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Directions In your initial post, After reading the case example,..


In your initial post, After reading the case example, discuss reflection questions that follow.


Teams A and B are asked to develop a process to improve triage and care in the ED to decrease wait times and improve satisfaction of patients and families. At an initial meeting, Team A identifies its core values as innovation, transparency, flexibility, and consensus. Team B’s core values are teamwork, evidence, inclusiveness, and transparency.

Team A: At the second meeting, Team A’s leader encourages the team members to review the data they requested (current wait times, current processes, etc.) and to think about all the factors that slow the process of placing patients in rooms for care (e.g., the length of time in the room, what they do throughout their visit, etc.). Team members are asked individually to list strategies addressing each factor that leads to increased time and decreased satisfaction. After each person shares his or her ideas, commonalities across factors are sought and common strategies are identified.

At the third team meeting, the entire group devises pilot tests of changes that could be implemented and evaluated one at a time. At a fourth meeting a week later, the group analyzes the “cost” of time, effort, and disruption each small test of change would require and decides how to evaluate the effectiveness of each change to achieve the goals of increased satisfaction of patients and decreased wait time. They also decide that provider satisfaction is critical, and incorporate this into their evaluation scheme. Finally, based on these decisions, they prioritize which test of change should be implemented first, second, and so on. This process took 4 weeks, with one 2-hour meeting each week.

Team B: Team B also asks for data on the basis of which to make decisions. Team members spend their time during the second meeting talking about how the data are incomplete and do not capture the entire situation. At the second meeting, the leader asks them to brainstorm about the factors involved and potential strategies. Two members of the group who have worked in the ED the longest, and another member who is in the highest position of authority, speak most often and take notes, while others nod their heads in agreement. When the team leader asks if there are any additional ideas, none are offered.

At the third meeting a week later, one third of the original team does not return due to “time conflicts” however, both of the experienced individuals return and lead the meeting. One new approach to the problem is identified, and it is decided that this approach will be implemented and evaluated. The formal leader thanks everyone for coming and for thinking about how to work so efficiently “within the constraints we had.” This process took 3 weeks.

Reflection Questions

  1. How do you think the core values of each team in the scenario above influenced the way they approached the challenge they were given?
  2. Did any of the core values self-identified by either team as important to them seem less readily apparent to you?
  3. One team took less time to devise a solution, and its implementation of the solution appears as if it, too, will take less time. How do you think the members of each team felt about the experience of participating in this effort? What might be some core values that guided their work together?
  4. Do you think both teams’ approaches are equally effective, or would one team’s approach produce better results than the other’s? Why?