Business Process Improvement: 10 Steps to Dealing with People Challenges

We often hear in the quality improvement literature the following expression: "It's the Process, Not the People" [1]. But with some quality improvement (QI) teams that are experiencing difficulties it is the people that are causing the problem not the process. What is a leader to do?

People by themselves are complex organisms. If you put them together on a team the complexity increases rapidly. The complexity becomes confounded because of the different personalities, trust issues, competing agendas, relationship issues, career desires, differing core values, communication difficulties, lack of accountability, lack of participation, desire for a prominent role, and the need for recognition.

So how does a team leader herd and shepherd this collection of individuals with multiple interacting behavioral issues into a high performing team?

Not all quality improvement team members will be ready, willing, and able to help at the start of the project. Some members are drafted or "voluntold" members and not sure why they are there, others may be willing but are cautious about their level of participation, and others will have the analytic and behavioral skills to tackle the problem and be ready to start the improvement process.

One potential answer is the Tuckman Model [2] of team maturity in working with quality improvement teams. This model shows how a team goes through the forming, storming, norming, and performing stages in their journey to becoming a high performing QI team. Understanding this model will help a team leader mold a collection of individuals into a high performing team. We have observed many times team members who arrive at the initial meeting with no idea of what is expected of them. This makes the launch of the improvement project more difficult than when the members have a clear understanding of what they are going to get involved with, what is expected of them, and their time commitment. This also delays how quickly the team can get to the norming and performing stages.

The team leader is appointed to be in charge of an improvement team; however team members also typically expect the leader to solve their problems of coming together and working as a team. Because of this, many teams focus their initial efforts and time on identifying who is responsible for team process and who is responsible for process improvement. The truth is, everyone is responsible for both components and those who have "responsibility" are a resource, not the holder of the problem.

For a quality improvement team to be able to achieve their goals, members must take full personal responsibility to succeed rather than wait for any others to take responsibility.

Here are ten steps leaders can follow to start teams off on the right foot:

1. Develop a Team Charter/AIM Statement: The sponsor should develop a draft of a team charter/AIM Statement and make the issue a burning one that will resonate with the team members and make them want to be part of this improvement effort. Building passion in team members for an improvement is a key role of the sponsor. The team can finalize/modify the draft of the Team Charter/AIM Statement as they move through the problem solving process.
2. Select appropriate team members: When considering who should be on an improvement team separate the willing and able from the unwilling and unable. The more you can stack the team with willing and able members the greater the chances are that the project will be a success. Tip: Do not settle for those who are available; there is always a reason why they are available.
3. Inform everyone who is either involved in the project or impacted by the project: Initially, it is the sponsor’s role to informthose who are on the team, as well as those who might be impacted by the improvement effort, of what will be taking place and when. This informing process helps to gain as many believers and supporters as you can, as soon as possible. This is the process of continually building support for the team to investigate an issue and make change. Tip: Be sure to keep in touch with project leaders on a regular basis.
4. Develop team ground rules at the first meeting: At the start of an improvement team develop and agree on the rules of conduct for the team and post them where all can see at every meeting. If the group gets off track, the rules often help refocus your efforts. These rules can be modified as the team progresses through the Tuckman team stages since new ground rules may be needed at higher levels of performance. These rules can also be measured at the end of each meeting on a scale of 1 (poor performance) to 5 (superior performance) or strongly disagree to strongly agree. Those at the low end of either scale need to be addressed by the team leader and have the group agree on a remedial plan to improve them.
5. Make sure everyone understands their role: Role clarity should be addressed at the start of the team process. It is important to describe the roles of team sponsor, team leader, team members, and facilitator so everyone understands which role they are in and what is expected of them in that role.
6. Build the trust level of the team: Trust comes about as a team develops an identity.As the team’s identity develops, members feel mutually accountable to one another for the team’s objectives and progress. A team identity helps overcome a lack of commitment and effort, conflict between team goals and members’ personal goals, or poor collaboration.
7. Handle team conflicts in a professional way: Conflicts cannot be resolved when there are heightened tensions and team members make personal attacks or aggressive gestures.
8. Reinforce who is responsible for the team’s success: When team members fail to complete assignments, have poor attendance at team meetings or low energy during meetings, duck out of responsibilities for any number of reasons, or feel overwhelmed by the scale of a problem or a situation, it is important to realize that a problem exists. Whatever the reason, if people fail to take responsibility, they'll fail in their jobs, they'll fail their teams, and they'll fail to grow as individuals. All of this makes it important to address the issue early on.
9. Use a decision making process: A quality improvement team should always follow a defined and tested problem solving process such as PDCA to ensure it covers all the possible steps in the process.
10. Communicate: Use as many visual tools as possible to communicate your progress in problem solving . Share ideas openly and ask for feedback (feedback = commitment). Your group is not a special team of problem solvers. The ones who are not in your group will almost automatically not take interest in your solutions if they feel they are not part of what is going to happen when processes are improved.

Following the above ten steps on how to begin a team correctly will help you initiate a team development process that will help you move through the forming, storming, and norming phases and advance quickly to the performing stage.

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