Download - Wave 3: Learning Session 2
New Approach to Controlling SuperbugsVirtual Learning Session 2
The Discovery Phase
Agenda:1. Welcome and Introductions2. The Discovery Phase3. Discovery and Action Dialogue4. Improvisation5. Wise Crowd6. TRIZ
The Premise Of Positive Deviance
No matter how bad things are, there are always people in the group that do a better job, despite having access to the same resources
Positive Deviance-the 6 D’sPositive Deviance-the 6 D’s1. Define: the problem and a successful outcome
2. Determine: if there are any “positive deviants”
3.3. Discover: uncommon practices/behavioursDiscover: uncommon practices/behaviours
4. Design: activities enabling others to access and practice new behaviours
5. Discern: effectiveness of activities or project through ongoing monitoring and evaluation
6. Disseminate
PD Tools
• Kick offs • Improvisation• Sharing Stories• Discovery and Action Dialogues• TRIZ• Wise crowds• Social Network Analysis• Ethnography
“Act your way into a new way of thinking…”
ImprovizationAn Approach for
Practicing Positive Deviance
Our Road to ImprovDiscovery & Action
Dialogues
Departmental Improv (e.g. General Surgery Unit)
Site-Wide Improv Day
Improv Day at Toronto Western Hospital
• Players (cast)
• Planted core group; audience
participation
• Artistic Director
• Can instruct Players to “play up” certain
behaviours; sentiments
• Keep the element of surprise/improv
Lights… Camera… Discovery & Action!
Core Group Member
Residents
ICPs; Nursing; Government
Lessons Learned• Less can be more
• Provide very basic scenario outlines
• Use artistic director to uncover interesting themes.
• Take advantage of multi-disciplinary group
• Have a DAD!
• Follow-up with participants – they may have different perspectives/ideas for next improv
Discovery and Action Dialogues:• 15-20 minute sessions • Ideally done right on the unit• Include those that want to be involved• Encourage a multidisciplinary group• Facilitator runs through a series of questions
that affirm the problem, identify barriers, uncover existing solutions, generate ideas/actions
Discovery and Action Dialogues:How They Work
• Group selects a specific problem• The group as a whole identifies what the
solution looks like including key measures of success
1. How do you know or recognize when ______ is present?
2. How do YOU contribute effectively to solving _____?3. What prevents you from doing this or taking these
actions all the time?4. Is there anyone you know who is able to frequently
overcome barriers?5. Do you have any ideas?6. What needs to be done to make it happen? Any
volunteers?7. Who else needs to be involved?
Tips for FacilitatorsDo:• Hold the dialogue in the participants’ local
context – e.g. the unit• Make impromptu invitations as you enter • Designate a scribe to take notes• Start with the purpose, We are here to
stop…
Do:• Give questions back to the group-wait 20 seconds
for a response• Encourage everyone to speak• Work through all questions without worrying about
the order• Demonstrate genuine curiosity in everyone’s
contributions
Avoid:• Answering questions that have not been asked• Missing opportunities to “catch butterflies” – record
actions to be taken by participants• Coming away with a to-do list for yourself• Responding positively or negatively to contributions-
let the group sift through their own assessments
Always remember:
“Nothing about me without me”
Take 5
• Questions?• Experience
with DAD?• Outcomes?
Wise Crowd
TRIZ “theory of inventive problem solving”
• Define an unwanted result e.g. hospital acquired infections
• Design a system that would reliably create the unwanted result
• Compare the adverse system to the current system
Example• Design a system where you will reliably
infect 100% of patients with a superbugs within a few days of admission
Next Steps
• Continue to work on core team and “launch”
• Start using the DAD process and other methods on the floors
• Begin to think about data collection
• Next Learning Session: Monday February 7th 1 pm EST
• Next Coaching Call: Monday February 14th 1pm EST
www.stopsuperbugs.com