Wednesday, November 11, 2015

"What do you need to let go of in order for your team to make a breakthrough"

There is so much new and useful information in my notebook that I wrote in the front of it my name and cell phone number, and then in a big box with stars around it "Reward if Found", just in case I lose it.

Holy shit. My thinking has been bent. I haven't tweeted all day because I could not turn an ear away from the conversation that are happening even for a moment. Our day started with a reflection on what we accomplished yesterday, revisiting our Lego display's and continuing to think about the problem. If you want to create a transformational solution, you have to accept that you cannot see the solution to your problem from where you are starting (depicted beautifully below, where the dot on the left represents the problem and the dot on the right represents the solution(s)). We are in the process of climbing the mountain and are close to reaching the summit.

The other thing we did this morning was start to turn insights into "how might we" style questions. Here's a couple of the things that our group came up with:

We've done a lot of diverging as a group, spending time with other groups and learning from their expertise and then bringing it back to our own group. The session I attended this morning was lead by Thomas Goetz discussing how we translate data into action. Right now there is so much latent data, data that could be useful to patients or clinicians but we can't get it or can't get it in a useful form. It's just stuff that already exists that says something to you (lab results were used as an example - I can see my cholesterol number, but so what, what does that mean to me?) 

So what do we do about this? Well Thomas shared about the 4 phases of data: evidence, relevance, consequence and action. An example of this outside of healthcare could be one of those electronic speed monitoring signs that tells you your speed as you pass by. "Your speed is" is the evidence, it is what is. "You need to slow down" is the relevance. "The decision to take the risk and keep going that speed and perhaps get a ticket, or slow down" is the consequence. And "What I choose to do" is the action. So if we think about this in healthcare, test results are designed for, at best, doctors, and at least for the patient, the person who needs to act upon it. How might a better design enable a build on that, adding to verses taking away (yes, and). 

Also related to data we talked about The Principle of Progressive Disclosure, where you get to see the highest level of the data and then can drill down into whatever level you desire. An example used here was around the weather. I can see what the temperature is today, right now. Then I can drill into that and see hour by hour, the rest of the day. I can go further and see the forecast for the rest of the week. And we started talking about how might we have access to healthcare information in a similar way, where all of the information exists but I'm able to access it at my pace and comfort level. I was a particularly huge fan of this idea and even more the opportunity for folks to self-identify their learning style and start to receive information in the way and at the pace that is most comfortable to them. I think it could have a transformation impact on patient engagement. 

Organization of data is another issue altogether, with the current trend and tendency to be the creation of a dashboard. Dashboards can be counter productive because it can be so pervasive that you can't understand change. We shouldn't give people a dashboard without giving them a steering wheel. 

So this hour (I know!! It was a LOT for 1hr!) was really just getting input and information from someone who has expertise in a different but perhaps complimentary space to help you think about your problem differently and overcome obstacles. We had to take this knowledge (my new knowledge was from the Thomas Goetz group while my teammates all split and went to other sessions) and bring it all back together to think about our prototype for a transition tool/program/system/we don't know. Some of the questions that we had at this point were how will this integrate with all that we are already doing? How do different transition points build on the next transition point? How might we turn a linear transition plan into a circular one, to identify critical relationships and key levers? We decided (or thought about) how if we could pick 1 point that has the biggest leverage then that's where we should start because it could help to carry several things forward and have telescoping impact with one thing building onto the next. We were considering things like diagnosis as a major and important transition point, and transition to school (preschool and/or college), transition from pediatric to adult care, transition from being a CF patient to being a transplant patient, just as some examples. Then we had lunch and everything changed. 

We had lunch with a different adviser named Ed Porter and he challenged us to think about the piece of this that, if removed, our system would crumble. And all of us sort of went "ah-ha!" because we realized that it wasn't a specific transition that we needed to focus on but rather the key components that make up any transition point and came up with a list that included things like it must have information (we haven't defined what kind yet), it must have collaborative communication, it must solicit perspective from both (or all) parties it impacts, it must include experience and support, it must include empathy and it must include mindful presence. We didn't define these things further at this point, but we started to think more about how we could create a new way to communicate (patients and clinicians) through these transitions points that are disease agnostic, and less about which transition is actually the most important. And after we created this list, then we were rethinking which of these is critical to the success of the interaction, which is our key lever. While they all perhaps "lift", which ones lift 25lbs and which lift 250lbs. The advice we got was to start there. To choose the lever that could have the biggest impact and then test it.

So following lunch, we as a team were to present our new thinking - where are we now - to a group of other teams and advisers. We were also asked to share the questions that we still had, and talk about where we were stuck. We got INCREDIBLE feedback from the rest of the group, questions like "What do you envision this idea to actually be? Is is an online tool? A face to face encounter? Both, and? How are you thinking about whose needs must be met? There is more than 1 person in this service relationship so do you need 3 tools (patient, caregiver, provider) rather than 1 tool? And how might the other stakeholders fill the toolboxes of the groups that they're not a part of (how do I (caregiver) give the provider the tools they need to help me transition successfully and how do they fill the patients box?) This specific example was coming from the concept of groups like Sisters by Heart that send a new diagnosis package to parents of kids diagnosed with congenital heart defects to help them get started on this journey. What a crazy good idea!! We were challenged to think about how what we create now has to be responsive to the fact that time is changing simultaneously - is the creation of this going to be ongoing and dynamic, will there be a feedback loop for continual improvement? Are the solutions we are creating going to be additive or integrative - we have to make sure that we're not creating more work for anyone, and perhaps even think about what already exists that we could derive valuable information from, re-purpose something and see it through a different lens. It was suggested that we focus on impact versus intent, that whatever we create doesn't necessarily have to be measurable, but it must be communicable.

I think that one of the greatest questions posed was what does the community already have to solve the issues of that community, and how do you build on those strengths instead of trying to fix problems. (((drops the mic, exits the room)))). Wow. We had to take all of these new great thoughts and new ways of looking at this back to our smaller working group and identify what it is time for right now, thinking about how our world will organize around what we focus on, and how do we change our focus. How do we choose that starting point? We run experiments, trying more than one option so that we have the opportunity to compare and contrast, to learn. How do we stack the deck in our favor without artificially creating an outcome? We talked about these things for a while as a group, and then ended our day by talking about all of the things that we want to take to 100% (partnership, joy, just for example), and all of the things that we want to take to 0 (fear, frustration, etc). Tomorrow we get more specific with our actual plan, it my mind doesn't explode before then!

The part I glazed over in the middle was the mid-afternoon walk where we paired up with someone that we didn't know. We were asked to find someone in the room (approx 100 people) and pair up and take a 30min walk with them, getting to know them a little bit, and to come back prepared to answer the question "What do you need to let go of in order for your team to make a breakthrough". And through the conversation that we've had over the past few days on the importance of appreciating perspective, I recognized what I need to let go of in order to better collaborate with the team and on the project in order for it to be successful is the mindset I have that if I stop running (metaphorically) that my son will die.

More tomorrow on how this all comes together and where we go from here.

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