Wednesday 22 September 2010

Options for large scale spread; excellent new report by WHO, IHI, Harvard

A new report about large scale change and spread of simple, high impact interventions is available now. And it is a really good summary of methods old and new. I highly recommend it for anyone planning simple large scale spread, especially if you think you know the answers. This report summarises a variety of methods and is very pragmatic in it's use of examples.

The World Health Organization Patient Safety Programme and the Harvard School of Public Health commissioned the United States Agency for International Development’s Health Care Improvement Project (HCI), managed by University Research Co., LLC (URC), to present its understanding of and experience with the effective adoption of simple, high-impact interventions, such as the Surgical Safety Checklist. URC is joined in this effort by the Institute for Healthcare Improvement, which also has decades of experience in this field.

Readers should note this report and advice covers the spread of simple, high impact changes - namely it does not cover complex, system related changes.

The report covers:

III. Spreading Evidence-based Interventions
IV. The Scientific Basis for Spread
A. Framework for Spread
B. Individual Adoption and Behavior Change
C. Positive Deviance
D. Factors that Influence the Rate of Spread
E. Understanding the Social System
F. Integrating Content into Process Design
G. Testing and Implementing Change
H. Executing for System-level Results
V. Approaches for Large-scale Spread
A. Natural Diffusion Approach
B. Executive Mandates
C. Extension Agents Approach
D. Emergency Mobilization Approach
E. Affinity Group Approach
F. Collaborative Approach
G. Virtual Collaborative
H. Wave Sequence Approach
I. Campaign Approach
J. Hybrid Approaches
K. Lessons Learned from Large-scale Spread
VI. Which Approach Should Be Used to Disseminate Checklists?

(And thank you to the authors of the report for referencing my book on how good practice doesn't spread)

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