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Overview

What Is NIATx. Overview. Mark Zehner, NIATx Milwaukee County November 20 th 2013. Nobody should have to suffer twice. Dave Gustafson. Reduce Waiting Times Reduce No-Shows Increase Admissions Increase Continuation. Original Aims.

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Overview

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  1. What Is NIATx Overview Mark Zehner, NIATx Milwaukee County November 20th 2013

  2. Nobody should have to suffer twice.Dave Gustafson

  3. Reduce Waiting Times Reduce No-Shows Increase Admissions Increase Continuation Original Aims

  4. Every system is perfectly designed to achieve exactly the results it gets.Paul Batalden

  5. Customers are served by processes. 85 percent of customer-related problemsare caused by processes. You must improve your processes to better serve customers. Why Process Improvement?

  6. Small changes create a big difference for both clients and staff. Effective changes don’t have to be expensive Devoting an hour a dayof a receptionist’s time to confirm next-day appointments cost one agency $4,000 per year. The resulting reduction in no-shows increased their revenues by over $400,000 per year. Small Changes, Big Impacts

  7. Change is Hard • As I say, it shall be done • “Yeah, right” • Just hope things are better tomorrow • Chances are they’ll be worse • If we only had more money we would be so much better at doing this • Please, share with us just where that money tree is

  8. What makes this approach to change different? Change is a big experiment No mistakes, no right or wrong Data tells you if the change was an improvement Customer guides change ideas

  9. “For all its macho rhetoric and technological content, reengineering in the end is like any other effort to change the way people work: Culture counts big. Change won’t occur merely because management wills it.” (Title) Name(s) of presenter(s) Organizational Affiliation Stewart, T.A. (1993). Reengineering: The hot new managing tool. Fortune, August 23, 41-48.

  10. Small changes do increase client satisfaction. Satisfied clients are more likely to show up and continue their treatment. More clients in treatment make your work more rewarding. More admissions and fewer drop-outs improve the bottom line. Why Organizational Change?

  11. So, how do you do it?

  12. NIATx Model Tab 2

  13. Process Improvement Model People Change Tools Executive Sponsor Change Leader Change Team aim Walk-through Flowcharting Nominal Group Technique PDSA Cycle Project Rules Use existing resources Sustain the gains Measure change

  14. The NIATx Change Process • Complete a Walk-through • Choose an Aim and set a Goal • Measure the Effectiveness of Change • Select and Test Changes • Sustain the Gains

  15. People Three Key Roles Executive Sponsor Change Leader Change Team Tab 3

  16. Executive Sponsor Has the authority to allocate the resources for this particular project Sees the change/improvement as a priority Identifies the problem and articulates the vision

  17. Executive Sponsor Responsibilities Chooses the change leader Works with Change Leader to identify who will be on the change team Invites staff to be on the team Removes barriers and allocates resources Allows/Empowers the team to make changes

  18. Change Leader Person who feels passionately about the change Able to influence others at all levels of the organization Ability to instill optimism; sees the big-picture; focused and goal-oriented A good sense of humor

  19. Change Leader Responsibilities Serves as a catalyst to develop ideas Successful communicator: facilitates change team meetings, is consistent, concise (data), creative, engaging (incentives), and a skilled listener Minimizes resistance to change Keeps the Executive Sponsor updated on change team activities

  20. What do Change Team Members look like? Front line workers and supervisors in unit where changes will be implemented Other employees impacted by the change People with special knowledge about the changesuch as customers, family members, experts from outside the organization, IT staff…..

  21. Identify possible changes that could meet the objective Decide how to implement the change Create and conduct rapid-cycle pilot tests until goal is achieved Study results to see if the change should be adopted, adapted or abandoned Change Team Responsibilities

  22. Fix key problems Pick a powerful Change Leader Get ideas from outside the organization Use rapid-cycle testing Understand and involve the customer Five Principles

  23. Why a Walk-through? The walk-through… Helps understand the customer and organizational processes Provides a new perspective Allows you to feel what it’s like Lets you see the process for what it is Seeks out and identifies real problems Generates ideas for improvement Keeps you asking why?…and why? again

  24. 1. Agency director or executive sponsor plays the role of client and or family member 2. Inform staff in advance that you will be doing the walk through 3. Encourage staff to treat you as they would a client; no special treatment 4. Think, feel, observe 5. Record observations and feelings 6. Involve staff, get their feedback How to Do a Walk-Through

  25. Strengths No waiting Efficient intake process Positive group experience Friendly staff Opportunities Long intake process Cumbersome paperwork No privacy No family services Walk-through Results

  26. How to begin? Ask 3 Questions: • What are we trying to accomplish? (AIM) 2. How will we know that a change is an improvement? (MEASURE) 3. What change can we make that will result in improvement? (CHANGE) Act Plan Reference: Langley, Nolan, Nolan, Norman, & Provost. The Improvement Guide Study Do

  27. Measuring the Impact of Change:How will we know that a change is an improvement? 1. Define measures 2. Collect baseline data 3. Establish a clear aim 4. Collect data consistently 5. Chart and document progress, including date you implemented a change 6. Ask questions

  28. Making Changes PDSA Cycles Plan the change Do the plan Study the results Act on the new knowledge Adapt Adopt Abandon

  29. Process Improvement A P S D D S P A A P S D A P S D Changes that Result in Improvement DATA Hunches Theories Ideas Reference: Langley, Nolan, Nolan, Norman, & Provost. The Improvement Guide

  30. NIATx Web site: www.niatx.net Tutorial Conference Calls Promising Practices Electronic Newsletter Case studies Learning Collaboratives Technical Assistance and Tools

  31. For More Information • www.niatx.net • Mark Zehner, M.S., • Associate Researcher | NIATx • Center for Health Enhancement Systems Studies (CHESS) • University of Wisconsin-Madison (UW) • Ph: 608-265-6322 • Mark.Zehner@chess.wisc.edu

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