Wave 2: Learning Session 2
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  • Mention: how to raise hand for question Annotation Arrow Emoticons Oct 20, 2010
  • Solutions before our eyes What enables people to find these solutions? Findings are accessible to all
  • Six D’s – See Handbook


  • 1. Did you Join the Call Correctly? If there is NO phone icon beside your name: 1. Hang up and disconnect from WebEx. 2. Rejoin using original link. Enter name & Email & click on Join Now 3. A popup will display the phone information . Direct Line Enter number Line with Extension “ I will call in” You Joined Incorrectly!  There is NO phone icon beside your name. You will be Unable to join the breakout sessions. You Joined Correctly!  There IS a phone icon beside your name. You will be able to join the breakout sessions.
  • 2. Interacting in WebEx Oct 20, 2010
    • Be prepared to use:
      • Pointer
      • Raise your hand
  • 3.  
  • 4. New Approach to Controlling Superbugs Virtual Learning Session 2 The Discovery Phase
  • 5. Agenda:
    • Welcome and Introductions
    • The Discovery Phase
    • Discovery and Action Dialogue
    • Improvisation
    • Wise Crowd
    • TRIZ
  • 6.
  • 7. The Premise Of Positive Deviance
    • No matter how bad things are, there are always people in the group that do a better job, despite having access to the same resources
  • 8. Positive Deviance-the 6 D’s
    • D efine: the problem and a successful outcome
    • D etermine: if there are any “positive deviants”
    • Discover: uncommon practices/behaviours
    • D esign: activities enabling others to access and practice new behaviours
    • D iscern: effectiveness of activities or project through ongoing monitoring and evaluation
    • D isseminate
  • 9.
    • Discover uncommon practices/behaviors enabling the PDs to outperform/find better solutions to the problem than others in their “community”
  • 10. PD Tools
    • Kick offs
    • Improvisation
    • Sharing Stories
    • Discovery and Action Dialogues
    • TRIZ
    • Improv
    • Wise crowds
    • Social Network Analysis
    • Ethnography
  • 11.
    • Emphasizes hands-on learning
    • Focuses on actionable behaviours
    • “ it is easier to act your way into a new way of thinking than to think your way into a new way of acting”
    Using an inquiry based process: DAD
  • 12. Discovery and Action Dialogues How They Work
    • Group selects a specific problem
    • The group as a whole identifies what the solution looks like including key measures of success
  • 13. What this looks like:
    • 15-20 minute sessions
    • Ideally done right on the unit
    • Include those that want to be involved
    • Encourage a multidisciplinary group
    • Facilitator runs through a series of questions that affirm the problem, identify barriers, uncover existing solutions, generate ideas/actions
  • 14.
    • Be sure not to ignore little changes, suggestions and adaptations that emerge
    • Answers and successful strategies that emerge will differ by organization, unit etc…
    • Provide feedback to others and rapidly act on suggestions or communicate why they can’t be acted on
    • Try not to be silent or wishy-washy on suggested actions
  • 15.
    • How do you know or recognize when ____ the problem selected is present?
    • How do YOU contribute effectively to solving the problem?
    • What prevents you from doing this or taking these actions all the time?
    • Is there anyone you know who is able to frequently___ solve the problem, overcoming barriers?
    • Do you have any ideas?
    • What needs to be done to make it happen? Any volunteers?
    • Who else needs to be involved?
  • 16. Tips for Facilitators
    • Do :
    • Hold the dialogue in the participants’ local context – e.g. the unit
    • Make impromptu invitations as you enter
    • Designate a scribe to take notes
    • Start with the purpose, We are here to stop…
  • 17.
    • Do:
    • Give questions back to the group-wait 20 seconds for a response
    • Encourage everyone to speak
    • Work through all questions without worrying about the order
    • Demonstrate genuine curiosity in everyone’s contributions
  • 18.
    • Do Not:
    • Answer questions that have not been asked
    • Miss opportunities to “catch butterflies” – record actions to be taken by participants
    • Come away with a to-do list for yourself
    • Avoid responding positively or negatively to contributions-let the group sift through their own assessments
  • 19.
    • Always remember:
    • “ Nothing about me without me”
  • 20. Take 5
    • Questions?
    • Experience with DAD?
    • Outcomes?
  • 21. Wise Crowd
  • 22.
  • 23. Improv Mohammad Salhia Toronto Western Hospital
  • 24. “ Act your way into a new way of thinking…” Improvization An Approach for Practicing Positive Deviance
  • 25. Our Road to Improv
    • Discovery & Action
    • Dialogues
    Departmental Improv (e.g. General Surgery Unit) Site-Wide Improv Day
  • 26. Improv Day at Toronto Western Hospital
  • 27.
    • Discovery & Action
    • Dialogues
    Departmental Improv (e.g. General Surgery Ward) Site-Wide Improv Day
    • Players (cast)
      • Planted core group; audience
      • participation
    • Artistic Director
      • Can instruct Players to “play up” certain
      • behaviours; sentiments
      • Keep the element of surprise/improv
    3. Site-Wide Improv
  • 28. Lights… Camera… Discovery & Action!
  • 29. Improv Day
    • Discovery & Action
    • Dialogues
    Departmental Improv (e.g. General Surgery Ward) Site-Wide Improv Day
    • Four 45 minute sessions
    • Agenda per session
      • Introduction: What is PD; Why Improv?
      • Set-up improv
      • Discussion  DAD
  • 30. Core Group Member
  • 31. Residents
  • 32. ICPs; Nursing; Government
  • 33. Lessons Learned
    • Less can be more
      • Provide very basic scenario outlines
        • ID player; their relationships
    • Use artistic director to uncover interesting
    • themes.
    • Take advantage of multi-disciplinary group
      • Have a DAD!
    • Follow-up with participants – they may have
    • different perspectives/ideas for next improv
  • 34. TRIZ the power of creative destruction
    • Define an unwanted result e.g. hospital acquired infections
    • Design a system that would reliably create the unwanted result
    • Compare the adverse system to the current system
  • 35. Next Steps
    • Continue to work on core team and “launch”
    • Start using the DAD process and other methods on the floors
    • Begin to think about data collection
  • 36.
    • Next Coaching Call : Monday October 28 th 1pm EST
    • Next Learning Session : Monday November 15 th 12pm EST
    • www.stopsuperbugs.com
  • 37.
  • 38.