By Karen Zeribi

After months of preparation, Shift-Results hosted its first Improvement Design Intensive June in Seattle in June!   We came up with this idea about a year ago when we noted that clients were asking for more support during the challenging design phase of improvement initiatives.  There are so many barriers – time, skill, insight – that get in the way of creating a solid design.  Yet, the design period is the most important to make sure you are making the most of limited resources, achieving results as quickly as possible, and starting your initiative on the right foot with your community.

The idea of the Improvement Design Intensive grew from these conversations, and we became increasingly convicted that this was a great idea.  We outlined plans for a guided experience for a small number of teams, to coach them through protected team time to draft their charters to describe the key elements of the design of their initiatives.   We took a leap of faith in our idea and booked the Hotel Andra in Seattle to make sure that our design teams were well-fed with great food catered by one of Seattle’s most beloved chefs, Tom Douglas.

You can imagine our excitement when teams from Maryland, California, and Seattle signed up for the inaugural Improvement Design Intensive!  We were inspired by their vision for their improvement initiatives to make last changes in the United States education system at multiple levels – retaining special education teachers of color, re-engaging youth in their education through King County’s Open Doors pathways and keeping 9th grade students on track to gradate from high school.   All three teams were operating within a networked improvement structure or were in the process of designing a networked improvement effort.   As we spoke with each of these teams during the application process, we were eager to learn more about their work and most of all, for them to meet and learn from each other!

 

We welcomed our guests on Wednesday morning and each team shared about their initiative and why it is critical to improving outcomes for students in our education system.  The three teams had so much to talk about; it was immediately apparent that they would be important resources to one another. While each team was in a different phase of design of their improvement network, they all had important reflections to share with one another.

Over the course of our first day together, teams worked together to establish how they would work together as a team, wrestle with scoping the aims for their networks (the hardest part!) and designing a family of measures to create a culture of using data for improvement.   We talked about the iterative nature of design and that insights in designing measures will lead to further refinement of the aim.  This is part of the challenge, and why we were there together for 2.5 days!

We ended the first day with one of our favorite topics – learning by doing and Plan, Do, Study, Act Cycles.  Although PDSA is not a new concept (stemming from Walter Shewhart in 1939!), it is difficult to create a network culture that balances implementing effective changes with the freedom to experiment, adapt and learn by doing.   That night, we exemplified learning by doing as we rolled up our sleeves and made pasta together at our Hot Stove Society cooking class! We all got to know each other better as we crafted our very own delicious potato gnocchi, tortellini, and kale salad.

We launched the next day with guest speakers – Conrad Mitchell and Erin Moore – who are active leaders in other networks that Shift-Results supports. Both Conrad and Erin entered their network communities as “patients” or “family of a patient”, roles that are traditionally in a power imbalance with the medical care team that they interact with almost daily while living with chronic and life-threatening conditions.

Erin and Conrad shared their journey from being a patient and a mom of a patient to becoming a leader in their community, who inspires other people to lead and contribute their unique lived experience.  Their advice to teams designing their networks was powerful. One of Erin’s lessons she shared was, “People want to contribute their ideas, they just don’t have a place to do that. So creating that space for them and partnering with them, even if it’s challenging is so critical to the success of the work and learning. And the rewards are so great if you can figure out how to do it in that way.” A few important learning points Conrad shared was, “The diversity of your team is really important. Inclusion is really, really important. You want many different types of voices in there because their different experiences within that continuum helps give you a rounded experience that you can share with people.” He continued, “The most important point that he learned is QI says to start small but what’s even more important is to start.”

Teams reflected on this advice and spent time thinking about whose voices were underrepresented in their planning efforts and how to engage those people to build a better design and create leadership in their network.

Teams returned to the work that they started on Wednesday as they drafted a theory of change for their network with a key driver diagram, a visual that illustrates aims, key drivers (essential elements to accomplish the aims), and changes that the network teams will test and adapt for their contexts. The second day was the most intense part of the Improvement Design Intensive! Teams narrowed in on their collective vision for their improvement efforts and all teams left that evening with draft aims, measures, and a list of changes!   Can you imagine how many conference calls it would have taken to get this far?  Our out of town guests took advantage of Seattle’s free first-Thursdays to visit museums and explore other popular sites in downtown Seattle.

The final day provided the teams with the opportunity to design their structures to learn from each other in the network.  While some networks were to plan regular monthly or quarterly in-person meetings, others were planning how to connect people across the country using technology.  Teams also designed their reporting systems to make sure they had clear processes to manage knowledge and data in their networks.  Coaching time also allowed us to dive into the specifics of each team’s context and think about long term goals – for example, could the network staff run reporting and improvement coaching for the first couple of years, and then build the leadership and skills of district staff to assume this role later?  These are examples of the important strategies to be considering from the beginning to get the most out of your design and hard work!

We ended the Improvement Design Intensive inspired by the next steps of each of the teams.  They shared the essence of their designs in an elevator pitch and convinced us (though we were convinced already) that we wanted to whole-heartedly support their improvement network!

It probably won’t come as a surprise to anyone if we share that we do improvement on our improvement work.  We received so much thoughtful praise for the Improvement Design Intensive as well as great ideas for how to make it even better next time.  We are already rolling up our sleeves to make changes to our design to deliver an even better Improvement Design Intensive with more targeted 1:1 coaching, cross-team sharing opportunities and more opportunities to engage with the content before the session.   We extend our gratitude and admiration for the three amazing teams that joined us in June – we can’t wait to see the amazing things that your network does in the world!

I really appreciate feedback throughout the process and hands on. I appreciate that you all made sure that the space was safe to share and inclusive.

 

Thank you so much for your patient support! Felt like you really tried to understand us, our context, and what we are grappling with. Loved the mix of high-level strategic thinking with VERY practical templates and tools. Well done!

 

Thank you! Wonderful opportunity to work with such experts who could answer ANY question with detailed and thoughtful feedback. The whole experience was at a really higher level than so many training opportunities. You all really know your stuff.

 

The organized time allowed us to move on tasks in a way that was much faster than we would have accomplished without it.

 

With both of your guidance and time to spend thinking about it, I was able to solidify some of my ideas about this process, the aim, the measures, and stakeholders. I was able to translate the dream into some reality and now need to move forward to get the dream team together!!

Please join us for one of the upcoming dates, October 23 – 25, 2018 or February 5-7, 2019!