Thanks to all from a fellow change agent virtually attending #IHI26Forum

Even from afar, I’m sensing the energy and excitement for transformational improvement in health care. Thanks to all who’ve shared with those of us unable to attend in-person. All the sharing inspires me and I want to share, too.

The enthusiasm that comes from conference attendance, meeting new people and hearing new ideas is always contagious and a powerful stimulus for action.

o   Nurture the enthusiasm

o   Bring it home to your organization

o   Share what you learn

Once you get home, you may find you have so many new ideas that you feel a bit overwhelmed by the options. Where do you start? How do you choose the best ideas to try in your organization?A simple way to start is to separate the ideas into two buckets for now:

o   Ideas that address YOUR organization’s big problems

o   Ideas that address problems you haven’t yet identified or know aren’t relevant to you

The problems you’ve already identified will be supported by your data – data from metrics, surveys, focus groups, etc…

Don’t spend your precious resources chasing problems that may not apply. Go where you know you need to go first. Pick the projects that address YOUR problems.

Now that you’ve picked those practices that address your needs, it’s time to consider a few important questions:

o   Was the practice effective where it was tested?

o   Could the practice work for you?

o   Can you try the practice safely?

You may assume that because a practice is shared at a conference it must work. But stop and consider a few questions to be sure you understand the intervention well enough to try it in your organization.

Does it work?

  • Did the implementers measure the outcome accurately and in exactly the same way before and after the intervention? Sometimes as we learn during a project, we make changes, forgetting that the changes will impact our assessment of the outcome. Infrequent events are especially sensitive.
  • Did the implementers take care to reduce the impact of other, concurrent actions that could have an effect on the outcome? How certain are you that the effect on the outcome was from the intervention alone?
  • Was the change in outcomes clinically important? This is different than a statistically significant measure of change. It asks whether the change is important to patients and their providers.
  • Consider whether you have enough detail to evaluate and replicate the intervention. If not, contact the developer. They should be happy to share.

After satisfying for yourself that you have enough detail to determine that the intervention seemed to make an important difference where it was tested, and that you can replicate it, it’s time to consider:

Could the intervention work for you?

  • Are your patients and setting similar enough? If not, what effect is any difference likely to have on the observed outcome?

If you’ve determined that the intervention might work for you, how well do you understand the potential risks to your patients and staff?

  • Did the implementers measure and report adverse events? If not, you should contact them to ask.
  • When you pilot the intervention, can you monitor its implementation to protect your patients and staff?

These screening questions may help you sort through all your new options to help pick the projects that may best suit your organization and goals for improvement. Here’s to your success!  TheEvidenceDoc 12/10/14

P.S. If you’d like a checklist of the screening questions, contact TheEvidenceDoc here.