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A presentation by Jack Peterson of Peterson Associates presented at the Fall conference for the South Dakota Association of Healthcare Quality 2009
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The Fast Track Approach to Gainingthe Most from Your Team
1
© 2009 J Peterson & Associates, Inc.
South Dakota Association of Quality Managers2009 Annual Convention
September 24, 2009Sioux Falls, South Dakota
Jack L. Peterson, MS, FAAMA, CPHQPresident, J Peterson & Associates, Inc.
Facilitation
Class Roster Pre-testLearning ObjectivesSeminar SchedulePresentation ComponentsGround Rules
3© 2009 J Peterson & Associates, Inc.
Pre-TestIndividual effort, 3 minutes
Group review, individual scoring
Results secret, except for person with highest score
Used to establish learning point of reference and re-enforce important concepts and information
4© 2009 J Peterson & Associates, Inc.
Learning Objectives
Broadly define: “Facilitation” and Principles of facilitation
Discuss features of 5 stages of facilitationDescribe effective decision making traits,
most effective methods for managing conflict and principles of meeting management
Articulate uses of conversation types and levels of empowerment in facilitating decision making
5© 2009 J Peterson & Associates, Inc.
Seminar Schedule1:45 – 2:35 pm
2:35 – 2:50 pm Break
2:50 – 3:45 pm
Pre-testGround RulesFacilitation DefinedFacilitation StagesKnow Your Participants
Gaining ParticipationDecision MakingConflict & ResolutionManaging MeetingsFacilitation Tools
© 2009 J Peterson & Associates, Inc. 6
Ground RulesCommitment
To LearnTo UseTo Teach
ExpectationsParticipate fullyAsk questionsReflect on application to work
© 2009 J Peterson & Associates, Inc. 7
Facilitation Defined
8© 2009 J Peterson & Associates, Inc.
Facilitation DefinedDefinition
Somebody who enables a process to happen, especially
somebody who encourages people to find their own
solutions to problems or tasks
© 2009 J Peterson & Associates, Inc. 9
Facilitation Defined
Role Differentiation: Process vs. Content
Process (How) Methods How relations are maintained Tools being used Rules or norms set Group dynamics Climate
© 2009 J Peterson & Associates, Inc. 10
Facilitation DefinedRole Differentiation: Process vs. Content
Content (What) Task Subject of discussion Problems being solved Decisions made Agenda items Goals
© 2009 J Peterson & Associates, Inc. 11
Facilitation DefinedPrinciples
Maintain NeutralityActively ListenInquire SensitivelyParaphrase for understandingIntegrate ideasKeep team focusEngage members
© 2009 J Peterson & Associates, Inc. 12
Facilitation DefinedJob
Establish the ground rulesControl the environment Bring the issue to conclusion or resolutionCelebrate the successThree Penguins (get ‘er done, change and
have fun!)
© 2009 J Peterson & Associates, Inc. 13
Facilitation DefinedAura
EnthusiasticAttentive and listenFlexible and gain consensusCheck ego
© 2009 J Peterson & Associates, Inc. 14
Facilitation DefinedProblematic Aspects
Listening to respondInquiring of irrelevant issuesSubstituting your words for theirs without
permissionFavoring (advancing) an idea you likeAllowing diversionsDisrespectful or insensitive commentsFailure to recognize, encourage, reward active
thoughtful involvement© 2009 J Peterson & Associates, Inc. 15
Facilitation DefinedFacilitation Core Practices Observation
Sheet Exercise (“Facilitation at a Glance! 2nd Ed., page 26)
Pair up 1 minute per person1st person: select 1 behavior that helps and
explain to partner2nd person: select 1 behavior that hinders and
explain to partner
© 2009 J Peterson & Associates, Inc. 16
Facilitation DefinedFacilitation Core Practices Observation
Sheet Exercise (“Facilitation at a Glance! 2nd Ed., page 26)
Provide feedback – 1 Minute
Did you learn something you had not previously considered?
Were the explanations explanatory?
© 2009 J Peterson & Associates, Inc. 17
Stages
18© 2009 J Peterson & Associates, Inc.
Facilitation StagesDesigning
Initiating
Conducting
Ending
Follow-up
© 2009 J Peterson & Associates, Inc. 19
Facilitation StagesStage 1: Designing
Two-Step StageAssess the setting, issue and participants
(Interviews , Surveys, Emails, On site observation)
Create an agenda Draft and staff with leaders and participants (can be
sample) Request feedback Resolve inconsistencies Publish final (preferably in advance)
© 2009 J Peterson & Associates, Inc. 20
Facilitation StagesStage 1: Designing
Time CommitmentUsually preparation time equals delivery timeFactors Affecting Preparation Time
Length (e.g., hours, days) Complexity (e.g., several established teams, multi-
aspect issue(s) Participants (e.g., 5, 50, 500) Tools (e.g., preparation of new or tailored tools) Research (e.g., new or emerging problem, old
problem with new twist)
© 2009 J Peterson & Associates, Inc. 21
Facilitation StagesStage 1: Designing
Meet with team leader (content expert, senior official)Review agendaReview objective(s)Review roles (including recorder, time keeper)Review logistics
Roomaudiovisual, flip charts, lighting, meals/snacks)
© 2009 J Peterson & Associates, Inc. 22
Facilitation StagesStage 1: Designing
Potential IssuesUse of a template (e.g., focus team handout;
discussed in Stages 2 and 3)Charter (purpose)not well understoodDisagreement between leaders and teamDisagreement among members
© 2009 J Peterson & Associates, Inc. 23
Facilitation StagesStage 2: Initiating
Centering
Meet team leader 10-15 minutes
© 2009 J Peterson & Associates, Inc. 24
Facilitation StagesStage 2: Initiating
Seating (Room set-up important) Least effective: classroom Most effective: tables (seating minimum 4,
maximum 10)
Lighting Adequate to interact, take notes Controllable for slide and video presentations
Room Temperature – temperate
© 2009 J Peterson & Associates, Inc. 25
Facilitation StagesStage 2: Initiating
Barriers addressed Pillars Walls Obstructions to view of participants
Use of Agenda Template (Handout) Two meetings, 1-2 weeks apart 1st for review of issue and preliminary solutions Intervening 1-2 weeks for obtaining buy-in,
conducting any further research, developing draft documentation
2nd for finalization and education material creation© 2009 J Peterson & Associates, Inc. 26
Facilitation StagesStage 3: Conducting
ManagementEnsure members participateKeep to the ground rulesManage any conflicts that ariseUse parking lot for items to be discussed
laterStay positiveStay on course
© 2009 J Peterson & Associates, Inc. 27
Facilitation StagesStage 3: Conducting
Check the Progress (discussions moving in right direction)
Check the Pace (implement ideas quickly; if participants not engaged, ask if pace satisfactory)
Check the Process (Keep to agenda; if participants not engaged, ask whether discussion /tool helpful; or take a break)
Take a Group Pulse (Stay tuned in to group/individuals; reconnect group/individuals, periodically summarize activity)
© 2009 J Peterson & Associates, Inc. 28
Facilitation StagesStage 4: Ending
Use template/format that leads group through phases
Ensure there is clarity onNext stepsWhat decidedWho responsibleWhen next steps/actions due
Create or agree on next meeting agenda and rolesCheck the Parking Lot - revisit if uncovered or
dispose
© 2009 J Peterson & Associates, Inc. 29
Facilitation StagesStage 4: Ending
Evaluate the meetingWere objectives accomplished?Did participants participate?Were tools effective?Improvements?Were meeting arrangements/environment
conducive to participants needs/meeting purpose?
Reward participation and recognize accomplishments
© 2009 J Peterson & Associates, Inc. 30
Facilitation StagesStage 5: Following-up
Team Leader Handles (normally)
Ensures agreed upon actions/activities took place as planned and implementation successful)
Communicates implementation progress, timely monitoring results (1st to participants, then to others)
© 2009 J Peterson & Associates, Inc. 31
Facilitation StagesProblematic Aspects
Team Leader changes or leaves without replacement (and actions or activities remain)
Implementation FailsHandling dysfunctions of a team
Absence of trustFear of conflictLack of commitmentAvoidance of accountabilityInattention to results
© 2009 J Peterson & Associates, Inc. 32
Facilitation StagesTeam Assessment Tool
Lencioni, P: The Five Dysfunctions of a Team: Jossey-Bass, 2002, pages 192-193
See Handout
© 2009 J Peterson & Associates, Inc. 33
Learning About Your Participants
34© 2009 J Peterson & Associates, Inc.
Know Your ParticipantsFirst Steps
Either prior to beginning your work as a facilitator or upon starting, learn about your participants’ relationship
Various scenarios
© 2009 J Peterson & Associates, Inc. 35
Know Your ParticipantsAssessing a Group
Determining the status of the team members in relation to the team
Methodologies Sample questions for functional level @ page 41,
Facilitation at a Glance! If the team otherwise functioning entity, consider
Lencioni tool See Group Assessment Survey tool at pages 42-44,
Facilitation at a Glance!
© 2009 J Peterson & Associates, Inc. 36
Know Your ParticipantsAssessing a Group
Problematic Aspects
Team is comprised of strangers
Team is dysfunctional
Team gets along well, but is mildly dysfunctional
© 2009 J Peterson & Associates, Inc. 37
Know Your ParticipantsAssessing a Group Personal History Exercise:
Work in three’s3 minutes (1 minute to complete, 2 to share)Complete name and 3 questions on handoutShare with partners
J Peterson & Associates, Inc. 38
© 2009 J Peterson & Associates, Inc. 39
BREAK TIME !
(Back in 15)
Gaining Participation
40© 2009 J Peterson & Associates, Inc.
Gaining ParticipationBarriers to participation
Lack of familiarity with material or issueOne or more dominant participantsLack of security about what they have to offerNo buy-in to the issue (do not see as issue)Presence of “senior” staff Personal matter interfering with normal
behavior
© 2009 J Peterson & Associates, Inc. 41
Gaining ParticipationCreating Conductive Environment
Conditions conducive to participation Comfortable space (size, temperature) Well-lighted Furnishings (chairs, tables) Adequate audiovisual (flip charts can be used, white
board) Participants prepared for their part on team Facilitator prepared for his or her part Environment is “safe” Environment is “valued”
© 2009 J Peterson & Associates, Inc. 42
Gaining ParticipationCreating The Conditions
Ensure participants & leader are preparedEvaluate space in advance or discuss
accommodations with person on site, convey needsLearn about your participantsRead the reference and research materialConfirm the issue to be resolvedPrepare for the facilitation (rest, interested,
engagement)Play a game (“Facilitation at a Glance!”, pages 54-
57)
© 2009 J Peterson & Associates, Inc. 43
Gaining ParticipationRemoving Barriers
Break the ice (even if you know them; see resource list)
Engage participants and learn names quicklyNeutralize dominant participants
1st Acknowledge input 2nd Interrupt if needed; call on another 3rd Interrupt early on dominant persons – others
need in 4th Call a break – understand passion, measured
input
© 2009 J Peterson & Associates, Inc. 44
Gaining ParticipationRemoving Barriers (cont.)
Engage quiet members “safely” Begin with introductions (participants and
issue(s))Buy-in to the issue to be resolved – see
activities in “Facilitation at a Glance!, pages 49-50
© 2009 J Peterson & Associates, Inc. 45
Gaining ParticipationProblematic Issues
Room (fixed classroom seating, table too large, room too large or too formal)
Participants reluctant to speak up (senior staff present)
Group unruly
© 2009 J Peterson & Associates, Inc. 46
Decision Making
47© 2009 J Peterson & Associates, Inc.
Decision MakingTraits of Effectiveness
Assumptions are uncovered (by participants)
Conflict confronted
All ideas given fair shake
© 2009 J Peterson & Associates, Inc. 48
Decision MakingConversation Types
Useful in determining phase group is in1. Sharing of Information: reporting2. Perception and Assumption (expressing
impressions and foundations for discussion) 3. Planning (objective, strategy construction) 4. Solving a Problem (discussing to resolve) 5. Building Relationships (team/relationship
building)May necessitate redirection if conversations not
constructive © 2009 J Peterson & Associates, Inc. 49
Decision MakingOptions
Consensus
Compromise
Majority Vote
Subgroup
Leader (or other single individual)© 2009 J Peterson & Associates, Inc. 50
Decision MakingConsensus
IS mutual understanding, “best” answer, can live with it
Is NOT unanimous, everyone happy, “on Board”
RequiresTimeEngaged participationImaginative thinkingOpen mindsCommunication skills
© 2009 J Peterson & Associates, Inc. 51
Decision MakingProblematic Aspects
Poor decision makingAimless conversationsVoting versus consensusTime expiresDysfunctionalAssumptions
© 2009 J Peterson & Associates, Inc. 52
Decision MakingExercise: Nominal Group Technique or
Multi-Voting (one of many approaches)Need a volunteer scribeStep # 1: Individually write down, then state what
you perceive is main reason others are not hereStep # 2: Eliminate duplicationsStep # 3: Letter, not number, the remaining
reasonsStep # 4: Individually, rank order of importance,
numbering each of the lettered reasonsStep # 5: Combine rankings – address next time!
© 2009 J Peterson & Associates, Inc. 53
Conflict and Resolution
54© 2009 J Peterson & Associates, Inc.
Conflict & ResolutionArguments and Debates
Differences of opinion are healthyArguments are not
See Facilitation at a Glance!, page 84 for characteristics of each
© 2009 J Peterson & Associates, Inc. 55
Conflict & ResolutionSome key aspects
Recall body language, tone, inflection
Breath!
Solutions, not problems; future, not past
© 2009 J Peterson & Associates, Inc. 56
Conflict & ResolutionStarters for the Conflictees
“Be aware of yourself” (look in the mirror – issue real, or just “yours”)
“Be aware of others” (trust, high EBA with you, good of group or just care; listening to learn)
Set the scene for cooperative resolutions.
You can’t make people do things they don’t want to do
© 2009 J Peterson & Associates, Inc. 57
Conflict & Resolution1st Approach: 4 Questions
“What do you want?” – the most important question you can ask someone, then listen!
“What are you doing to get it?”
“Is it working?”
“Do you want to figure out another way?”
© 2009 J Peterson & Associates, Inc. 58
Conflict & Resolution2nd Approach – 3 Stages
1st : ask how much really needed; tell their point of view
2nd: let them determine path to take to get there
3rd : empowering – don’t “fix” it for them by telling them how you would do it
© 2009 J Peterson & Associates, Inc. 59
Conflict & Resolution3rd Approach
Allow emotions to be vented (but not endlessly!)
Restructure the discussion to allow for resolution (get to closure and move on)
© 2009 J Peterson & Associates, Inc. 60
Conflict & ResolutionIntervention Strategies
Deciding when to intervene
Is discourse unconstructive, personal, ongoing, circling around repeatedly?
Will intervention cause more disruption? (consider doing nothing)
© 2009 J Peterson & Associates, Inc. 61
Conflict & ResolutionIntervention Strategies
Deciding how to interveneState what you are seeing in behavior State effect behavior is apparently having Ask group/individual if effect is conducive
to resolving issueAsk how we can move onStay positive & don’t “get into the
gutter” with participants
© 2009 J Peterson & Associates, Inc. 62
Conflict & ResolutionHandling Resistance
Can be based onPoor environmentDistrustLack of communication
Rule # 1: don’t ignore it (results in no resolution, even deeper anger/resistance, festering emotions
© 2009 J Peterson & Associates, Inc. 63
Conflict & ResolutionHandling Resistance
Consider:
Invite participant(s) to state why they are resisting
After actively listening, ask for suggested resolution
© 2009 J Peterson & Associates, Inc. 64
Managing Meetings
65© 2009 J Peterson & Associates, Inc.
Managing MeetingsMeetings that do not work: those
Without an agendaUnless topic very narrowly defined, chair
identified, participants know why attending - all in advance
Can still fail due to lack of guidance on the start, run and finish
Attended by unprepared participantsNot leadWithout closure
© 2009 J Peterson & Associates, Inc. 66
Managing MeetingsFundamentals
Create and use an agendaPurposeTopicTime estimatesMethodsDesired outcomesPerson presentingDiscussion process (for facilitated meetings
and can be held by chairman and presenter)© 2009 J Peterson & Associates, Inc. 67
Managing MeetingsFundamentals (Cont.)
Develop process notes
Describe how meeting will be facilitated (tools and techniques to be used)
Describe how participation managed (group discussion, small group discussion, individual effort)
© 2009 J Peterson & Associates, Inc. 68
Managing MeetingsFundamentals (Cont.)
Clarify roles and responsibilitiesFacilitator – processTeam Leader or chairman – contentRecorder – meeting minutes Timekeeper – allotted time
Set Ground rules
© 2009 J Peterson & Associates, Inc. 69
Managing MeetingsFundamentals (Cont.)
Manage participation – agenda to participants, keep on track, keep discussion active
Periodically check status or process – 4 P’sProgress – if none being made or to close out issuePace – discussion is languishing or moving too
quicklyProcess – if tool not yielding desired results or
properly used Pulse –if members distracted or appear frustrated
© 2009 J Peterson & Associates, Inc. 70
Managing MeetingsFundamentals (Cont.)
Take minutes – summaries are best (unlike those in “official” healthcare!)
Decide next step(s) – decisions made, who, what, when (and perhaps how)
Evaluate – improvements (including facilitator); ask if objectives met – improve process
Tools include Forcefield “analysis”, exit survey, formal survey (infrequent) and thumbs up
© 2009 J Peterson & Associates, Inc. 71
Managing MeetingsFundamentals (Cont.)
Set ground rules, such as Attendance Timeliness Confidentiality Interruptions Pagers and phones Respect Accountability Participation
© 2009 J Peterson & Associates, Inc. 72
Managing MeetingsEffective Discussion Process
Start/open discussionExplore ideas on topicAsk for any needed clarificationManage participation process, timePeriodically summarizeTest summary for agreementKeep digressions in checkAttain closure
© 2009 J Peterson & Associates, Inc. 73
Managing MeetingsTechnical Aspects
Tools Flipchart Parking Lot Neutral Position Agenda Media
Use different stimuli (video, audio) More important if a lengthy facilitation Exercises, Small and Large Group Discussion
© 2009 J Peterson & Associates, Inc. 74
Managing MeetingsTechnical Aspects
Techniques Flipchart
Dark colors, not redPrint – and in their wordsAnimatePost
SlidesGenerally few wordsUsed for participant, not facilitatorLeave something to the imagination (omit details)
© 2009 J Peterson & Associates, Inc. 75
Facilitation Tools
76© 2009 J Peterson & Associates, Inc.
Facilitation ToolsVisioning BrainstormingWritten BrainstormingForcefield Analysis (pros, cons)Multi-voting, Nominal Group TechniqueCause and Effect and Fishbone or
Ishikawa DiagramDecision GridsTroubleshooting
© 2009 J Peterson & Associates, Inc. 77
ResourcesCovey, Stephen R. Principle-Centered Leadership. Covey
Leadership Center, 1991Goal QPC and Joiner Associates, The Team Memory Jogger II,
1st Edition, 1995 Bens, Ingrid, Facilitation at a Glance! 2nd Ed.: Goal QPC: 2008Scholtes, P.R. et al. The Team Handbook, 3rd Edition. Joiner,
1996Lencioni, Patrick. The Five Dysfunctions of a Team: A
Leadership Fable. Jossey-Bass. 2002Newstrom, J.W. and Scannell, E.E. Games Trainers Play.
McGraw-Hill. 1980. Newstrom, J.W. and Scannell, E.E. Even More Games Trainers
Play. McGraw-Hill. 1994Oriel Incorporated, The Team Handbook, 3rd Edition. 2003
© 2009 J Peterson & Associates, Inc. 78
Contact InformationContact InformationJack L. PetersonPresidentJ Peterson and Associates, Inc.Suite A506 Autumn Willow WayEl Paso, TX 79922-1858
Phone 1-915-203-3606Facsimile 1-913-832-9597
www.jpandacorp.com