Change is all around us! Thousands of passionate people at St. Michael’s Hospital are working right now on countless projects and initiatives to improve the way they do what they do, while at the same time actually doing their work.
“I see great enthusiasm for quality improvement in every corner of the hospital, and together we’ve achieved so much,” says Dr. Chris Hayes, medical director of quality and performance. “But I also see that this work can add extra time and effort, on top of the already busy work that we do to care for patients. It can lead to overburdening of providers and contribute to quality improvement – and other change initiatives – not being successful.”
Dr. Hayes took these concerns to the Institute for Healthcare Improvement in Boston where he spent a one-year Harkness Fellowship researching the best way to design and implement quality improvement projects.
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“To succeed, the people who are implementing the changes need to be able to reliably do the new tasks and see value in what they are being asked to do,” explains Dr. Hayes. “There needs to be the right balance between how valuable the outcome will be, and how much cognitive and physical work it will take to get there.”
It’s not a complicated recipe, but Dr. Hayes said people tend to go through a lot of trial and error – and exhaustion – trying to get it right.
Dr. Hayes conducted a literature review, site visits, expert interviews and focus groups. He distilled what he learned into six main questions to ask, including one about extra workload, before planning and implementing a change. He developed the Highly Adoptable Improvement model and tool to help determine exactly how likely a change initiative is to succeed, or if further thought is needed.
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“I piloted the assessment tool with 16 improvement advisers from the Institute for Healthcare Improvement,” says Dr. Hayes. “They all took it back to their institutions, and tried it out on their quality projects. They said the model was intuitive, clear and useful, and it opened their eyes to why some projects just weren’t getting anywhere. They all said they’d keep using the tool.”
Learn more and download the tool at www.highlyadoptableqi.com.
