Michelle Archuleta, HP/DP Director Tuba City Regional Health Care Corporation

1. Appreciative Inquiry a transformational change process at the program level – Adding new skills and techniques to your toolbox Michelle Archuleta, HP/DP Director Tuba City Regional Health Care Corporation SDPI Grantee Meeting November 14, 2007

3. What is Appreciative Inquiry? • It is based on the simple idea that organizations move in the direction of what they ask questions about. • For example, when groups study human problems and conflicts, they often find that both the number and severity of these problems grow. • In the same way, when groups study high human ideals and achievements, such as peak experiences, best practices, and noble accomplishments, these phenomena, too, tend to flourish. • Thus, appreciative inquiry distinguishes itself from other change methodologies by deliberately asking positive questions to ignite dialogue and inspired action within organizations.

4. The Appreciative Approach • A strategy for intentional change that identifies the best of ‘what is’ to pursue dreams and possibilities of ‘what could be’ a cooperative search for strengths, passions and life-giving forces that are found within every system that hold potential for inspired, positive change. • (Cooperrider & Srivastva, 1987)

5. Assumptions • In every community something works. • What we focus on becomes our reality. • Reality is created in the moment - there is more than one reality. • The act of asking questions influences the community in some way. • People have more confidence and comfort to journey to the future when they carry forward parts of the past. • If we carry forward parts of the past, they should be what is best. • It is important to value differences. • The language we use creates our reality.

6. Interview’s Question 1: About You • To begin, can you tell me what is it that you do now? What most attracted you to your present work? What do you find meaningful, or of value, in your current work? Question 2: High point or peak experience • As you look over your experience with the SDPI grantee program, there have been many ups and downs, peaks and valleys. Can you think of a time that stands out as a “high point” for you - a time when you felt most alive, most engaged, or really proud. • What was it about you and others around you that made it a peak experience?

7. Interview’s (continued) • Question 3: Creating a transformational program environment. • A transformational program is one that is reflective, seeks to understand, opens itself to differences, and raises levels of interacting with one another. • What does your DP/HH Program need to create and nurture to be transformational?

8. Harvesting • Personal Inquiry • Reflection • Learning • Shared vision • Story • Conversation

9. Discovering our Positive Core • Each story determines the “root causes of success”. • Why did the positive story occur? • What were the contributing factors? • Consider the best practices, values, training, leadership, resources, structures, systems, processes, relationships that support success.

10. TRADITIONAL APPROACH Chalk Lines Define Problems Time Drags No Fun Hard Work Mechanical » Vibrant « Analyze Failures STATIC, INERT, DEAD »Alive « HOW DOES THIS HAPPEN ?!? EXAUSTED! Top Only – Few involved answers from experts Focusing on what’s wrong Searching for “Root Cause” of Failure/Decay if you look for problems, you’ll find and create more problems “Fix” the past Obstacles treated as barriers OVERWHELMED NO TIME TO MAKE IT HAPPEN Low Energy E F

11. APPRECIATIVE APPROACH AMPLIFY WHAT GIVES LIFE Search for What Works Time Flies » Vibrant « NEW Possibilities CREATIVITY »Alive « Unexpected MORE ALIVE! ORGANIC, EMERGENT In-Sync HOW DOES THIS HAPPEN ?!? Energy CAN’T be stopped All (or all levels) involved solutions from within Focus on WHAT WORKS Search for root causes of success “If you look for successes, you’ll find and create more successes” Create the Future Obstacles treated as Ramps into NEW Territory Whole Greater than Sum of Parts HIGH Energy E F

12. Problem Solving Appreciative Inquiry “Felt Need” Valuing the best of “what is” Identification of the problem Analysis of causes Envisioning “what might be” Analysis of possible solutions Dialoguing “What should be” Innovating “What will be” Basic Assumption: Basic Assumption: An organization is a problem An organization is a mystery to be solved. to be embraced.

13. The AI “4-D” Cycle DISCOVERYAppreciatingWhat Gives Life? The best of what is … DESTINYLearn, adjust & DO Create/Sustaining What will be … DREAMImagine/Envisioning What might be … Positive TOPIC Choice DESIGN Determine/Constructing What should be …

14. Where Has AI Been Used? How?

15. Case Studies Organizational Change • TCRHCC – Division of Nursing Summit • 250 nursing staff employees • Created Advisory & Planning Team (Aug/Sept ’07) • Host Nursing Summit in Spring ’08 • Change Agenda: • Break thru barriers – dept level, mgt, internal, external • 3 personnel systems, NPEA, IHS>638 corporation • Shared Leadership at all levels/ownership • Investment in nursing staff • December 10: one day, cross-disciplinary mini summit for a ‘kick off’ to launch change agenda.

16. Navajo Area Physical Activity/Fitness Appreciative Inquiry Summit • Involves Navajo Area HP Coordinators and community partners. • Developing our change agenda • 8 Service Units, area/local priorities • “How to remember ourselves within our Navajo context” • Can we keep saying, “Taa ajee teeago”? • Do we need to change?

17. Navajo AreaDiabetes Conference – Summer 08 • Strategic Planning for next 5 years • Blend of AI, Open Space, World Cafe’ • Internal and External Stakeholders • Whole system approach

18. “There is no power greater than a community discovering what it cares about” Margaret Wheatley, Turning to One Another What will it take for our DP/HH programs to get to this level of change? What is keeping us from achieving our own ‘inquiry’ of what we care about, with our programs, our communities and ourselves?

19. Thank You “No problem is solved with the same thinking that created it.” - Albert Einstein