Hi. We’re Sherry Campanelli, Program Compliance Manager and Laura Newhall, Clinical Training Coordinator, from the University of Massachusetts Medical School’s Disability Evaluation Services. As an organization, we are committed to ongoing quality improvement efforts to enhance our services for people with disabilities. Earlier, we wrote about common techniques that help a quality improvement (QI) team to be successful. Today we share some potholes and pitfalls we’ve encountered in group facilitation and our tips for negotiating them successfully:
- New problems or issues frequently arise in the middle of a QI project. Team members, management, or external events (such as changes in the industry) can generate issues unrelated to the original charge. This can be discouraging for the team members and leader and can delay completion of the project. The following may be helpful.
- Reaffirm the team’s goals, mission, and review data as a group to ascertain if the new issue should be addressed in this venue or in another way.
- Allow team members to opt out of participating in the new task. Seek new members for the team as needed to address the new issue(s).
- Keep a “hot” list of issues that arise to be addressed by future QI teams.
- Recommendations from team not fully accepted. A less than enthusiastic response from decision- makers to a team’s recommendations is a challenge for any team.
- Set expectations with the group up front that recommendations might be accepted, rejected or amended.
- Sustain the group’s enthusiasm during the revision process by reminding them of the importance of their work and input regardless of the outcome.
- Emphasize the positive feedback before sharing constructive feedback. Thank team members for their efforts.
- Ensure that relevant decision-makers are regularly briefed so the team can make “mid-course corrections” toward options likely to be approved.
- Difficulty achieving full team consensus. This can be due to dominating or defensive team member(s), incomplete information or team members needing more time for analysis.
- Encourage subgroup and individual work on the issue between meetings.
- Allow the team to live with ambiguity for a while to enable consensus to develop.
- Document what’s already been decided and refer team members back to prior discussions.
Thoughts to Ponder:
“The best-laid plans of mice and men / Often go awry” – from a poem by Robert Burns. The QI team process does not always go smoothly; however, these unexpected challenges present opportunities for better overall outcomes.
From a motivational poster by the British government in 1939, the facilitator must “keep calm and carry on” through the potholes and pitfalls of the QI team process.
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