Spread
Learning Session 2
November 15, 2002
Ron Moen
Spread
Population of Focus
for your BTS Aim
Target Population for Spread
- Other offices
- Other departments
- Other counties - Other key systems
Spread
Spread means making improvements
beyond the scope of the Collaborative
Team
Spread Readiness
Success of collaborative team
Intention
Organizational priority
Leadership responsibility
Some Key Components
of a Spread Strategy
Infrastructure
Communication
Social System
Schedule for spread
Measurement and Feedback
Infrastructure
 Topic a key strategic initiative
 Set 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
Communication
Distinguish between communicating
awareness and technical knowledge
Use multiple communication
channels
Identify and train your key
messengers (Change agents, content
expert, opinion leaders)
The WAY in which we
communicate is important
SHAPE
BEHAVIOUR
SHARE
INFORMATION
General
Publications
flyers
newsletters
videos
articles
posters
Adapted from Ashkenas, 1995
Personal
Invitation
letters
reports
postcards
Interactive
Activities
telephone
email
visits
seminars
learning sets
modeling
Face-to-face
one-to-one
mentoring
seconding
shadowing
Promotion Materials Which Show
Evidence of:
 Relative advantage (evidence from
testing)
 Compatibility with current values
 Simplicity of the change and the transition
 Testability of the change
 Ability to observe the change and its
impact (your successful teams can
provide this)
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
Plan and Schedule for Spread
Consider completeness and coverage
as a way to direct the spread
 Completeness: all changes, limited
entities
 Coverage: all entities, limited
changes
Design a flexible spread program
Practices
100%
Coverage
100%
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
Introduction to Action Period 2
Summary of Action Period 1
Plan work for Action Period 2
Team Report out and Feedback
Summary of Action Period 1
Progress:
Most teams have:
Engaged teams
Communicating across teams
Tested changes
Reported core measures
Summary of Action Period 1
Progress:
Opportunities for Improvement:
Monthly reports on your progress
Annotated run charts
More “small scale” sequential testing
Use more change concept ideas
More interaction through the web site
Overall Aim: Improve enrollment in Medicaid
Simplifying
requirements
Changes
to MAXIS
notices
Improved
Phone
referral
applications
procedure
Concurrent Cycles at Minnesota
Team Assessment
Place an X on the scale that best represents the team’s progress in achieving
the aims.
-|------------|-----------|------------|----------|----------|------------|-----------|-----------|1
2
3
4
5
1 Activity but no testing
Team engaged in data collection and developing changes. No tests of
change or evidence of testing within last month.
2 Modest improvement
Testing has begun. There is antidotal evidence of improvement.
3 Improvement
Implementation has begun. Improvements have reached 50% of at least
one goal.
4 Significant Improvement
100% of at least one goal is reached.
5 Outstanding Sustainable Results
Targets exceeded. Changes spread to larger system.
Aim of Action Period 2
Build on successes and learning
Help each other be successful
Gain additional skills in topic and
improvement science
Plan additional testing cycles
Build implementation and spread plans
Action Period 2
Team Meetings
1. Summarize new knowledge learned at LS2
2. Draft overall plan for Action Period 2
(See Project Planning Form on page before
Change Concept Tab)
3. Plan one or more cycles for testing changes
from your Project Plan
(Use Faculty as a resource for help)
(stop at 10:00 a.m.)
10:00 – 10:30 Break
Team Report out and Feedback
(10:30 – 12:00)
Give team name and aim
Share plan for next few cycles
Receive feedback from others
Learning Session 3
Share Results and Celebrate Success
Develop a System for Spread
Date for Learning Session 3: