Discovery & Action Dialogue (DAD)

Discover, invent, and unleash local solutions to chronic problems

Five Structural Elements – Min Specs

Structuring Invitation
We’re going to uncover the behaviors and practices some of us are already using to tackle our shared challenge. It’s like going on a treasure hunt to find the solutions hidden in our midst.”

2. Space and Materials

• Space for groups of five to seven to stand or sit around tables [breakouts of five to seven].
• Paper for each group.
• Seven questions prepared in advance for small groups to display (see attachments).

3. Participation Distribution

• Roles include host [tech host], group hosts, scribes, and participants.
• Minimum group size is two.
• Everyone is invited and has an equal opportunity to contribute.
  

4. Groups Are Configuration

• Groups of five to seven
• Whole group

5. Steps and Time Allocation

Intro: Describe the shared problem and share the structuring invitation. (1 min.)

DAD Groups Assemble: Participants form small groups of five to seven [breakouts]. They name a host to manage the conversation and make sure each question is addressed and a scribe to take notes. (3 min.) The Magnificent Seven: Each group host restates the problem and asks the seven questions. They display the questions for the group [in screen share and in the chat]. Launch the Treasure Hunt: Participants in each group answer the questions together, one at a time. The group host poses each question and keeps the group on track but does not participate in answering the questions (see Tips for DAD hosts below). The scribe takes notes and may help answer the questions. Signal [broadcast a message] when it is time to move to the next question, allotting equal time for each one. (15–60 min.) Recap Highlights: Everyone returns to plenary. Invite each group’s scribe to highlight “wow” stories, behaviors, or actions the group discovered, and share next steps from their group. [Participants can list suggestions in the chat.] (5 min.) Who Else to Invite?: Ask the whole group who else to invite to the next dialogue. (3 min.)

WHY? Purposes

• Discover tacit and latent behaviors and practices that are positively deviant from the norm
• Spark the emergence of new solutions
• Inspire rather than compel behaviors that solve complex problems
• Generate changes that are sustained because they are discovered and invented by the people doing the work
• Solve local problems locally and spread momentum across units
• Build relationships between people in diverse functions and levels that otherwise don’t work together to solve problems

Taking it online

DAD works online with no major adjustments.

Tips for DAD Hosts

Do not

• Answer unasked questions.
• Go on about a personal interest.
• Miss opportunities to record participant actions or behaviors that solve or start to solve the problem.
• Take on work that should be done by participants.
• Make decisions about someone without them.
• Judge contributions. Let the group evaluate.

Do

• State the purpose clearly. “We’re here to stop safety lapses.”
• Give questions back to the group. Wait for responses.
• Encourage quiet people to contribute.
• Challenge cynicism with positive reframing. Has this ever been done well?
• Be flexible with the order of questions.
• Maintain humility and learn from the group. Be willing to “sit at the feet” of people with solutions.
  

Tips

• Create an informal climate for DAD by starting with introductions, restating the shared tough problem in plain language, and sharing an anecdote.
• Hold DAD where the participants work to minimize obstacles to participation.
• Group hosts need practice to become skilled at this approach; encourage them to ask their scribes for direct feedback.
• See tips for group hosts above.

Riffs and Variations

Use the first three questions to prompt creative destruction and explore factors that make a problem worse (“What can you do to make sure that problem X becomes much worse?” etc.). Use the same questions to guide one-on-one conversations.

Practical Applications

DAD can help cross-functional groups reduce harm to patients from safety lapses, collect data for an ethnographic project, and aid team members remedy dysfunctional behaviors that are eroding trust and productivity.

Optional String

Use insights and curiosity generated by DAD to launch action research with Simple Ethnography or Improv Prototyping.

Tips for running this activity online

• Pick an online whiteboard tool that allows you to use a large, zoomable canvas.
• Set up each topic at a different area of the board, spread them out just like you would do it on the walls of a room.
• Invite participants to zoom in and visit each section during the review section of this exercise.
• If you’re not using an online whiteboard, we’d recommend using a collaboration tool such as Google Docs to collect the information for each step under a separate heading. Invite everyone into the document to share their ideas but be very clear in regards to editing rights.
• When facilitating group discussion, we’d recommend that participants use non-verbal means to indicate they’d like to speak. You can use tools like Zoom’s nonverbal feedback tools, a reaction emoji, or just have people put their hands up.The facilitator can then invite that person to talk.
• During group work, use a video conferencing tool where you can assign the participants into breakout rooms (eg. Zoom).
• When briefing the exercise and assigning the pairs or groups to work together, keep all participants in the main video conference room and explain best practices.
• After this step is completed, turn on breakout rooms so each group can work on their tasks.
• After the group breakout groups are completed and participants return to the main room, debrief the exercise.
• If you do not have breakout sessions, keep everyone in the main room, though invite groups to communicate in private messages or small groups in Slack. 

Attribution: Liberating Structure developed by Henri Lipmanowicz and Keith McCandless together with a group of coaches working to eliminate MRSA transmissions in hospitals: Sharon Benjamin, Kevin Buck, Lisa Kimball, Curt Lindberg, Jon Lloyd, Mark Munger, Jerry Sternin, Monique Sternin, and Margaret Toth. Inspired by Jerry and Monique Sternin’s work in Positive Deviance.

Source: Liberating Structures