one of the best but forgotten niatx tools
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TRANSCRIPT
STAR-SI is a partnership between the Center for Substance Abuse Treatment and the Robert Wood Johnson Foundation, and is administered through NIATx.
One of the best but forgotten
NIATx Tools; Workshop
Eric Preuss, Clinical Project and QA Coordinator, Community and Family Resources
Gena Hodges, Iowa STAR-SI Project Coordinator,Iowa Department of Public Health
2009 SAAS/NIATx Conference (Tucson, AZ)
Objectives
• Discuss the Five Key Principals of the NIATx Model and Nominal Group Techniques’ role in flowcharting
• Flowcharting as a process tool
• Create a flowchart
• Identify one process at your agency to flowchart
Five Key Principals
1. Understand and involve the customer
2. Fix key problems that keep the CEO awake at night
3. Pick a powerful change leader
4. Get ideas from outside the organization or field
5. Use rapid cycle testing to establish effectiveness of changes
Nominal Group Technique (NGT)
•Getting everyone’s input
•No wrong ideas
•Every idea is valued
•Method at a glance
Seven Step Process
1. Preparation
2. Silent idea generation
3. Round-robin recording of ideas
4. Serial discussion of ideas
5. Preliminary voting (rank/rate)
6. Discussion of preliminary vote
7. Final voting, follow-up and nextsteps
Let’s test the steps
Need a change leader for each group
~ Timed activity working through the NGT
~ Leader picks the historian
~ First (4) steps we’ll do together
Step – 1 Preparation
• Focus1. What’s keeping the CEO awake at night?
Determine the initial question –
2. Send out the focus prior to the day of the meeting
• Logistics 1. Location of meeting
2. Save the date - out to team 2-3 weeks ahead
3. Agenda – one week ahead
4. Set up room with tools needed before the meeting starts
Step 2. Silent Idea Generation
Initial Question: What can we do to get tothe Summit on time?
• Think about current process - what was your process this morning?
Step 3 – Round Robin Recording• ironed clothes• got out of bed at ____?• took a shower for ___ minutes• brushed teeth, shaved put on make-up• rode an elevator• took medication/vitamins • read the newspaper, e-mail or watched T.V.• ate breakfast• Made phone calls, answered e-mail• exercised • dressed, put on deodorant/cologne • made bed/tidied room
Step 4 – Serial Discussion
• Take each idea and discuss it one at a time to clarify.
Step 5 – Preliminary vote on ideas (rating and ranking )
• Each member gets to make an independent judgment on the ideas they feel will (most likely) solve the question issue/focus.
Step 6 – Discuss Preliminary Vote
• Not to change participants minds; goal is to discuss any consistencies or inconsistencies in the voting patterns
Step 7 – Final Vote on Ideas
This is when independent judgments become group decision.
The final vote helps:• Determine the outcome of the meeting• Provides a sense of accomplishment, and should serve as a record of the final group judgment in relation to the initial question
Moving on …
• The information from step seven will be used to flowchart
• Don’t forget to type up findings and share with team and other staff ~ could be done through a flowchart
Why Flowcharting
• Learning is more effective with a visual
• Mapping tool to describe new/existing processes
• Forces organizational focus on process
• Helps achieve continuity of care
• Share tried practices with co-workers
• Diagnosis bottlenecks
Flow charting identifies:
• Name of the process
• Where the process begins
• Where the process stops
• What is and is not included
• Key stake holders
• Process owners
Common Key Symbols for Flowcharts
Are you ready for clothes?
No
Yes
A square identifies a step in the process
A diamond is a decision point in the process and asks a “yes or no” question. Named the decision tree because it needs two lines leaving it like branches
Action
Post-It Notes are great for flowcharting.
Extra ~deodorant
Get Dressed
Start
Common Flowchart Symbols Continued
= document symbol, such as materials or components, i.e. a document or script will be used or developed for use
= outputs/database symbol, represents a change or issue of the data/base
= connector symbol, connects
ideas, treatment episodes, pages, of information that is not on the flowchart.
= terminator symbol, used to start and to end the flowchart process.
Monday
+ feedback
Clients happy that they only
have one release form
now.
Clients happy that they only
have one release form
now.
It works!
Need assistance
Make your own symbols
Make your own symbols
REMINDER
Types of flowcharts
• Client/Consumer• Staff • Team• Reporting • Administrative/Board of Directors• Strategic Planning/Modernization Act• Organizational• Personal• Others
CFR Experience
• Client Management Information System
• 8 County Agency
• 12 locations
• Multiple Levels of Care (Adult and Adolescent)
• Mandate to create uniform client flow/processes
What we discovered
• Time allotment – Flow Charting Fridays
• Each location had different process
• Who had the “right” process
• Nominal Group Process
• Consumer/Staff friendly
• Staff Training
• Sustainability
Flowcharting Steps
• Step 1 ~ Define objective
• Step 2 ~ Define process
• Step 3 ~ Define first and last steps
• Step 4 ~ (Quite 1) Have each person write down process steps on yellow Post-it notes
• Step 5 ~ Have everyone place their yellow Post-it notes on wall paper to create a flowchart.
Flowcharting Steps Continued
• Step 6 ~ Review flowchart
• Step 7 ~ (Quiet 2) Have each person use lime Post-its to identify and record bottlenecks and blue Post-its to describe suggestions for process improvements
• Step 8 ~ Place blue and lime Post-its on flowchart
• Step 9 ~ Review suggested changes
Flowcharting Steps Continued
• Step 10 ~ (Quiet 3) Ask each participant to pick the three changes that offer the best combination of ease of implementation and impact on objective
• Step 11 ~ Conduct multi-vote to select changes to initially pilot test
• Step 12 ~ Discuss next steps
Flowchart the morning process items
• Goal/objective: Arrive on time to Summit’s morning sessions
• Parameters
• Small groups
• Nominal group process
• Flowchart
Do you have outdated processes that lack client friendliness?
• Identify one process at your agency that could be improved by flowcharting.
• Anything you’d like to change?
Wrap up
• Questions
Participants asked for the contact information of the software company EFR used to flowchart their agency processes.
Here’s the link to Anasazi http://www.anasazisoftware.com/
Contact information
Eric Preuss
e-mail [email protected]
Phone: 515-576-7261 opt. #4 extension 1102
Gena Hodges
e-mail: [email protected]
Phone: 515-281-8465
www.niatx.net for resources and instructions on tools