RROHC™ NEWSLETTER SPRING 2010
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"Teams
in combat can't afford to be out of
sync any more than healthcare professionals can, because in either
situation, death
or disability can result."
"It takes a lot more time to communicate
without a plan or shared mental model."
"I often observe the graceful,
beautiful 'dance' of teams in which interdisciplinary team members work
in a
coordinated and seamless manner with patients and families."
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RROHC Revisited Free Introductory Webinar
We continue to offer the RROHC Revisited Free Introductory Webinar on a periodic basis
for those who need a refresher and those who are new to the RROHC program. Following is information on
the next session.
RROHC
REVISITED
Date:
Thursday, May 13, 2010 Time:
9:00am to 10:30am PACIFIC Cost:
Free
To
join the RROHC Revisited Webinar, click on the following
link:
https://www2.gotomeeting.com/join/698098666
To Join the Conference Call, Dial 712-338-7101 Access
Code: 698-098-666 Audio
PIN: Shown after
joining the meeting Meeting ID: 698-098-666
If you are interested in
scheduling a complimentary RROHC Revisited Webinar specifically for your facility, contact Hansten Healthcare PLLC or Kathy
Watkins.
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Shared Mental Models: Swarming to a Cultural Change
Ruth Hansten | Healthcare
organizations must provide better health outcomes. To accomplish that long-term goal, attitudes
and behaviors at the point of care, as well as teamwork, must be
transformed. As your RROHC faculty, we hear
from leaders overburdened with economic challenges, the tempo of techno-change,
and resistance or negativity from coworkers.
Even the most engaged and enthusiastic leader experiences moments of
drooped shoulders and crossed eyes.
Catherine the Great said: "You philosophers
are lucky men. You write on paper, and paper is patient. Unfortunately, Empress that I am, I write on
the susceptible skin of human beings."
Team members may be impatient with us or with the pace of change, and we
are not Empresses who can rule by fiat.
Question: How can we help people
transform THEMSELVES through their behavioral choices? Answer:
By developing and implementing a clear, shared mental model, offering education
on the concepts and skills, along with coaching culture, and by allowing
positive behaviors to develop into "swarms."
Shared Mental Models
We can
learn so much from the field of neurobiology, teamwork studies from the military
and symbolic systems or the information systems world. Teams in combat can't afford to be out of
sync any more than healthcare professionals can, because in either situation, death
or disability can result. As we
developed the RROHC 10 steps or best practices, we knew from empirical
application of education at 160+ hospitals or healthcare organizations, that all
must possess a mental model before they can apply the ideas in their work. We also combined critical thinking theories
that prescribed application of concepts and models to create productive memory
and the templates for clinical judgment. From Case Western and the College of William and
Mary (Druskat, Pescosolido), shared mental models are "theories in
use" or "shared cognition" that can be used with complex adaptive
systems to aid with both explicit and implicit messaging among team members. The psychological ownership, continuous
learning and "heedful interrelating" allow business and psychology to
aid us, as well as the military, in moving toward better teamwork.
Now to the world of Info systems: If we
have shared goals, we then have "joint intention," which works well
in environments where teams must "filter and fuse an overwhelming amount
of information and make critical decisions under time constraints." The "shared understanding of team
structure" [different roles] enable a team member to develop a higher
level of abstraction about capabilities, expertise, and responsibilities."
(Yen, Fan, Sun, Chen et al, Penn State, Volz, R, Texas A and M).
Sounds like RROHC to me!
What Does This Mean
for Us?
It is time to
evaluate whether or not your coworkers have been educated. What do they think RROHC is? Can they name
any of the steps? What kind of education
was offered to them? An hour at
orientation is helpful (better than no training), but will not suffice when we
look at actually changing practice for each individual. Does the RN have an idea in mind about how
s/he sets up checkpoints or huddles for each shift? If not, then how can the RN adequately
supervise the NA? The result: no
psychological ownership and shared understanding. It takes a lot more time to communicate
without a plan or shared mental model.
Hive Minds
Len Fisher wrote The Perfect Swarm:
the Science of Complexity in Everyday Life (Basic Books 2009) about how
intricate patterns grow out of simple rules.
We can learn from other beings:
ants or fish, and how they use swarm intelligence to behave in a way
that their individual actions become "intelligent." The fastest route to the honey quickly
becomes the dominant one. UPS used this
idea when they asked drivers to learn from each other and they discovered that
the fastest route included the most right turns. Applying this knowledge saved UPS 3 million
gallons of fuel in 2006. The TCAB
projects (Transforming Care at the Bedside) allow for one point of care
discovery to quickly disseminate into practice at other facilities. The RROHC program allows simple rules to be
used and adapted at many healthcare organizations. We swarm and learn from each other's
successes. I often observe the graceful,
beautiful "dance" of teams in which interdisciplinary team members work in a
coordinated and seamless manner with patients and families. It looks simple, but took months of developing
shared mental models, clear roles and "rules of the road" regarding teamwork,
and requires ongoing reciprocal feedback.
Time is saved because the positive patterns or swarms have been
developed and are nourished.
For all RROHC leaders attempting to transform culture, the Perfect Swarm would
encourage us to be sure that the simple rules are clear for all members of the
team. Then leaders are free to coach
each individual to discover what best patterns have emerged from experiential
application of the RROHC principles and practices. Skillful coaching allows the individual to
recognize his/her own strengths and challenges, to identify barriers,
successes, and to build on what s/he has identified, always making the choice
to care and engage in the transformation at hand. Measurement of individual skill growth will
soon build, as staff members behave in the same manner, and their collective
actions together form a new culture.
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New RROHC Level 1 Specialist Certification
Guided Self-Study Program Begins Monday, June 21, 2010
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| It's time to start identifying key staff at your facility to join the RROHC Level 1 Specialist Program that begins Monday, June 21, 2010. Up to 37% improvement has been evaluated as a result of participation in this program, and countless on-site problems have been avoided or solved through the six-step critical thinking problem-solving process taught in the program.
Take a look at the improvement in delegation skills pre- and post-RROHC Level 1 certification, as shown on the following graph:
Fees for the RROHC Specialist Level 1 training program,
including instructor-guided self-study, is $475/person group rate
for 3 or more from your facility (or $495/person
single registration), plus textbooks and internal copying of portfolio.
Contact Hansten Healthcare PLLC or Kathy Watkins for
more information, or to register members of your team for the RROHC Specialist
Level 1 Class that begins on Monday, June 21, 2010. |
New Publication: The Nurse Executive's Coaching Manual
For leaders embarking on the journey to elevate
professional practice to world class levels, the comprehensive travel guide has arrived!
The Nurse Executive's Coaching Manual is a must
read for honing the most important tools for healing: ourselves and our
conversations with each other and those we serve. This handbook's encouraging narrative and
conversational tone inspires belief in the reader's abilities to ask the
difficult questions that will lead to growth.
Kimberly McNally | Authors Kimberly McNally and Liz Cunningham
incorporate the theories and themes of great thinkers into step by step, simple
approaches and tools for coaching. Emerging with new skills and sample
questions, we can learn from the field experiences of these expert coaches and
even begin to reconnect with ourselves. Kimberly Cunningham |
We predict that this manual and
the I-COACH Model will become the key encyclopedia and guide for nurses whose
passion is improving health care for our communities! You can purchase your copy of The Nurse Executive's Coaching Manual at www.nursingknowledge.org/STTIbooks (Sigma Theta Tau).
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About Hansten Healthcare
As a healthcare provider, you strive for optimal, individualized,
relationship-based care, along with satisfying working conditions, and
teamwork. As a citizen, you desire superior technical care delivered
with the same compassionate focus and respect, in order to achieve your intended
results.
Hansten Healthcare PLLC provides practical,
exemplary service in consulting, based on decades of rich experience in
clinical practice, leadership, and administration. We focus on the
common building blocks of healthcare services and the systems that
support them.
Our mission is to promote healing and wholeness, transforming
organizations through relationship enhancement and skill development.
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The RROHCTM Program
is a protected copyrighted and registered trademarked program of Hansten
Healthcare PLLC (HHC). If you wish to use our ideas and/or materials, we
would be pleased to provide licensing and/or to register your organization in
our programs in accordance with our fees and pricing schedules. You may not use
our intellectual property or materials unless you are a client of HHC and/or
have obtained express written permission from us.
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