Do you struggle with the scale of the improvement required in health systems? Does it feel overwhelming at times when you look at all the data that is available to us from incident reporting, patient complaints, audits, benchmarking studies and the like? It can feel very daunting, where to start, how to scale up the improvement effort, which improvement method should be used, cost, time etc.
I have been involved in health care improvement at the level of microsystem redesign for 15 years of my career. The best method I have seen and used, to get change at scale and pace across a whole system of care, is the Breakthrough Collaborative method, pioneered by the Institute for Health Care Improvement (IHI), 20 years ago. I trained in the USA with IHI in 2001 and recently published an evaluation of the Breakthrough Collaborative method. This is a method which with training and support can be an important tool for clinicians, clinician managers and executives to drive improvement across systems of care.
Plan Do Study Act
The Breakthrough Collaborative method came out of the manufacturing industry and it works on a statistical approach that says, if on your own you were to have 20 trials at trying to figure out the best way to do something to get improvement, it could take up to six months to do each of those tests of change, collect the data, learn from trial and then trial again etc. These are known as Plan Do Study Act cycles (PDSA). However, if you had 20 teams (or more) working simultaneously on the same problem, you would get to the best approach much faster as you have now dramatically increased the numbers of trials of change you can do. Once you have that best approach, knowledge is then shared rapidly between teams and hence the term ‘breakthrough’ in improvement. You literally get a breakthrough as you go from small numbers of teams to all teams using the best change strategies.
There are now whole systems in the UK, Europe and USA that use this approach as their preferred improvement method to deliver whole of system change. Particularly with respect to common harms, e.g. falls, pressure sores, infections, VTE prophylaxis, ventilator acquired pneumonia, etc.
In my workshop at the Strengthening Clinician Engagement Conference, I will be taking participants through the Breakthrough Collaborative method. Demonstrating how this method works and the importance of building capacity in front line staff and creating ‘organisational readiness’ to drive improvement efforts. The workshop will be interactive with opportunities to explore and trial this method.
Book by June 12th to save $200!
 Harrison BT, Chen J, et al. Improving red cell transfusion in the elective surgical setting: an improvement collaborative with evaluation. Vox Sanguinis Vox Sanguinis (2015) International Society of Blood Transfusion DOI: 10.1111/vox.12237