Institute on Healthcare Systems

Workshops and Activities

Workshop 1: Develop Awareness (June)

Objectives

Develop awareness of ourselves and others.  Learn how to learn about ourselves and others, and why it matters.  Develop awareness of the value and potential challenges of diversity, and the importance of managing it well in order to achieve our desired outcomes.  Develop a relational map of roles on our clinical unit.  Learn how to develop relationships of shared goals, shared knowledge, mutual respect - and how to create psychological safety - among diverse colleagues.

Participants

QI and Leadership Teams, facilitated by Coaching Team

Modes of delivery

Personal assessment tools, personal stories, response to videos, relational mapping, facilitated conversations.

Pre-work

Develop a 3-minute personal story, using the Challenges & Choices format.  Create a pie chart to represent your own social identities - for example race, gender identity, disability, education, parent education - not to be shared with others but as a basis for self-reflection. Watch “Dangers of a Single Story,” "Theory of Enchantment,"The Power of a Simple Idea” and “Building Psychological Safety.”  Optional reading: "A Hole in the Heart of Anti-Racism Training."

Content

Welcome, the Coaching Team introduces themselves.  Brief introduction to the frameworks for the change process. Review constructive and destructive listening behaviors. Co-create ground rules for our learning community, and how we will all deal with inevitable breaches.  

Facilitate conversation about “Dangers of a Single Story,” “The Power of a Simple Idea” and “Building Psychological Safety.”

Share your personal story with one other participant.  Practice mindful listening with each other.  Introduce your partner to the whole group.  Invite 2 or 3 participants to share their personal story with the whole group. Facilitate debrief with attention to professional and social identities.  Did others' stories seem to overlap with your own?  How did your identities shape your own story?  

Ask participants to develop a relational map of their clinical unit, with attention to professional roles as well as social identities within those roles. Where is relational coordination currently strong?  Where is it less strong? What are the consequences for outcomes? What are the root causes?  How might social identities be affecting the relational map? How might social identities be affecting the seven dimensions of relational coordination - frequent, timely, accurate, problem-solving communication, shared goals, shared knowledge, mutual respect? What important information might you be missing? How can you learn more about that?

Process reflection: How are we doing as we learn how to learn about differences? What can we learn from what happened today about how to build shared knowledge, shared goals, mutual respect? About how to create a safe space?

Post-work

Use a weekly journal to reflect on what you learn. Pay special attention to professional and/or social identity differences on your relational map that are challenging in some way.  Consider the impact of power differences due to professional and social identity, as well as seniority.

Workshop 2: Develop and Practice Skills (early September)

Objectives

Develop and practice skills for harnessing difference as a resource and for recognizing and repairing the inevitable ruptures and bumps. Learn how to teach these skills to our colleagues.

Participants

QI and Leadership Teams, facilitated by Coaching Team.

Modes of delivery

Simulations, games and/or theater to understand the perspectives of others and respond appropriately.  As participants observe simulations, they will use protocols to help identify the seven dimensions of relational coordination.  Which are relevant in a given situation? Which are present? Which are lacking?  From whose perspective?  

Content

Welcome, invite participants to reflect on what they’ve learned since we last met.

Engage in game or simulation. Invite participants to serve as actors and observers.  Observation protocol includes attention to interactions around teamwork in general, then noting the influence of professional and social identities.  Coaches lead a reflective debrief among actors - what did they think? How did they feel? - then invites observers to speak.

Process reflection: How are we doing as we learn how to learn about differences? What can we learn from what happened today about how to build shared knowledge, shared goals, mutual respect?  About how to create a safe space through listening and power-sharing?  Which conversations about social identities would you like to have that you don’t feel you can have now? What would help make that more possible?

Post-work

Use a weekly journal to reflect on learning. Pay special attention to professional and social identity differences on your relational map that are challenging in some way.  Consider the impact of power differences due to professional and social identities, as well as seniority.

Baseline Assessment:  RAD Survey (mid-September)

Objectives

Invite our colleagues to participate in the automated baseline RAD Survey to assess relationships of shared goals, shared knowledge, mutual respect - and psychological safety - among colleagues with different professional and social identities.

Participants

All participants in the clinical unit are invited to respond to the automated RAD Survey.

Workshop 3:  Review Data and Prepare to Co-Design Interventions (late September)

Objectives

Review baseline data from the RAD Survey. Prepare to share the data with our colleagues on the unit, and to engage them in co-designing interventions based on the data.

Participants

QI and Leadership Teams, facilitated by Coaching Team.

Content

Review results of the baseline RAD Survey.  Brainstorm how to share data with our colleagues on the unit, practice doing it.  Brainstorm possible interventions.  Develop and practice methods for co-creating interventions with our colleagues.

Co-Design and Implement Interventions (October-November)

Objectives

Share data with our colleagues on the clinical unit, co-design and implement interventions with them using rapid cycle improvement.

Participants

QI Teams and Leadership Teams, facilitated by Coaching Team.

Follow-Up Assessment:  RAD Survey (early December)

Objectives

Invite our colleagues to participate in the automated follow-up RAD Survey to assess changes in relationships of shared goals, shared knowledge, mutual respect - and psychological safety - among colleagues with different professional and social identities.

Participants

All participants in the clinical unit are invited to respond to the automated RAD Survey.

Workshop 4: Reflect on Progress, Celebrate and Plan (mid-December)

Objectives

Reflect on and learn from our experiences thus far. Review follow-up data from the RAD Survey, assess progress.  Celebrate!  Identify areas for continued improvement.

Participants

QI Team and Leadership Team, facilitated by Coaching Team

Modes of delivery

Conversational, reflecting on participant experiences using qualitative and quantitative assessments.

Pre-work

Reflect on what you’ve learned thus far from your implementation efforts.  What have you learned about yourself, about others, and about your workplace?

Content

QI Team assesses progress building relational coordination across professional and social identities, and assesses progress toward other desired outcomes.  Assess enablers and hurdles for speaking up, helping others, showing respect for differences, etc. and how you might address those. Help participants to navigate specific professional and social identity differences.  Develop an updated action plan for continued progress.

RAD Learning Lab (starting in January)

Objectives

To share, sustain and spread our learning over time rather than allowing our learning to degrade over time, inviting other clinical units and other health systems to engage in this improvement process. 

Participants

QI Teams, Leadership Teams, and Coaching Teams from all three health systems join this Learning Lab as they complete their first year of work.

Modes of delivery

Conversational, reflecting on participant experiences, and making structured group presentations with updates on a periodic basis.

Content

Support participants in continuing to use the tools and concepts they learned, even when they move beyond the unit where they learned them.  Create an environment for sharing the learning across clinical units and across health systems.

Post-Assessment: RAD Survey (June)

Objectives

Invite our colleagues to participate in the automated final RAD Survey to assess changes in relationships of shared goals, shared knowledge, mutual respect - and psychological safety - among colleagues with different professional and social identities.

Participants

All participants in the clinical unit are invited to respond to the automated RAD Survey.