Day 4 of Improvement Advisor Training

Day 4 of training and my brain is buzzing... I'm loving all the training on statistical analysis (Shewhart charts, scatter plots and what-not), and applying this to our work and quality improvement projects.

The morning was spent reflecting on our "Strength Deployment Inventory" -- similar to Myers-Briggs indicator, but which I like better due to its focus on motivation -- instead of behaviors. Interestingly, it tests for your motivation when things are going well, and again when you're feeling stressed and in conflict with others.

It reminds me of work with Ralph in business school, specifically in the smaller individual study that I did after his capstone course on Top Management Processes. It really is amazing how differently leaders act in stress or when feeling under attack, and how contagious this is for others on the team.

In fact, much of our work this week reminded me of Ralph and business school -- specifically things like "ladders of influence" and "psychology of change". Other concepts I realized were really fancy words for things I've picked up along the way; for instance, "affinity charts" really just means grouping items together into "buckets" or categories.

Because of this, by far my favorite part of the past few days has been learning about other participants' improvement programs. For instance, a project in Ghana aims to reduce under-5 mortality by 70% by working with nine hospitals with the highest rate of mortality since October 2009. The project focuses on the top three causes of under-5 mortality: birth asphyxia, prematurity, and neonatal sepsis. The main drivers identified for the situation include delay in seeking care, delay in responding to care, and unreliable use of protocols.

Indeed, one of the biggest learnings is comparing and contrasting maternal health in all of the countries that are represented. For instance, one participant talks about the challenges working in Afghanistan, where the rate of institutional delivery is 19%. At the same time, he talks about the influx of women doctors into Afghanistan from Pakistan and neighboring countries since the US invasion -- including his wife. Another participant talks about working in Malawi, where gloves are rationed and doctors often use only one glove during surgery. Or Ghana, where antenatal care registration is a whopping 90%, but where quality and standardization of care highly varies.

This cross-pollination of ideas, challenges, and best practices is definitely one of the best parts of the workshop. Looking forward to going back to India and applying these lessons!