104 ◾ Duke Rohe
problem-solving methods; it is simply an option when complexity, time, and size of a problem call
for something more creative.
A design method called Solution Session developed and used at M.D. Anderson Cancer Center
since 2001 has been used twenty times and has never failed to deliver positive results. e method
has been employed at two other hospitals by other facilitators with similar success. Team leaders
who have used it nd it the method of choice to apply to their other messy problems. Both sta
and leadership nd it an extremely ecient method of making change happen. And nally for the
facilitator, it best leverages the team’s time in producing valuable change. Every engineer should
have a version of this design method in his or her hip pocket to be used as appropriate.
Ingredients of a Solution Session combine three concepts: GE WorkOut™ (change accelera-
tion process), Osborn–Parnes Creative Problem Solving Process, and an Accountability Maturity
model. It draws on all roles and departments impacted by the problem to come together (team size
ranging from12 to 60 members) to an event to identify all the messes, issues, and ideas related to
the problem; then participate in subteams (silos) to design their part of the solution. As the design
from the six to eight subteams’ solutions mature, they are ultimately wired together into a single
system of changes, and then rewired back into the culture and organizational processes.
Facilitating a Solution Session
Typically a team leader will approach the facilitator with what seems to be an impossible mess of
a process they want to x. e Solution Session method will deliver success as long as its process
is followed. e facilitator builds condence with, “Since it has worked twenty times in past proj-
ects, this project will not fail either.” Talk the team leader through the steps (see Figure13.1, the
ideal schedule) and the roles to show her what it takes.
Facilitator: is person, usually the management engineer, sees to it that the team leader
administers the methodology steps. e facilitator’s boldness, condence, and encouragement are
what convince the team leader that her project will succeed. e facilitator runs the four-hour
Solution Session idea generation event using the creative problem-solving process. e facilitator
also rides shotgun on the change aspects of the project and coaches and warns the team leader when
to communicate to keep momentum high, assure eective meetings, prompt her of next steps, and
so on. In short, the facilitator sees to it that the team leader knows and is eective in her role.
Team Leader: is person is truly the key to the project’s success. e facilitator remains
vigilant, infusing input, condence, and caution along the way. e team leader administers the
methodology and sees to it that the sponsor, subteam leads (explained later), and members all
know and perform their roles eectively. She is also responsible for all the communication, follow-
up, and clerical work needed to keep the project eective. is may sound like a daunting role;
however, once she makes the roles and accountabilities clear up front, the accountability is placed
squarely on the members’ shoulders. en she simply follows up on the subteam leaders’ progress
and makes sure everyone is performing their role as appropriate. e subteam lead eectively man-
ages meetings after the Solution Session.
Mr. Big Sponsor: e senior executive sponsor is the point of authority who goes to battle
for the resources the project team needs. For best results, the sponsor should have a span of inu-
ence over a large portion of the process being redesigned. Sometimes this may require two or
more VPs to be the Mr/Ms Big over the success of the project. e sponsor commits to endeavor
to do anything in his or her power to do the blocking/tackling needed for project participation
and implementation.
Facilitation Techniques ◾ 105
Member: ese individuals represent their functions and professions in the project design
and decision making. Communications that aect the areas they represent are funneled through
(to and from) them. ey commit to take the time necessary to meet, design, and implement the
solution created by the team.
Accountability principle: e fear of being the rst to fail keeps it from happening. In each
of these roles, it is made clear that out of the twenty projects using this method, none has experi-
enced failure. e expectation to succeed builds an accountability line-of-sight from the sponsor
down to each of the members. No one wants to be the failure point for the whole team.
Possible Solution Session Planning Schedule
1. Prework
2. Sensing Session
3. Session Planning
4. Session Running
5. Implementation Follow through
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a Secure a Team Leader champion to commit to complete process
b Valid vision/strategy completed/tested Case for change completed
c Secure a supportive, legitimate Mr. Big to champion the Session and implementation
d Develop the rules for session engagement
e Develop list of prework Fact Finding questions by function if possible
e Send out a Call for Commitment to targeted team candidates (all who influence/affected by output)
f Call one-on-one if response is slow (leverage Mr. Big if needed)
a Schedule session with key function candidates
b Meet with Mr. Big - to understand session role and follow through enforcement
c Get candidates to develop lists of questions they want answered from other areas
d Create communication plan needed to inform, create momentum, open interdepartment networking
e Encourage/attend departmental data gathering/sensing sessions with functions staff
f Fact Finding -- make sure all areas arrive at session with available facts
a Scope size of session based on team ability, session complexity,
b Develop the Agenda timing of Mr. Big, CPSI Training, Probing Statements, Action Plan creation and Presentation
c Poster the Ground rules, Fact Finding turned in, Purpose, Agenda
d Prethink the session set up needs: tables, material, fun things, scribing support, post-its
e Create walkaway workbooks: tabbed with prework, tools, agenda, training slides, session output, commitments,
a Facilitator equipped with CPSI knowledge, Team Leader role defined participant/leader
b Mr Big establishes importance, commitment, support and challenge to have committable action plan presented in designated times
c Run the folks thru Mess/Problem/Idea Finding using both divergent/convergent thinking
d If running multiple teams - schedule collective sessions to report output findings
e If team is cohesive -- move to entire group participating in Idea
f If teams can not, then run finding sessions separate. Combine their output at the end.
g Schedule Mr Big to return to hear highlights of the ideas
h Team presents their committable action plan to Mr. Big
i Gather all pieces of data and send session summary of finding to team members
a Team Leader schedule necessary followup session to report on their commitments
b Sub team meet before follow-up meeting
c Follow-up meeting
d Sub team meeting before final-up meeting
e Final-up meeting
f Develop a strategy for implementation success: Start with we are successful, how did we get there? en turn into action steps
g Followup on each member commitments, team leader runs interference where needed, Use Mr. Big leverage to push support thru
h Keep communication of progress to members to inform/ keep momentum high
i Along side each implementation step, pave way for management/culture acceptance
j Set D-Day for implementation -- allow for lead time for training, equipment acquisition
k Create an action item punch list and update weekly for team
l Update culture as as the implementation progresses. Be honest with results.
m Bulldog each impediment in the way of success until it happens. People rarely fail, they just quit
n As key success factor data comes in, report it to the masses
o Personal and organizational confirmation/celebration in use
Figure 13.1 Possible Solution Session planning schedule.
106 ◾ Duke Rohe
Secure and interview your Mr. Big: Mr. Big Sponsor or the senior executive leader must be
powerful enough to inuence participation and implementation. Once a Mr. Big Sponsor is cho-
sen, a meeting is held to (1) validate his/her interest in the importance of xing the problem, (2)
discover any preconceived or pet solutions to the problem they might have, (3) see what nancial
limits there are to team solutions with good business cases, and (4) establish the level of commu-
nication (content and frequency) desired.
Case for action and purpose: People have a hard time ghting for what they don’t under-
stand. To solidify why a change is needed in the mind of all, the team leader drafts a couple of
compelling paragraphs describing the imperative for change. It would be wise to validate the case
for action with a few who were aected by the change. e team leader also crafts a single-sentence
purpose statement that captures the essence of what the change eort is trying to achieve.
Create a fact-nding question: Some team leaders consider fact-nding the most impor-
tant step. It surfaces facts, perceptions, reluctances, and processes existing in the current system.
Targeted fact-nding questions are crafted to draw out the facts, knowledge, and sacred cows
of those attending the session. Typically there is a set of general questions to all attending the
Solution Session, and a set of custom questions tailored for the major functions represented. e
responses to these questions are displayed in a matrix and distributed for all to see prior to the
session event.
Principle: People are reluctant to make decisions until all the facts are known.
Sensing Sessions: e purpose of the Sensing Session is to inform and legitimize the follow-
ing to those coming to the Solution Session event: (1) the case for action, (2) the conditions of their
participation, (3) the importance of their role and responsibility, (4) what to expect at the Solution
Session event and subsequent subteam meetings, and (5) how and when the fact-nding questions
are to be completed and returned.
Preparing for the Solution Session event: Ideally, it takes 5 weeks from the time the team
leader and facilitator meet to the time the fact-nding questions are returned and communicated.
ough the fact-nding questions will not be reviewed at the session itself, they are the prethink-
ing exercise to bring forth all the available facts around the current system. Preparing for the
session, the facilitator consults with the team leader to secure Mr. Big’s availability, the room to
accommodate the session, 3 × 5 Post-it™ pads (1 pad per every 2 attendees), Post-it ip chart paper,
Crayola® washable maker pens (slim style), and snacks. It is also good to make a poster of the
session purpose statement. To add legitimacy, make a certicate of appreciation for participation
signed by the team leader and Mr. Big(s).
Solution Session (idea generating) event: e Solution Session is a rapidly paced idea gener-
ation event that uses the Osborn-Parnes Creative Problem Solving Process, which generates three
times the traditional brainstorming rates. In 4 hours, as many as 60-plus members will generate
literally hundreds of problems and related ideas that will be the starter uid for developing design
solutions. is is the rst opportunity for members to bond as a team to collectively design the
system that will rid them of the problems plaguing them. Instead of individuals whining that the
system does not work, they are all generating ideas that will ultimately be considered in the design
of the new system without the problems. As facilitator, your job in 4 hours is to push the attendees
from diverse functions to generate as many ideas as possible to dissolve the critical problems that
exist. is is a generative right-brain process (discussed in the Innovation section) that should
have very little discussion or analysis. e more ideas generated the better. Quality is equal to
quantity because there are more option from which to choose. e ideas from these 4 hours will
later become the starter uid for the subteam (workgroups) solutions designing the ideal system.
Facilitation Techniques ◾ 107
Agenda for a Typical 4-Hour Event (Full process
explained in the “Innovation” section)
A typical agenda begins with a kicko (including Mr. Big), and an explanation of the project’s
purpose and importance, along with the idea process, which lasts about 20 minutes. is is fol-
lowed by:
◾ Mess-nding: generating all the possible messes related to purpose, then cluster by theme
(25 min).
◾ Problem-nding: generating all the problems in the form of how-to statements (how to
educate sta, how to enforce compliance, how to …), then cluster by theme (45 min).
◾ During a break, all the problems from the multiple teams are consolidated and the team sits
down to come up with ideas to solve them.
◾ Idea-nding: each problem is called out, determined if it is a keeper or a sleeper, then ideas
(practical to whimsical) are generated and attached to it (60 min).
◾ Subteam sign-up: subteam presentation to Mr. Big (20 min).
During subteam sign-up: ere are usually 6 to 8 themes or clusters of problems (with ideas
attached) on the wall. All members attending sign up to be on one or more themes or subteams.
Each subteam converts the ideas into proposals for legitimate short- or long-term solutions. A
subteam leader either volunteers or is assigned. Anyone who does not sign up for a subteam can
be assigned by the team leader. Note: Member sign-up increases both knowledge and acceptance
of the nal solution.
At the end of the session: Mr. Big returns to hear about some of the ideas generated for each
of the subteam categories. A brave volunteer from each group presents a few ideas. e team is
informed that a follow-up meeting will be scheduled in three weeks for each subteam to present
their preliminary proposals to Mr. Big. It is a nice touch to conclude the session with certicates
of participation signed by Mr. Big and the team leader and to serve lunch (thinking is hard work).
Processing Session Output
Tape down all the problem and idea Post-it notes generated on the ipchart paper. Type up and
send each subteam’s output to the leads of the subteams within 3 business days. e subteams
cannot meet without this processed list of messes/problems and ideas.
Subteam Meetings: Subteams meet as often as needed (suggest 60- to 90-minute meetings)
to work through adding and converting the ideas into a set of solutions to address all the problems
related to their theme (i.e., education, accountability, automation). ere is often overlap in solu-
tions designed between subteams, but that is to be expected when working in focused silos. eir
goal is to return to the follow-up meeting with 80% baked solutions to present to Mr. Big and
the rest of the team. is focused eort further bonds the members to the purpose of the Solution
Session. No one wants to let their subteam down or be a failure point for the entire team. If there
are diculties with a member’s participation or departments not being helpful, the team leader
contacts Mr. Big to help change their minds. It is the team leader’s responsibility to assure these
meetings are facilitated eciently and eectively. If the team leader is not condent that the sub-
team lead can manage this, she must assign a facilitator or act as facilitator herself until the team
can function eectively.
108 ◾ Duke Rohe
Communication creates momentum: e team leader is the listening post for all the sub-
teams’ needs and progress. It is best to broadcast once or twice a week to all the team members
each subteam’s progress to keep the importance and momentum high. is keeps the eort in the
forefront of everyone’s mind. Encouragement, progress, and hurdles are all helpful to report. A
good team leader is a master of knowing the frequency and content to communicate.
Follow-up meeting: e follow-up meeting is simply an executive summary of the proposals
from each of the subteams to date. is is when Mr. Big and all the subteams get to see the begin-
nings of the solutions being formed. It is also quite bonding when each member realizes they are
an integral and accountable part of the rest of the team. e announcement of the date of a nal-
up meeting for nal proposals (3 to 6 weeks later) is given at this time. Tip: Let the subteams know
that Mr. Big will attend the meeting and it is amazing how fast they work to deliver a top-notch
presentation. It should be noted that the duration between the follow-up and nal-up meeting
could be months depending on the season and the complexity of the problems.
Final-up meeting: After the subteams have received the input and knowledge of the follow-
up meeting, they return to rene and craft their nal proposals so they t into a comprehensive
system. Each proposal must have a good business case and plan for implementation. All along,
their meeting minutes have been channeled through the team leader who has been monitoring/
communicating/coordinating the loose ends to the respective subteams. All subteams prepare to
deliver their nal proposal to Mr. Big and the collective team members. Both short-term (within
6 months) and long-term (beyond 6 months) proposals include everyone’s input.
Implementation and conclusion: e members that created the solutions are the same ones
who implement and retrot them back into the existing organization. e old way, with all its
problems, is dismantled and replaced with the new way. Some Solution Session implementations
have taken years to complete due to complexity and resources; but there has yet to be a team that
has quit or lost steam in making the solution a success.
Here’s an appeal: We suggest that you at least try using this right-brain approach in develop-
ing and integrating change. It is fast, respectful of each member’s time, engaging to the end, and
built to last by those who are aected. It also leverages the facilitator’s (your) value to the organi-
zation. You simply see to it that the methodology is followed and everyone remains in their role.
Team leaders call the methodology magic for they don’t know how it works; it just creates great
results. If it can get an aircraft carrier of an academic state institution like ours to turn on a dime,
just think what it can do for your healthcare organization.
Success Factors for Broad-Scale Change
e following are success factors in proverb form distilled by observing twenty successful broad-
scale change projects using the Solution Session methodology. See if they can help out your projects.
1. Know when to renovate or reengineer. Renovate analyzes what exists then xes it.
Reengineer creates what needs to be, then retrots it back into the organization.
2. A passion to make a dierence does. A team leader’s willingness to incur sacrice for a
great cause ushers the resolve to achieve it.
3. e condence that you can is the courage to try. If you knew there was a project method
at which you could not fail, would you be willing to attack the seemingly impossible?
4. If you remain in your role, you remain eective. e sponsor, to resource and reinforce;
the team lead, to administrate and communicate; the member, to design and implement;
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