collaborative cycle reflective discussion · pdf file · 2017-02-23collaborative...

Collaborative CycleReflective DiscussionAn approach for facilitating group work

Catalyst Training: Session 1 | 2017 | Center for Care Innovations

A collaborative cycle is a way to structure a meeting to produce a creative result.

2Catalyst Training: Session 1 | 2017 | Center for Care Innovations

Catalyst Training: Session 1 | 2017 | Center for Care Innovations 3

THE STRUCTURE

1. Set up a generative activity

2. Generate tangible content in pieces

3. Sort, organize and label content groups

4. Reflect, discuss, share insights

5. Agree on take-aways & next steps


You’ll recognize this pattern embedded in many of the methods

Use it as a framework for exercises you do with colleagues



REFLECTIVE DISCUSSION


A way to think critically together as a team to improve communication and the development of insights.

Use it after any work activity, when you are stuck and at team check-ins.

Capture key points, insights or actions that result.



1. Start with an open-ended question — “how did it go?”

2. Encourage more detailed description - “say more about that.”

3. Encourage alternative viewpoints. Ask for the positive aspects and the negative aspects.

4. Generate new action — “what could we do as a result?”

5. Agree on take-aways & next steps


TRY IT: Catalyst Program Benefits & Challenges


1. Organize in groups of five or six. Get sticky notes and a sharpie pen for each person.

2. Write down and share: Benefits and challenges you expect by participating in the Catalyst program.

3. Push the number of ideas —everyone should write at least 7 to 10 each .

4. Stop and sort your notes into groups collaboratively.

5. Discuss the groups and categories of goals among your team.

6. Together, we’ll review each group in a round robin.


COLLABORATIVE CYCLE

What is the pattern we use?

Why are the different steps important?

How can you apply this back home?

Other questions?




Why reflect?

What makes a good facilitator?

How/when could you apply it back home?



Dimension & Diagram

Understanding your project’s context

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To better understand your project, you need to look at and research many

different aspects, or dimensions, of it.



You already do this when faced with unstructured problems in your own life.

Center for Care Innovations and Innovation Consultancy / Kaiser Permanente 15Catalyst Training: Session 1 | 2017 | Center for Care Innovations

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What will you consider and research?

• Location

• Price

• House condition

• Layout

• How it feels

• Property

• Schools

• Transportation

• Neighbors

• Access to services

• Crime


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How you do it

Tour houses, neighborhoods•

Talk to people•

Set up a spreadsheet•

Make maps and overlap data•

Use specialized tools•

Set a plan/timeline•



• determine one or more ways to get information

choose how to capture, organize and assess that information

For each dimension you:


Applying this idea…

What are some dimensions of your projects?

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What are dimensions of your project to research?

• Patient/staff/leadership experience or activities

• Policies, protocols, workflows

• Technology involved

• Quantities like no-show rates, by time period, costs

• Organizational goals

• Social/cultural norms


✔


AEIOU

activities in the context

environments those activities happen in

interactions between people and things

objects (tools) that are used

users (and stakeholders) in the context

A helpful mnemonic

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Research things outside of your organization

What other, similar organizations are doing•

Trends • - technology, policy, societal

What• ’s happening in other industries

Different kinds of subject matter experts•

Business or academic literature•


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Planning your research dimensions

• Brainstorm dimensions that could be relevant to your project, one per sticky note (20m)

Push the boundaries of what you consider relevant — make a creative leap or two!

2. Review and cluster them (15m)

3. For 5 of them, work through how you will gather information and how you could organize and evaluate it.



Project Planning Time

~8-week research/understanding phase

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Project Planning - research & understanding• Revisit your project’s topic, goals and your approach in

relation to today’s topics. “What do we think we’re working on?”

• Make an initial plan for the people, activities and other dimensions you will research to better understand your project’s context. Use the 11x17 timeline if helpful.

• Consider how your team will manage time/work together.

• Consider communications to colleagues and leadershipThis is just a draft, don’t over think it.

You’ll have more time tomorrow and with your coach.Catalyst Training: Session 1 | 2017 | Center for Care Innovations


Co-Design Harnessing the Power of Patients and Care


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Co-design Overview

• Setting Context

• Examples

• How to Do This

• Toolkit

• Reflection


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Evolution of Mindset and Service

Healthcare organizations were built around the •organizations’ needs

For awhile it worked well for patients and system overall•

Now we need to build it around their needs, •expectations, values

We need to treat patients as customers that have many •choices…



“Value is not created in the companyand then exchanged with customers;rather, value is co-createdby the company and the customers.”

Partners vs. Patients

-Prahlad & Ramaswamy

• Surveys

• Focus groups

Shadowing•

Interviews•

Journey•Mapping

Patien• t Advisory Councils

Pee• r Navigators

• Co-design

- Patients on project team

- Creating value with us

Advising&

ConsultingDiving Deeper

Evolution of Engaging with Patients as Partners

Mindset: Use this approach to actively listen and create solutions with patients at every touch point in their healthcare journey across improvement /innovationefforts.

Patients as PartnersFeedback

Why Partner with Patients?

• Transform care in a way that truly matters to patients.

• Patients highly value sharing their stories and ideas with you

• Challenges what you “know and “assume” through humble inquiry

• Leading businesses have found that when they begin collaborating with customers, new value is created.

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Sampling


Who� Defined patients; i.e., Medicare member 65+ yo.� Paneled at ‘Clinic X’� Patient is willing/able to participate for project duration� Ability to communicate clearly, speak in a group� Open-minded, willing to share real experience/thoughts� Available and willing to attend scheduled meetings

� Available and willing to keep self-journal

How many� 4-6 of the same patients for duration of program/ project� At least 3-4 per phase if different patients� Have back-up participants so no one patient gets fatigued

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Ethics


Define� Design consent to cover duration of project� Complete the consent process prior to engaging patients� Include language for video / audio capture as necessary� Include NDA if there will be proprietary/prototypical product

involved

Incentives� Thank you gifts: gift cards, groceries,

vouchers, etc.� Amount can vary� Incentive plan; per engagement thank you

Activitie

sDesigning the Engagement Structure

� Define when it will be valuable to bring in patients

� Select activities/ methods to use at each phase of work

� Define questions/topics you’d like patients to address before they engage

� Provide clear background for patients to participate with comfort/confidence

� Create an engagement plan that the full team including patients can reference.

� Estimate and communicate the amount of time; e.g., no longer than 1.5 hours per engagement

� Provide food/snacks to ensure success!

Understand experience

Define problems/gaps

Frame opportunities

Develop ideas

Test ideas/ solutions

Narrow & shapesolutions

Value - Methods Framework

Discovery Ideation Try | Test Impact

Generate concepts

Design ideal experience

Define / Prioritize Solutions

Pilot ’super-users’

Early adopters when operationalizedVa

lue

Met

hods

Ob• servationsShadow•

• Interviews• In-home visits• Empathy Mapping• Journey Mapping

• Brainstorming

• Storyboarding

• Role Playing

• Enactments

Co-design (in-person + virtual)

• Prototype

• Rapid Experiments• PDSAs• Enactments

• Simulations

• Pilot solution

• Measurement

• Change Package

Co-design in your project

• Use the stakeholder engagement worksheet to think through who you can engage in co-design activities throughout your project.

• Reference the Value-Methods Framework to inspire approaches.

• For one of your early co-design activities, create a draft plan — objective, recruit, activity, facilitation/discussion guide


1. Leverage our patients as valuable assets andchange agents to make the safety net bettertogether

2. Engage patients as ongoing partners with projectteams at the hospital and clinic level to co-designoptimal healthcare delivery solutions

3. Establish longitudinal relationships with patients toenable deep, meaningful, continuous engagement andinput to transformation work

4. Expand traditional patient engagement behaviors with the use of virtual interactions

Reflection: Engaging Patients as Partners


Toolkit


Journey MappingDiagram the user’s experience


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What is a Journey Map?

• It is a flow chart of a user’s experience in a specific function or service

• It’s composed of a core set of activities

• Activities are detailed with smaller actions/interactions

• A variety of other information is layered on top such as user’s emotions, pain points, interactions with others.


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Breast Pumping


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What is the value of a Journey Map?

• It makes the user’s experience tangible

• It supports collaborative discussion with stakeholders

• It incorporates qualitative and quantitative information

• It allows deeper understanding and analysis

• It allows you to prioritize what to work on

• It supports more creative insights or solution strategies


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How-to

Decide what part of the user• ’s journey you’ll represent.

Itemize key activities that • the user does

Arrange them in a sequence across the page•

Group sets of activities as a stage•

Add other • “layers” of information

Thinking | Feeling | Pain Points | Quotes | Notes•



Examples

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Searching for a Home


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Cooking Dinner


coordinate between family

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Guiding tips

• A Journey Map is iterative — make it and remake it

• Interviews and observations are key data sources

• Build bottom-up and top-down

• Thoughtfully and creatively choose and represent information relevant to your project’s goal

• Show stakeholders the Journey Map for reflections, comments and improvements

• Start simply and add to the journey map over time



Advanced example


Title and “guiding principles”


Stages


User Activities


Thinking | Feeling | Doing


Opportunities


Today, focus on activity & stages


Let’s try it!

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Approach

Identify a user journey related to your project•

Itemize key activities that • the user does

Arrange them in a sequence across the page•

Group sets of activities as a stage•

Add other • “layers” of information

Thinking | Feeling | Pain Points | Quotes | Notes•



Reflection

• How did it go?

• What’s challenging about it?

• What value do you see in it?

• How could you apply it in your project?


Center for Care Innovations and Innovation Consultancy / Kaiser Permanente Center for Care Innovations and Innovation Consultancy / Kaiser Permanente 60


Analyzing ResearchBuilding a case from rich data


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Grounded Theory, Glaser & Strauss

Grounded theory is a general methodology — a way of gathering, thinking about and explaining situations from rich data.



Four modes of awareness1. Closed2. Suspected3. Mutual pretense4. Open

Stakeholders in each mode of awareness of imminent death had distinct behaviors and strategies to cope with the situation.

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Constant Comparative Method

The analytical approach to creating grounded theory.

The researcher identifies concepts in the data and constantly compares it to additional data to reinforce or negate the concept.


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How to:

Identify interesting aspects to the field data you gathered. (Patterns, consistent behavior, set ups, pain points, etc.)

Give these concepts names. Find additional evidence to reinforce or negate the idea.

Settle on a small number of concepts, organized hierarchically with supporting evidence.

Construct a narrative that explains what happens, why it happens and implications for change.Catalyst Training: Session 1 | 2017 | Center for Care Innovations


An Example


transitions &recovery


hospital = life suspended

the new normaluncertainty




pain management

managingmedications

managing“life”

economicrecovery

emotionalwell being

Categories of uncertainty

coordinatingcare



coordinating care

“I believe the doctors, nurses, patient, caregivers, etc should all come together to make key decisions regarding a patient's discharge planning.”

“I feel relieved when I talk to my doctor but angry when they are in rush to get to the next patient.

I have to rely on them, but I feel like I’m on hold until they are available.”

un-rushed integrated

“The nurses that took care of me in the hospital for both surgeries and my urologist's nurse were incredible... They were also an invaluable resource for me during recovery when I had questions.”

continuity



uncertainty

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How to Analyze Qualitative Data


Focus on an activity/phenomenon you wish to •understand.

Gather data across many dimensions through •observation, show-and-tell interviews, participation.

With a small team, go through the data. Characterize •what actually happens. (Affinity Sort, Journey Map)

Identify concepts and themes in the data. What is •challenging? What are different patterns of behavior?

Categorize the concepts and themes in a hierarchy and •illustrate with examples from the data.


Review and discussion


Question & ReframeRecognize and challenge convention


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Convention:

“a way in which something is usually done, especially within a

particular area or activity.”


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Orthodoxies:

“Tightly-held beliefs that guide an organization’s decisions and their

interpretation of new information.”



What’s good about conventions and

orthodoxies?

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When can they be bad?


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Why is it hard to change them?


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Why it’s important to be able to identify


• Convention is stable, the world is ever- changing

• Not all practices were meant to be conventional

• Organizational memory can be faulty

• New value creation is often on the other side of convention

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A few points


The key goal is to recognize them, without judgement•

Not all are bad, in fact many aren• ’t

There are • internal ones, specific to the organization

And • external ones, common to the industry

They exist on many • levels

Challenging orthodoxies needs to be done with respect •and grace. Being light hearted about them helps.

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How to recognize them


• Digging deeper into iconic stories of the organization

• When you hear the same phrase or argument from many different people in the organization

• Look for them after “We can’t do that because…” or “We tried that once…”

• Asking “Why not?” with true curiosity numerous times

• Ask your newest colleagues what they see

• When new, external information is quickly dismissed


Conventions and orthodoxies

Discuss your project and its context a bit to warm up1.

Brainstorm conventions and orthodoxies related to your 2.project - remember to use sticky notes!

Consider those in the industry, in your organization and 3.in your own mind…

Evaluate which ones could be challenged by potential 4.solutions to your project


Review and discussion

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Refine and pitch your project plan

• Characterize your project’s TOPIC.

• Characterize the OBJECTIVE of the project and the SCOPE you’ll use to keep it manageable.

• Describe WHO you will talk doing what ACTIVITY and what you want to LEARN about from them.

• Describe OTHER DIMENSIONS you will research and what you want to LEARN from them.

• Share what you’re most excited/scared about in your plan to engage in or learn about your project.


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Planning Questions• Do we have good questions about our project topic?

How are we thinking about our project after these two days?

• Who are our target stakeholders, their experiences and how will we engage them?

• What are our other dimensions we will research? Draft plans for getting access to those dimensions.

• Where can we place/corner to have the project exist visually/tangibly?



Conclusion & Next StepsResources and Expectations


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Conclusion & Next Steps

• Reflect on A New Way of Working: Six Principles

• Schedule & Expectations

• Catalyst Portal

• Coaches

• Webinars

• Survey & Conclude



Reflecting on the Two Days

2015 CATALYST PROGRAM | SIX PRINCIPLES FOR WORKING DIFFERENTLY 92

Day 1

Innovation & Working Differently•

Six Principles•

Collaborative Cycle & Reflective Discussion•

Observation•

Show and Tell Interview•

Dimensioning Your Project•

Initial project planning•

2015 CATALYST PROGRAM | SIX PRINCIPLES FOR WORKING DIFFERENTLY 93

Day 2

• Co-design

• Journey Map

• Analyzing Qualitative Research

• Questioning Convention

• Project Planning


Schedule & Expectations

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Overall Program


Jan Feb Mar Apr May Jun

Grants awarded SESSION #1 SESSION #2 SESSION #3

Virtual kick-off Learn about users and your project’s context using human centered methods

Ideation, concept generation, prototyping & rapid experiments, preliminary measures

Define solution direction, compelling presentation to leadership

Virtual Learning Virtual Learning

Onboarding Milestone #1 Milestone #2 Milestone #3

Insight about your opportunity area. Experiences and issues well-structured. Identified pain points and challenges.

Promising solution directions that have been tested with real users in the field. Understanding

of the value of a successful solution.

Well-defined solution direction communicated

in a way that builds support and engagement

from others in the organization.

Hands-on coaching and remote support

Catalyst Training: Session 1 | 2017 | Center for Care Innovations2015 CATALYST PROGRAM | SIX PRINCIPLES FOR WORKING DIFFERENTLY 97

Expectations & Next Steps: PHASE 1

• Use the methods we practiced here to work on your projects.

• Focus on the creative understanding of your project area and empathize with the users involved.

• Use your coach and the Catalyst portal as a sounding board and for ideas and mentorship.

• Attend supplementary webinars to support your learning and progress.


Dates to Remember

Virtual Swap Meet (optional)March 15, 1:00 PM PDT

Co-Design Tips + Webinar Recording Discussion

Training #2April 11-12Preservation Park, Oakland

Principles 3-5Question & ReframeImagine & ModelTest & Shape

These should already be on your calendar.


Milestone 1 Deliverable

Upload to the wearecatalysts.org portal by April 11.

What problem/opportunity did you set out to solve for?1.

What methods did you use to explore this further?2.

What were your insights from those activities?3.

How did you reframe and refine your opportunity 4.statement based on what you learned?

“Capture quotes,…”

Microphone icon created by Iconic from Noun Project.

…photos,…videos,…

…and other artifacts from your work.

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A Catalyst is…

2015 CATALYST PROGRAM | SIX PRINCIPLES FOR WORKING DIFFERENTLY

AN INNOVATOR

Lead and participate in design and innovation activities to tackle familiar problems in new ways.

A CHAMPION

Bring unconventional approaches and thinking to existing projects.

A CHANGE AGENT

Facilitate others to apply design thinking to their innovation initiatives.

collaborative cycle reflective discussion · pdf file · 2017-02-23collaborative...

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