Deeper Dive Into CollaborativesChange Packages

Colleen Kennedy January 30 & 31, 2013

What We Will Cover

Change Package• Drives action periods• Directs the work of teams• Ideas for change• Teams test these change ideas during action

periods• Test on a small scale• Spread adapted changes• Plan multiple series of PDSA’s

Source: Institute for Healthcare Improvement

Change Packages

• 2 examples – both good• At your tables, please take five minutes to:

• Review• Consider: if you were participating in a collaborative, would this

help direct the work of your team?

• Group thoughts?

Change Packages• Key content of the collaboratives• Outlines what changes will lead to

improvement• Focuses team’s attention• To accomplish the aim of the collaborative• Credible changes

• Research literature• Expert recommendations

Change Packages: Development

• Literature Reviews• Case Studies• Expert recommendations

• Faculty/Expert meeting• Key partners in technical content

• Information used to create a “straw dog”• Present to expert group• Expand on change ideas with the group

Change Packages: Development

• Improvement advisor and director prepare first draft after expert meeting

• Conference calls for larger group discussions• Smaller group calls for specific aspects of the

package• Faculty member linked to each content

element

Change Packages: Structure

• Start with a high level view and more to detailed change ideas

• Organized in logical sequence• Group like changes together• Err on side of being too specific

Change Packages: StructureAdmission

Medications

Move steps in the process close

together• Place ASA in easy reach

of provider.• Make aspirin use for AMI

patients a high prority via education of staff.

• Put an aspirin dispenser on ECG machine.

• Consider an ASA candy bowl.• Compose a jingle to keep ASA

benefits in the mind of the provider (marketing strategy).

• Designing a Perfectly Adverse System

TRIZ Defined

• How to?• Create a question• “How can you make sure none of your

teams even try a change idea?• Answer the question• Identify which of those things are actually

done• Discuss which of the things you should stop

and how!

TRIZ

TRIZ• Imagine you are a collaborative director

building a change package• How can you make sure none of your teams

even try a change idea?• Answer the question• Identify which of those things are actually done

• Group sharing

Change Packages: Tips• Start with a high level strategy• Change concepts at higher level• More detailed change ideas• Organized in logical sequence• Group like changes together• Err on side of being too specific• “Test run” change package with pilot team if time

permits!

Change Packages in Practice

• Key part of Learning Sessions• Introduced to teams• Structures and directs their work• Explains what they “are getting into”

Change Ideas Worksheet• List of change ideas for learning session

participants• Can use the change ideas worksheet to

identify:– What changes are already in place– What improvements are needed– What change ideas should be high priority/included in

action planning

Change Ideas Worksheet

To be included in Action Planning?

High Priority / Early Change?

Improvements Needed

What we currently have in placeChange Ideas

Project Planning Worksheet

• A tool for planning action period activities• Outlines what changes will be tested• Who will own the changes• When they will happen

Project Planning Worksheet

What We Have Covered

Deeper Dive Into CollaborativesQuestions?

Colleen Kennedy January 30 & 31, 2013