Take Aim At The Performance'''

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Performance Support 2001 Presents
Take Aim At The Performance...
Not the performer.

Wednesday 10/3/2001 930 - 1100
Gary J. Dickelman Christensen/Roberts
Solutions Epiance
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Addressing the right problem
What is a Performance Centered System??
EPSS??
Performance Support??
Performance Centered System??
Performance Centered Design??
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Overview of Performance Support

• Performance centered systems enable people to do
  it because they have access to integrated task
  structuring, data, knowledge and tools at the
  time of need.
• It is business performance.
• Business performance is enabled through human
  performance.
• Performance centered systems are representations
  of work processes that match the tasks at hand,
  are appropriate for the people who have to do the
  work, and contain just enough information.
• User centricity is necessary but not sufficient
  for a system to be performance centered.
• Usability (in the conventional sense) is
  necessary but not sufficient for a system to be
  performance centered.

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Overview of Performance Support

• Performance centered systems are representations
  of work processes that match the tasks at hand,
  are appropriate for the people who have to do the
  work, and contain just enough information.

appropriate for the person
match the tasks
contains just enough information
The Performance Zone
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Overview of Performance Support

• Performance centered systems are representations
  of work processes that match the tasks at hand,
  are appropriate for the people who have to do the
  work, and contain just enough information.

appropriate for the person
match the tasks
contains just enough information
The Performance Zone
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Overview of Performance Support

• What do we mean by being out of the performance
  zone?

appropriate for the person
match the tasks
The Performance Zone
contains just enough information
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The Game of 15
The pieces for the game are the nine digits-1,
2, 3, 4, 5, 6, 7, 8, 9 . Each player takes a
digit in turn. Once a digit is taken, it cannot
be used by the other player. The first player
to get any set of three digits that sum to 15
wins.
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A Game Board
4 3 8 9 5 1 2 7 6
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Another Game Board
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• What do we mean by being out of the performance
  zone?

appropriate for the person
match the tasks
The Performance Zone
contains just enough information
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Activity

• Out for Blood

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Exercise Out For Blood

• This exercise illustrates some aspects of a
  performance diagnostic process.
• You will be presented with a four-part situation
  in each part you will need to make a decision on
  the best way to proceed.
• The scene is a small New England hospital
  laboratory. The hospital has been getting patient
  evaluations with a lot of complaints about blood
  drawing, and asks you, the instructional designer
  in HR, to help.

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Competencies for blood drawers

• All persons who draw blood must
• Be able to perform the proper blood drawing
  techniques, as documented in the Lab Policy
  Procedure Manual, Volume 1, pp.34-48.
• Know the blood drawing requirements (types of
  tubes, special handling, patient preparation) for
  the most commonly ordered tests, documented in
  the Lab Policy Procedure Manual, Volume 3,
  pp.120 - 145.
• Be able to communicate effectively with medical
  staff such as physicians and nurses.
• Be able to communicate effectively with patients
  and families.
• Have an associates degree or higher.
• Have certification as a medical technologist,
  medical lab technician, lab technician or
  phlebotomist.

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Complaints about blood draws
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Part 1

• The hospital is trying to go after a new nursing
  home account. Since part of the job will be to go
  to the nursing home and draw blood, management
  wants good metrics on blood drawing to show the
  nursing home execs. The laboratory manager
  decides to talk to you about refresher training
  in customer service and blood drawing.Management
  wants the metrics to improve before the next
  round of evaluations. You have 15 days. If you
  make the right decisions, this should be enough
  time.The first thing you do is
• Confirm the nature of the problem
• Assemble, review, and validate competencies
  required for drawing blood
• Arrange refresher training in customer service
  and blood drawing, as requested or
• Arrange for all blood drawers to be assessed for
  retraining needs.

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Confirm the nature of the problem
By starting here, you will discover the nature of
the problem and its extent. You take a day to
go over the evaluations, which tell
youComplaint 1 blood drawn into the wrong
type of tubes, necessitating redraws. Location
of patients who complained Emergency
roomComplaint 2 being bruised when blood is
drawn in the morning.Locations AllComplaint
3 receiving rude and abrupt treatment when
blood is drawn in the morning.Locations Floors
N1 and N2You know that the lab doesn't draw
blood in the emergency room. So, you conclude
that the complaints about mistakes being made
that require redraw don't apply to the lab. That
means the actual problems that concern the lab
are only complaints 2 3. You make a note to
talk to the ER director later, and continue.
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Part 2

• Next you interview the lab manager and learnThe
  day shift is required to draw blood between 730
  - 830 AM.When they're finished, they go back to
  the lab and spend the rest of their shift
  analyzing specimens.Each tech is expected to
  complete their assignment in an hour.Each tech
  is expected to treat patients with courtesy and
  to observe good patient care technique.Your
  next step is to
• Assemble, review, and validate competencies
  required for drawing blood
• Find out if these job requirements are clear and
  understood by the techs
• Arrange refresher training in customer service
  and blood drawing, as requested or
• Interview patients that have complained in the
  past.

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Find out if job requirements are clear and
understood by techs
You discover that the lab techs do understand the
job requirements. It takes you two days to
interview the lab techs so that you can eliminate
this common factor in performance discrepancies.
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Part 3

• But, digging deeper, you discover that the day
  shift techs have several concerns. They feel
  pressured for time. If they're not back to the
  lab in an hour, the tests are delayed and the
  doctors and the lab manager yell. They need to
  take more time with the patients that are
  difficult to draw. The lab manager scoffs at
  this, however, and says the accepted industry
  standard is to average 5 minutes per patient,
  which is what they get. Your next step is to
• Get a list of the tasks involved in blood
  drawing
• Persuade the lab manager to increase the time
  allowed per patient for better patient care or
• Observe the lab techs as they draw blood.

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Observe the lab techs as they draw blood

• You discover they have several ways of working
  when rushed
• Techs move quickly and talk quickly to the
  patients, which is confusing and disconcerting to
  the very ill and elderly patients
• Techs informally "swap" patients, so that the
  better blood drawers get fewer but more difficult
  patients
• Techs give brief or incomplete instructions to
  patients so that they don't always compress the
  puncture site long enough -- which can cause
  bruising.

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Part 4

• You also discover that since the new computer
  system went live, techs are being interrupted by
  nurses and floor clerks. They ask the techs
  questions about how to order future lab tests in
  the computer. They also sometimes ask for
  clarification when certain blood tests require
  special patient preparation. This information is
  not in the computer, but in the lab manual. These
  problems can take anywhere from a few seconds to
  5 minutes to resolve, and can happen several
  times in an hour.Based on the information
  you've gotten so far, you know what your
  recommendation will be to the lab manager
• Recommend no interventions for the lab -- the
  blood drawers are not the problem.
• Talk to the lab manager about increasing the
  number of people who draw blood in the morning
• Give the techs an in-service training about what
  their priorities should be the patients come
  first!

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Recommend no interventions for the lab -- the
blood drawers are not the problem.
The patients complain because the lab techs are
rushed.The lab techs are rushed because of
interruptions from the nursing area. You don't
need any interventions for the blood drawers, but
you should talk to nursing about their
performance discrepancies.If you had jumped to
an assumption that the problem was the lab techs'
attitudes, knowledge or skills, you would have
missed this.
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Performance Diagnostic Tool
- Organizational
- Departmental
- Team
Identify discrepancy
- Individual
Ensure task with discrepancy is essential to
business objective
Ensure discrepancy has a significant negative
impact
External to
Internal to
Performer (s) People
performer(s)
performer(s)
Environmental
Resources
(Intangibles)
(Tangibles)
4.
6.
7.
1. Organizational
2. Organizational
5.
3.
8.
Cognitive
Physical
Knowledge /
Environment
Systems
Hardware Tools
Incentives
Inherent Ability
Support
Environment
Skills

intelligence

job aids

training

computers

clear unambiguous

Rewards pay,

marketing strategy

noise

emotional

documentation

software

education
objectives
bonuses,

products/services

light
ability

electronic

experience

VCR's

meaningful
recognition

problems/threats to

temperature

physical
performance

calculators
achievable standards

Feedback
organization
physical layout

attributes
support
automobiles


metrics captured and
frequent, specific,

business

education

user interface
available

Consequences
opportunities

artistic gifts
design
procedures that are
understood.

internal

accurate, available, up-

Desired behavior
motivation
to-date.
not punishing
Check and fix this end first
Prepared by Christensen/Roberts Solutions,
derived from a model developed by Performance
Technologies Australia Pty Ltd, used with
permission
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Overview of Performance Support
You need to create process models, capture
dynamics, and simulate the process.
appropriate for the person
match the tasks
contains just enough information
The Performance Zone
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Overview of Performance Support
You need to create diversity models, discover the
preferences of performers and reflect them in
interface representations.
appropriate for the person
match the tasks
contains just enough information
The Performance Zone
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Overview of Performance Support
appropriate for the person
match the tasks
You need to engineer content (data, information,
knowledge) as hypertext/hypermedia from the task
content domain.
contains just enough information
The Performance Zone
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Overview of Performance Support
These activities address the cognitive model of
learning and performance support represented by
the diagram.
Identify a compelling business need Develop a
project mission statement and action plan Create
process models Create diversity models Develop
information and knowledge bases Develop
representations that work for human
beings Design interactions and create user
interface Conduct performance centered usability
evaluations.

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Overview of Performance Support
These activities are the stuff of Total Quality
Management. If you skip these steps, you
introduce tremendous risk with regard to creating
a performance centered system.

Identify a compelling business need Develop a
project mission statement and action plan Create
process models Create diversity models Develop
information and knowledge bases Develop
representations that work for human
beings Design interactions and create user
interface Conduct performance centered usability
evaluations.
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Overview of Performance Support
Representations are created long before a
single line of code is written or a window is
painted. They are abstractions of business
problems that make sense to people who have to do
the work. Only essentials are included in
appropriate representations.
Identify a compelling business need Develop a
project mission statement and action plan Create
process models Create diversity models Develop
information and knowledge bases Develop
representations that work for human
beings Design interactions and create user
interface Conduct performance centered usability
evaluations.
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Overview of Performance Support
Graphical user interfaces (GUIs) are a physical
means by which to render performance centered
representations. They include metaphors
comprised of objects and actions, constructed
from graphical artifacts that are quickly
recognized by performers.
Identify a compelling business need Develop a
project mission statement and action plan Create
process models Create diversity models Develop
information and knowledge bases Develop
representations that work for human
beings Design interactions and create user
interface Conduct performance centered usability
evaluations.
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Overview of Performance Support
An iterative GUI development process, such as
Rapid Application Development (RAD), that is
centered around the performer is necessary to
produce a performance centered system. We call
such a process performance centered usability
evaluation.
Identify a compelling business need Develop a
project mission statement and action plan Create
process models Create diversity models Develop
information and knowledge bases Develop
representations that work for human
beings Design interactions and create user
interface Conduct performance centered usability
evaluations.
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Where is Knowledge Management?
Each of these steps of the lifecycle includes the
activities of establishing the information/knowled
ge base, creating the collaborative environment,
and determining how the ecology of knowledge will
manifest itself in the system.
Identify a compelling business need Develop a
project mission statement and action plan Create
process models Create diversity models Develop
information and knowledge bases Develop
representations that work for human
beings Design interactions and create user
interface Conduct performance centered usability
evaluations.
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Examples

The average person has the attention span of a
ferret after two cappuccinos.
- Dennis Miller
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Conclusions