What do you want to accomplish?
1. Review established roadmap. Review objectives and agree on agenda for session # 2. Facilitate a brief recap and review of accomplishments from last session.
2. Review action plan. Discuss progress on related aspects of the action plan and determine next steps as necessary.
3. Encourage discussion. Provide opportunity for team members to present and discuss their findings related to the audit, staff feedback and patient’s perspective. This information should be placed onto the process-map and used to facilitate the implementation of the process change. Critically review the audit findings and identify gaps in current process. Review staff’s questions and feedback and develop an appropriate response plan.
4. Gemba. Verify appropriate details related to the scheduled Gemba. The team should be appropriately assigned to observe and evaluate the bedside reporting process on the designated unit(s) and group(s) of staff during shift handover. Using the safety criteria as their standard, the team should evaluate the quality of the patient hand-off. Upon completion, the team will regroup to discuss and document their observations. The team should also use the same criteria to evaluate the current reporting process on their own unit and identify gaps accordingly.
5. Identify barriers. Engage the team in identifying potential or existing barriers that would interfere with implementing and sustaining a bedside reporting process on their unit.
Hint: list identified barriers on post-it poster paper and allow for space to document groups’ problem-solving brainstorm.
6. Identify ways to overcome barriers. Divide the group into smaller working groups and engage them in a problem-solving exercise, identifying ways to overcome the anticipated barriers. These ideas will assist with the implementation and coaching process.
Hint: Encourage out-of-the-box
creative brainstorming.
7. Develop an action plan. Review overall session and verify objectives achieved. Develop and agree on an action plan. Determine effective method and manner for providing communication and feedback to staff and agree on how this will be implemented and sustained. Determine and document next steps and person(s) responsible for the completion.
8. Evaluate session. Encourage participants to provide feedback on effectiveness of the working session, noting what went well and what could have been done differently. Utilize this information to optimize upcoming sessions.
9. Prepare for next session. Review objectives for next session and determine steps for preparation as needed. This will include preparation of templates and examples of standard work, reporting tools and clinical scenarios. Examples are included in the resource section of this blog.
Several pilot units were identified for the Gemba. The team observed the pilot units during shift huddle, charge nurse-to-charge nurse, nurse-to-nurse, and health care aide-to-health care aide report. Individuals were assigned specific areas and asked to observe the bedside reporting process and to write down their specific observations for group discussion. This exercise effectively generated ideas and further motivated the group. Lessons learned were added to the “parking lot” of ideas.
