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Quality and Performance Improvement in Healthcare: Theory, Practice, and Management Seventh Edition

Chapter 4

Using Teamwork in Performance Improvement

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Objectives

Demonstrate the effective use of teams in performance improvement activities

Compare and contrast the differences between the roles of the leader and the members in performance improvement teams

Illustrate the contributions that team charters, team roles, ground rules, listening, and questioning can make to improve the effectiveness of performance improvement teams

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Three Approaches to Performance Improvement

Rapid improvement team

Disseminate information or develop an educational training program

Develop a functional or cross-functional PI team

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PI Team Composition

Composition

Which departments are involved in the process?

Who are the customers of the process? Or, who will receive the product or service that the process produces?

Who supplies the process? Or, who provides materials or services for use in the process under investigation?

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PI Team Roles

Leader

Facilitator

Member

Recorder

Timekeeper

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PI Team Leader Activities

Preparing for and scheduling meetings

Sending out announcements of meetings and other necessary materials

Conducting meetings

Focusing the group’s attention on the task at hand

Ensuring group participation and asking for facts, opinions, and suggestions

Providing expertise in the organization’s PI methodology and PI tools and techniques

Coordinating data collection

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PI Team Leader Activities (continued)

Assigning tasks

Facilitating implementation of action plan items

Critiquing the meetings

Serving as the primary spokesperson and presenter for the team

Keeping attendance records

Contacting absent members personally to review the results of the meeting and provide any materials that were distributed during the meeting

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PI Team Facilitator Activities

Serving as advisor and consultant to team

Acting as a neutral, nonvoting member

Suggesting alternative PI methods or procedures to keep the team on target

Managing group dynamics, resolving conflicts, modeling compromise

Acting as coach and motivator for the team

Assisting in consensus building when necessary

Recognizing team and individual achievements

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PI Team Member Activities

Participating in decision making and plan development for the team

Identifying opportunities for improvement

Gathering, prioritizing, and analyzing data

Sharing knowledge, information, and data that pertain to the process being investigated

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PI Team Recorder Activities

Recording information for the group

Creating appropriate charts and diagrams

Assisting with notices and supplies for meetings

Distributing notices and other documentation to team members

Developing meeting minutes

Producing an agenda for new meetings with assignments for team members from the previous meeting

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PI Team Timekeeper Activities

Helps the team manage its time

Notifies team during meetings of time remaining on each agenda item

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Team Charters

Explain what issues the team was implemented to address

Describe the goal or vision

List the initial members of the team and their respective departments

Helpful to keep the team’s objective in focus

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Mission Statements

Organization-wide or team-based

Should answer the following questions:

What process is to be improved?

For whom is the process performed?

What products does the process produce?

What is not working with the current process?

How well must the process function?

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Sample Mission Statement

Evaluate hospital laboratory services for patients with regard to safety issues, error-reduction processes, and delivery of services while maintaining 94 percent compliance with these services.

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Vision Statements

A description of the ideal end-state

A description of the way the process should function

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Sample Vision Statement

Safe and timely laboratory services are provided 98 percent of the time.

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Ground Rules

Ground rules are basic expectations for team members and include a discussion of:

Attendance

Time management

Participation

Communication

Decision-making

Documentation

Room arrangements

Clean up

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Problem-Solving Techniques

Inclusive: Gather all viewpoints and consider each

Exclusive: Get a result as quickly as possible

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Effective Team Objectives

Establish goals cooperatively with all members participating

Communicate in a two-way mode

Value open expression of both ideas and feelings as important perspectives on organizational issues

Distribute leadership and responsibility among all team members

Distribute power among all team members

Match decision-making techniques to the type of decision-making situations

View periodic controversy and conflict among team members as a positive aspect of team growth

Focus on the issues for which they have been organized to address

Be cost-conscious in their PI efforts

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QI Toolbox Technique: Agenda

Lists the tasks to be accomplished during a meeting

Ensures that every team member knows what items will be discussed or worked on

Should be sent to all team members before the meeting

This allows them to prepare ahead of time to discuss specific agenda items

Should include an indication of how long the team will spend on each item

Setting time frames for agenda items helps the team leader to keep the group focused on the process and moving forward

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Continuum of Care Team Example

Team leader: Emergency department intake coordinator

Team members: Representatives from the business office, health information services, administration, utilization review, and finance

Ad hoc members: Representatives from regulatory affairs, reception, nursing, case management, and an emergency department physician

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Continuum of Care Team Example (continued)

Mission Statement:

Evaluate the emergency department’s clinical assessment process in regard to patient privacy, data collection, and staff communication while maintaining 95 percent patient and employee satisfaction with this process.

Vision Statement:

Design a centralized clinical assessment center to facilitate patient privacy, data collection, and staff communication

Project Presentation

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