What is Process Triage? ......................... 2 Why Process Triage? .............................. 3 Process Triage Roles & Responsibilities
• Executive Sponsor*........................... 4 • The Host*...................................... 6 • Team Leader.................................. 8 • Team Member................................ 9
After the Triage Workshop........................ 11 Venue Requirements............................... 13 Workshop Readiness Checklist (Download ) 14 * Frequently the same individual. Process Triage® Support Contact: Joseph (Rosey) Rosenberger Consulting Facilitator Process Triage LLC Mobile: 913-269-3410 US Central Time Text message first please, include your name + “triage” mailto:[email protected]
Process Triage – What is it? A fast, results-focused process and team improvement protocol
A Medical Triage assesses patients, determines how severe their injuries are and then treats them in the right order within available capabilities.
In Process Triage, our patients are business processes and instead of injuries we have inefficiencies and other types of pain points to assess and direct remedies.
At we leverage your staff’s expert process knowledge and some mathematics to triage one or more of your business processes.
Following our triage workshop guide, we choose your process (the patient), select your triage team members, and then facilitate them through the triage workshop. We’ll identify and prioritize a slate of improvements to launch immediately and outline the business case for any delayed opportunities.
Triaging develops your continuous improvement culture. A continuously learning and improving organization excels in two things; top-down direction that focuses on both the customer experience and resource stewardship and tactically savvy improvements driven by front-line experts from the bottoms-up.
Triaging syncs top-down strategy with bottoms-up execution quickly and thoroughly. A day of triaging yields 90 days of focused business and process improvement.
Triaging launches great teams. Triaging is a superb team launching tool. Triaging’s highly interactive, collaborative nature requires fact based, business-focused conversations. Newly introduced team members reveal their expertise that, in turn, builds respectful professional relationships. The objective facilitator keeps conversations focused on the task and hand.
These focus points ensures your success. Your facilitator welcomes your time to discuss them further as needed, and looks to you to perform these points to the best of your ability.
Triaging finds workable improvements. When your front-line high performers understand your overall strategy, they’ll make improvement suggestions if they know you’ll resource them. Since the triage protocol begins with your strategic intent, every improvement action item or project proposal has strategic fit.
Triaging outlines your business case for more resources. Smaller improvements and the plans for bigger improvements that cannot be delivered in 90 days are called Not Yet’s. Each Not Yet includes a level-of-effort estimate. Considered together, the stack of Not Yet’s feed your business case for additional resources that, if acquired and allocated, accelerate progress toward your objectives. Skip-level senior executives who observe the second half of the triage are pre-sold on such business cases.*
Triaging exposes potential leaders. Great executives, among many skills, are especially good at recognizing talent. Triaging exposes highly imaginative individual contributors who must persuade their peers to prioritize their improvement proposals. Executive sponsors often clear their calendar to observe the second half of triage workshops to both find these individuals and sharpen their own situational awareness.
Triaging improves situational awareness. High performing employees are willing to “fall on their swords” over principles or proposals they deeply care about. Yet sometimes their passion is misdirected because they lack the big picture. Process triaging broadens their perspectives and clarifies what’s most important to fix.
Triaging fosters good staff work. Triaging is philosophically grounded in The Doctrine of Completed Staff Work. The triage protocol begins with the host’s strategic direction and limits its scope to what the expert team can influence. These recommendations are based upon expert knowledge, and present clear, actionable courses of action.
Decide how triaging workshops support your management philosophy. It easy and almost trite to say you are committed to continuously improving your business. Who isn’t? But actually empowering your front-line experts, who perform your critical processes, to offer and lead improvement changes with your money requires a lot of mutual respect and trust. That respect and trust comes from a shared situational awareness of how a critical process is performing relative to your business objectives. Process Triaging delivers that situational awareness and presents your expert team an opportunity to show your where and why the process’s design or execution must change, including the size and priority of such changes. If you want tactical improvements to be identified and driven with bottoms-up buy-in, the Process Triage approach is a perfect fit for you.
Decide how much authority you want to delegate to the triage team. The Process Triage protocol requires you delegate some things. By simply selecting a triage team member, you grant them the privilege of defining what the process is for triaging purposes, including describing its performance capabilities. You grant them the gravitas to say what what’s hindering your objectives in pointing out points-of-pain. You trust them with sizing and scoping the action items and projects that will remove these point-of-pain. You’re trusting their judgment when they rank and prioritize these proposals. Executive Sponsors understand this and typically welcome this sort of empowerment.
When it comes to assigning and scheduling these proposals for completion within the next 90-days however, they are now allocating resources. That resource allocation is a different kind of delegation that takes on management responsibility. You have three choices:
• Low delegation: Do not attempt to assign or schedule the ranked proposals. As long as you support their highest priority proposals, or explain why you cannot in compelling, fact-based terms, but do support others, your triaging will serve you well.
• Medium delegation: Allow them to assign and schedule the ranked proposals, stipulating will receive these as a recommendation – good staff work, but are not bound by them. You will certainly support what fits in your portfolio of responsibilities and discretionary budgets.
• High Delegation. Have them assign and schedule the triaged proposals, grant them budget guidance and assign the necessary staff work time to refine and confirm the triage ranking and assignment results. Approve their completed staff worked proposals. This is essentially empowering a self-managed team.
Reserve enough budget to support the triage results. The Process Triage workshop delivers a prioritized stack improvement proposals in two sizes; a one or two person, action-item size Small Now and a larger team effort, project-sized Big Now. They are forced ranked by their highest value to your customer, your financial bottom line, and your personally stated strategic direction.
Regardless of whether or not you let them assign and schedule the proposals (see the previous discussion point), it is absolutely essential you back their highest value proposals with real, budgeted resources. The risk of conducting a triage session that requests they tell you what to focus on and then you not to support it will destroy the team’s willingness to offer suggestions in the future.
Decide how you’ll use Small & Big Now assignments for staff development. The prioritized list of improvement proposals are excellent task assignments for developing your staff. Consider pairing up a younger high-potential employee with a seasoned “triaging-grade” expert to grow their skills and honor your triage team members.
Always observe the second half of triage sessions. Assuming you have a subordinate serving as the triage session’s Process Triage Host, this host will come to you to resources any opportunities the triagers don’t have bandwidth for. You’ll understand the context when your host delivers a completed business case.
A process triage session is a skip-level team meeting that is entirely focused on understanding how to implement your objectives. The triage’s first half does not have any deliverables you could not be briefed on by the team leader in much less time. The second-half work of identifying points-of-pain and sizing their solutions sharpens your situational awareness regarding people, process and technologies.
Schedule follow-up progress reviews. The more you pay attention to triaged proposals, the more devoted your triage teams will be to delivering your objectives. When they see you’re maintaining your focus, they’ll maintain theirs.
Publicly announce triage-driven resource allocations or policy changes. When your triage team sees you publically support their triaged recommendations with real budgets or policy changes, you solidify their confidence and professional trust in you. By doing so you demonstrated your confidence in them to take fact-based risks on your compass heading.
Publicly celebrate triaged proposal accomplishments. When you celebrate a proposed improvement’s completion that came the triage session, the informal leaders who comprised your triage team will, themselves, gain more respect and confidence and deliver higher levels of performance.
Process Triaging does not fix things, it finds what to fix next. It improves situational awareness for a moment – which is good, but its value is how it focuses your team to fix the right thing first.
The Process Triage Host How to get the most from your workshop
Know your destination. Your first responsibility is to define and articulate your process’s role in your overall business plan and objectives.
At the mid-point of the triage, after your team has completed the wall work (mapped and marked it up with performance notes) you’ll personally review your destination with them†, described in terms of what the process must be capable of doing by a certain date.
Typically this goal is expressed as a measurable objective in speed, a financial or market size metric, a product or service quality level, or volume of work.
The familiar S.M.A.R.T. format is a good model for expressing objectives.
Select the best triage team members. They need to be hands-on familiar with the process and its infrastructure on a daily basis. They must know the details of how work gets done with the tools and talent available so they can anticipate your objectives’ impacts and opportunities. Make sure every significant work product or deliverable within the process is represented by at least one content expert and one infrastructure expert. The same expert often wears both hats. Sometimes this knowledge takes two people, such as a computer program user (not the program’s design expert) and an expert from the IT staff. Typically one content expert covers several steps or deliverables in the process.
Select the team leader. The team leader is your first among equals team member; not necessarily a manager or supervisor unless they are this process’s expert in their own right. Consider appointing a high-potential junior team member as a professional development exercise.
The Team Leader is responsible for the Workshop Readiness Checklist (WRC). They are your triage workshop project manager, by any other name. The WRC lists the entrance criteria that must be met to have a successful triage experience. Review it with them and assist as needed.
The team leader represents your interests when you’re not in the room. He/she assists the facilitator by deciding whether or not a discussion topic should be allowed to continue or parked for later. They help with other team-related requests the facilitator may require. When it is time to rank and prioritize the Small Now’s and Big Now’s (action items and projects that address pain points), your team leader may be asked to break tie votes.
Observe the second half of the triage if at all possible. After you stand tall and declare your goals and objectives with the clarity and panache, the team identifies points-of-pain the process has
now or will have as they pursue your –- now their goal. Each pain point will be proofed to make sure it’s relevant, so listening to the nominator’s justification improves your situational awareness.
Because points-of-pain are the top three or four from each team member’s viewpoint, duplicates cluster on the map. These clusters generate additional discussions worth listening to. Your presence reinforces that you’re actively listening to their insights and perspectives.
After all the pain points are proofed, each one is targeted for removal by a Small Now action item-size task or a Big Now project-size proposal – short-handed to Smalls ‘n Bigs. These are two of the three triage sorting categories. Your situational awareness increases in detail as you watch (not assist!) your team make these assignments.
Watch how they interact, debate, demonstrate expertise, and achieve consensus. You’ll have good development topics for your 1:1 mentoring time later.
Tailor the ranking criteria for the Smalls and Bigs. The Small Now action item and Big Now project proposal worksheets are spread out side-by-side and then force-ranked (no ties) three times. The first ranking pass selects which Small or Big matters most to your customer – called its Moment of Truth Value. The second pass ranks them by the impact to your bottom line, called Use of Cash Value. These ranking criteria also work well in more specific terms. For example, the Use of Cash might be dialed in to Use of Labor Resources if labor is the primary way the process consumes cash. As long as the first ranking reflects value to your consumer and the second reflect value to the investor, the triage protocol works.
The third and final ranking pass prioritizes on your objective – so that may not change.
Decide beforehand how you will handle the scheduling and assignments of Smalls and Bigs. The last triage protocol step is to schedule and assign the Small Now action item or the planning (only the plan!) for Big Now projects, if they can be completed within 90 days at current workloads. Any Small or Big that cannot be scheduled is flagged a Not Yet (the third triage category). You’ll want the team leader to emphasize your expectations if you are not present.
Here are your two options:
1. The Team’s scheduling and assignments are FINAL ENOUGH.
This is affirming or declaring your triage team is, for all intents and purposes, a self-managed team. They have the skills, resources and authority to deliver any Small or Big Now they schedule and assign. Your management responsibility is to accept their triage findings as completed and approved staff work.
2. The Team’s scheduling and Assignments are NOT FINAL
This affirms their rankings, scheduling, and assignments are their recommendation in the spirit and fact of completed staff work you will respectfully consider and modify based on everything else on your plate – and theirs!
These six focus points ensures your success. Your facilitator welcomes your time to discuss them further as needed, and looks to you to perform these points to the best of your ability.
The Process Triage Team Leader Tips for your success
It’s a compliment from the host. Your workshop host has appointed you as the first among equals during the triage workshop. Congratulations! You’re on point for the team similar to a lead sled dog; you set the example in energy and focus for others to follow.
Own the Workshop Readiness Checklist. The process triage’s success depends upon how well it’s planned. The Workshop Readiness Checklist – the WRC lists the necessary entrance criteria. Help the host complete the items. You’re welcome to compare notes and ask questions of your triage facilitator. Work with your host to select the best process content experts. The ideal team member is one who lives with the process you’re triaging on a daily basis and understands, not just how things work well, but how things break or fail.
When you help select the team members, avoid non-expert observers. This is not a training venue, and some process points-of-pain merit some confidentiality between experts to identify and discuss freely.
Represent the host. Understand your host’s strategic objectives or goals for the process you’re triaging. These are typically some improvements in speed, total cost, customer satisfaction, or a measurement of quality. Help your team keep this compass heading in mind, especially during the triage’s second half when the team’s work products must stay true to these goals.
Represent the team. While your expert team members can speak for themselves on matters related to their expertise, if something needs to be said on behalf of the team, such as “We agreed on “X”; the facilitator looks to you for such remarks. The facilitator will probably ask you step up to the mapping wall and explain the process to guests and other executives as needed. No need to be shy; the facilitator uses the moment for coaching and helps you through the process. After the triage is over, someone must be able to explain the map to others.
Assist the triage facilitator. Depending upon the triage facilitator, you may be asked to make notes on a flip chart or contact a process content expert to get them on the speaker phone to answer a question. The facilitator may ask you to break tie votes when it comes to prioritizing and assigning action item-size Small Now’s and project-size Big Now’s.
Along with your responsibilities as content expert team member, consider the above focus points for a successful team leader result.
The Process Triage Team Member How to get the most from your workshop
Your invitation is a compliment from the host. Your workshop host has recognized you as a process content subject matter expert. Your host not only welcomes, but depends upon your insights the process triage offers. Your judgments about what process changes will be needed, when they’re needed must guide the innovations necessary to meet business objectives. Expect a challenging and rewarding journey.
Your expert knowledge is enough. The Process Triage analysis method requires a triage team that has hands-on knowledge based on daily integrations in the process. Your awareness of what the process comprises – its design, rules, tools and technologies, and people skills must be practical, pragmatic, and fact-based. Exactly what your already know.
You’re welcome to bring process notes, diagrams, and performance scorecards – whatever helps you contribute to the triage. Check with your Team Leader to determine if pertinent documents should be shared or reviewed with the triage facilitator beforehand. There will be a shared folder for them‡.
Understand the purpose of process triaging. The most important process triage result, from an expert team member’s view point is that it enables those who must live with necessary process changes to actually define and drive these changes – to own them, consistent with the executive’s stated objectives. Triage team members also scope and prioritize the efforts these objective-supporting changes require. Your observations help the executive allocate available resources immediately, and fetch more resources for delayed improvements.
Another important benefit is shared between team members. Each team member is situationally aware of the nature and urgency of what pain points must be addressed and who they impact. Team members as a group recognize what problems and opportunities must be dealt with immediately, and which ones must wait for more resources.
Identify Points-of-Pain with Measurements. The host will review your process’s business objectives mid-way through the triage. You’ll then offer your top three or four observations where you see or expect to see the process struggle or fail. These are called points-of-pain. Describe these pain points in as specific, measurable terms as reasonable, avoiding generalizations. For example, the directional but vague, “Too many bad addresses.” Is a less actionable point-of-pain than the more specific, “34% of the addresses have street address errors.”
The reason you’ll want to be as specific as possible has to do with what you do with the pain points after we verify they are indeed relevant to the objective. Each one will be addressed by an action item-size Small Now or a more complex, project-size Big Now. Pain points described in crisp, specific
measurements are more likely to drive Small Now’s, and Small Now’s are relatively easier to fund and accomplish. Vague points of pain that suggest Big Now projects encounter funding resistance, no matter how high their priority.
By the way, do not collaborate with others about your pain point. While it is tempting, it suppresses pain points that would otherwise merit attention.
These focus points will ensure your success. Your facilitator welcomes your time to discuss them further as needed, and will look to you to perform these points to the best of your ability.
Process Triage – Then What? What happens after the workshop
Review the triage results. The triage nominated, prioritized, and (if it was in scope) assigned and scheduled Small Now action items to be completed and initiated planning for Big Now projects. Unassigned Small and Big Now’s tagged with a Not Yet cover sheet await resources or another Small or Big Now to complete first. Every Small and Big Now, if implemented, advances the team toward their process’s objectives.
All triage participants, including the executive sponsor, host, team leader, and team members – all are on the same page. They understand the host’s objectives in practical terms. Those who know the process best agree on what improvements all should focus on first, then next, and so on.
Complete block #4 of the Small / Big Now Worksheet. Triaging is designed to make excellent directional recommendations with a simple scope and priority choices – action item or project; now or later. This may not be rigorous enough to “green light” the Small or Big Now immediately.
Working from the top priority Small or Big Now, make a few notes about additional staff work, if any, needed to understand the deliverable. We recommend an economic cost-benefit estimate, however approximate.
Who completes Block #4 is the Host’s decision. Some assign it to a junior team member with senior mentor for staff skill development. Some do it themselves because it involves executive responsibilities such as staffing or business model changes, or it’s faster or, so they’ll understand the deliverable better in order to explain it.
If Block #4’s completion discovers a material change in scope that merits revisiting its ranking, choose the best way to change the rank. Here are your options:
• Preferred: Don’t re-rank until the worksheets are fleshed out (see talking point #3, next). • Acceptable: Have the team huddle and re-rank one more time based on Block #4’s information. • Beware: The host granted the team some authority to prioritize improvements if assigning and
scheduling was included in the triage. Changing their decisions should involve them with the same respect granted previously.
Flesh out the selected Small and Big Now’s. If a Small or Big Now’s meaning or scope lack enough clarity to assign and schedule it, then complete the staff work to make it so.
Consider assigning this staff work to a junior team member, along with a mentor coach, for staff development.
Integrate the Small and Big Now’s into the larger organization’s improvements queue. If the triage was one of a series of triages to launch or update a larger organization’s improvement efforts, hand them over to the improvement program management office (PMO). The PMO should announce any changes in priority or schedule based on the organizations’ custom.
If the PMO has not integrated Process Triage-generated projects before, it behooves the host to explain to the PMO how these projects were nominated, ranked, and presented, and how changes or modifications should be announced.
Publicly Celebrate Completions and Funding Not-Yet’s. A Process Triage event fits within a decision cycle. There are several decision cycle models, such as PDCA, OODA Loop, or DMAIC. All of them include the completion of some action, observing its result, then continuing the cycle.
An efficient and effective organization excels at understanding its environment. The organization acts proactively to shape its environment and reacts to protect itself or exploit opportunities. When the organization acts or reacts successfully, it celebrates and reinforces such behavior. As the triage team accomplishes a Small or Big Now -- reinforce their post-triage follow through!
Hosts who acquire additional resources to put Not Yet’s in the schedule queue should announce it. This is like pouring gasoline on a fire; the team will understand, in real terms, that their triaging effort helped gain additional resources to do what they said needed done.
Schedule the next (even faster) Triage Workshop. The off-the-shelf, standard triage fills a 90-day bucket with Small and Big Now deliverables. The list needs refreshing and re-prioritizing at some point, usually longer than 90 days for first-time triagers.
Next, and subsequent triage updates go faster, typically half the time. The ACTION>RESULT Map changes very slowly as it is designed specifically triaging; it is a what map, not a how map, and what the process does is quite stable.§ Returning team members’ familiarity with triaging decreases this time further.
Schedule the first triage re-fresh 90 days from the first and expect to push it out if progress on the initial Small Now / Big Now list takes longer than expected. A slate of mostly Small Now’s hastens a refresh.
Integrate Small’s and Big’s into performance reviews. “What have you done for me lately?” captures a question often implied in performance reviews. Consider bringing or asking for completed Small and Big Now’s to performance reviews. When you do, you drive continuous improvement values deeper into your winning culture.
The proof-point in the grand scheme of things is establishing and reinforcing a decision cycle that is top-down strategically and bottoms-up tactically. Refreshing the Small and Big Now’s demonstrates it.
Process Triage Venue Requirements The room set-up is simple
Select a comfortable, big enough room with tables, away from daily work areas. The team will spend about eight hours in the triage session, not counting lunch. Comfortable chairs are a plus. The facilitator provides a thin, portable foam-core wall that leans against the wall the team will face. The facilitator will build the ACTION>RESULTSM Map for triaging on this portable wall with the team. The portable wall will not harm the room’s wall surface.
The room should not be convenient for team members to return to their work location if possible. Breaks are provided to check e-mails and make phone calls.
A couple of flip charts on stands will do. The facilitator will provide a portable LCD projector to present instructions about the triage protocol. Team members are welcome to share the projector for process-related information. A free-standing projector screen is nice to have if convenient, otherwise we’ll use what’s available (a wall or built-in screen).
Healthy snacks and beverages are welcome. Snacks and beverages are always welcome as the workshop is a roll-up-your-sleeves working session.
