Facilitating, brainstorming and “six thinking hats”

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Sometimes it is good to be humble and facilitate the work of smart, innovative colleagues. I recently had the opportunity to meet with some amazing nurse leaders at UCHealth and talk about improving the work life of nurses. We spent two hours white-boarding (or in this case, large post-it boarding) our ideas. They spoke too quickly for this novice doodler to add anything more than a couple of rudimentary doodles, but I very much enjoyed the interaction and capturing the free flow of ideas. In this session, I served purely as facilitator, and had little to contribute from a content perspective. It is remarkable how effective and refreshing this is: to remove oneself from the details of the discussion and purely think about categorizing, shaping, guiding a discussion to a productive conclusion.

Although I’m a fan of Edward de Bono’s books on Serious Creativity, and Six Thinking Hats, I don’t claim to be an expert practitioner of his ideas. I do, however, often use the Thinking Hat colors to easily redirect comments during meetings that threaten to derail conversations, for example:

“This will never work, because ….” (“Thanks! That’s black hat thinking, and we’ll get back to that later in this meeting, meantime, lets ….”)

“Hey, what about this other idea that I had”  (“Hold on, let me jot that down on this other sheet. OK, with your permission, lets return to our current discussion on …”)

“Are we even thinking about this right? because …” (“Great point. Do we want to pivot and discuss this now? Or shall we finish our current discussion?”

At the right time, these are crucial inputs. At the wrong time, it can derail a nicely-unfolding sequence of collaborative comments. So, to guide our conversation, I set up a couple of items:

  1. We were scheduled to meet in our fancy 10th floor Board room, a room with a large projection screen, lots of hanging art, and NO WHITE BOARD. So, I requested a tripod with large post-it notes. Although I’ve not seen it done, I asked the attendees to remove all the meeting-overflow chairs lining the windows and use the windows themselves as my massive white board (so satisfying!).
  2. Arbitrarily, I suggested that “Low hanging fruit” would be a discussion category, written in green. “Blue Sky” thinking would be generating ideas about the ideal day for nurses. “Red hat” would indicate the things nurses hate about their working day.  And so on. I very much enjoyed running back and forth and placing comments in the right spots on the wall so that threads of conversation did not cross, and to allow older threads to be resurfaced smoothly. And, it was easy to see where we needed to fill in more details as the meeting went on.
  3. Finally, having ended up with dozens of possible projects, I asked the participants to “put your nickel down,” something I learned from a physician attending when I was a resident. Often during rounds, we would generate numerous possible diagnoses for a patient. Part of the learning process was “committing” to a specific diagnosis. So, he would ask us to “put your nickel down” on the ONE diagnosis, of all those discussed, and to see in the next couple days as test results returned, which diagnosis was correct, and see how our intuition and diagnostic skill performed. One learns SO MUCH from committing to something rather than “seeing how it turns out.” Similarly, “putting your nickel down” allowed us to choose the 1-3 ideas that we would put our collective efforts into.

One of the nurse participants let me know: (1) “Your handwriting is too nice for you to be a real doctor” and (2) “Can we do this more often? It is a good feeling to have a doctor scribing comments for a meeting of nurses.”

As Maui would say from the recent movie Moana, “You’re Welcome.”


Author: CT Lin

CMIO, UCHealth (Colorado); Professor, University of Colorado School of Medicine

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