By Practice Managers ULT
ALTERNATIVE MEETING FORMATS
Aside from the traditional top to bottom information dissemination, there are other methods that can involve the staff to bring up problems in the efficiency of the clinic and work together in finding resolutions for these problems.
The Following is one of these methods that you can implement easily and effectively.
RAP MEETINGS UP!
By that we mean use the RAP format, it stands for Reflective Adaptive Process, which is an approach to meetings that aims to engage all staff members in improvement efforts. RAP encourages staff to think and act like a team, rather than a loose collective, by attacking problems from multiple viewpoints. This process uses representation and facilitation to engage physicians, nurses, and office staff in the improvement efforts. RAP requires a shift in mindset as it does not emphasize traditional top-down information-sharing but encourages staff to reflect and discuss problems and challenges they are facing at work. The facilitator helps the group use quality improvement, brainstorming, and prioritization techniques to create new, stronger problem-solving strategies. RAP is designed to pinpoint why problem-solving attempts have failed in the past and to save promising new plans from failure. It encourages practices to create a team that consists of at least one representative from every part of the practice, designates a timekeeper and a recorder, and chooses a facilitator who can model effective communication and moderate conflict. Some practices may benefit from rotating RAP team members so that everyone can participate in the meetings.
STEP BY STEP
Here are the steps for implementing RAP in your practice:
1. Create a team: The team should consist of at least one representative from every part of the practice. Designate a timekeeper and a recorder or rotate these roles among team members. RAP teams can vary in size as long as all parts of the practice are represented.
2. Choose a facilitator: The facilitator should be someone who can model effective communication and moderate conflict. The facilitator should keep conversations focused by asking questions like, "What was our original intent when we started this discussion?" Keep in mind that facilitators should play a neutral role during meetings.
3. Establish ground rules: The team, and especially the facilitator, can use ground rules to keep the meeting's topics in focus and avoid counter-productive speech.
4. Establish a regular meeting schedule: Practices often start by incorporating RAP into their existing meeting schedule or by holding a new breakfast or lunch meeting once a week. After a consistent meeting pattern is established and the team has learned the process, many RAP teams meet twice a month.
5. Conduct RAP team discussion: Team members talk freely about problems and challenges they are facing at work. The group then examines each problem from every team member's perspective.
6. Use quality improvement, brainstorming, and prioritization techniques: The facilitator helps the group use these techniques to create new, stronger problem-solving strategies.
7. Identify the top three issues: When the discussion concludes, the group should identify the top three issues using a process such as multi-voting.
8. Develop an action plan: The team should create an action plan for each of the top three issues. This plan should include specific, measurable goals, and timelines.
9. Implement the action plan: The team should implement the action plan and track progress toward achieving the goals.
10. Evaluate the results: The team should evaluate the results of the action plan and determine whether the goals were achieved. If the goals were not achieved, the team should revise the action plan and continue the improvement process.
Appoint someone for the following roles.
Roles within the team:
- Timekeeper: Advises the group of time relative to the agenda, keeps the discussion moving according to the time schedule, warns the group when 15 minutes, 10 minutes, and 5 minutes of meeting time remain, and helps to ensure that the meeting ends on time.
- Recorder: Takes notes, records who has committed to do what, records plan-evaluation strategies, types notes and distributes them, and maintains an archive of meeting notes.
- Facilitator: The facilitator should be someone who can model effective communication
and moderate conflict. The facilitator should keep conversations focused by asking questions. They ensure all parts of the practice are represented, ensures all key roles are filled, keeps the discussion moving, moderates discussion and makes sure everyone speaks and is heard, reminds the group of ground rules, keeps the focus on system-level problems, redirects speech away from territory-policing and blaming, maintains a comfortable environment for open communication, keeps the group accountable by asking who will do what, when, encourages the group by reminding them of past successes, and optionally records key points on a flip chart in front of the group.
RULES
Here is a sample of ground rules that all meetings should follow:
1. Start and end meetings on time. Be prompt.
2. Respect the opinions of others.
3. Avoid side conversations during the meeting.
4. Agree to disagree when necessary.
5. Maintain confidentiality when sensitive issues are discussed.
6. Focus on system-level problems instead of blaming individuals.
7. Refrain from pointing fingers at others.
8. Keep an open mind to new ideas and perspectives.
9. Stay focused on the agenda and avoid straying off-topic.
10. Participate and engage in the discussion.
11. Distribute meeting minutes to keep everyone informed.
By following these steps, your practice can successfully implement RAP and engage staff members from every part of the practice in improvement efforts.
SO GO RAP UP YOUR MEETINGS!
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