Build a Team

a. Assembling an Improvement Team

• Key Players – For many improvement projects you will likely want to include
  1. One or more team members with relevant technical expertise
  2. A representative of system leadership and/or someone who represents day-to-day leadership
  3. Always consider staff nurses, medical assistants, receptionists and clerical staff as possibilities
  4. Part-time care team members, including residents and fellows, who relate to the challenge at hand
  5. Increasingly, one or more patients are being included on improvement project teams, as appropriate

• The Role of A Champion – A champion for your project is important, but doesn’t necessarily need to be involved in the day-to-day work of the improvement team.
• Group Size – In most cases you don’t want an improvement team to be too large. A diverse group of 3-6 people representing different practice roles and expertise can get the job done.
• Motivation – While it may seem to go without saying that it is best to have a core group of people on any improvement project team who are highly motivated to address the concern in question, it is good to remind yourself to take this into account when taking a last look at who you plan to invite.
• When Partnering – If you are partnering with one or more other practices, the composition of the improvement team each practice puts together will vary. In such instances, it can help to focus on learning who performs key functions in each context, even as you consider whether you want to work informally with a group with which you have a relationship, or with a practice organization with which you are affiliated that may be able to provide some infrastructure support for working together.

b. Coordinating an Improvement Team

• Inviting Participation – Invitations to join an improvement team are usually more successful if extended in person on a one to one basis. Your first task is to explain and clarify the purpose of the project you are considering and why an individual’s participation seems essential. This first conversation also provides a good opportunity to sound out an individual’s thoughts, concerns, and potential contributions to the effort (and an early opportunity to address and respond to each of these).
• Technical Assistance – It is important that improvement teams reach out for whatever technical assistance they need along the way, just as you would for a diagnostic or treatment consult.
• Meeting Plans – Clear, outcome-focused meeting plans (agendas) elicit and sustain team member engagement.
• Time Management – Since time is money, it is good to remember that a good meeting ends on time. A great meeting ends early. Consider quick huddles, lunch meetings, emails, texts, and staff messaging in the EMR as ways to facilitate communication. Remember that a mix between cultivating communication and relationships and getting tasks done is needed – the right balance changes over time. Getting work done between meetings is almost always necessary and keeps meetings short.
• Set goals for yourselves by way of short, action-oriented items.
• Track progress and communicate progress to team members continually – visually, if possible.
• Action Plans – It is important to take the time to draw up more detailed action plans as needed.
• Progress Checks – Clear assignments concerning the work to be done between meetings coupled with informal low-key progress checks between meetings conducted in a supportive and enabling way by the team’s leader can be especially helpful.
• Coordination When Partnering With Other Practices – When partnering with other practices, one of the best opportunities for some mechanical advantage can come from conversations you encourage between those playing similar roles and/or performing similar functions in different practices.