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Unity is Strength:
The PowerofCollaboration
Kevin Warren
President/CEO
Texas HealthCare Association
Melody Malone,PT, CPHQ, MHA
Quality Improvement Consultant
TMF HealthQuality Institute
Objectives
At the conclusion of the session, participants
should be able to:
 Recognizethebenefitsof forming coalitions for
a common purpose.
 Apply a plan to form a successful coalition.
 Form project teamsfocused on achieving
specific outcomes.
 Implement a project teamfocusedon achieving
a specific outcome.
OurProcess…Today
Project TeamSpecific
Process
Purpose Players
Community Focus

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Benefits
 Resource Sharing
 Knowledge /Expertise
 CommunityPresenceandTrust
 Opportunitiesforcommunitycohesion
 SharedResponsibility(andRisk)
 Collective Leverage /Bargaining
 Mitigate “GroupThink”
“Knowledge is of two kinds. We know a
subject ourselves, orwe know where we can
find information upon it.”
Samuel Johnson, 1775
What’s theGoal?
Improvementof some components,processes,
or outcomes?
OR
Complete systemtransformationtoensure
successeverytime?

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Purpose(s)ofExternal Coalition
Building?
 CensusGrowth?
 Clinical Improvement?
 ReducingRehospitalizations?
 Specializedservice delivery?
 Staff retention/recruitment?
 Policydevelopment?
 CommunityInvolvement/Outreach?
DeterminingtheNeed (“Reflection”)
ConsiderThis…
Organizational Description: Environment, Service Offerings, workforce profile,
Assets, Regulatory Requirements, M/V
KeyCustomers: Their requirements and how do you know?
Competitive Environment: Organizational Position, Success Factors, Data
Sources
Strategic Planning: Your Strategic Challenges / Advantages and why
are they important?
Performance Improvement: How do you measure success/opportunity?
Source: AHCA/NCAL NationalQuality Award
Bronze Application Criteria
Being Effective
 Be specific(purpose,timeline,structure)
 Have a Plan
 Make it Measurable
 Take Ownership
 OpenCommunication
 Feedback

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“What endures is youreffect on other
people and the kind of world, organization
and culture that you've helped to create.”
Jeffrey Pfeffer
Stanford University
Building organizational
momentumthrough
meaningfulrelationships
with front-linestaffas
daily problemsolvers
What wewant is to:
 Maximize efficiencyandeffectiveness
 Retainstaff
 Ensure thatemployeesare fullyengagedon
a dailybasis
 Avoidharm
 Be successful

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Questions:
 Whendidyoulearnhow tobe on a team?
• RedRover, RedRover
• Sports
• School
•Did everyonepulltheirweight?
MoreQuestions:
 Do youhave teamworknow?
• On the floor?
• In a QI team/PIPteam?
• In your leadershipteam?
MoreQuestions:
 What’sthe barriertoteamwork?
• Hierarchy
• Language
• Education/knowledge(formal/informal)
• Shared purpose
• Hidden agendas
• Turnover

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First Things First
 We have tocreate a culture of teamwork.
Let’s watch a movie
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So…
 How easyis it to connect to:
•Individuals
Empathy
 Fuelsconnection
 Perspectivetaking
 Stayingoutof judgment
 Recognizingemotioninothersand
communicatingthat
Empathy
 FeelingWITHpeople
 A vulnerablechoice
 I have toconnectwithinmyself toasimilar
experience
– Dr.Brené Brown

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So…
 How easyis it to connect to:
•Individuals
•Teams
CultureofTeamwork
 To beunderstood,you must first
understand
 InvestingInsidetheNursing
HomeWalls
First Things First
 Create aculture of teamwork
• We can’teat ouryoung– use empathy
• We have tobreakdownbarriers
• We have toforgive
• We have toask forforgiveness

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Successful QI Project Teams
 Needanorganizational culture of quality
 Needasharedmental model
 Have accountability
 Have a blame-freeenvironment
Blame-FreeEnvironment
 Humanerror isnotthe cause of accidents,it
isa symptomof deepertrouble.
 Humanerror isnot random.
 Humanerror isnot the conclusionof an
investigation,itisthe beginning.
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Human Factors
“HumanFactors”is abouthow featuresof our
tools,tasksandworkenvironmentscontinually
influence whatwe doandhow we doit.
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ThreeCategoriesofPerformance
Gaps
 The planitself wasinadequate toachieve
desiredoutcome (planningerror).
 The planis notexecutedproperly
(executionerror).
 There wasa deliberatedeparture from“safe”
practice (violation).
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Movingto a teamculture
 Fuel connections–empathy
 Grow knowledge,skillsandabilities
 Developasharedmentalmodel
 Be a learningorganization
 Coach andmentordaily
Onecaution!
 AvoidGroupThink
• Desirefor harmonyor conformity in the
group resultsin an irrationalordysfunctional
decision-making outcome.
 Watch out for:
• Suppression of individual opinions, and
• Creativethought

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TeamProcess
Team Members
Cognitions
Knowledge
“Think”
Behaviors
Skills
“Do”
Attitudes
Affect
“Feel”
TeamConflict
 Is ita bad thing?
 NO!
 Constructive conflictisacomponentof high-
functioningteams
ResolvingTeamConflict
 Understandandappreciatevarious
viewpoints
 Acknowledgethe conflict
 Discussthe impact
 Agree toa cooperativeprocess
 Agree tocommunicate

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TheSocial Age
Requiresustobe:
 More strategic
 More creative andinnovative
 More solutions-oriented
 And,doit faster!
PIP Team Charter
 Servesasa catalyst
 Givesdirectiontothe team
 Givesprotectionthe teamneedstosucceed
 Communicatestonon-teammemberswhat
isgoingon
PIP Team Charter
 Bringsthe teamtogetherforacommon:
• Mission
• Scope of operation
• Objectives
• Timeframe
• Consequences

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PIP Team Charter
 Project Name:
 TeamLeader:
 TeamMembers(resident/familyincluded?):
 Aim Statement:
 Sponsor:
 Frequency of reports:
 Timelines/deadlines:
 Other (Resourcelimitations?):
Let’s Build a Team
Let’s Build an Action Period

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“It's notwhetheryourglassisemptyorfull,it's
whatyoudo withitthatreallymatters.”
– SueNelson Buckley
About TMF
TMF HealthQualityInstitute focuseson
improvinglivesbyimprovingthe quality
of healthcare throughcontractswithfederal,
state andlocal governments,aswell asprivate
organizations.Formore than40 years,TMFhas
helpedhealthcare providersandpractitioners
ina varietyof settingsimprovecare fortheir
patients.
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About theQIO Program
Leadingrapid,large-scale changeinhealth
quality:
 Goalsare bolder.
 The patientisatthe center.
 All improversare welcome.
 Everyone teachesandlearns.
 Greatervalue isfostered.
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Contact
Melody Malone, PT, CPHQ, MHA
Quality Improvement Consultant
TMF HealthQualityInstitute
214-632-2238
Melody.malone@hcqis.org
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Patient Safety:Nursing Home Team
nhnetwork@tmf.org
1-866-439-5863
http://texasqio.tmf.org
This material was prepared by TMF Health Quality Institute, the Medicare Quality Improvement
Organization for Texas, under contract with the Centers for Medicare & Medicaid Services (CMS), an
agency of the U.S. Department ofHealth and Human Services. The contents do notnecessarily reflect
CMS policy. 10SOW-TX-C7-14-52