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![Page 1: Actions Set a clear aim for the performance of your eligibility system Define why your key audiences (governor, legislature, public) should support it.](https://reader030.fdocuments.in/reader030/viewer/2022032313/56649e735503460f94b72501/html5/thumbnails/1.jpg)
Actions
• Set a clear aim for the performance of your eligibility system
• Define why your key audiences (governor, legislature, public) should support it given their interests
• Establish specific actions steps to get there in the next year
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Sustainability and Spread
Learning Session 3April 24, 2003
Ron Moen
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Sustain Improvement
Spread Improvement
Improvement
Creating a New System
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Sustainability: “Hold the Gains”
Sustainability means continuing to profit from gains rather than experiencing a one-time effect of your efforts
(You have achieved something that you wish to sustain)
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Old System New System
Some Inhibitors:“We met our goals”“We assumed the improvement would hold”Other priorities took all resources away
(not on senior management’s radar screen)Did not learn how to hold the gainsNo infrastructures are in place
Hold the Gains:
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Readiness for “Hold the Gains”
Success of collaborative team Intention Organizational priority Leadership responsibility
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Three Key Components of a Strategy to Hold the Gains
1. Communication
2. Infrastructure
3. Design Effective Control System
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Hold the Gains: 1. Communication
Aim, successes, learning's, and
benefits to all stakeholdersDocument the new processKeep in contact with your team
and other teams
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Training and development of new skillsChanges to job descriptions, policies, and
proceduresAssign ownership for improvement and
maintenance work of the new processInvolvement of senior leaders in taking
responsibility for the efforts to sustain the change and remove inhibitors that might allow slippage back to the old system
Hold the Gains: 2. Infrastructure
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Hold the Gains: 3. Design Effective Control System
Design using the Model for Improvement
• Use the 3 questions• PDSA Cycles
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1. What are we trying to accomplish? Hold
the gains after successful improvement 2. How do we know a change is an
improvement? Performance/outcome measures will remain at the improved level
3. What changes can we make that will result in improvement? Standardization Identify and remove any special
causes
3. Design Effective Control System
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Some PDSA Cycles:
Plan to standardize and verify conformance to the standard
Sustain the change by using run charts or control charts to monitor outcome measures
3. Design Effective Control System
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Sustain Improvement
Spread Improvement
Improvement
Creating a New System
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Target Population for Spread
Population of Focus for your BTS Aim
Spread
- Other offices - Other departments
- Other counties - Other key systems
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Spread:
Spread means making improvements
beyond the scope of the Collaborative
Team
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Readiness for Spread
Success of collaborative teamIntentionOrganizational priorityLeadership responsibility
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Five Key Components of a Strategy for Spread
1. Infrastructure
2.Communication
3.Social System
4.Schedule for spread
5.Measurement and Feedback
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Spread: 1. Infrastructure
Topic a key strategic initiativeSet up the project
Executive sponsor: sets the agenda Day-to-day leader: the driver Target population: who will be the adopters of
the changes Communication plan: start early Measurement strategy: system wide
Staging plan - The plan to reach all units in the target population over time with all of the changes
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Spread: 2. Communication
Distinguish between communicating awareness and technical knowledge
Use multiple communication channels
Identify and train your key messengers (Change agents, content expert, opinion leaders)
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Adapted from Ashkenas, 1995
SHAREINFORMATION
SHAPE BEHAVIOUR
GeneralPublicationsflyersnewslettersvideosarticlesposters
PersonalInvitationlettersreportspostcards
InteractiveActivitiestelephoneemailvisitsseminarslearning setsmodeling
Face-to-faceone-to-onementoringsecondingshadowing
The WAY in which we communicate is
important
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Spread: 3. Social System
Content, context, and community Understand the relevant circumstances
affecting peoples’ ability/willingness to adopt the changes
Take advantage of the existing relationships within the system
Develop “communities of practice” among those with similar roles
Don’t forget improvement knowledge
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Spread: 4. Schedule for Spread
Consider completeness and coverage as a way to direct the spreadCompleteness: all changes, limited
officesCoverage: all offices, limited changes
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Design a flexible spread program
Offices
Par
ts o
f th
e S
yste
m
100%
100%Coverage
Co
mp
lete
nes
s
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Spread: 5. Measurement and Feedback
Data collected on: -Outcome measures -Measures to track spread of specific changes
Reporting to provide feedback Data and reporting at different levels
within the organization