10 - Fundamentals of Workflow Process Analysis and Redesign - Unit 7 - Facilitating Meetings For Implementation Decisions

Fundamentals of Workflow Process
Analysis and Redesign

Facilitating Meetings for
Implementation Decisions
This material Comp10_Unit7 was developed by Duke University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.
Implementation Decisions:
Learning Objectives
1. Describe major health care facility decisions in process redesign
that includes EHR technology
2. Draft an agenda and facilitation plan for a decision making
meeting,
3. Prepare a presentation to communicate findings of a workflow
analysis or process redesign to health care facility decision
makers, and
4. Document those decisions that are made and actions identified in
a decision making meeting
5. Critique a decision making meeting agenda, facilitation plan or
scenario to identify problems and how they could have been
prevented
2
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Fundamentals of Workflow Process Analysis & Redesign
Facilitating Implementation Decisions Meeting
Major Decisions in EHR-related
Process Redesign
Which processes to automate or redesign
Which redesign option to implement
EHR functionality requirements
How candidate systems measure up against
requirements
Process change and system implementation
plans
3
Effective Meetings
4
A single effective meeting will substantially
change the capacity of a group to
achieve desired outcomes (Bolea & Scott, 2012)

Effective meetings:
Face the current reality and gap between as is and
where we want to be
Identify unused potential to improve, and
Commit to action / implementation plan
Health Care Decision-Making
In the health care field, the steps of making a
decision may be remembered with the mnemonic
BRAND, which includes

Benefits of the action
Risks of the action
Alternatives of the prospective action
Nothing: That is, doing nothing at all
Decisions

(Wikipedia, 2012)

5
BRAND Change Matrix Template
PROCESS Benefits
of the action
Risks
of the
action
Alternatives
of the
prospective
action
Nothing:
doing nothing
at all
Decision
Process option 1:
Process option 2:
Process option 3:
7.1 Table Change Matrix Template (courtesy of Dr. Meredith Nahm,
2012)
6
Example Process Redesign
Meeting Might Include
Presentation of opportunities for redesign
For each redesign opportunity:
Rationale for the change:
Pros and cons of each competing redesign options, or analysis of
multiple options to justify the chosen one
Cost assessment of making the change
Decision whether or not to move forward with the change,
if resources were limited, a priority for the change would be assigned.
Review of approved changes and their priority
Next steps
7
Meeting Purpose
to tee up the key decisions along with the
information necessary to make them for the
decision makers
and ultimately, to obtain the decisions needed to
move the project toward successful completion.
8
Practice Workflow and Information
Management Redesign Specialists
Role (as Meeting Facilitator)
Facilitation
Process of designing/running a successful meeting
Practice Workflow and Information Management
Redesign Specialist s role (as the facilitator)
Work with practice leadership to plan the agenda,
Attend to meeting logistics
Provide decision-making materials in advance
Conduct, maybe facilitate, the meeting
During the meeting, present or provide for presentation of decision-
making materials
Gain agreement on next steps

9
Group Decision-Making Process
Process resulting in the selection of a course of
action
Results in a choice
Systems

Consensus
Voting-based methods
Majority required
Plurality
Dictatorship

(Wikipedia, 2012)
10
Meeting Participants Role
Work within the established ground rules
Review decision-making material in advance
Notify the facilitator in advance if additional
information is needed
Provide reality checks, i.e, question options,
rationale and assumptions used in cost/benefit
analysis
Participate in decision-making
Participate actively in the meeting
Complete action items and follow-up as needed

11
Key Elements of Success
Involvement of key personnel
Have thought through potential solutions
Results in ownership of ideas
Solutions
Develops commitment for implementation
Immediate focus on changes which will make
the greatest possible contribution to
improvement and Meaningful Use
Initial implementation planning is begun in the
next steps debriefing wrap-up session at the
conclusion of the decision-making meeting

12
Exercise
A Patient check-in (registration) is shown in a process diagram on the
following slide. Assume the practice leadership wishes to use
consensus among the practice manager, senior nurse, two physician
extenders and the two practice partners as the decision-making style.
Assume that resources are limited and the process changes will need
to be prioritized.

Review the diagram, pause the slides, and
1. Create a meeting agenda
2. List decision making materials needed to make decisions about the
process

Afterward, restart the slides and we will talk through the results.

13
New Patient Check-in: Redesigned
Process
7.2 Figure New Patient Check In. (eQHealth Solutions (formerly Louisiana Health Care
Review) and the Mississippi Regional Extension Center, 2012)
14
Example Topics for Agenda
Introductions

Goal of the meeting and expected
products

Review of documentation of process
analysis and redesign

Summary & next steps

15
Decision-Making Materials
BRAND matrix
Process diagram
16
Meeting Logistics
Making arrangements for the meeting
Scheduling so that necessary decision makers can
attend
Room size and layout
Supplies
Refreshments & breaks
Travel time & parking
Building access
Providing materials in advance such that participants
have time to review them
17
Conducting the Meeting
Open the meeting by stating the meeting purpose
to make decisions on
Review and follow the agenda
Monitor the agenda / time
Encourage participation from all attendees
Help participants reach consensus
Document decisions
Document next steps and follow-up / action items

18
Documenting a Meeting
Key information to be documented
Approved / denied process changes
Priorities for approved changes
Chosen alternatives
Next steps
Action and follow-up items
19
Debriefing Wrap-up
A wrap-up debriefing at the close of the
meeting summarizes the decisions
The purposes of the debriefing are:
To confirm agreement
To agree on next steps to move forward with
implementing approved changes

20
Method Also Apples to the Other
Types of EHR-related decision-
making meetings
Which processes to automate or redesign
Which redesign option to implement
EHR functionality requirements
How candidate systems measure up against
requirements
Process change and system implementation
plans
21
Summary
Identified major types of EHR-related process
decisions
Provided strategies, tools, and aids for planning
and conducting a decision making meeting
Provided tools for documenting decisions made
and actions identified in a decision-making
meeting
Identified professional development areas
related to planning and conducting meetings

22
References
References
Bolea, A., & Scott, B. (2010). Creating effective meetings. Retrieved 2011, from Business advisors.net:
http://business-advisors.net/files/dwnld/Creating_Effective_Meetings_a.pdf
Group decision making. 2011. In Wikipedia.org. Retrieved December 21, 2011, from
http://en.wikipedia.org/wiki/Group_decision_making

Charts, Tables, Figures
7.1 Table: Courtesy of Dr. M Nahm, 2012.
7.2 Figure: Permission for use by eQHealth Solutions (formerly Louisiana Health Care Review) and the Mississippi
Regional Extension Center. 2012

23

10 - Fundamentals of Workflow Process Analysis and Redesign - Unit 7 - Facilitating Meetings For Implementation Decisions

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Analysis and Redesign

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