Eliminating
Missed HPV
Vaccination
Opportunities:
One Performance
Improvement At
A Time
Toolkit
Antonia Blinn
Massachusetts League of
Community Health Centers
Action plan (WWW)
What:
Action/Commitment
Who:
Responsibility
By When:
Deadline
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What is Process Mapping?
A simple method to
visually display the
various steps, events,
and operations that
constitute a process.
.
Chaos becomes clear.
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When to Utilize Process Mapping?
Process mapping is used to:
• gain agreement on the scope of the project
• better understand the process to be improved
• reveal unnecessary, complex, and redundant steps
in a process
• compare actual processes against the expected
process
• identify steps where additional data can be collected
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Perceptions of a Process
What we think it looks
like:
What we wish it would look
like:
What it actually looks
like:
Do not jump to “What we wish it would look like”
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Steps to Develop a Process Map
1.
Form the appropriate team, gather materials (banner paper, Post-It®
notes, markers, dots) and find a wall space large enough to
accommodate the completed map.
2.
Define the process to be reviewed. Name it. Agree on the process start
and end. The start and end should match the scope of the project
written in the charter.
3.
Determine how complex and detailed of a map you will need to give you
what you want.
4.
Assign symbols:
- Rectangle for steps
- Oval for start and stop
- Diamond for decision
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Steps to Develop a Process Map
(continued)
5.
Identify the process steps

Start by rapidly writing process steps on Post-It® notes and placing them
on the paper.

Write large with one process step or item per Post-It® note.

Don’t worry about order, don’t worry about priorities, just list them!
6.
Now sequence the steps - arrange the steps the way work is currently
done and draw arrows.
7.
Validate the map to ensure it represents the situation as it really is
today. Change the process map to correspond with the physical
process.
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Validate the Process Map
1.
Patient
Calls
TouchTone
Phone?
Automated
System
Answers
Patient
Chooses
Routing
Option
Call Placed
In Queue,
On Hold
Call Gets
Routed To
Voice-Activated
System
Scheduler
Answer
Phones
Call Ends
Are the process steps identified correctly?
Start
End
Task
Review
Or Decision
Direction
2.
Is every feedback loop closed?
3.
Does every arrow have a beginning and ending point?
4.
Is there more than one arrow from an activity box? Perhaps it should be a
diamond.
5.
Is there anything missing?
6.
Do the workers who do the process every day agree that the map reflects
reality?
7.
Ask the questions:
•
•
•
•
•
8.
Patient
Waits?
What happens if…?
What could go wrong?
Who…?
How…?
When…?
Walk through the actual
process with the entire team.
Change the process map to
match the actual process.
Update the map
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Example: Process Map
Baseline Patient Contact Information
Collection Process
Start
Start
End
Task
Task
Review
Or
Decision
Direction
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What is
Change Acceleration Process
(CAP)?
A good technical solution is simply not
enough for success
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Change Acceleration Process
Leading Change
Creating a Shared Need
Shaping a Vision
Mobilizing Commitment
Current
State
Transition
State
Improved
State
Making Change Last
Monitoring Progress
Changing Systems & Structures
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Change Acceleration Process
Leading Change
Having a sponsor/champion and team members who demonstrate visible,
active, public commitment and support of the change.
Creating A
Shared Need
The reason to change, whether driven by threat or opportunity, is instilled
within the organization and widely shared through data, demonstration or
demand. The need for change must exceed its resistance.
Shaping A
Vision
The desired outcome of change is clear, legitimate, widely understood and
shared; the vision is shaped in behavioral terms.
Mobilizing
Commitment
There is a strong commitment from constituents to invest in the change,
make it work, and demand and receive management attention; Constituents
agree to change their own actions and behaviors to support the change.
Making Change
Last
Once change is started, it endures, and learnings are transferred throughout
the organization. Change is integrated with other key initiatives; early wins
are encouraged to build momentum for the change.
Monitoring
Progress
Progress is real; benchmarks set and realized; indicators established to
guarantee accountability.
Changing
Systems And
Structures
Making sure that the management practices (Staffing, Development,
Rewards, Measures, Communication, Organizational Design, and Information
Technology Systems) are used to complement and reinforce change
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Mobilizing Commitment: Why is this
Important?
 Understanding the key
stakeholders whose
support and commitment
will “make or break” the
change effort
 Key difference between
success and failure
Mobilizing the Commitment of Key Stakeholders is
Essential to the Success of the Change
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Mobilizing Commitment Tool:
Stakeholder Analysis
Used For:
 Identifying stakeholders and understanding
resistance
 Developing strategy to eliminate or lessen
resistance
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Mobilizing Commitment
Stakeholder analysis & resistance tool
Name
(Key
Stakeholders)
Issues /
Concerns
“Wins”
Influence
Strategy
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Shaping a Vision Tool:
Elevator Speech
Used For:
Clearly and simply stating the need for
change and describing the future state
Rallying the support and commitment of key
stakeholders
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Elevator Speech
Simple 4-part formula for your elevator speech:
“What our effort is about . . . .”
“Why it is important to do . . . .”
“What success will look like . . . .”
“What we need from you . . . .”
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Communication Plan
Stakeholders
Message
Media
Who
When/Where
(inform, persuade,
influence)
• (written, newsletter, bulletin
board, senior leader memo,
events, meeting one-on-one,
department meeting, all staff
mtg., offsite meeting
Which team
member?
Dates/Times
Announce the
Project
Shaping the vision
Mobilizing
Commitment
(what’s in it for this
group/individual)
Begin to monitor
progress
Changing Systems
& Structures
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Resources and Contact Information
Massachusetts League of Community Health Centers
– Antonia Blinn
– ablinn@massleague.org
HPV Initiative (Join or get on list serve)
– Allison Hackbarth
– Allison_hackbarth@jsi.com
MA Chapter of American Academy of Pediatrics (MCAAP)
– Cynthia McReynolds
– cmcreynolds@mms.org
MCAAP Website has quick links to key HPV materials:
http://mcaap.org/immunization-hpv/
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