Rapid Process Improvement Workshops (RPIWs)

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What is a RPIW?

A Rapid Process Improvement Workshop (RPIW) is an improvement workshop that brings together staff  from the organisation or health and care system improve a process. It is a facilitated workshop that helps accelerate an improvement and change to practice.  An RPIW has a fundamental operational goal: to create a more reliable, efficient, patient driven process. If successful, an RPIW can lead to higher quality with less time/energy/resources needed to make the process run. Analysis and redesign are always taken on with the patient as the focal point and patients may/should be part of the RPIW. This allows the focus to be on what would the patient value? What should they expect out of a highly performing healthcare system?  An RPIW is also an educational event. Participants will be given some training in how to understand a complex process in new ways, using tools that can help and to see things in new ways.  They will be positioned to lead further change efforts and act as a champion for improvement.

What are the benefits of an RPIW?

RPIWs are part of cultural change and help to embed improvement into the way we work, they shine a light on waste and allow us to scrutinise any process. They are a catalyst for change. 

The structure of the RPIW process, active participation of all participants, and focus on rapid change all allow for greater success of process improvement initiatives. The benefits of any change are generally immediate and effective, with all those involved fully engaged and enthused by the process, feeling valued and contributing to the effectiveness of their particular area. The process focuses on speed, efficiency, and delivering consistently high quality to service users. The RPIW also gives an opportunity for participants to learn about improvement tools and approaches and try these out during the workshop. Ideally participants then become champions for future improvement work and support for other RPIWs.

What is the format?

An RPIW is a facilitated event that typically runs over five days. Participants are taken through steps of defining the problem process under analysis, mapping its current state and then eventually designing a new, improved future state. Great care is taken during the workshop to incorporate the input of front line employees and patients, as well as to understand the current state of the process by going to the workplace to observe, measure, and get input from those who work within the system on a daily basis. There are several characteristics that contribute to the success of an RPIW:

  1. Daily involvement of leadership. Senior leaders will be involved in the sponsorship of the workshop, and daily in debriefs of the group’s progress to ensure that there is agreement on direction, scope, and that changes evolving are consistent with overarching priorities. Resource needs are also addressed in these debriefs.
  2. A “hands – on” approach: teams will spend a significant amount of time observing and analysing the process first hand. Thus, time is spent in the workplace seeking the input of front line staff.
  3. An emphasis on consolidating change, training, and sustainability – embedded from the start. Significant time will be spent in the workshop facilitating changes by disseminating new practices, training staff in new procedures, and communicating objectives to a broad cross section of stakeholders. Long term sustainability is the goal.

What preparation is needed?

Preparation is key to the success of an RPIW. During this time which usually last between 6 -10 weeks, information is collected from the process that is the focus of the work. Much of this will be from direct observation of the service.

What are the roles and responsibilities of people involved in the RPIW?

The RPIW team is built from a cross section of the workforce applicable to the area of focus. The team structure of an RPIW is strictly adhered to; this enables the correct level of authority and facilitation to implement immediate changes. There is:

  • A Sponsor who will "Champion" the team, provide the necessary "clout" to move things along and remove blockages to implementation of changes;
  • Process owner or owners who will ensure staff are available for the workshop and act as the go-to person regarding the process being reviewed and is responsible for the implementation of the agreed changes to the process;
  • A Workshop Team Leader who effectively runs the workshop during the week, and who does not work normally in the team involved in the process;
  • Team Leader(s) who co-ordinates and organises team activities and assists the Workshop Team Leader, again, who usually works outside the team involved. 
  • Most importantly, are the Team Members, the 'do-ers' of the team who are going to be allocated to either the Home Team or the Away Team. The Home Team will continue work as normal, but be in a position to expedite the changes with immediate effect where required. The Away team will be away from their working environment during the period of the RPIW and will forward changes to the Home Team and provide feedback to the Home Team daily on progress, issues or actions that are necessary;
  • Outside eyes – The RPIW usually includes someone who doesn’t know the process and can ask questions that can really help ‘see’ things from a different perspective.
  • Others – depending on the process that is being improved, outside ‘experts’ may be invited to some or all of the RPIW. They may include data specialists, clinical ‘experts’, someone with a special interest or knowledge of the area, someone who has already made improvements in a similar process etc.

What is expected of me as a participant?

The workshop period is spent dedicated to the event, and typically means stepping out of one’s “day job” for that time for core participants. Some may be asked to be “on call” for the RPIW, meaning that their input is necessary for only part of the event. These staff will be asked to block out time to meet with the core team during certain periods only. Participants will be asked to manage other responsibilities in such a way that their full attention can be provided to the team.  The purpose of an RPIW is redesign and improve. The environment is meant to be one of safe, open discussion. The facilitator will review “ground rules” at the beginning of the event to ensure that all share a like vision of the professional, supportive environment necessary to allow for positive change.

Why is the workshop so intensive? Are five days really necessary?

RPIWs are necessarily intensive for two principal reasons: First, the educational component ‐ a “how to” of rigorous process improvement ‐ is meant to allow participants to apply similar methodologies to other problems in their work environments. In short, they will both “do” and learn.  Secondly, RPIWs are typically focused on processes that are complex, with variation and often have been the focus of prior, ineffective change efforts. Several days to vastly improve such a process and hold the gains is often very little when considered in this way. Many improvements in our health and care system will cross many departments and organisational boundaries and involve staff from many health and care organisations and the third sector.

What happens after the RPIW?

After the workshop RPIW teams are still involved with monitoring and sustaining the new process. Teams will probably need to meet weekly for 1‐2 months to ensure the process is stabilised, accomplish any follow‐up action items, and review the process. Reviews are usually completed at 30 days, 60 days and 90 days to ensure that the new process is being followed and improvements have been sustained.