Management of clinical healthcare environments with team strategies

Team Rules of Engagement
1. Quality Work
  1. Purpose and mission
  2. Completed on time
    1. Collaborative Effort
2. Satisfied with work
  1. Trust members
    1. Grades Reflect Quality
3. Never miss a deadline
  1. Completes projects early
    1. Applies time management
      1. Knows how to delegate
      2. Ask for help when needed
    2. Sensitive to time demands
4. Quality
  1. open minded
    1. support/honest
      1. Regularity
      2. email/phone with questions
      3. Style
      4. Precise/Positive
      5. Avoid argument, aggression, or tension
      6. Open/supportive
      7. Required dates
5. Communication
  1. Email/text/google hangout
    1. Identify issues
      1. Instructor contacted
      2. Potential problems
      3. Failure to return communication, participate in meetings, agree on direction
6. Feedback
  1. Meaningful discussion
    1. Coach adjustments
      1. Engaged feedback
      2. Send Ecards/emails
7. Supportive
  1. produce better outcomes for goals set
  2. Offer help
  3. Acceptance towards others
    1. Empathsize
    2. Input is valued/appreciated
      1. Conflict Resolution
      2. Communicate openly
      3. Identify issues early
      4. language clear/free of coercion
8. Objectives
9. Measure of Success
10. Timeliness
11. Communication
12. Problem Solving Process
  1. Members see a problem, bring attention to group
13. Recognition
14. Behavior
Vision Statement
To manage clincial healthcare environments
1. Any clinical inpatient or outpatient location
2. Team strategies
  1. Theory: team strategies will show improvement and be more useful
  2. Promotion
    1. positive relationships
    2. satisfaction
      1. Both patients and staff
    3. effectiveness
3. Individuals
Article 8
1. Citation: De Rond, M. 2010.
2. Description: Assess qualities needed for high performing teams
3. Framework: comparison of business to healthcare setting
4. Design: 1,052 analysts in different settings
5. Characteristics: business/sport environment, multiple tasks
6. Variables: age, setting, career
7. Outcomes: choose your best team for project objectives
8. Data adequacy: high number with variety
9. Findings: qualities needed: drive, focus, intelligence, high expectations
10. Level and Quality: Level IV, good quality
Article 5
1. Citation: Patel, S. 2015.
2. Description: examples of companies with fantastic cultures
3. Framework: aspects of culture can decided employee benefits
4. Design: 10 companies reviewed
5. Characteristics: technology based with core values
6. Variables: size of company, employee satisfaction rates
7. Outcomes: Employees want to feel empowered
8. Data adequacy: only 10 companies reviewed
9. Findings: core values vary from person to person
10. Level and Quality: level IV, low quality
Article 7
1. Citation: McAdam, R, 2002.
2. Description: Critique and review role in idea generation
3. Framework: literature review from individual and team perspectives
4. Design: 51 studies reviewed from 1998-2001
5. Characteristics: creativity, innovation, idea generation
6. Variables; multiple dates from studies with different key elements
7. Outcome: need more research on idea generation
8. Data adequacy: multiple studies but outdated
9. Findings: identifies agenda for further research
10. Level and Quality: Level V, good quality
Article 3
1. Citation: Miners, C, et all, 2015.
2. Description: new approach to management structure focusing on collaboration
3. Framework: 120 tope teams in various industries reviewed
4. Design: quantifies key factors affecting effectiveness
5. Characteristics: define teams, outcomes, dimensions of climate
6. Variables; size of teams, location, age
7. Outcome: teams designed and assembled based on desired outcome
8. Data adequacy: variety of team structure and numbers
9. Findings: clearly define team role and climate for positive outcomes
10. Level and Quality: Level II, good quality
Article 4
1. Citation: Mukherjee, N et all. 2016
2. Description: study on groups vs. individuals in decision making process and key insights
3. Framework: database search from 1995-2015 with key words of 50 articles
4. Design: key word search and year with methodology
5. Characteristics: intellectual and judgemental tasks
6. Variables: date, name, key objectives validity
7. Outcome: limited number of studies, variabilities on gender
8. Data adequacy: Not a high number of articles, many outdated
9. Findings: groups effective with management and policy issues
10. Level and Quality: Level I, good quality
Article 9
1. Citation: Andretta, P., Marzano, D. 2012.
2. Description: How team factors contribute to clinical performance and patient outcomes
3. Framework: literature review providing descriptions of optimal team based competencies
4. Design: 91 studies from 2003-2010
5. Characteristics: clinical area of obstetrics and gynecology
6. Variables: date of publication, patient outcomes, quality, safety
7. Outcomes: Stable team with defined roles provides success
8. Data Adequacy: 91 articles with relevant information
9. Findings: interdisciplinary teams are essential for success and management of patients
10. Level and Quality: Level V, good quality
Article 10
1. Citation: Landry, A., Erwin, C. 2015.
2. Description: Investigate how team processes work to facilitate effectiveness
3. Framework: survey sent to healthcare professionals about processes
4. Design: survey from American College of Healthcare Professionals
5. Characteristics: good communication, coordination, collaboration, cooperation
6. Variables: all levels of healthcare teams, characteristics
7. Outcomes: team processes need work in many areas
8. Data adequacy: large sample size with all questions answered
9. Findings: team processes need improvement in communication, conflict, and resolution
10. Level and Quality: Level V, good quality
Article 2
1. Citation: Bossy, D etall. 2016.
2. Description: investigate how individuals perceive participation in group-based management support
3. Framework: focus group study using interview guide
4. Design: qualitative study with 16 individuals
5. Characteristics: logic with social spaces to construct identity
6. Variables: 3 focus groups, setting, age
7. Outcomes: policy contributes to group decisions
8. Data adequacy: only 16 participants with 6 in each group, no control group
9. Findings: participants maintained a strong emphasis on their own responsibilty
10. Level and Quality: Level III and low quality
Article 6
1. Citation: McEvily, et all, 2015>
2. Description: Identify concepts for linking formal and informal elements for team goals
3. Framework: survey to companies addressing areas of growth
4. Design: 18 companies used with a total of 10 areas
5. Characteristics: social networks, organizational functioning, structure
6. Variables: size and type of company, age
7. Outcome: need common goals to align in order to meet organizational components
8. Data adequacy: current with multiples different types
9. Findings: social networking is key to the function and structure
10. Quality and Level: Level IV, good quality
Article 1
1. Citation: Domke-Damont et all. 2014
2. Description: Individual vs. Teams on reflections of desired behavioral norms
3. Framework: teams in strategic management classroom given 1 of 2 versions of assignment
4. Design: graduate students multi gender age 22-45
5. Characteristics: classroom, paper and pencil, quiet environment
6. Variables: age, gender, time, personal opinion
7. Outcome: desired norms, effectiveness, project scores
8. Data adequacy: not a high number of participants one study only
9. Findings: higher team effectiveness and scores but not higher satisfaction
10. Level and Quality: Level II, low quality
Innovation Tools
Activity Map
1. Purrpose
  1. Escape from past patterns
2. Participants
  1. 3-5 co-workers
3. Time
  1. Typical work day= 10 hours
4. Materials
  1. computer, paper, pen
5. Information gained
  1. capture/drill down what is really happening
6. Facilitate project
  1. HIghlight relationships, evaluate value, eliminate redundancies
7. Brainstorming
  1. Purpose
    1. Generate new ideas
  2. Participants
    1. 5-10 co-workers
  3. Time
    1. One hour= 100 ideas
  4. Materials
    1. colored pens, paper, white board, meeting room
  5. Information gained
    1. sharpen focus, build off other's ideas, perfect vision statement
  6. Facilitate project
    1. provides solutions to question, formats information, clear direction
8. Prototype
  1. Purpose
    1. Experience events/situations
  2. Participants
    1. members of leadership team
  3. Time
    1. 1-2 weeks
  4. Materials
    1. computer, internet, paper, pen
  5. Information gained
    1. understand real working system; find flaws
  6. Facilitate project
    1. create new design; find out what can be changed; what works
Capstone Projects Assessment
1. CompletedCapstoneProjects-TEMPLATE.docx
  1. Relationship: Multi-step; group centered; patient involvement
  2. Relationship: Creates value, creative, need metrics
  3. Relationship: Quality management, risk taking, measurable
  4. Relationship: integrative therapies, staff satisfaction, cost
  5. Relationship: new experiences, improve education
  6. Relationship: increase knowledge, continuity of care
  7. Project 1
  8. Project 2
  9. Project 3
  10. Project 4
  11. Project 5
  12. Project 6
Evidence Table
Peer Review
1. Internal feedback
  1. Added other healthcare areas/ask why
    1. capstone questions.docx
2. External Feedback
  1. Broad include patient care/strength in collaboration
3. Survey Questions
  1. external response questions.docx
References
1. capstone references.pdf
Obstacles
1. Verbal
2. Nonverbal
  1. Template
    1. ObstaclesBarriers-TEMPLATE.docx
3. No Feedback
Reflection
1. Risk taker
  1. Creative/Open minded
    1. Continue self assessments
  2. Knowledge share
    1. Build trust
  3. Embrace change
2. Define goals and roles
  1. Facilitate positive movement
    1. Engage others
  2. Set timelines
  3. Obtain more feedback
    1. Collaborate with a mentor
3. Personal Characteristics
4. Professional Strategy
Elevator speech
1. Wow speech
2. Introduction
3. Hook
4. Under 60 sec
5. Goal clearly defined
6. Peer review
  1. elevator speech.pdf
Article searches
Capstone 2
1. Laying the foundation
  1. Vision statement revised
  2. To manage healthcare environments with team strategies through a rotations process versus individuals in order to promote positive relationships, satisfaction, effectiveness, and professional development
    1. see references
    2. Evidence sources
      1. promote effective communication
      2. improve culture
      3. increase motivation and staff satisfaction
    3. Supported national health initiatives
      1. CDC National Health Initiatives
      2. The National Public Health Workforce Strategic Plan- goals/strategies to strengthen the public health workforce
      3. lack of the right number of people with the right skills in the right place at the right time
      4. IHI Leadership Alliance
      5. leaders need to deliver great health care with high value
    4. Opportunity for change
      1. specifics on elements
      2. numbers needed for rotation
      3. fresh perspective
  3. Revised elevator speech
    1. Description
      1. new model focused on a rotating team approach to develop effective management
    2. What will it do
      1. promote positive relationships, satisfaction, effectiveness
    3. Relationship to a national healthcare initiative
      1. CDC National Health Initiatives, National Public Health Workforce Strategic Plan- new goals and programs to strengthen workforce environment
  4. Accelerator concepts
    1. Using an accelerator
      1. Neil Collins Innovate New Albany- bring people in the community together-promote growth/business development
    2. Lessons from an accelerator
      1. use resources to understand market, create partnerships, use resources
    3. Characteristics of an excellent accelerator
      1. verify products/service; address a need that will satisfy population
    4. Advice for new projects
      1. fall in love with your pain not your solution; constant change may be necessary
    5. Concepts apply to capstone projects
      1. prove science behind your technique; know who you will distribute to; use references as an opportunity
2. Peer review feedback
  1. Week 4
    1. Specific Contributions
      1. address employee turnover d/t poor management
      2. new model rotating team approach
    2. Value to the healthcare organization
      1. improve positive relationships, satisfaction, effectiveness
      2. strengthen workforce environment
    3. Potential enhancements
      1. 75% statistic confusing
      2. hear more about model
  2. Week 7
    1. Contributions
      1. timeline with project completion
    2. Value
      1. aggression
      2. education
    3. enhancements
      1. clarify after pilot how long for evaluation process
      2. aggression timeline very quick
  3. Week 10
    1. Values
      1. improve performance, morale, culture
      2. positive impact on organization
    2. Contribution
      1. reduces cost, builds credibility, room for growth
      2. barriers identified and addressed
    3. Improvements
      1. hear more about culture change
      2. more about staff retention
3. Business case for innovation
  1. Cost projections
    1. Staff
      1. 4 staff members at 90,000 yearly for rotating team
      2. administrative assistant 55,000 yearly
      3. staff for procedures; 6 staff for 60,000 yearly
    2. Equipment
      1. computer
      2. printer
      3. equipment for procedures maintenance
      4. 10,000 yearly
      5. office supplies
      6. ipad for all members of team for consistency in system
    3. Education
      1. continuous yearly for leadership classes
      2. educational conferences on cardiology
      3. potential nationally conferences
      4. support for advancement in degree
      5. 12,000 yearly
      6. Jon Heller VCU Health CEO
      7. 6% profit for organization
      8. dont be afraid to have a joint venture with competitor
      9. organize revenue to include expenses and benefits
    4. Technology
      1. upgrades to computer
      2. microsoft programs
      3. support from IT of systems
      4. 5000 yearly
    5. Anticipated profit or loss
      1. no bonus given save 150,000 yearly
      2. equal distribution of salaries
      3. no top heavy pay scales
    6. Costs not included
      1. failure of model
      2. staff resigns
      3. meeting expenses; white boards, handouts, projection screen
      4. travel
      5. conference educational travel expenses
      6. cause model to not rotate properly and strain of other members causing burnout lack of motivation and profit loss
      7. could cause loss of profits for department if team not successful
  2. Benefits Summary
    1. Quantitative
      1. Measured or counted
      2. salaries needed to members of rotation
      3. number of employees
      4. staff turn over rate
      5. survey results on management effectiveness
      6. Mickey Obrien OSU Supply Chain Manager
      7. purpose: address escalating medical supply cost and demonstrate need
      8. Evaluate cost and compare to other products based on quality, usage, time savings, perception
      9. ensure products utilize evidence based practice outcomes, clinical efficacy, and fiscal responsible ideas while creating a safe environment
    2. Qualitative
      1. staff satisfaction
      2. perception of unit culture
      3. reputation of unit
      4. quality of work delivered
      5. professional development
    3. Other
      1. consistency of staff
      2. new ideas created
      3. innovation process
      4. decrease in job burnout
      5. intrapersonal relationship maintaining positivity
  3. Timelines
    1. Aggressive
      1. planning 3 months
      2. approval 2 months
      3. funding 2 months
      4. communication continuous 6 months
      5. education continuous 6 months
      6. pilot 6 months
      7. evaluation 6 months after first pilot
      8. go live 7 months
      9. implement 7 months after review
      10. assign resources
      11. core project team
      12. identify key stakeholders
      13. shorter time frame
    2. Nonaggressive
      1. planning 12 months
      2. approval 12 months
      3. funding 13 months
      4. communication start 12 months
      5. education start 12 months
      6. pilot 14 months
      7. evaluation 15 months
      8. go live 16 months
      9. implement 16 months after review
      10. estimation
      11. account for risk responses
      12. walk through schedule
      13. longer timeframe
    3. Rita Johnson Project manager STEMI OSU
      1. determine resources to identify timeline
      2. goal should be defined
      3. potential barrier for time delay
      4. map out timeline
      5. should include input from stakeholders/participants
      6. include environment
  4. Risk Assessment
    1. List of risks for capstone project
      1. Change in culture
      2. Value
      3. Employee readiness/satisfaction
      4. Not effective management style/unable to complete tasks
    2. Medication plans for each risk
      1. uncertain of future events create both negative and positive-opportunities
      2. effective use of resources
      3. reassure stakeholders of process improvements
      4. negative risk- avoid-mitigate-transfer-accept
      5. positive risk- exploit-enhance-share-accept
    3. Chris Bloomfield Director of Accreditation OSU East
      1. major risks- patient safety with adherence to standards of accrediting bodies
      2. guiding principles- transparency and willingness to adapt
      3. quality initiatives need to be met in everything we do
  5. Community Benefits
    1. List of benefits to the community from this capstone project
      1. Growth and empowerment to the management field
      2. Promote job satisfaction and retainment to the OSU community
      3. Lifelong residents to Grandview area
      4. Positive culture which transpires to environment
    2. Ray DeGraw Mayor of Grandview Heights
      1. Promotion of Grandview Yard development and business growth
      2. Housing market continues to maintain value
      3. Lifelong residents value and care about community
      4. Even during tough financial times; education still important
      5. neighbors OSU community and respects advancement
  6. Capstone Project Benefits
    1. Short term
      1. Changes in patient satisfaction
      2. overall cost reduction, see changes quickly
      3. Changes in employee satisfaction
      4. Improve performance, morale and culture change, celebrate success
      5. Changes in patient outcomes
      6. Increase satisfaction, potential to increase positive feedback on others
      7. Changes in the healthcare organization's reputation in the community
      8. Proactive stakeholder engagement, identify key barriers early on
    2. Long term
      1. Changes in patient satisfaction
      2. Show results to help fine tune changes
      3. Changes in employee satisfaction
      4. Staff retention, increase trust
      5. Changes in patient outcomes
      6. More feedback opportunity, build credibility, able to show results visually
      7. Changes in the healthcare organization's reputation in the community
      8. Build momentum and growth, promote education
    3. Diane Gordon Administrative Director OSU East
  7. Comparison of SWOT and BCI Frameworks
    1. Similarities
      1. helps to develop a strong business strategy
      2. encourages innovation and creative thinking
      3. positive return on investment
      4. creates value; goal development
    2. Differences
      1. SWOT
      2. encourages bringing a team together for brainstorming session
      3. not a lot of time is needed; can be completed at any time
      4. examines internal and external factors
      5. brainstorming session creates ideas and goals
      6. BCI
      7. individual proposal
      8. idea is already created with a summary page
      9. customer research to convince management
      10. investment requirements with time needed
    3. Value of this information in meeting national health initiatives
      1. creates goals and strategies to strengthen the public health workforce
      2. working environment
      3. quality of leadership
      4. organization support
4. Implementation Plan
  1. Capstone Project Scope
    1. Scope
      1. Work Included
      2. staff members in rotation and education requirements; each member performing week rotation with collaborative creation of job description and responsibilities for 3 month trial period; brain storming session when meetings are needed for advanced expectations; effective management of daily operations and schedule
      3. Work not included; out of scope work
      4. budget creation of unit; unrealistic goals that are not manageable; concentrate on single unit only for first implementation phase
    2. Anticipated accomplishments
      1. solution, benefits, criteria for technique; learn from framework about a successful strategy; gain critical knowledge and tools to make smarter decisions; meet ever changing needs of the healthcare market
    3. Relationship to national health initiatives
      1. strengthen public health workforce; help meet the goals initiated by the CDC for improving incomplete workforce planning, insufficient retention strategies, contextual environment, and competency of workers
    4. Required approvals; include rationale for this approval
      1. approval from health system and administration would include Diane Gordon and Twilla Lee and HR representative; change in job description and scope; approval of budget change and new management technique
  2. Infrastructure
    1. Milestones
      1. Milestone 1 planning
      2. 3 month process to determine how many people will be involved, resources needed, potential barriers, map out timeline and process, research, brainstorming
      3. Milestone 2 approval
      4. 2 month process to communicate entire scope with stakeholders and assess environment and culture; include all deliverables
      5. Milestone 3 funding
      6. 2 month process to develop new jobs description and scope; approval of budget changes and new technique associated
      7. Milestone 4 communication
      8. continuous process to help with early identification of risk factors and provide a better work culture and definition; gain trust and value
      9. Milestone 5 education
      10. continuous process to assess team performance and readiness; clear and open; gain tools to make effective decisions and learn from errors
      11. Milestone 6 pilot
      12. 6 month process to serve as a template for future projects and techniques; start with one unit to test hypothesis and theory
      13. Milestone 7 evaluation
      14. After pilot at 7 months to potentially increase stakeholder confidence; continue to adjust and develop changes with team
      15. Milestone 8 go live
      16. 7 month process to take into consideration all feedback and resources to build success
      17. Milestone 9 feedback review and integration
      18. 7 month process to help strengthen the public work force and continue to meet goals and expectations
Capstone 1
Key Learnings
1. Concise Ideas to reflect leadership style
  1. Personal Application: Toxic behaviors can empower change and innovation
  2. Use past experience to shape Elevator Speech
    1. Personal Application: Elevator speech concise and on topic with key elements addressed in creative way
    2. Strategies
2. Use Evidence to support theory
  1. Personal Application: PICOT question formation and policy change
  2. Rate and understand evidence
    1. Personal Application: Use EBP to drive future changes
    2. Strategies
3. Utilize innovation organization systems as example
  1. Personal Application: OSU lacking as an innovative driven organization compared to others nationwide
  2. Rely on theory for support
    1. Personal Application: Theories shape organization innovation
    2. Strategies
4. Use communication strategy to understand audience
  1. Personal Application: Leading health indicators of populations in disparity to meet risk reduction objectives
  2. Critical Thinking and teamwork to understand bias
    1. Personal Application: Critical thinking paper helps to understand bias, persuasion, and fallacies
    2. Strategies
5. Innovative Leadership: Leading from Within
6. Evidence Based Practice
7. Innovation in High Performing Organizations
8. Health Promotion/Disease Prevention