1 The Role of the Executive Sponsor Key Learning from IHI HAI ACTION WORKGROUP Jim Conway Senior Vice President, IHI [email protected].

1 The Role of the Executive Sponsor Key Learning from IHI HAI ACTION WORKGROUP Jim Conway Senior Vice President, IHI [email protected]

2 80% of change efforts fail Warren Bennis & Arthur D. Little

3 Current Theory: Factors that Facilitate Improvement Ideas Will Execution Confidence - Initial success encourages even more ambition Possibilities- Aim connects will to ideas Sequencing-Connect changes to execution skills

80% of Teams make significant progress in 12 months Teams have the will and resources IHI Team develops and customizes learning for participants Teams are actively and transparently engaged in their plan IHI Infrastructure supports programs Primary DriversSecondary Drivers Latest Results Drivers- System Level View Appropriate sponsor supportsponsor Work connects to organizations priorities Right team members Day to day leader devotes time Establishes and maintains a Driver Diagram on the topic with at least a moderate degree of belief the theory will result in improvementDriver Diagram Establishes a sequence of ideas to test based on the theory. Uses a learning system to continuously refine the content Helps teams set customized aims and plans with aligned measures/goals and changes Delivers and coaches on the content one at a time Community/collaboration successfully engages teams, helping to set pace and tempo-meetings and activities conducted with flawless execution Teams test and learn from multiple changes based on a customized plan and reports key measures over time Robust, engaging Extranet/Reporting/Communication system Learning/Oversight system across programs Develop/Support the IHI team V9 4

5 Sponsor The Sponsor is the leader who is responsible and accountable to their organization for the performance and results of the Community improvement team. This person is not a member of the team, but is responsible for securing the resources for the team to accomplish their aim and communicating their progress to other leaders in the organization.

6 Attributes of Sponsor Basic knowledge of improvement Authority to muster resources and remove system barriers in the organization Direct connection to senior leadership Understands that their responsibilities include the success of improvement team Their administrative position and responsibilities are typically aligned with the improvement team.

7 Some Typical Sponsor Responsibilities Building Will for the improvement initiative. Helping select team members. Assisting the team leader in connecting the teams work to organizational priorities (develop a close relationship to team leader) Reach agreement on the aim for the teams work. Working with the team to get the resources it needs (especially support from IT, HR, Finance, etc.). Removing any organizational barriers to improvement. Be aware of how the improvement teams work is affecting the rest of the system Keeping abreast of the progress of the team. Influencing the tempo. Communicating the teams progress to the management team. Developing a strategy to spread the work of the improvement team.

8 Feedback from Sponsors in IHI IMPACT Program Some Strategies to be an Effective Sponsor Use inspiring stories and tell them across the organization to make the improvement really align to organizational strategy. Ok to start small and work up to full role of sponsor. Ability to sometimes just observe and keep quiet at team meetings and do follow-up with team leader. Sponsor may need to hold clinicians more accountable and keep them engaged in the improvement effort.

9 The Purpose of Reviews of Projects by Executives To learn whether the project is on track, or is likely to fail If the project is not achieving the intended results, to understand why: Lack of organizational will? Absence of strong enough ideas for improvement? Failure to execute changes? To provide guidance, support, and stimulus to the project team on will, ideas, and execution To decide whether the project should be stopped.

10 Process of Project Review Pre-meeting Preparation Know the context for the project, and be prepared to remind the team why the project is important, and how it fits into the overall goals and system-level measures of the organization. Read the project report prior to the meeting. Communicate with the project leader to establish a meeting agenda and expectations: review of aim, measures, results, prognosis, ideas for next cycles of improvement

11 Process of Project Review Meeting Itself Start the review by clarifying the aim. Look for aims set at the level of best practice, or raising the bar, rather than more conservative goals. Then ask about the measurements. Look for a few solid measures, well-defined, with comparative data available. Within 3 to 5 minutes of the project review, you should move to reviewing the data. Look for clear graphic displays. Share with the team two to three good elements of the project and provide encouragement. Discuss trends and prognosis with the project team. Are you going to achieve this projects aim?

12 Process of Project Review Meeting Itself (cont.) If Ideas are the problem, ask questions that will stimulate the search for ideas. What ideas do you have for further improvement? Where are you looking for new ideas? Whos the very best in the world at this? How could we find out? Give explicit permission, and broad encouragement, to try small scale tests of big ideas. If Execution is the problem, it is a good opportunity for you to teach good project management and change leadership skills to the project team, and to learn about the larger organizations barriers to execution in its culture, information systems, human resource policies, and other areas.

13 Process of Project Review Meeting Itself (cont.) If there is any uncertainty about the projects prognosis, try to determine whether the failure mode is primarily related to Will, Ideas, or Execution. If it appears that Will is the problem, this is often something that the CEO or other senior executive can make a major impact on.

14 Process of Project Review Finish the meeting by asking: Where do you need help from me? Meeting Follow-up Set a reminder to call or email the team leader in a week, and periodically thereafter, asking for the results of tests of change. Communicate to the team what you have done in response to their requests for help.

15 #1 Predictor of a Teams Success (% 4s) in a Community A complete progress report submitted each month

16 Monthly Team Progress Reports Teams report progress to their sponsors and other Senior Leaders Teams share their progress with other interested parties in their organization Teams share their learning with the rest of the HAI ACTION WORKGROUP Input for monitoring progress of the workgroup

17 Great Monthly Reports Review of Aim and Measures It is clear what changes are being tested and what changes have been implemented Multiple run charts pertinent to the key measures Not more than two pages long

18 Lets Review the HAI Action Group Monthly Form

19 Change Reliability Never Events? N ever take teams into a program if they are not supported by the organizationresources, sponsorship, and knowledge about execution Never start a program without a reasonable degree of belief that the theory will lead to results, an understanding of cause and effect, and a measurement system that works for improvement Never let a team go unattended or work for more than a month with aims that do not fit with organizational priorities, or are not aligned with their measures and changes Never run a program that is unreliable with respect to adult learning principles: engaging, content-focused activities, opportunities for interaction in small groups, customized to needs of participants, and feedback on progress

20 Leadership Actions System-level aims Regular review of progress Removal of barriers to success Intentional development of culture and capacity Regular celebration of achievement

21 Quality improvement begins with love and vision. Love of your patients Love of your work If you begin with technique, improvement wont be achieved. A. Donabedian, M.D

1 The Role of the Executive Sponsor Key Learning from IHI HAI ACTION WORKGROUP Jim Conway Senior Vice President, IHI [email protected].

Documents

success of improvement

resources ihi team

community improvement

improvement teams work

management team

ihi team v9

teams progress

improvement ideas