Home Run
Schedule “Reflect on Day” on Your Calendar– Review Whether Objectives Were Accomplished
– Identify Areas of Improvement, Practice
Schedule “Prepare for Tomorrow”
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#3 Coach, Delegate, Evaluate, Repeat.
• Assign your team tasks and coach them to success vs
doing them yourself
– Delegate, support, coach, monitor
– Results in capability growth and better teamwork
– Only accept complete good quality work, coach until that
happens
– Be Clear:
– Clear Direction
– When to come back to you
– The reason for the work to be done well
– What Quality work looks like
– The impact if the work is not done well
#3b Coach, Delegate, Evaluate,
Repeat.
What can you do
TOMORROW?
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#4 Manage Your Energy
• Energy is a finite but renewable
resource
• What gives you energy, what drains
it?
• Maximize your health and
wellbeing:
– Body, Mind and Spirit
• Realize, your effectiveness is
influenced by your energy level
#5 Get Organized
• Organize your work space
– Calendar, Desk, Desktop, Task list,
– How can you minimize interruptions?
• Use a Timer. Literally use a timer.
– Mutual respect
– Audible alarm is powerful
– What would make you more efficient?
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#5b Organize Your Communications
Make it clear what you want communicated, how frequently, means of communication
Limit email access to beginning of the day and end of the day
Never fight, deliver bad news or provide constructive feedback over email or texts – do it in person
Have a discussion with all your staff about communication desires, expectations, establish standards
Use visible visuals to keep everyone informed
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#6 Break TraditionAsk yourself & team:– Do we need this meeting?
– Non traditional time slots- 15 minute, 30, minutes, 45 minutes
– Start on time, End on time. Use a timer
– Spend time planning your meeting
– Spend time immediately after to send notes
– Assign ‘monkeys’ to appropriate people
– Go to them – Leave your office
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Managing Attention33
• Understand that disruptions are time wasters• Be respectful• Leaders set the culture, model behavior• Set ground rules around cell phone and computer use• Keep meeting purpose front and center
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Chat
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What is the Number One Tip
You Would Give Others?
Please send your message to All Participants
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Going Forward
Based on your time study and analysis, pick 3 things you
can do to save you time
Develop a plan to launch these within the next month
with a target date of completion within 3 months
Be intentional about where you will redeploy your time,
including driving improvement.
Do this exercise on a periodic basis, at least quarterly, to
continue managing your time.
Questions?
Please chat in or, if you are connected by
phone, raise your hand to be unmuted!
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LQI Communications
• All sessions are recorded• Recording and materials sent in post-call email and uploaded to
your MyIHI account
• Pre-work materials are located in LMS
• Listserv address for session communications:
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Lesson 3
Kathy Duncan, RNDirector
Institute for Healthcare Improvement
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Tuesday, February 21, 1 PM ET
Practice Improvement Essentials
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Thank You!39
Rebecca Goldberg
Please let us know if you have any questions or
feedback following today’s LQI Coaching Call.