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Sdaqm Facilitation Presentation Final Fall 09

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A presentation by Jack Peterson of Peterson Associates presented at the Fall conference for the South Dakota Association of Healthcare Quality 2009

A presentation by Jack Peterson of Peterson Associates presented at the Fall conference for the South Dakota Association of Healthcare Quality 2009

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  • 1. The Fast Track Approach to Gaining the Most from Your Team © 2009 J Peterson & Associates, Inc.
  • 2.
    • South Dakota Association of Quality Managers
    • 2009 Annual Convention
    • September 24, 2009
    • Sioux Falls, South Dakota
    • Jack L. Peterson, MS, FAAMA, CPHQ
    • President, J Peterson & Associates, Inc.
  • 3. Facilitation
    • Class Roster
    • Pre-test
    • Learning Objectives
    • Seminar Schedule
    • Presentation Components
    • Ground Rules
    © 2009 J Peterson & Associates, Inc.
  • 4. Pre-Test
    • Individual effort, 3 minutes
    • Group review, individual scoring
    • Results secret, except for person with highest score
    • Used to establish learning point of reference and re-enforce important concepts and information
    © 2009 J Peterson & Associates, Inc.
  • 5. Learning Objectives
    • Broadly define: “Facilitation” and Principles of facilitation
    • Discuss features of 5 stages of facilitation
    • Describe effective decision making traits, most effective methods for managing conflict and principles of meeting management
    • Articulate uses of conversation types and levels of empowerment in facilitating decision making
    © 2009 J Peterson & Associates, Inc.
  • 6. Seminar Schedule
    • 1:45 – 2:35 pm
    • 2:35 – 2:50 pm Break
    • 2:50 – 3:45 pm
    • Pre-test
    • Ground Rules
    • Facilitation Defined
    • Facilitation Stages
    • Know Your Participants
    • Gaining Participation
    • Decision Making
    • Conflict & Resolution
    • Managing Meetings
    • Facilitation Tools
    © 2009 J Peterson & Associates, Inc.
  • 7. Ground Rules
    • Commitment
      • To Learn
      • To Use
      • To Teach
    • Expectations
      • Participate fully
      • Ask questions
      • Reflect on application to work
    © 2009 J Peterson & Associates, Inc.
  • 8.
    • Facilitation Defined
    © 2009 J Peterson & Associates, Inc.
  • 9. Facilitation Defined
    • Definition
      • Somebody who enables a process to happen, especially
      • somebody who encourages people to find their own
      • solutions to problems or tasks
    © 2009 J Peterson & Associates, Inc.
  • 10. Facilitation Defined
    • Role Differentiation: Process vs. Content
      • Process (How)
        • Methods
        • How relations are maintained
        • Tools being used
        • Rules or norms set
        • Group dynamics
        • Climate
    © 2009 J Peterson & Associates, Inc.
  • 11. Facilitation Defined
    • Role Differentiation: Process vs. Content
      • Content (What)
        • Task
        • Subject of discussion
        • Problems being solved
        • Decisions made
        • Agenda items
        • Goals
    © 2009 J Peterson & Associates, Inc.
  • 12. Facilitation Defined
    • Principles
      • Maintain Neutrality
      • Actively Listen
      • Inquire Sensitively
      • Paraphrase for understanding
      • Integrate ideas
      • Keep team focus
      • Engage members
    © 2009 J Peterson & Associates, Inc.
  • 13. Facilitation Defined
    • Job
        • Establish the ground rules
        • Control the environment  
        • Bring the issue to conclusion or resolution
        • Celebrate the success
        • Three Penguins (get ‘er done, change and have fun!)
    © 2009 J Peterson & Associates, Inc.
  • 14. Facilitation Defined
    • Aura
      • Enthusiastic
      • Attentive and listen
      • Flexible and gain consensus
      • Check ego
    © 2009 J Peterson & Associates, Inc.
  • 15. Facilitation Defined
    • Problematic Aspects
      • Listening to respond
      • Inquiring of irrelevant issues
      • Substituting your words for theirs without permission
      • Favoring (advancing) an idea you like
      • Allowing diversions
      • Disrespectful or insensitive comments
      • Failure to recognize, encourage, reward active thoughtful involvement
    © 2009 J Peterson & Associates, Inc.
  • 16. Facilitation Defined
    • Facilitation Core Practices Observation Sheet Exercise ( “Facilitation at a Glance! 2 nd Ed., page 26)
        • Pair up  
        • 1 minute per person
        • 1 st person: select 1 behavior that helps and explain to partner
        • 2 nd person: select 1 behavior that hinders and explain to partner
    © 2009 J Peterson & Associates, Inc.
  • 17. Facilitation Defined
    • Facilitation Core Practices Observation Sheet Exercise ( “Facilitation at a Glance! 2 nd Ed., page 26)
    • Provide feedback – 1 Minute
          • Did you learn something you had not previously considered?
          • Were the explanations explanatory?
    © 2009 J Peterson & Associates, Inc.
  • 18.
    • Stages
    © 2009 J Peterson & Associates, Inc.
  • 19. Facilitation Stages
    • Designing
    • Initiating
    • Conducting
    • Ending
    • Follow-up
    © 2009 J Peterson & Associates, Inc.
  • 20. Facilitation Stages
    • Stage 1: Designing
      • Two-Step Stage
        • Assess the setting, issue and participants
          • ( Interviews , Surveys, Emails,   On site observation)
        • Create an agenda
          • Draft and staff with leaders and participants (can be sample)
          • Request feedback
          • Resolve inconsistencies
          • Publish final (preferably in advance)
    © 2009 J Peterson & Associates, Inc.
  • 21. Facilitation Stages
    • Stage 1: Designing
      •   Time Commitment
        • Usually preparation time equals delivery time
        • Factors Affecting Preparation Time
          • Length (e.g., hours, days)
          • Complexity (e.g., several established teams, multi-aspect issue(s)
          • Participants (e.g., 5, 50, 500)
          • Tools (e.g., preparation of new or tailored tools)
          • Research (e.g., new or emerging problem, old problem with new twist)
    © 2009 J Peterson & Associates, Inc.
  • 22. Facilitation Stages
    • Stage 1: Designing
      •   Meet with team leader (content expert, senior official)
        • Review agenda
        • Review objective(s)
        • Review roles (including recorder, time keeper)
        • Review logistics
          • Room
          • audiovisual, flip charts, lighting, meals/snacks)
    © 2009 J Peterson & Associates, Inc.
  • 23. Facilitation Stages
    • Stage 1: Designing
      •   Potential Issues
        • Use of a template (e.g., focus team handout; discussed in Stages 2 and 3)
        • Charter (purpose)not well understood
        • Disagreement between leaders and team
        • Disagreement among members
    © 2009 J Peterson & Associates, Inc.
  • 24. Facilitation Stages
    • Stage 2: Initiating
    •  
      • Centering  
      • Meet team leader 10-15 minutes
    © 2009 J Peterson & Associates, Inc.
  • 25. Facilitation Stages
    • Stage 2: Initiating
      • Seating (Room set-up important)
          • Least effective: classroom
          • Most effective: tables (seating minimum 4, maximum 10)
      • Lighting
          • Adequate to interact, take notes
          • Controllable for slide and video presentations
      • Room Temperature – temperate
    © 2009 J Peterson & Associates, Inc.
  • 26. Facilitation Stages
    • Stage 2: Initiating
      • Barriers addressed
          • Pillars
          • Walls
          • Obstructions to view of participants
      • Use of Agenda Template (Handout)
          • Two meetings, 1-2 weeks apart
          • 1 st for review of issue and preliminary solutions
          • Intervening 1-2 weeks for obtaining buy-in, conducting any further research, developing draft documentation
          • 2 nd for finalization and education material creation
    © 2009 J Peterson & Associates, Inc.
  • 27. Facilitation Stages
    • Stage 3: Conducting 
      • Management
        • Ensure members participate
        • Keep to the ground rules
        • Manage any conflicts that arise
        • Use parking lot for items to be discussed later
        • Stay positive
        • Stay on course
    © 2009 J Peterson & Associates, Inc.
  • 28. Facilitation Stages
    • Stage 3: Conducting 
        • Check the Progress (discussions moving in right direction)
        • Check the Pace ( implement ideas quickly; if participants not engaged, ask if pace satisfactory)
        • Check the Process ( Keep to agenda; if participants not engaged, ask whether discussion /tool helpful; or take a break)
        • Take a Group Pulse ( Stay tuned in to group/individuals; reconnect group/individuals, periodically summarize activity)
    © 2009 J Peterson & Associates, Inc.
  • 29. Facilitation Stages
    • Stage 4: Ending 
      • Use template/format that leads group through phases
      • Ensure there is clarity on
        • Next steps
        • What decided
        • Who responsible
        • When next steps/actions due
      • Create or agree on next meeting agenda and roles
      • Check the Parking Lot - revisit if uncovered or dispose
    © 2009 J Peterson & Associates, Inc.
  • 30. Facilitation Stages
    • Stage 4: Ending 
      • Evaluate the meeting
        • Were objectives accomplished?
        • Did participants participate?
        • Were tools effective?
        • Improvements?
        • Were meeting arrangements/environment conducive to participants needs/meeting purpose?
      • Reward participation and recognize accomplishments
    © 2009 J Peterson & Associates, Inc.
  • 31. Facilitation Stages
    • Stage 5: Following-up 
      • Team Leader Handles (normally)
        • Ensures agreed upon actions/activities took place as planned and implementation successful)
        • Communicates implementation progress, timely monitoring results (1 st to participants, then to others)
    © 2009 J Peterson & Associates, Inc.
  • 32. Facilitation Stages
    • Problematic Aspects
      • Team Leader changes or leaves without replacement (and actions or activities remain)
      • Implementation Fails
      • Handling dysfunctions of a team
        • Absence of trust
        • Fear of conflict
        • Lack of commitment
        • Avoidance of accountability
        • Inattention to results
    © 2009 J Peterson & Associates, Inc.
  • 33. Facilitation Stages
    • Team Assessment Tool
      • Lencioni, P: The Five Dysfunctions of a Team: Jossey-Bass, 2002, pages 192-193
      • See Handout
    © 2009 J Peterson & Associates, Inc.
  • 34.
    • Learning About Your Participants
    © 2009 J Peterson & Associates, Inc.
  • 35. Know Your Participants
    • First Steps
      • Either prior to beginning your work as a facilitator or upon starting, learn about your participants’ relationship
    •  
      • Various scenarios
    © 2009 J Peterson & Associates, Inc.
  • 36. Know Your Participants
    • Assessing a Group
      • Determining the status of the team members in relation to the team
      • Methodologies
        • Sample questions for functional level @ page 41, Facilitation at a Glance!
        • If the team otherwise functioning entity, consider Lencioni tool
        • See Group Assessment Survey tool at pages 42-44, Facilitation at a Glance!
    © 2009 J Peterson & Associates, Inc.
  • 37. Know Your Participants
    • Assessing a Group
      • P roblematic Aspects
        • Team is comprised of strangers
        • Team is dysfunctional
        • Team gets along well, but is mildly dysfunctional
    © 2009 J Peterson & Associates, Inc.
  • 38. Know Your Participants
    • Assessing a Group
    • Personal History Exercise:
      • Work in three’s
      • 3 minutes (1 minute to complete, 2 to share)
      • Complete name and 3 questions on handout
      • Share with partners
    J Peterson & Associates, Inc.
  • 39. BREAK TIME !  (Back in 15) © 2009 J Peterson & Associates, Inc.
  • 40.
    • Gaining Participation
    © 2009 J Peterson & Associates, Inc.
  • 41. Gaining Participation
    • Barriers to participation
        • Lack of familiarity with material or issue
        • One or more dominant participants
        • Lack of security about what they have to offer
        • No buy-in to the issue (do not see as issue)
        • Presence of “senior” staff
        • Personal matter interfering with normal behavior
    © 2009 J Peterson & Associates, Inc.
  • 42. Gaining Participation
    • Creating Conductive Environment  
        • Conditions conducive to participation
          • Comfortable space (size, temperature)
          • Well-lighted
          • Furnishings (chairs, tables)
          • Adequate audiovisual (flip charts can be used, white board)
          • Participants prepared for their part on team
          • Facilitator prepared for his or her part
          • Environment is “safe”
          • Environment is “valued”
    © 2009 J Peterson & Associates, Inc.
  • 43. Gaining Participation
    • Creating The Conditions
      • Ensure participants & leader are prepared
      • Evaluate space in advance or discuss accommodations with person on site, convey needs
      • Learn about your participants
      • Read the reference and research material
      • Confirm the issue to be resolved
      • Prepare for the facilitation (rest, interested, engagement)
      • Play a game (“Facilitation at a Glance!”, pages 54-57)
    © 2009 J Peterson & Associates, Inc.
  • 44. Gaining Participation
    • Removing Barriers
      • Break the ice (even if you know them; see resource list)
      • Engage participants and learn names quickly
      • Neutralize dominant participants
        • 1 st Acknowledge input
        • 2 nd Interrupt if needed; call on another
        • 3 rd Interrupt early on dominant persons – others need in
        • 4 th Call a break – understand passion, measured input
    © 2009 J Peterson & Associates, Inc.
  • 45. Gaining Participation
    • Removing Barriers (cont.)
      • Engage quiet members “safely”
      • Begin with introductions (participants and issue(s))
      • Buy-in to the issue to be resolved – see activities in “Facilitation at a Glance!, pages 49-50
    © 2009 J Peterson & Associates, Inc.
  • 46. Gaining Participation
    • Problematic Issues  
        • Room (fixed classroom seating, table too large, room too large or too formal)
        • Participants reluctant to speak up (senior staff present)
        • Group unruly
    © 2009 J Peterson & Associates, Inc.
  • 47.
    • Decision Making
    © 2009 J Peterson & Associates, Inc.
  • 48. Decision Making
    • Traits of Effectiveness
      • Assumptions are uncovered (by participants)
      • Conflict confronted
      • All ideas given fair shake
    © 2009 J Peterson & Associates, Inc.
  • 49. Decision Making
    • Conversation Types
      • Useful in determining phase group is in
        • 1. S haring of Information: reporting
        • 2. Perception and Assumption (expressing impressions and foundations for discussion)
        • 3. Planning (objective, strategy construction)
        • 4. Solving a Problem (discussing to resolve)
        • 5. Building Relationships (team/relationship building)
      • May necessitate redirection if conversations not constructive
    © 2009 J Peterson & Associates, Inc.
  • 50. Decision Making
    • Options
        • Consensus
        • Compromise
        • Majority Vote
        • Subgroup
        • Leader (or other single individual)
    © 2009 J Peterson & Associates, Inc.
  • 51. Decision Making
    • C onsensus
        • IS mutual understanding, “best” answer, can live with it
        • Is NOT unanimous, everyone happy, “on Board”
        • Requires
          • Time
          • Engaged participation
          • Imaginative thinking
          • Open minds
          • Communication skills
    © 2009 J Peterson & Associates, Inc.
  • 52. Decision Making
    • Problematic Aspects
        • Poor decision making
          • Aimless conversations
          • Voting versus consensus
          • Time expires
          • Dysfunctional
          • Assumptions
    © 2009 J Peterson & Associates, Inc.
  • 53. Decision Making
    • Exercise: Nominal Group Technique or Multi-Voting (one of many approaches)
        • Need a volunteer scribe
        • Step # 1: Individually write down, then state what you perceive is main reason others are not here
        • Step # 2: Eliminate duplications
        • Step # 3: Letter, not number, the remaining reasons
        • Step # 4: Individually, rank order of importance, numbering each of the lettered reasons
        • Step # 5: Combine rankings – address next time!
    © 2009 J Peterson & Associates, Inc.
  • 54.
    • Conflict and Resolution
    © 2009 J Peterson & Associates, Inc.
  • 55. Conflict & Resolution
    • Arguments and Debates
      • D ifferences of opinion are healthy
      • Arguments are not
      • See Facilitation at a Glance!, page 84 for characteristics of each
    © 2009 J Peterson & Associates, Inc.
  • 56. Conflict & Resolution
    • Some key aspects
      • Recall body language, tone, inflection
      • Breath!
      • Solutions, not problems; future, not past
    © 2009 J Peterson & Associates, Inc.
  • 57. Conflict & Resolution
    • Starters for the Conflictees
      • “ Be aware of yourself” (look in the mirror – issue real, or just “yours”)
      • “ Be aware of others” (trust, high EBA with you, good of group or just care; listening to learn)
      • Set the scene for cooperative resolutions.
    • You can’t make people do things they don’t want to do
    © 2009 J Peterson & Associates, Inc.
  • 58. Conflict & Resolution
    • 1 st Approach: 4 Questions
      • “ What do you want?” – the most important question you can ask someone, then listen!
      • “ What are you doing to get it?”
      • “ Is it working?”
      • “ Do you want to figure out another way?”
    © 2009 J Peterson & Associates, Inc.
  • 59. Conflict & Resolution
    • 2 nd Approach – 3 Stages
      • 1 st : ask how much really needed; tell their point of view
      • 2 nd : let them determine path to take to get there
      • 3 rd : empowering – don’t “fix” it for them by telling them how you would do it
    © 2009 J Peterson & Associates, Inc.
  • 60. Conflict & Resolution
    • 3 rd Approach
      • Allow emotions to be vented (but not endlessly!)
      • Restructure the discussion to allow for resolution (get to closure and move on)
    © 2009 J Peterson & Associates, Inc.
  • 61. Conflict & Resolution
    • Intervention Strategies
      • Deciding when to intervene
        • Is discourse unconstructive, personal, ongoing, circling around repeatedly?
        • Will intervention cause more disruption? (consider doing nothing)
    © 2009 J Peterson & Associates, Inc.
  • 62. Conflict & Resolution
    • Intervention Strategies
      • Deciding how to intervene
        • State what you are seeing in behavior
        • State effect behavior is apparently having
        • Ask group/individual if effect is conducive to resolving issue
        • Ask how we can move on
        • Stay positive & don’t “get into the gutter” with participants
    © 2009 J Peterson & Associates, Inc.
  • 63. Conflict & Resolution
    • Handling Resistance
      • Can be based on
        • Poor environment
        • Distrust
        • Lack of communication
      • Rule # 1: don’t ignore it (results in no resolution, even deeper anger/resistance, festering emotions
    © 2009 J Peterson & Associates, Inc.
  • 64. Conflict & Resolution
    • Handling Resistance
      • Consider:
        • Invite participant(s) to state why they are resisting
        • After actively listening, ask for suggested resolution
    © 2009 J Peterson & Associates, Inc.
  • 65.
    • Managing Meetings
    © 2009 J Peterson & Associates, Inc.
  • 66. Managing Meetings
    • Meetings that do not work: those
      • Without an agenda
        • Unless topic very narrowly defined, chair identified, participants know why attending - all in advance
        • Can still fail due to lack of guidance on the start, run and finish
      • Attended by unprepared participants
      • Not lead
      • Without closure
    © 2009 J Peterson & Associates, Inc.
  • 67. Managing Meetings
    • Fundamentals
      • Create and use an agenda
        • Purpose
        • T opic
        • Time estimates
        • Methods
        • Desired outcomes
        • Person presenting
        • Discussion process (for facilitated meetings and can be held by chairman and presenter)
    © 2009 J Peterson & Associates, Inc.
  • 68. Managing Meetings
    • Fundamentals (Cont.)
      • Develop process notes
        • Describe how meeting will be facilitated (tools and techniques to be used)
        • Describe how participation managed (group discussion, small group discussion, individual effort)
    •  
    © 2009 J Peterson & Associates, Inc.
  • 69. Managing Meetings
    • Fundamentals (Cont.)
      • Clarify roles and responsibilities
        • Facilitator – process
        • Team Leader or chairman – content
        • Recorder – meeting minutes  
        • Timekeeper – allotted time
        •  
      • Set Ground rules
    © 2009 J Peterson & Associates, Inc.
  • 70. Managing Meetings
    • Fundamentals (Cont.)
      • Manage participation – agenda to participants, keep on track, keep discussion active
      • Periodically check status or process – 4 P’s
        • Progress – if none being made or to close out issue
        • Pace – discussion is languishing or moving too quickly
        • Process – if tool not yielding desired results or properly used
        • Pulse –if members distracted or appear frustrated
    •  
    © 2009 J Peterson & Associates, Inc.
  • 71. Managing Meetings
    • Fundamentals (Cont.)
      • Take minutes – summaries are best (unlike those in “official” healthcare!)
      • Decide next step(s) – decisions made, who, what, when (and perhaps how)
      • Evaluate – improvements (including facilitator); ask if objectives met – improve process
      • Tools include Forcefield “analysis”, exit survey, formal survey (infrequent) and thumbs up
    © 2009 J Peterson & Associates, Inc.
  • 72. Managing Meetings
    • Fundamentals (Cont.)
      • Set ground rules, such as
        • Attendance
        • Timeliness
        • Confidentiality
        • Interruptions
        • Pagers and phones
        • Respect
        • Accountability
        • Participation
    © 2009 J Peterson & Associates, Inc.
  • 73. Managing Meetings
    • Effective Discussion Process
      • Start/open discussion
      • Explore ideas on topic
      • Ask for any needed clarification
      • Manage participation process, time
      • Periodically summarize
      • Test summary for agreement
      • Keep digressions in check
      • Attain closure
    © 2009 J Peterson & Associates, Inc.
  • 74. Managing Meetings
    • Technical Aspects
      • Tools
        • Flipchart
        • Parking Lot
        • Neutral Position
        • Agenda
        • Media
          • Use different stimuli (video, audio)
          • More important if a lengthy facilitation
          • Exercises, Small and Large Group Discussion
    © 2009 J Peterson & Associates, Inc.
  • 75. Managing Meetings
    • Technical Aspects
      • Techniques
        • Flipchart
          • Dark colors, not red
          • Print – and in their words
          • Animate
          • Post
        • Slides
          • Generally few words
          • Used for participant, not facilitator
          • Leave something to the imagination (omit details)
    © 2009 J Peterson & Associates, Inc.
  • 76.
    • Facilitation Tools
    © 2009 J Peterson & Associates, Inc.
  • 77. Facilitation Tools
    • Visioning
    • Brainstorming
    • Written Brainstorming
    • Forcefield Analysis (pros, cons)
    • Multi-voting, Nominal Group Technique
    • Cause and Effect and Fishbone or Ishikawa Diagram
    • Decision Grids
    • Troubleshooting
    © 2009 J Peterson & Associates, Inc.
  • 78. Resources
    • Covey, Stephen R. Principle-Centered Leadership. Covey Leadership Center, 1991
    • Goal QPC and Joiner Associates, The Team Memory Jogger II, 1 st Edition, 1995
    • Bens, Ingrid, Facilitation at a Glance! 2 nd Ed.: Goal QPC: 2008
    • Scholtes, P.R. et al. The Team Handbook, 3 rd Edition. Joiner, 1996
    • Lencioni, Patrick. The Five Dysfunctions of a Team: A Leadership Fable. Jossey-Bass. 2002
    • Newstrom, J.W. and Scannell, E.E. Games Trainers Play. McGraw-Hill. 1980.
    • Newstrom, J.W. and Scannell, E.E. Even More Games Trainers Play. McGraw-Hill. 1994
    • Oriel Incorporated, The Team Handbook, 3 rd Edition. 2003
    © 2009 J Peterson & Associates, Inc.
  • 79. Contact Information
        • Jack L. Peterson
        • President
        • J Peterson and Associates, Inc.
        • Suite A
        • 506 Autumn Willow Way
        • El Paso, TX 79922-1858
        • Phone 1-915-203-3606
        • Facsimile 1-913-832-9597
        • www.jpandacorp.com
  • 80.  

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