John W. Moran, Ph.D. Wallace Consulting, LLC Senior Quality Advisor Public Health Foundation

Creating and Sustaining Healthy Teams QI Award Program Kick-Off Training December 5, 2012 John W. Moran, Ph.D. Wallace Consulting, LLC Senior Quality Advisor Public Health Foundation Senior Fellow, University of Minnesota School of Public Health (c) 2012 Wallace Consulting, LLC

Objectives: Understand why teams fail Understand techniques to build and maintain High Performance Teams Understand the team roles and team members’ responsibilities Identify the characteristics of effective teams Understand Team Performance Cycles Understand how to get a team moving again Understand how to make teams successful (c) 2012 Wallace Consulting, LLC

We often hear in the quality improvement literature the following expression: “It's the Process, Not the People” • With some quality improvement (QI) teams that are experiencing difficulties it is the people that are causing the problem. • People by themselves are complex organisms and if you put them together on a team the complexity increases rapidly. • The complexity becomes confounded because of the different personalities, trust issues, competing agendas, relationship issues, career desires, differing core values, etc. • How does a team leader herd and shepherd this collection of individuals with multiple interacting behavioral issues into a high performing team? It's Not Always Just the Process: 10 Steps to Dealing with People Challenges, Contributor: Erin Barkema, Harry Lenderman and John W. Moran, Process Excellence Newletter, Posted: 05/31/2012, http://www.processexcellencenetwork.com/people-performance-and-change-in-process-improveme/articles/it-s-not-always-just-the-process-dealing-with-peop/ (c) 2012 Wallace Consulting, LLC

What Type of Teaming Executive Teams Quality Improvement Teams Natural Work Place Teams Project Teams Self-Directed Teams Cross-Functional Teams Emergency Response Teams Other Types of Teams (c) 2012 Wallace Consulting, LLC

Understanding Your Team Member Composition:Personal Preferences Profile • Tool to get to know your team members. • Tool to pick team members. • In teams there usually are differences in preferences among team members. • Working together successfully requires us to understand those differences and manage them in a mutually satisfactory way • Need to think about implications that these differences may have on the way we work together and interact. (c) 2012 Wallace Consulting, LLC

The Five Dysfunctions of a Team Results Inattention to… Accountability Avoidance of… Commitment Lack of… Conflict Fear of… Trust Absence of… The Role of the Facilitator/Coach Confront Difficult Issues Focus on Collective Outcomes Force Clarity and Closure Demand Debate Be Vulnerable P. Lencioni 2005 (c) 2012 Wallace Consulting, LLC

Stages Of Team Development Stage 1: Forming Types of Behavior: driven by a desire to be accepted avoid controversy or conflict serious issues and feelings are avoided people focus on being busy with routines individuals are also gathering information and impressions trying to determine what is appropriate Task Focus: orientation to scope of the team’s task understand what is to expected (c) 2012 Wallace Consulting, LLC

Stages Of Team Development Stage 2: Storming Types of Behavior: different ideas compete for consideration and team members open up to each other and confront each other's ideas and perspectives some team members will focus on minutiae to evade real issues in some cases storming can be resolved quickly, in other cases, the team never leaves this stage. The maturity of some team members usually determines whether the team will ever move out of this stage Task Focus: team addresses issues such as what problems they are really supposed to solve, how they will function independently and together and what leadership model they will accept (c) 2012 Wallace Consulting, LLC

Stages Of Team Development Stage 3: Norming Types of Behavior: team members adjust their behavior to each other as they develop work habits that make teamwork seem more natural and fluid – cohesion agree on rules, values, professional behavior, shared methods, working tools and even taboos team members begin to trust each other and feel good about being part of the team Task Focus: data flow between members ideas are free flowing and they solicit and give each other feedback on actions related to the task (c) 2012 Wallace Consulting, LLC

Stages Of Team Development Stage 4: Performing Types of Behavior: function as a unit as they find ways to get the job done smoothly and effectively without inappropriate conflict or the need for external supervision. team members have become interdependent, motivated and knowledgeable. team members are now competent, autonomous and able to handle the decision-making process without supervision. dissent is expected and allowed as long as it is channeled through means acceptable to the team. Task Focus: team will make most of the necessary decisions and is totally focused on the problem (c) 2012 Wallace Consulting, LLC

Stages Of Team Development Stage 5: Adjourning Termination Concluding the team Emotional some times - relief sometimes Later a feeling of loss - "Deforming and Mourning" Celebration (c) 2012 Wallace Consulting, LLC

Stages Of Team Development Stage 5: Adjourning It is important at this stage to take the time to celebrate achievements After all, the team may work together again Remember to be sensitive to team members: may be stressful for certain members developed close relationships used to the routine of meeting (c) 2012 Wallace Consulting, LLC

Some Cautions Even the most high-performing teams will revert to earlier stages in certain circumstances Many long-standing teams will go through these cycles many times as they react to changing circumstances For example, a change in leadership may cause the team to revert to storming as the new people challenge the existing norms and dynamics of the team Team leader role changes from supervisor to participant Facilitator needs to be directive at times pointing out destructive behaviors (c) 2012 Wallace Consulting, LLC

Tate Family Every Team has at least on member of the Tate Family: Dick – runs everything Devas – disruptive Imi Poten – big shot Ro – change everything The Twins – Agi and Iri - Trouble The Other Twins – Hesi and Vegi – pour cold water on everything Facili – pulls it together (c) 2012 Wallace Consulting, LLC

Coaching QI Teams To High Perfromance The purpose of coaching QI Teams is to: Build a partnership between the coach, team leader, and team members Help the team move to a higher level of achievement Help the team overcome obstacles Help the team navigate a politically sensitive situation Provide training or problem solving assistance (c) 2012 Wallace Consulting, LLC

Seven Rules of Coaching Start where your client “is” and not where you think he should be or where you are Confirm Readiness: Is the client receptive to coaching? Do they want to be coached? Have they requested coaching or been told to get it? What do they expect to get from coaching? Set Expectations: Establish goals Intent is to help not run the team Build trust – who do you have to report your results to – make it clear Establish when and where coaching will take place (c) 2012 Wallace Consulting, LLC

Seven Rules of Coaching • Observe The Team: • Identify destructive behaviors • Document specific incidences • Document their strengths and weaknesses • Understand what they think is blocking or hindering their progress • Develop an Improvement Plan: • Describe observed team behaviors and the impacts; both good and bad • Review causes that lead to bad outcomes for the team • Set realistic change expectations • Build the plan around their strengths • Describe specific corrective actions to overcome weaknesses • Indicate any training that may be required and how they can obtain it (c) 2012 Wallace Consulting, LLC

Seven Rules of Coaching • Confidentiality: • What you observe, recommend, or help the Team with stays in “Vegas” • If you must report your finding to some one higher in the organization let the team know at the outset • Follow-Up: • Set a time to follow-up with the team to see if progress has been made • Ask them to send you brief updates on a regular basis – what is and is not working (c) 2012 Wallace Consulting, LLC

Want to understand what are the current blocks/behaviors that are holding us back as a Team? Which ones can we change? Which ones can we influence? How can we change them? Action Plan How soon can we change them? Timeline (c) 2012 Wallace Consulting, LLC

These Are The Things WE/I Are Gong To: Improve Continue Doing Start Doing Stop Doing Aha Learnings Best Practices Do Differently Where can we make improvements? What is working well should be continued? What are we doing that is not working? What should we put in place.? To Make us a Responsive and Functional Team? (c) 2012 Wallace Consulting, LLC

The ABC’s of PDCA, G. Gorenflo and J. Moran Plan Check/ Study • Identify and • Prioritize Opportunities 7. Develop Improvement Theory 1. Reflect on the Analysis 2. Develop AIM Statement 8. Develop Action Plan 2. Document Problems, Observation, and Lessons learned 3. Describe the Current Process Do • Implement the • Improvement 4. Collect Data on Current Process Act 2. Collect and Document The data Adopt Standardize 5. Identify All Possible Causes Adapt Do 3. Document Problems, Observations, and Lessons Learned 6. Identify Potential Improvements Abandon Plan (c) 2012 Wallace Consulting, LLC

Creating and Sustaining Healthy Teams Applications and Tools for Creating and Sustaining Healthy Teams, G. Duffy and J. Moran, Editors Public Health Foundation, April 2011 Download at: http://www.phf.org/resourcestools/Pages/Applications_and_Tools_for_Creating_and_Sustaining_Healthy_Teams.aspx (c) 2012 Wallace Consulting, LLC

Ten steps leaders can follow to start teams off on the right foot: • Develop a Team Charter/AIM Statement • Select appropriate team members • Inform everyone who is either involved in the project or impacted by the project • Develop team ground rules at the first meeting • Make sure everyone understands their role It's Not Always Just the Process: 10 Steps to Dealing with People Challenges, Contributor: Erin Barkema, Harry Lenderman and John W. Moran, Process Excellence Newletter, Posted: 05/31/2012, http://www.processexcellencenetwork.com/people-performance-and-c hange-in-process-improveme/articles/it-s-not-always-just-the-process-dealing-with-peop (c) 2012 Wallace Consulting, LLC

Ten steps leaders can follow to start teams off on the right foot: • Build the trust level of the team • Handle team conflicts in a professional way • Reinforce who is responsible for the team’s success • Use a decision making process • Communicate It's Not Always Just the Process: 10 Steps to Dealing with People Challenges, Contributor: Erin Barkema, Harry Lenderman and John W. Moran, Process Excellence Newletter, Posted: 05/31/2012, http://www.processexcellencenetwork.com/people-performance-and-c hange-in-process-improveme/articles/it-s-not-always-just-the-process-dealing-with-peop (c) 2012 Wallace Consulting, LLC

John W. Moran, Ph.D. Wallace Consulting, LLC Senior Quality Advisor Public Health Foundation