PEER RESPONSES FOR Patient Outcomes and Sustainable Change
Shabnampreet Kaur
Jan 14, 2023, 12:03 AM
Change is the law of nature and in healthcare change is inevitable. Sometimes changes can be overwhelming for the employees, so the framework and change theories like Roegrs’s change model can be very helpful (Barrow et al., 2022), "IHI Module QI 201: Planning for Spread: From Local Improvements to System-Wide Change." provides excellent examples to make the readers understand the systematic process of bringing a change (Institute for Healthcare Improvement, 2022c). Kurt Lewin’s change theory suggests three steps: Unfreezing, change, and refreezing, and Everett Roger’s diffusion of innovation describes five characteristics of innovations which are: relative advantage, simplicity, trialability, observability, and compatibility. Lewin and Roger explain a stepwise framework that healthcare professionals can use to bring change. The current culture of the practice site is a kind of laissez-faire, where employees are allowed to do as they choose, which according to the learner is not good for implementing the DPI project. Employees need to have strong leadership, certainly not a dictatorial type but servant leadership can help towards making the project successful. The leadership will be defined and day-to-day managers will be identified. The learner along with the mentor has planned to make a team with the learner as the project manager and sub-teams, which will have their respective leaders/managers. After defining the leadership, the key goals and incentives of the site will be aligned with the fall project. The next step according to the IHI framework is set up for spread, The learner will identify the target population and the initial strategy to reach out to the target population identifying the adopter audiences is helpful since it will help the learner as the project manager to make the implementation of the intervention easier. Better ideas and cases for better ideas will be developed to set examples/; Communication is the key to making the project more adaptable;e for all and successful with a positive impact. The learner will identify communication methods such as emails, encrypted text messages, and web-based communication applications as the communication method. The next step is using the best methods to spread the knowledge about intervention and for this local community, a leader can be sued. Finally, measurement and feedback play a vital role in monitoring the progress of the program, so a reliable outcome measure will be developed such as surveys from the enrolled patient population and employees involved in the team. It is very important to take into consideration all the components of the IHI framework for spread. The learner will also use the new idea scorecard with the project team(Institute for Healthcare Improvement, 2022b). Each team member will be asked to evaluate the change by ranking it from 1 to 5 in Roger’s five categories: relative advantage, simplicity, compatibility, trialability, and observability. The project design is as follows: screening the patient at risk of falls using the CDC STEADI Stay Independent questionnaire, assessment using chair rise speed, balance test, and gait measurement, and the intervention which is a tai chi exercise program for all the individuals screened positive. After evaluation of the change based on the New idea scorecard, potential barriers will be discussed and specific strategies will be shared to overcome the barriers. For example, some team members might struggle with the outlook system which is one of the communication methods to be used by the team in terms of simplicity. Here, clear instructions and guidelines can be provided to the embers based on their learning style. For members who prefer a visual style, a PowerPoint video will be shown to set up the account on outlook, settings and managing passwords, storing information, flagging the emails based on priorities, etc. Using Roger’s model or Lewin’s three-step change process, the e new change can be introduced.
Barrow, J., Annamaraju, P., & Toney-Butler, T. (2022, September). Change management. NCBI.
Institute for Healthcare Improvement. (2022b, April). Using a new idea scorecard. IHI.
Institute for Healthcare Improvement. (2022c, August). QI 201: Planning for spread: From local improvements to System-Wide change. IHI.
