“Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it.” - Goethe
“What should be?” – Co-constructing
Through collaborative thinking, the team chooses innovative processes that are in alignment with both the strengths identified in Discovery and the imagined hopes of the future (Dream). As an example, the group may focus on enhancing collaboration by devising ways to expand the “voices” and representation at the IDG “table” (e.g., hospice aides, volunteers, patients and families).
Questions during this design stage of the process might include:
What is in place to keep the IDG on the right track?
How has the team leader and every team member supported these achievements?
What are the characteristics of the IDG’s most supportive and productive members?
What is the best thing the IDG has put in place to support these achievements?
What emerge are provocative propositions that bridge the best of what is (Discovery) with what might be (Dream). These are bold, affirmative statements. For example:
“The Dream IDG is a passionate, committed, coordinated and integrated group united in our focus on achieving the patient/family goals of care through our dynamic and collaborative plan of care. We exist outside of fixed times, space or agendas. Communication is constant, collaborative and courageous. Our exceptional care in meeting the patient/family needs is captured in detailed descriptive documentation of every aspect related to the terminal journey and the palliation of total pain.”
“How to empower, learn, and adjust/improvise” – Sustaining
This final phase of the Appreciative Inquiry (AI) process involves a commitment from members of the IDG to implement the steps needed to create the envisioned future. The questions are framed to engage the team in imagining they are looking back at the previous three years and recalling how they were able to become the Ideal IDG (see Part II). Questions to ask include:
What type of goals did the IDG establish to achieve the 2018 “ideal IDG” award?
What allowed the goals to engage the IDG?
What were the one or two essential actions the team took and you as a team member took to achieve the team’s goals?
How has the IDG maintained its positive progress?
The AI process results in new ways of seeing our teams, our organization, our world, and ourselves. This generates new ways of being and doing based on relationships and connections.
What has excited the team most in the AI process? What visions do they hold for sharing this with others? Inspired by the progress there is the energy generated by continuous learning, adjustment, improvisation and innovation, leading back into the 4-D cycle. This is the sustaining stage.
There are many ways to engage in this process - its beauty is in its adaptability. The Corporation for Positive Change, an internationally recognized leader in AI, recommends the use of paired interviews followed by group discussion to fully engage the entire group in the process. A sample agenda might include:
Overview of the process.
Paired interviews – Discovery. Participants take turns asking all the Discovery questions and writing down their partner’s answers. The team then switches places with the 2nd person asking the partner the same question.
Group discussion – Discovery. Participants share 1 brief highlight from their partner’s response to each question.
Paired interview – Dream (same process as above).
Group discussion – Dream (same process as above).
Paired interview – Design.
Group discussion – Design.
Paired interview – Destiny.
Group discussion – Destiny.
It is not necessary to go through all the stages of the 4-D cycle at once or even at all to benefit from the power and possibility of AI. Nor do you necessarily need a skilled facilitator to get started. Find ways to introduce positive questions into the IDG. Begin to reframe problems into “possibilities” that have yet to be discovered. Celebrate successes and share the stories. Trust the process; it has a life of its own. And the rest…well that will be your story!
This blog series provides a brief and simple introduction to AI. For those interested, there are multiple resources for in-depth education online and in print. The Appreciative Inquiry Commons provides education and the sharing of information and tools about the AI process. Materials on that site informed much of this blog.
Posted by: Suzanne Karefa-Johnson, MD, Senior Physician Consultant, Weatherbee Resources, Inc.
Appreciative Inquiry Commons - www.appreciativeinquiry.case.edu. A website with resources and tools that are generously shared with the public
Appreciative Inquiry in Healthcare, Natalie May, Daniel Becker et al, Crown Custom Publishing, Inc., 2011
The Corporation for Positive Change - http://positivechange.org/. Offering information, free resources, training and consulting.
Bushe, G.R. (2011) Appreciative inquiry: Theory and critique. In Boje, D., Burnes, B. and Hassard, J. (eds.) The Routledge Companion To Organizational Change (pp. 87103). Oxford, UK: Routledge. Accessed at http://www.gervasebushe.ca/AITC.pdf