Step 2: Establish a Team

 

Why a Team is Important:

Improvement efforts require problem solving and figuring out effective solutions that involve complex systems.  The knowledge, skills, experiences, and perspectives of a multidisciplinary improvement team are especially critical because:

  • Systems and processes can be complex
  • Creativity is necessary
  • The path to improvement is often unclear
  • Effective improvements should involve the most efficient use of resources possible
  • Cooperation is essential to implementation
  • Team members have a stake in the outcome
  • Processes involved are often cross-functional
  • No one individual has sufficient knowledge to solve the problem

At times our temptation, out of respect to the busy schedules of our colleagues, may be to work alone (or perhaps with only one other staff member) on an improvement project.

 

tipResist the temptation to work alone.  Quality improvement is truly a team sport.

 

A team may assume many roles; Step 2 specifically focuses on forming improvement teams.  By the end of Step 2, you should be able to list your project sponsor, project champion (which may be you!), and the potential members of your improvement team.

 

Who Should Be on the Improvement Team:

Having the right people on an improvement team is critical to a successful improvement effort.  An effective team needs to be flexible enough to respond to the ongoing challenges of quality improvement. A solid improvement team is typically cross-departmental, interdisciplinary, may serve a single purpose, and may be more informal in nature than an ongoing team chartered for other purposes.  While not all team members need to have prior QI experience or training, the team should have access to resources and staff with current knowledge, experience, and training in quality improvement methodology.

When structuring the team, think about the following:

It is important to stress that the diversity of the team is more important than the number of members

Be sure to include members, who, collectively, are familiar with all the different parts of the system and/or process(es) — managers and administrators as well as those who work in the process, including clinical staff, front-line workers, receptionists and clerks, student affairs, and/or academic partners.  It is important that the team include a diverse group of individuals who have different roles and perspectives on the processes under consideration.

The team should have a clearly identified “champion” who is committed to the ideal and process of continuous improvement. This individual should be interested in building capacity in the practice for ongoing improvement and implementing effective “processes” that will enable improvement. Such processes may include gathering and reflecting on data, seeking out best practices, and engaging voices and perspectives of individuals involved in all aspects of the process/activity under scrutiny. The role of the champion is to ensure that the team functions effectively and fulfills its charter for the organization.

 The sponsor is a person outside the team that gives approval to conduct the project, provides support and direction, serves as a link to senior management,, provides needed resources, reduces barriers on behalf of the team, and provide accountability for the team members. The sponsor also provides the team with assurance that the project is valuable and aligned strategically with organizational priorities.  Many teams struggle because they don’t have a “go to” person when they get stuck, so it’s smart to identify your “go to” person up front.  The sponsor is not a day-to-day participant in team meetings and testing, but should review the team’s progress on a regular basis.

  When deciding whether to involve students or other key stakeholders such as families or other campus partners on your team, it may be helpful to remember that students, partners, and stakeholders define quality.  They can provide feedback about what works due to their unique view of processes, programs, and services.  Involving students, campus partners, or other stakeholders in your quality improvement activities my bring out information that can help contextualize issues and point you in the right direction when determining the root causes of the problem you are trying to address.

tipThe people who do the work need to be the ones to change the work.  

 

Characteristics of Team Members

Thoughtful attention toward selecting members for a QI team is critical to successful improvement. While there is not a specific “how-to” guide for QI team selection, there are some worthy guiding principles to consider. An ideal QI team member:

  1. Represents any discipline and ideally works directly with the system targeted for improvement
  2. Is willing to learn from other team members
  3. Is willing to maintain open communication with staff, leadership, and students
  4. Is willing to assume individual responsibility that contributes to the team’s success
  5. Commits to the success of the improvement project

 

Team Meetings:  Too Busy to Meet?

In a hectic college health setting, meetings can always be cancelled, but they cannot easily be scheduled.  You know from experience the difficulty of accomplishing a project without regular communication and exchange of ideas.  Once your improvement team is formed, set regular, recurring, in person meetings.  Try bi-weekly. You may be able to adjust your schedule during different phases of the project.  Sometimes quick 5-10 minute huddles between formal meetings are sufficient to rapidly problem solve and keep momentum.

 

Managing Documents:  Do We Really Need a Paper Trail?

You never know when you might need to refer back to an early aim statement, graph, or early set of meeting notes.  Sometimes the significance of an idea or product does not become apparent until further down the road.  During your improvement team’s first few meetings, agree on a method for documenting and storing project work.  Preserve work from the beginning as you work through each step of the improvement journey, including all PDSA cycles.

Document using:

 

Improvement Journey Exercise #2

  1. Who is your project sponsor?
  2. Who is the project champion?
  3. List potential members of your improvement team.