A product of

Welcome!

Sit anywhere --

With people with whom you don’t usually work

4 per table

Experiential Learning

Experience

Reflect

Bridge

ApplyEvaluate

A product of

The Game Play

Steps Each Hour

Arrivals

Exits

Closure?

Staffing?

Paperwork

Extra Paperwork: Emergency Dept

# Extra Paramedic Patients Accepted

Add a checkbox:

Later, subtract from total Paramedic Turnaways

Calculate Scores…and Stretch

Team Dialogue

1. What felt real?

2. What drove your behavior?

3. Core strategies for improvement?

Real…

Drivers…

Strategies…

Process Flow Diagram

E

S

CCSD

Where to intervene to improve performance?

Collaboration Ladder

Minimal CommunicationMinimal Communication

High

Low

Jointly PlanJointly Plan

Treat Peers as CustomersTreat Peers as Customers

Communicate Needed InfoCommunicate Needed Info

Share ResponsibilityShare Responsibility

Innovation

Do we want people to challenge rules?

What is OK and what is not OK to challenge?

Rule Origin & Rationale

Benefit to Eliminate

or Modify?

Adverse Consequences

to Others?

Strategies…

Collaboration

Innovation

Data-driven decisions

Elements of Structure

Physical layout & environment Performance measures Reporting relationships Reward systems Information flows Policies, procedures Practices, norms Language

Structure Drives Behavior

Q: How to identify organizational structure that produces specific behaviors?

A: Simplest method is Force Field Analysis

Sample Force Field Analysis

COLLABORATION

DRIVING RESTRAINING

• Need to

coordinate

hand-offs to

meet efficiency

goals

• Pressure to be

a team player

• Desire to satisfy

customer

• Performance measures linked to dept. budgets

• No feedback re: impact of local decisions on others

• Culture glorifies individual achievement

Does your organization promote or (unintentionally) inhibit collaboration?

Force Field Instructions

1. Make a T-grid, naming the desired behavior on top.

2. Brainstorm drivers and list them on the left. (Be clear and concrete.)

3. Brainstorm constraints and list them on the right. (Be clear and concrete.)

4. Go back to consolidate duplicates, make sure they are explicit.

5. Go back and circle the top 2 on each list.

Final Questions

Personal What personal insight did you gain from the

simulation experience or the discussion?

Organizational What important issues surfaced that should be

formally followed up?