Achieving
Commitment
Participant Guide
600 East Superior Street, Suite 404
Duluth, Minnesota 55802
Phone: 218-727-9390
Fax: 218-727-9392
rhrc@ruralcenter.org
www.ruralcenter.org
Table of Contents
About the National Rural Health Resource Center ............................................... 2
Collaboration Toolkit Overview ......................................................................... 2
Modules in the Toolkit .................................................................................. 2
Using Moodle to Enhance your Learning ......................................................... 2
Module Introduction ....................................................................................... 3
Lesson 1: Commitment vs. Consensus .............................................................. 5
Activity 1: How to Spend $1 Million ............................................................... 5
5 Decision-Making methods .......................................................................... 7
Activity 2: Using a Decision-Making Method .................................................... 8
Reasons for Consensus ................................................................................ 9
What if We Cannot Agree? .......................................................................... 11
Lesson 2: Achieving Team Commitment .......................................................... 12
Activity 1: Team Commitment Assessment ................................................... 12
Team Commitment Assessment Debrief ....................................................... 13
Confronting Lack of Commitment and Follow Through .................................... 14
Activity 2: Peer-to-Peer Feedback ............................................................... 15
Insights and Reflections ................................................................................ 17
Appendix – Post-Session Activities ................................................................. 18
Team Commitment Assessment .................................................................. 18
Reading Material for Ensuring Commitment .................................................. 19
Achieving Commitment Participant Guide
1
ABOUT THE NATIONAL RURAL HEALTH RESOURCE CENTER
The National Rural Health Resource Center (The Center) is a nonprofit organization
dedicated to sustaining and improving health care in rural communities. As the
nation’s leading technical assistance and knowledge center in rural health, The
Center focuses on five core areas:
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Performance Improvement
Health Information Technology
Recruitment & Retention
Community Health Assessments
Networking
You can learn more about The Center by visiting www.ruralcenter.org.
COLLABORATION TOOLKIT OVERVIEW
MODULES IN THE TOOLKIT
The National Rural Health Resource Center has developed a six-module toolkit on
the topic of building and maintaining healthy collaborations. While the toolkit
focusses on the specific needs of rural health networks, their directors, members,
and stakeholders, anyone with a desire to build strong collaborations will find useful
tools and instruction.
The modules in the Collaboration Toolkit include:
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Collaborating for Mutual Success
Leading Collaboration
Building Trust in Collaborative Partnerships
Managing Conflict to Create Positive Outcomes
Achieving Commitment
Maintaining Collaboration through Transitions
USING MOODLE TO ENHANCE YOUR LEARNING
Moodle is a learning management system used by The Center. Your instructor will
provide you with instructions on how to access Moodle, and how it will be used to
enhance your learning, collaborate with your peers, and receive constructive
feedback from Center staff.
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MODULE INTRODUCTION
Module Overview
Achieving Commitment is the second of two modules on effective communication.
The first module in this two-part series is called Managing Conflict and
Disagreements to Achieve Positive Outcomes. The series focuses on commitments
in the context of fostering collaborations within and among rural health networks.
Achieving Commitment will help rural network directors discover what they can do
to ensure that network decisions have the level of commitment necessary to
achieve full follow-through and completion of projects, collaborations, or other
results.
Module Goals
Achieving Commitment provides instruction and activities to help network directors
build on the work they did in the module on Managing Conflict and Disagreements
to Achieve Positive Outcomes. A team's ability to work through conflict and
disagreements leads to higher quality decisions, and higher quality decisions
usually result in greater team member commitment.
Module Pre-Work
None
Module Post-Session Activities
Team Commitment Assessment - This assessment measures the degree to
which team members feel committed to the team. Use this assessment to help
develop increased understanding and trust among your team.
Clarification of Team Principles – This a list of ideas for establishing ground
rules for before, during and after meetings. This is an important prevention to
ensure that team members demonstrate commitment before, during, and after
meetings.
Commitment Clarification – A method to ensure that teams leave meetings with
no ambiguity about what they’ve agreed upon.
Cascading Communication – A method to ensure that team members fully
commit to agreements made during meetings.
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Module Learning Objectives
By the end of this module, you will be able to:

Describe the difference between gaining consensus and achieving
commitment. By experiencing a team decision-making activity, you will
determine what contributes to consensus and commitment, and why the
former does not necessarily guarantee the latter.
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Identify appropriate decision-making methods for different
situations. You will learn five decision-making methods and the situations
for which they are most effective.
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Plan for commitment. You will work through potential roadblocks to
commitment by applying tools and approaches to overcome those
roadblocks.

Improve commitment among team members. You will complete an
assessment of team commitment and identify areas for improvement with
your network teams.
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Plan for follow through. Finally, you will work with situations in which
follow through has dropped off, threatening commitment. You will identify
strategies for dealing with those situations.
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LESSON 1: COMMITMENT VS. CONSENSUS
ACTIVITY 1: HOW TO SPEND $1 MILLION
Instructions: Everyone in the session today has collectively been given $1 million.
In the next 5-10 minutes, you must decide how to spend it.
Rules:

You cannot simply divide the money up among yourselves

All of the money must be spent; it cannot be invested or saved

Some of the money must be given away
Use the space below to take notes on your activity discussion.
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How to Spend $1 Million Debrief
What part of this activity, if any, was easy for the group?
What part of this activity, if any, was a challenge for the group?
On a scale of 1-10, how satisfied and committed are you with the decision of the
group?
If you rated your group's decision anything but a 10, what would have needed to
happen (or not happen) to increase your rating?
Would you say your group achieved consensus? How about commitment?
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5 DECISION-MAKING METHODS
Decide and
Announce
Definition: Director makes a decision and announces it to
the individual or to the group
Rationale: Little time to make the decision without adverse
impact. Group is likely to support and implement the
decision
Gather Input
from
Individuals
and Decide
Definition: Director gathers input from individuals one by
one, then makes the decision
Gather Input
from Group
and Decide
Definition: Director calls a group meeting to collect input,
then uses the input to make the decision
Delegate with
Constraints
Definition: Director delegates the decision to an individual
or group with guidelines
Rationale: Need expert opinion of a few people to make
informed decisions. Stakeholder interests are represented
by selected individuals.
Rationale: Many people find this decision very important.
Synergy of thoughts may provide good options. Build
common understanding of a situation.
Rationale: Individual or group has experience and capability
to make the decision in a timely manner. Manager’s time
can be spent in another way.
Consensus
Definition: Director and group reach a decision that
everyone understands, can support, and is willing to
implement. If this agreement cannot be reached within the
time allowed, a fallback decision-making option (made clear
from the outset) is used.
Rationale: Change requires complete understanding and
buy-in. Need expertise of entire group to come up with a
solution. Group is experienced in using consensus.
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ACTIVITY 2: USING A DECISION-MAKING METHOD
Instructions: Circle the decision-making method you have been assigned. Then
identify one real-world situation where you have used or would use this method.
Use the table on the previous page to select a situation that matches the rationale.
Decision-Making Methods: Decide and Announce / Get Input from Individuals / Get
Input from the Group / Consensus / Delegate with Constraints
Take notes in the space provided as you answer the following questions:

How would you go about using the method?

What are the benefits of using the method?

What are the potential drawbacks are there to the decision-making method?
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REASONS FOR CONSENSUS
Definition of Consensus: Consensus occurs when a group reaches a decision that
everyone agrees to, understands, can support, and is willing to implement.
Commitment is the true test of consensus. Degree of commitment, as
demonstrated by follow through, reveals the depth of consensus and the motivation
for modifying ones position during a meeting.
The following are some of the positive reasons why members modify their own
positions and buy into or support the final decision. These are signs of commitment.
Positive Reasons for Consensus:

They agree with most parts of the option toward which the team is leaning

They feel they can let go of a non-crucial element in order to strengthen the
alliance and agreement

They see that several options can get the job done and are willing to modify
their position so long as the final decision does not compromise their values

Even if the choice is not “the best one” (in their opinion or in some intrinsic
sense), it appears to have the best chance of being implemented--being
implemented successfully--because there are so many people behind it

The “best” choice does not meet some key criteria, and, despite excellent
effort and creativity, no one can figure a way around the limits set by the
criteria (budget, time, etc.)

The team agrees to follow up later on some of the elements that could not be
included now
Think of an example where you or another member of your team modified a
position for one of the above reasons. How did that influence the quality of the
decision implementation?
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The following are some negative reasons why members modify their own positions
to go along with the final decision. They may be signs of consensus, but not
commitment.
Negative Reasons for Consensus:

They fear repercussion if they disagree

The team is unsympathetic to their point of view and bulldozes them to join
the group’s point of view

The leader favors a certain point of view and the dissenting member does not
want to appear uncooperative

The sheer volume of opinion persuades the member to “go along” even
though he or she is fairly sure of the “rightness” of his or her ideas; the
member begins to doubt himself or herself

The team is unskilled at listening to contrary points of view, and at creating
or finding ways to accommodate differing needs

The team member is unskilled at expressing ideas and lets go of opinions
because it’s too hard or too embarrassing to struggle with expressing them
Can you think of an example where you or another member of your team modified
a position for one of the above reasons? How did that affect the quality of the
decision implementation? How would you handle these situations?
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WHAT IF WE CANNOT AGREE?
Instructions: Take notes on overcoming obstacles to commitment or achieving
consensus or decisions.
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Agree to Disagree
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"The Freezer"
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Fallback Options

Best Case Scenario

Worst Case Scenario
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The Minor Objection

The Major Objection
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LESSON 2: ACHIEVING TEAM COMMITMENT
ACTIVITY 1: TEAM COMMITMENT ASSESSMENT
Instructions: Use the scale below to indicate how each statement applies to your
network team. Be sure to evaluate the statements honestly and without overthinking your answers.
3 = Usually
2 = Sometimes
1 = Rarely
____ 1. Team members leave meetings confident that everyone is committed to
the decisions that were agreed upon.
____ 2. Team members end discussions with clear and specific resolutions and calls
to action.
____ 3. The team is decisive, even when “perfect” information is not available.
____ 4. Team members support group decisions even if they initially disagreed with
them.
____ 5. When the team fails to achieve collective goals, each member takes
personal responsibility to improve the team’s performance.
____ 6. Team members consistently follow through on promises and commitments.
____ 7. When the team fails to achieve collective goals, each member takes
personal responsibility to improve the team’s performance.
____ 8. Team members value collective success more than individual achievement.
____ 9. Team members focus more on achieving objectives than on merely existing
or surviving.
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TEAM COMMITMENT ASSESSMENT DEBRIEF
Instructions: Discuss the following questions with another colleague in the
session.
What are some possible reasons for either your high or low score in this area?
Was there a time when your team members always followed through on
commitments and decisions?
What are some opportunities to improve commitment and follow through?
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CONFRONTING LACK OF COMMITMENT AND FOLLOW-THROUGH
The class will identify a strategy for responding in a way that helps the individual or
the group move toward commitment. For each scenario, the instructor will ask you
to think about:

What is likely causing this situation?

What is a possible intervention?
1. Team members begin to express concern and frustration that the discussion
isn't going anywhere, and that nothing is being accomplished.
2. A team member shows up for a meeting without having completed his or her
assignment. This is the third time it has happened in the last five meetings.
3. Outside of the team meeting, a team member is heard criticizing a decision
which the team had agreed upon.
For particularly challenging behaviors, you may need to enlist the
assistance of your board chair.
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ACTIVITY 2: NURTURE THE STRENGTHS OF YOUR TEAM MEMBERS
Part 1 Instructions: Ask yourself the following questions about the ways in which
the behavior of each of your team members affects the performance of the team.
Write your responses in the chart below.
What is each person’s uppermost strength or single most important
behavioral characteristic or quality that contributes to the strength of our
team?
Team Member
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Strength
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NURTURE THE STRENGTHS OF YOUR TEAM MEMBERS, CONTINUED
Part 2 Instructions: Starting with the Strength column from the previous page,
plan what you would say to one team member regarding his or her strength. What
examples would you give to support your perception?
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INSIGHTS AND REFLECTIONS
Instructions: Use the space below to write a brief answer to each question.
In what ways can you apply what you’ve learned today to be a more effective
network director?
What strengths as a network director did you learn about yourself today?
What opportunities to improve as a network director did you learn about yourself
today?
What key insights did you have?
What new goals will you sent to help you apply what you’ve learned?
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APPENDIX – POST-SESSION ACTIVITIES
TEAM COMMITMENT ASSESSMENT
Time: 5 minutes for the assessment, 20-30 minutes to debrief.
Purpose: This assessment measures the degree to which team members feel
committed to the team. Use this assessment to help develop increased
understanding and trust among your team.
Instructions: Use the scale below to indicate how each statement applies to your
network team. Be sure to evaluate the statements honestly and without overthinking your answers. See Debrief on next page
3 = Usually
2 = Sometimes
1 = Rarely
____ 1. Team members leave meetings confident that everyone is committed to
the decisions that were agreed upon.
____ 2. Team members end discussions with clear and specific resolutions and calls
to action.
____ 3. The team is decisive, even when perfect information is not available.
____ 4. Team members support group decisions even if they initially disagreed.
____ 5. When the team fails to achieve collective goals, each member takes
personal responsibility to improve the team’s performance.
____ 6. All members of the team are held to the same high standards.
____ 7. Team members consistently follow through on promises and commitments.
____ 8. When the team fails to achieve collective goals, each member takes
personal responsibility to improve the team’s performance.
What are some possible reasons for either your high or low score in this area?
Was there a time when your team members always followed through on
commitments and decisions?
What are some opportunities to improve commitment and follow through?
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READING MATERIAL FOR ENSURING COMMITMENT
Clarification of Team Principles
This is a form of establishing ground rules. You may find it valuable to chart the
discussion of these items on a whiteboard or flipchart, then distribute to all
members. Team members should discuss and come to agreement around the
following issues:

Structure for meetings
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Schedule for meetings
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Acceptable behavior during meetings (e.g., cell phones, interruptions)

Preferred method for communicating outside of meetings
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Timeliness in responding to each other outside of meetings
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Use of common resources (shared computer, schedule, etc.)
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Availability of team members during non-work hours
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Level of freedom in which team members can engage one another’s staffs
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Extent to which being on time is a priority
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Fallback option if consensus cannot be obtained
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Anything else the team deems important
Commitment Clarification
This is a method to ensure that teams leave meetings with no ambiguity about
what they’ve agreed upon.

Toward the end of the meeting (at least five minutes before the end), the
team leader asks “What have we agreed upon or decided today?”

Individuals respond and the team leader writes them down (whiteboard,
flipchart, even a legal pad to read back from).

If there is no agreement, the team dives back into discussion until there is
clarification around commitments and agreements.

Every team member (not just the leader) writes them down.
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Cascading Communication
This is a way to ensure that team embers fully commit to agreements made during
meetings, and to achieve alignment across the organization.

At the end of the meeting (immediately after Commitment Clarification) the
team decides which of the commitments and agreements should be
communicated to the rest of the organization.

Within 24-48 hours, every member of the team communicates the decisions
the team made to their staff members and any other teams they lead.

These are communicated face to face or over the phone – not by e-mail – so
people have an opportunity to ask clarifying questions.
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