1. Courtesy Reminders: During the webinar, you may select *7 on your phone to speak, and use *6 to mute. Please refrain from placing the phone on HOLD during the presentation.    March 9 from 2 – 3 pm    Hosted by: Kelly Court Efficiently Adopting Bundles and Protocols: Making Progress

2. MeetingPurpose Webinar 1 Engaging Stakeholders Dec 9, 2 pm Optional Coaching call Jan 27, 2pm Pre-work Huddle Identify participants Gather information needed for stakeholders 1 – Stakeholders Meeting Identify gaps in best practices Determine other key stakeholders Webinar 2 Action Planning January 13, 2pm 2 – Action Planning Meeting Discuss priorities Identify low hanging fruit Identify processes to test Webinar 3 Change Planning February 10, 2 pm 3 – Change Planning Meeting Involve staff doing the work Plan for just in time trials/tests 4 – Progress Check Meeting Reports on pilots and tests Decision to continue, or adopt the change Webinar 4 Making Progress March 9, 2 pm 5 – Implementation Planning Meeting Discuss the implementation checklist Determine next steps 6 – Implementation Follow-up Meeting Monitor progress with implementation Determine accountable staff Webinar and Meeting Structure

3. Best Practice Mindset Shift Tools Culture Four Elements of Change Management

4. Taking lessons learned, with input from front-line staff, to fully implement bundles and protocols into daily practice can be a challenge  Leaders and front-line staff are accountable  Not adopting approved changes is not an option  Safety Bundles and Protocols are not ‘suggestions’ Reminder: Shifting the Mindset

5. Discussion Would anyone who has involved front-line staff in small tests of change be willing to share: ….what has worked well with the cycles of testing? …. what has been a challenge during the cycles of testing? …. How easy is the decision to move to formal implementation of the change? *6 to unmute your line; *7 to mute your line

6. When to move to formal spread and implementation can seem like a tough decision. Consider these 3 factors: 1.Everyone who needs to test the change has 2.The process is stable, with few changes 3.Staff are satisfied with the current state Implementation Ready??

7. 5a – Implementation Pre-Meeting Planning  Determine who should attend the Implementation Planning Meeting  Be sure the include staff from key areas (This will vary by topic)  Choose an Implementation Checklist  Send an Agenda

8. Who to involve in this meeting? At this point, consider inviting those who play a role in the implementation of a change:  Units/departments  Information Technology/EHR?  Education – staff education, patient education?  Medical staff?  Human Resources?  Committee representatives?  Administration?  Others?

9. 5b - Implementation Meeting Agenda  Introduce any new attendees & review agenda  Discuss the Implementation Checklist – including methods of audit, measurement, or oversight  Assign dates and accountabilities to each item that applies  Confirm individual assignments before adjourning

10. Worksheet 5-4 - Implementation Checklist (Sample)

11.  Have the meetings been occurring and is the work on pace?  Can the team describe what is needed to move forward with implementation?  Be sure to compliment the work, if progress is on pace. 5c – Implementation Senior Leader Checklist

12. 5d – Implementation Post Meeting Assignments  Carryout the implementation tasks according to plan  Continue to monitor the plan

13. Moving to the Last Step Don’t assume the implementation went as planned Too often we move on to the next project and we gradually slide back to the “old way of doing things” Time to put processes in place to “hold the gains”

14. 6a - Implementation Follow-up Pre- Meeting Planning  Gather any updated data related to the bundle or protocol – outcome or process measures  Develop a plan to review the ‘current state’ of the implementation  Send an Agenda

15. 6b - Implementation Follow-up Meeting Agenda  Introduce any new attendees & review agenda  Attendees report out on each element of the Implementation Checklist that applied  Develop action plans for any gaps and assign accountabilities  Identify an individual or department accountable for monitoring for ‘drift’ (generally this is the area with the most front-line staff doing the work)

16. Implementation Checklist – Checking Progress

17. Document who will be monitoring performance going forward Worksheet 6-2 Process Control Plan

18. Process Control Plan Example

19.  Attend the Implementation Follow-up meeting and listen to the discussion  Is it clear which department and manager is accountable for sustaining gains?  Schedule a touch base with the team lead and manager 60 days out  Ask to see any measured results 6c – Implementation Follow-up Senior Leader Checklist

20. 6d - Implementation Follow-up Post- Meeting Stakeholder Assignments  Accountable stakeholders from the primary department monitor for continued use of the bundle or protocol  This protocol or bundle should be reviewed at least annually for any changes in best practice.

21. At this point, the change should be tied to an existing accountability structure – Quality Committee – Safety Committee – Shared Governance – Management Team At least annual spot checking of the outcome measure; may need a process measure if the outcome is “slipping” Think about a contingency plan – new PDSA cycles – if performance starts to slip Integrating the Change

22. IssueSuggestion There are limited resources in support departments (IT, Education, etc.) which limit progress on implementation This is likely an organizational issue. For example, if the practice has been to train during an annual skills fair, this may need to be reconsidered for safety practices. IT resources are a common bottleneck. An organizational discussion about where safety related changes rank in the list of changes may be needed. What could go wrong?

23. Implementation Planning Checklist Sample Agenda Improvement Workbook Worksheet 5-4 and Worksheet 6-2 Orientation of WHA Quality Resources

24. Questions?

25. Please complete the brief post-webinar survey We value your feedback and will follow-up with you if requested Thank you! Kelly Court kcourt@wha.org Feedback for Today