Case Study: How Skore Helps Mental Health Services for Children and Young People

Improving Placements for Local Children and Young People in South London

In 2017, a partnership of three NHS Trusts in South London embarked on a New Models of Care pilot in order to improve the experience of children and young people requiring inpatient placements in Mental Health Services. The partnership sought to reduce the distance that many children and young people, and their families, have to travel to these placements. The further from home a placement the greater the impact on the wellbeing of the patient and their family.

Change Platform Consulting led a series of workshops to understand the current state situation, develop a vision and then design future state processes. The workshops were facilitated using whiteboards and sticky notes along with Skore for the process capture and design. The team found the Skore approach both challenging and hugely valuable. The simple structure of the Skore approach challenges a team to not only describe WHAT happens but also WHY it happens. Furthermore, with it’s advanced RACI modelling, it asks WHO DOES the work, WHO OWNS the work and WHO ELSE needs to be involved.

“The team found the Skore approach both challenging and hugely valuable.”

These simple questions drive the discussion to the heart of the challenge a team is dealing with. It helps uncover problems within a process, it highlights misunderstanding, duplication and rework. All things we are looking to resolve or reduce in order to deliver a better service.

The Result of Skore Led Collaboration

In this phase of the programme the Skore approach helped the team model out different scenarios and make informed decisions about the best design moving forward. But more importantly it helped them address challenges in their existing ways of working and make immediate improvements even before they started implementing a solution.

As a result of these initial workshops the partnership saw a 75% reduction in the number of children and young people, from South London, staying outside the area. Across the partnership’s inpatient wards the total capacity used by local children and young people increased from 52% to 90%. The improved ways of working in this area also contributed to a 12% underspend against budget. All in the first 9 months.

These results demonstrate how the Skore approach and platform continually delivers value above and beyond the original project goals. It brings teams together and breaks down barriers in understanding very quickly. It delivers process discovery and analysis quicker than the competition. It forms the perfect basis for educating the workforce on the impact of changes to their ways of working. And helps you identify unexpected improvements.

Find Out More

To learn more about Skore and how it can deliver better outcomes for your organisation speak to one of our transformation experts here.

Change Platform Consulting is a specialist consultancy supporting clients to successfully understand and deliver strategic impact in the most complex of change initiatives. With significant experience in multi-organisation health and social care service change and transformation, they provide a range of services that support clients in people orientated change linked to strategic initiatives. Download the full case study here.

IDEFlite

Why do we need IDEFlite?

IDEFlite is the perfect way to communicate how a business process, and any underlying automation, is going to work between technical and non-technical audiences. This makes it an ideal point of reference throughout a project.

Audiences can use it to describe ideas, changes and potential issues in a way that reduces misunderstanding.

Unlike the typical flowchart modelling techniques, found in technical developments, IDEFlite is ideal for creating a high level view of a business process. It does so in a way that is easy to understand for anyone who needs to look at and comment on the model.

 

What is IDEFlite?

Based on IDEF0, IDEFlite is a simple, yet powerful, way to model activities, workflows and activities. It’s simple in that it uses a very limited notation which makes it easy to read for anyone.

While being very simple it can be used to describe extremely complex scenarios using decomposition. That is, every single activity can be described in more detail whenever required. Without the need for a complex library of descriptors.

When compared with IDEF0 one can see the primary difference is that IDEFlite does not make use of Controls and Mechanisms. Instead it focuses on Inputs and Outputs while including a human role.

How does it work?

The Building Blocks

 

Work is described as activities.

Every activity should have at least one input and output to set the scope of the work. All work should be owned by someone in the form of a supporting resource.

Activities are Linked Together

Work activities are linked together to form flow diagrams (processes).

Activities are Deconstructed to Form Hierarchy

Work activities can be deconstructed thereby creating a new detailed view of that activity. This forms a hierarchy of detail linking high level activities with low level tasks.

This is done when it is necessary to describe an activity in more detail. For example during a conversation about how something works. If the current flow does not adequately describe a particular interaction the user can take that step and create a detailed view.

Each level of detail is a new diagram, together this collection of hierarchically linked diagrams is a map.

Skore natively supports the use of IDEFlite, why not request a demo to see how.

How we keep Skore at the cutting edge

We’ve never wanted to sit still and we’re always looking for ways to improve our company, our services and our products. Earlier this year we released the latest version of our Skore web application. This included an almost complete rebuild of the whole app from ground up.

It’s no small undertaking to start from scratch but we felt the time was right. As you develop a product there’s lots of trial and error, some things work well others, not so much. Feedback from users is essential but so is our own experience using the product. And this is something we pride ourselves on, we use our product on a daily basis.

But it’s not just user experience and usability changes that are important. As we develop the software we learn what works and what doesn’t. We realise that some choices, that seemed right at the time, have challenged us later on. This is why it’s important to take the opportunities to rebuild when they arise. To apply, from the beginning, all the lessons we’ve learnt since the last time.

For those that have followed us since 2014 they’ll know that this isn’t the first time we’ve rebuilt the product, or redesigned the user interface. Here are some of our previous user interfaces that some users will remember, some more fondly than others!

Skore Prototype

While not the very first prototype you can see one of the first uses of the what and why boxes. The product was then called Score with a C. All the main controls are there which allowed us to start testing with real users before we officially released.

Skore Version 1

Our first official release of Skore was for the desktop only. The interface was simple, there was no way to apply styles to the content. The editor tool bar was along the top of the application rather than the left bar we use now. By this time we had added the sticky note feature that allowed the user to annotate process models.

All the key features were here by this point, rapid modelling, shortcuts, multi-layers and attachments on each box. Although in version 1.0 you could only share processes by PDF or with other users of Skore desktop.

Skore Version 2

Following a business review with the Happy Startup School we underwent a rebrand, new logo and website. Then we decided to follow up with a redesign of the Skore user interface.

We worked with Mike C from Think.gg to design a new interface with darker colours contrasted with the green we had adopted in our logo and website.

We implemented a bright fun backdrop to the app which proved controversial. Some users loved the playful background and others immediately asked us to remove it. We quickly implemented a configuration item for those that weren’t fans.

By this time the app had implemented stylesheets that let users change the look and feel of the visualisations, add images or choose from the library of icons.

It was shortly after the release of this version that we started working on our first web app. To get up to speed as quickly as possible we build a separate backend web application and graphted the new Skore editor on top of it.

One of the biggest challenges for us is that we used different teams, and different designs, for the main web interface and the editor interface. These were completely different apps that had been integrated. It soon became clear that we’d need a complete rebuild to resolve the increasing technical debt that had built up.

Skore Version 3

Back in late January we released our Unity interface, or Skore version 3, which brings all parts of the application into a single design. This version of the interface has undergone the most extensive user testing to date. This led to a standardisation of common functions such as Search, New, Edit and Save across each type of content in the workspace.

The interface also came in time for our new branding which was easily implemented into the system.

This is a great step forward for us, it demonstrates our commitment to continually improving the product. It’s not just the interface but the rebuild ensures we also constantly update and improve the architecture, security and performance of the application.

If you would like to learn more about Skore why not request a demo.

Process governance and agile

Do you need processes at team level?

At the heart of an agile organization is a deep understanding of how we work together. In an agile team, the constant collaboration between the members help doing so. Retrospective meetings are the institutionalised forum for talking about “how we work”. In reality, every time people talk together there is a little bit of “how” in the conversation. How many conversations end with “you do this, then I do that”.

There is little need to formalise processes in too much details at a team level. This is compensated by clear and open communication between the members.

Do you need processes at an organisation level?

This gets more complicated when several teams are working together (team = sharing coffee machine). Such as procurement and production; or sales and accounting. Or Head office – regional offices.

At this level, the interactions are less regular, and, we do not systematically voice concerns or “just” change  how things work. Processes change are often heavy and it’s easier to not do it.

This is where process definition gets critical to understand how things work. And this is where you need some sort of governance to make it right, especially around change.

What is process governance in an agile organization?

This post finishes with a list of open questions / thoughts because I don’t have a definitive answer (yet).

  • Create a system that allows continuous improvement (CI) of processes (willingness to do so, and an approach to make it) at cross-functional level
  • Create the incentive to do CI across several teams (incentive = people will find the time to do it)
  • Have a common language to describe the work so that everyone can prepare in the best way (Hello, Skore)
  • Process owner is key role to make that happen
  • Middle management is a key role to make that happen
  • Good understanding of outcomes of the process vs. outputs to be in the right context

The key seems to be to create “space” in the organisation for continuous improvement activities…

To be continued.

10 Steps to the Perfect Process

I’m often asked how much of what we do is down to the software and how much is down to our experience. It’s a hard question to answer. I’ve been doing this work for a long time and I’m always learning new things. Undoubtedly I see things that less experienced people might not but I had to start somewhere.

I’ve always found simple structures and approaches to be the most effective. The most effective for getting started, guiding you, learning from and building experience. That’s why we built Skore based on a simple, yet powerfully flexible, framework for describing processes, people, systems and data.

Skore has the framework built in to it, it makes it quick and easy to apply. But there is still an approach that underpins the application of the framework. After hundreds of training sessions I’ve put together the following 10 simple steps to creating the perfect process.

Do I follow these perfectly every time? No, but if you do follow them, along with Skore, you will create good quality and insightful process models of your organisation in 10 simple steps.

10 Steps to the Perfect Process

1. SCOPE
What is the scope for this process? Capture the Title, initial input and final output

2. ACTIVITIES
What is the work to be done? Verb and Noun, no need to worry about sequence

3. OUTPUTS
For each activity, add the output, trying to avoid just putting the past tense of the activity

4. FLOW
Only once all the activities have an output, hook them up. What does this output trigger next? This checks you’ve got the right activities

5. WHO
A process is not complete until the ‘Who does it?’ is filled in for EVERY activity. For higher levels, who is responsible? For lower levels, who does it?

6. ENRICH
Add in things like systems, data, document links, requirements, etc… depending on the reason you’re process mapping

7. TIDY
Align the tops, space apart… a neat process is a happy process

8. SHARE
Don’t keep the process to yourself, make sure the access rights are set up correctly and share the link to a wider audience. Switch on Comments if you want feedback directly through Skore

9. REFINE
Take the feedback and improve the process

10. PUBLISH
Decide who should approve the process (usually the Process Owner!) and Publish. Remember, this is just a line in the sand, it will change and need to be re-published. You can always roll back to an earlier version if needs be.

Download 10 Steps to a Perfect Process as a PDF.

The Magic of Hierarchy

The importance of hierarchy

Probably my favourite tool in the arsenal of analyst techniques has to be decomposition. Whether it’s functional or process decomposition there is nothing like it for arranging problems into the big picture. Then breaking that picture down into its component parts so that you can start to make sense of it.

And yet hierarchy, in recent years, has got a pretty bad reputation. As Stanford professor Bob Sutton wrote this weekend in this LinkedIn article. He was brought up to believe that hierarchy was bad and led to inefficiency, yet research for his new book showed that hierarchy is unavoidable.

Hierarchy is nature’s gift to us in helping us understand the World around us. Citing research by his colleagues Deb Gruenfeld and Lara Tiedens he describes how hierarchy is found in every single group of animals found in nature. To quote Gruenfeld and Tiedens directly:

“When scholars attempt to find an organization that is not characterized by hierarchy, they cannot.”

Hierarchy structures the relationships between people and things into parent, child and peer relationships. This makes it easier for us to remember those relationships, it provides an organising principle that is standardised across everything. We simply have to know how hierarchy works in order to understand something that is new to us.

This is what makes decomposition so powerful. It comes naturally to us human beings so is not really something that needs much in the way of education. When we apply it, it’s often to an area that seems chaotic and complex. By decomposing we overlay a hierarchy that allows us to understand what was previously incomprehensible. It allows us to break problems down into component parts in order to tackle them effectively and even start to predict what will happen when we make changes.

It doesn’t just aid understanding, it also helps us to remember. Instead of having to remember every single discreet component of an organisation you simply need to remember a small subset. You can then use this along with the hierarchical organising principle and you will be able to fairly accurately calculate the missing pieces.

Skore and decomposition

This is what makes decomposition one of the first things I do when introduced to a new problem and this is why we made decomposition one of the central parts of Skore. It surprises me how few products there are out there that help you do this easily, one of our favourites is Workflowy.

Right from the beginning we wanted to give people the ability to decompose as thought it was second nature. With Skore you simply capture a few high level actions that describe the ‘big picture’ then use the details button on each What Box to decompose to the next level creating a hierarchy as you go. This means it is really important that you complete the Why Box for each step. The Why Box is used to determine the outcome of each step, what’s expected once the action is complete. By doing this consistently you are setting your scope for the next level of detail and making it easier to focus on that detail.

Detail button on a What Box in Skore

When looking at any new problem Skore is one of the first tools I reach for, sketch out the big picture and then explore the details of any relevant parts.

3 things to remember

Hierarchy is all around us – it is an organising principle built into nature and helps us understand otherwise complex situations.

Use decomposition to organise and understand problems – start at the ‘big picture’ and break it down into component parts in order to understand what it is and what to do next.

Use the Details button in Skore to decompose a step – each What Box has a details button, clicking this will give you a clean canvas with the context of the parent step including the descriptions of the What and Why boxes. You can break individual steps into detail views as often as you need until you reach the right level of detail.

This is an extended version of an article from Human Automation.

Possible service interruption – June 13 2018

Some users of Skore may have experienced a temporary service interruption at approximately 2pm British Summer Time on Wednesday June 13th 2018.

This was caused when a name server, unconnected with Skore, was configured with incorrect domain resolution information. This in turn caused the domain to be redirected to a holding page that read “Hello World!”.

The issue was discovered, reported to the owner of the domain name service, and resolved within 60 minutes.

Bringing RACI into the 21st Century

In this presentation we look at some of the problems with RACI and explore visual RACI modelling with Skore app. A text description follows the presentation.

People are looking for an alternative

Over the past 12 months we’ve seen a lot of search traffic arrive on our blog looking for alternatives to RACI. In fact our blog post “Forget RACI – RATSI makes things clearer” is the second most popular page on our website.

A quick search on Google throws up a lot of articles trying to explain how to use RACI. Clearly something isn’t working.

What is RACI?

RACI is a tool for helping teams clarify roles and responsibilities, or rather, who does what around here! RACI stands for:

  • Responsible – the person responsible for doing the work
  • Accountable – the person ultimately accountable for the delivery of the work
  • Consult – A person that needs to be consulted during the work
  • Inform – A person that needs to know about the work

It’s typically used in a matrix form with roles along the top which can be cross referenced against activities down the side.

There are many alternatives

The concept behind RACI is sound, the idea that it should provide clarity around who does what in a project or process. However there are many different variations on the theme such as:

  • ARCI
  • RASI
  • RACIQ
  • RACIO
  • RATSI (our favourite)
  • RAPID
  • RACSI
  • DACI
  • CLAM

Each of these appear to be attempts to clarify and improve the definitions of each component. Some have a different focus such as on decision making or outcomes.

The problem with RACI

One of the biggest criticisms of RACI is the ambiguity in meaning between the different components. For example the difference between the meaning of Responsible and Accountable.

At a recent Skrum meetup we asked the audience to explain the difference. Even among this experienced group of change practitioners we found opposing meanings for these two definitions.

Another criticism of RACI is the lack of detail around the activities and the level of involvement expected from the different roles. Of course getting the level of detail right is difficult, too detailed and you don’t allow flexibility for the team to make their own decisions. Not enough detail and you leave too much open to interpretation and therefore don’t solve the problem of clarity and who is responsible for what.

As well as a lack of detail RACI doesn’t describe outcomes, it tends to focus only on activity. Including outcomes can provide more clarity around the work required and further clarity on the difference between the person doing the work and the person owning the outcome or deliverable.

Finally, a major problem with RACI, and it’s siblings, is that the resultant documentation (typically a matrix in a spreadsheet) is just too big and complex to be really useful to those that need it.

Introducing visual RACI modelling

Over the past 5 years we’ve been practising a form or responsibility modelling based on our process framework approach. This combines the definition of activities, outcomes and roles into a single picture.

This means, as a user, I can quickly and easily see the work required, how it flows, the outcomes expected at each step and the responsibility level. All at a glance.

With our framework it’s very easy to take each of those activities and break them down into more detail as required. So you can really get into the details if you need to.

When you reach the lowest level of detail required you can add as many roles as you need to each activity. You can choose to show these on the diagram or you can hide them in the responsibilities panel to keep the diagram clean and simple.

This information is available to any user that needs to see it and is easily searchable by any user with the correct access rights.

RACI reporting and analysis

Defining your activities, roles and responsibilities in a clear and visual way is an excellent way to get clarity among the team. Not just when you first gather the information but also as an ongoing asset, or reference tool, for the team in the future too.

Using Skore to capture this information not only makes it easy it also instantly provides additional insights you simply wouldn’t see if you were using a spreadsheet.

With the click of a button you can view a tabular report showing the activities, roles and their RACI assignment.

Using this data you can quickly create graphs that highlight patterns and help you focus your analysis and improvement activities.

Finally Skore provides instant job descriptions based on your RACI modelling. Clicking on the name of a role will show all the activities of that role and their RACI assignments. Ideal for exporting into job descriptions.

If you would like to learn more about using Skore for RACI modelling please do get in touch info@getskore.com.

Temporary suspension of justskore.it publishing from desktop app

We would like to inform all users of the Skore desktop application that the anonymous publishing feature justskore.it has been temporarily suspended since March 20th 2018. This has been caused by a change to one of the third party services that this feature is based on.

We will be returning the service as soon as we have completed the necessary updates to the product.

What is it?

The justskore.it feature in the desktop software allows a user to quickly and anonymously publish a .skore file to the internet. Anyone with the link can view the process created in Skore online.

The advantage of this feature is that you can quickly share ideas to anyone with an internet connection and a web browser. The downside is that the information is shared publicly and cannot be changed once it has been published.

How does it work?

The features uses https://github.com/ and saves the Skore xml data as a publicly available anonymous gist on the github service. As of March 20th 2018 github have ceased support for anonymous publishing therefore blocking Skore desktop app from publishing new processes to the service.

All previously posted processes will remain available. You can read more about the update from github here: https://blog.github.com/2018-03-20-removing-anonymous-gist-creation/

Solution

We are currently working on a new version of the Skore desktop software. This will include a new version of this feature which will allow publishing and sharing of the processes to our own servers. This will have the advantage of providing us more control over the data inline with data protection guidelines.

We are working to release this new version of the software over the next few months.

In the meantime users may consider saving your process as a .html file and uploading it to a service such as Sharepoint, OneDrive or WordPress.

Alternatively users should consider our web service. The Skore web service offers the ability to create and publish processes anonymous with the added advantage of being able to edit and update the process once published. This essentially means you can maintain a single URL link for any users to accesses the content. Examples of this feature include sharing processes embedded in a website or training material.

Our new freedom pricing model maybe suitable for users of the desktop software. Check out our pricing page for more information.

If you have previously purchased the desktop software we would be happy to talk about a discount to your first year.

For further information please contact info@getskore.com

Skore service interruption – March 22nd 2018

The main Skore service (https://app.justskore.it) suffered a short interruption at 15.07 GMT today and lasted up to 20 minutes for some users.

Those editing or viewing processes would have seen several error messages including; Server Unavailable, Proxy Error and 503 error.

The outage was caused during a routine reboot of servers in order to apply security patches to protect against the Meltdown and Spectre vulnerabilities.

Rebooting the servers took longer than anticipated which led to longer outage of the core Skore services. The knock on effect was that some services became temporarily unavailable.

We are reviewing our risk analysis for maintenance to ensure that we are taking all necessary precautions for future maintenance so that we can better inform customers during such updates.

We apologise for any inconvenience this may have caused.