Sustaining and Spread

1
Sustaining and Spread

• Sustaining Improvements
• Part of QI, Senior leadership, ownership
• What have you learned about sustaining?
• Spreading Improvements
• What is spread
• What spread activities are underway?

2
BTS Diffusion Process
Activity
Target
Example
Phase
Action Period 1
Testing
Early adopters
One care team in a clinic
Action Period 2
Testing and Implementation
Early majority
That care team and four others in the clinic
Last Action Period and Post Collaborative
Implementation and Spread
Remaining care teams (implement) and other
clinics (spread)
Early/late majority Traditionalists
3
IHI Spread Model

Social System -Unit for spread
-Key
messengers
-Listeners/connectors
-Communities of practice
-Motivators
incentives -Ability to adapt changes

Better Ideas -Case for new ideas

-Description of the new ideas
-Transition
materials
Communicated
-Modes -Purpose
Infrastructure
-Leaders
responsible for spread
-Staging plan -Technical
support
-Knowledge management
-Measurement/feedback