Tennessee Leading Quality Improvement:

Management Essentials Lesson 2: Leading Change and Influencing Others

June 8, 2016 These presenters have

nothing to disclose

Kathy Duncan, RN Janet Porter, PhD

Rhonda Dickman, RN, MSN, CPHQ Rhonda Dickman is a Quality Improvement Specialist with the Tennessee Hospital Association’s Tennessee Center for Patient Safety, supporting hospitals in their quality improvement work, particularly in the area of readmissions. She is also the clinical manager of the Tennessee Center for Patient Safety’s PSO (patient safety organization). Rhonda has worked in the field of hospital quality management since 2006 and has a clinical background in trauma, critical care, oncology, and organ donation.

rdickman@tha.com 615-401-7404

Introduction to Webinar Series Exclusive program for clinical leaders in hospitals that are part of the Tennessee Hospital Association Hospital Engagement Network (HEN) Focused on supporting clinical leaders who manage people or projects 9 webinars in total 1.5 contact hours for each webinar Webinar platform – enter with email and password

Competency Certificate CORE COMPTENCIES

Complete a management essentials self-assessment at the beginning and end of the webinar series. Attend seven of nine webinars.

Complete at least one IHI Open School lesson.

Participate in group chat or volunteer to share a personal experience during at least one webinar.

Attendance Chat name and organization into the chat box Email Rhonda Dickman that you attended – rdickman@tha.com

Log in to the webinar using your username and password: – User name: email address used to register – Password: the password you set up when you registered

5

6

7

How to chat

9 Chat

9

Name and the Organization you represent Example: Sam Jones, Midwest Health

Please send your message to All Participants

10 Chat

10

What is your biggest challenge when managing change?

Please send your message to All Participants

Faculty

11

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.

Faculty

12

Janet Porter, MBA, PhD, serves as consultant to hospitals and physician practices for Stroudwater Associates where she is a Principal and a member of the Board of Directors. Dr. Porter served as the Chief Operating Officer of Dana-Farber Cancer Institute; the Associate Dean of Executive Education at the University of North Carolina’s School of Public Health; the Interim CEO of the Association of University Programs in Health Administration (AUPHA); and the Vice President, and then COO, of Nationwide Children’s Hospital in Columbus, Ohio. She teaches at University of Miami, Ohio State University, University of North Carolina and Harvard. She currently serves on the AARP Board of Directors. Dr. Porter received her BS and MHA from Ohio State University, and her MBA and PhD in health care strategy from the University of Minnesota.

Build the skills and

capabilities needed to

lead quality improvement efforts at the

middle manager

level of an organization

Manage the Work

Manage Improvement

Develop Teams

Leading Change/Influencing Others - Session 2 June 8 JP

Time Management – Session 3 June 22 JP

Leveraging Teams with Partners – Session 9 Sept 14 JP

Patient and Family Engagement – Session 1 May 25 JP

Practice Improvement Essentials – Session 5 July 20 KD

Identify and Spread Improvement - Session 6 August 3 KD

Building and Creating Joy in Teams – Session 8 August 31 KD

Tennessee Leading Quality Improvement: Management Essentials Course

Project Management – Session 4 July 6 JP

Incorporating Finance in Improvement– Session 7 August 17

LQI Management Essentials Objectives

At the end of the program, participants will be able to:

Manage their own work and the work of others more effectively Build effective teams Design and lead quality improvement initiatives Use theories and apply tools to managing work, building teams and leading quality improvement efforts

14

Today’s Agenda

15

Practice from Session 1 Know Yourself Know Your Change Style Know Your Influence Style Know Your Work Style

Lesson 3 Preparation

Lesson 1: Practice Ask at least two patients what ideas they have about improving care, and/or choose an initiative you are already working on and invite a patient or family member to join the committee or next meeting

Tonya Phinnessee and Felisha Porter from Bolivar General Hospital, and Michele Bangma from Maury Regional Medical Center will share their experiences

16

Today’s Agenda

17

Practice from Session 1 Know Yourself Know Your Change Style Know Your Influence Style Know Your Work Style

Lesson 3 Preparation

Personal Preference or Inclination

1. Find a pen or pencil and a piece of paper. 2. Quickly sign your name the way you typically sign a check or other document.

3. Move your pen or pencil to your other hand and sign your name again.

S-1

Today’s Agenda

19

Practice from Session 1 Know Yourself Know Your Change Style Know Your Influence Style Know Your Work Style

Lesson 3 Preparation

Change Style Indicator 1) When asked to brainstorm a whole new way of doing work, do you: a. Welcome the opportunity to wipe the slate the clean? b. Want to make sure the current processes that already work are retained? c. Try to balance new ideas with current practices? 2) When you hear about new ways of doing things that might impact your department, do you: a. Talk with your staff right away about applying the ways? b. See how they work in other departments first? c. Go talk to the manager in another department to learn more?

20

Change Style Indicator 3) When you attend a conference and learn about new ideas, do you: a. Send emails to staff or set up meetings about the exciting new ideas you have heard? b. Follow key developments you have learned about to see how they pan out in other organizations? c. Do some research on the developments and contact other organizations to learn more? 4) When a problem in your unit/clinic/department is identified, do you? a. Approach the problem from a fresh perspective, developing a new solution? b. Wait to see if the problem will resolve itself as many problems do? c. Apply an approach that has worked well on a similar problem?

What Is Your Change Style?

Please indicate for the poll whether your change style is to be a conserver, pragmatist or originator

22

When Facing Change Conservers

Generally appear deliberate, disciplined, and organized - Focused Prefer clearly defined structure Start with traditional ideas when problem solving Don’t like surprises and uncertainty “May appear” cautious and inflexible Focus on details and implementation Value tradition and best practices Are convergent thinkers

May appear unorganized, undisciplined, unconventional and spontaneous – React in the moment Challenge existing structure Dismiss traditional ideas when problem solving Enjoy risk and uncertainty “May appear” impractical and miss important details Appear systemic in their thinking Can dismiss established practices with little regard Are divergent thinkers

When Facing Change Originators

Generally appear practical, agreeable, and flexible Value change that produces readily visible benefits More interested in functionality than tradition or novelty Operate as mediators and catalysts for understanding Are open to both sides of an argument Take more of a middle-of-the-road approach Appear more team oriented to their co-workers

When Facing Change Pragmatists

Change Style Questions

Did you agree with the style identified for you? Did you know that you had that style? What do you find challenging about working with others of different styles?

27

Suggestions for Increasing Effectiveness for those with Different Change Styles

In General

Consult with a person you believe to have a change style different from yours before proceeding.

Make efforts to understand the perspectives of those with styles other than your own.

Imagine putting on a hat of another style. Solicit feedback and suggestions. Step back and be aware of your initial reaction in a

situation, especially when you are aware of having an emotional response.

Today’s Agenda

29

Practice from Session 1 Know Yourself Know Your Change Style Know Your Influence Style Know Your Work Style

Lesson 3 Preparation

Influence Style Indicator 1) When trying to persuade others to care about your issue, which are you likely to use? a. A story b. A vision c. Data and facts d. Policies and precedent e. Bargaining 2) When you are researching how to justify a new way of doing things, do you? a. Look for stories that illustrate the need? b. Focus on outcomes? c. Seek data that explains the rationale for the change? d. Show how this change fits in with current responsibilities and goals? e. Focus on what’s in this change for everyone involved?

30

Influence Style Indicator 3) Which language are you most likely to use? a. “I had the same issue last year and let me tell you how ...” b. “The vision for this project is ...” c. “Our analysis of this situation suggests ..." d. “In order to comply with policy, we have to ..." e. “Let’s try to create a win-win ..." 4) What strategy will you take to try to influence others? a. Engaging with others and trying to build relationships and gain trust b. Creating a sense of shared purpose and higher possibilities c. Using logic and reasoning d. Stating preferences and applying pressure e. Compromising and making concessions to find common ground

31

What Is Your Influence Style?

Please indicate for the poll whether your influence style is primarily asserting, rationalizing, bridging, inspiring or negotiating.

32

©2011 Discovery Learning, Inc. All Rights Reserved.

You look for compromises and make concessions to reach outcomes that satisfy your greater interest.

You put forward your ideas and offer logical, rational reasons to convince others of your point of view.

You insist that your ideas are heard and considered and you challenge the ideas of others.

You advocate your position and encourage others with a sense of shared purpose and exciting possibilities.

You build relationships and connect with others through listening, understanding and building coalitions.

Influence Styles

Influence Style Questions

What style do you most identify with in terms of how you would try to influence others? What style would you never think to use to influence others?

34

Today’s Agenda

35

Practice from Session 1 Know Yourself Know Your Change Style Know Your Influence Style Know Your Work Style

Lesson 3 Preparation

Work Styles

Please indicate for the poll whether your work style is primarily to be analytical, driver, amiable or expressive.

36

Work Styles 37

A - Analytical • Cautious decisions

• Likes structure • Prefers to work alone

• Likes data, facts

C – Amiable • Slow at taking action

• Likes working with others • Supports and listens to others

• Works slowly, cohesively

B – Driver • Action oriented

• Likes control • Freedom to manage self, others

• Works quickly

D- Expressive • Spontaneous actions, risks

• Likes new ideas • Works quickly with excitement • Not good with follow-through

Work Styles Question

Do you recognize yourself in one of these four work styles? How do you think your work style influences the way you work with others?

38

Know Yourself

The more you know yourself, the better you will work with others The more you know yourself, the more likely you are to select organizations, teams, jobs that are a fit for you The more you know yourself, the more likely you are to be satisfied, engaged with your work

39

Assignments for June 22 40

Practice: – Complete a confidential management skills self-assessment at

https://www.surveymonkey.com/r/VJCGF6P

Instructions for accessing IHI Open School are available from: – Rhonda Dickman, THA – rdickman@tha.com – Taelor Barnette, THA – tbarnette@tha.com

Lesson 3

Janet Porter, PhD Principal, Stroudwater Associates

jporter@stroudwater.com

41

Tuesday, June 22, 2016 at noon

Managing Time and Attention