1. What is a Collaborative?
Diana Dowdle
Campaign Manager
20,000 Days Campaign

2. What is a Collaborative?
Brings together groups of practitioners to work in a structured way to improve aspects of the quality of their service.
Involves meetings to learn about:
best practice in the area chosen
quality methods
change ideas
share their experiences of making changes in local settings Ovretreit et al. (2002)

3. Collaborative Components
5 essential features
A specified topic
Clinical and Quality Improvement experts
Multi-professional teams from multiple sites
Model for improvement with clear & measurable targets
Series of structured activities
- Schouten et al. BMJ 2008 3

4. IHI Breakthrough Series Model
Select Topic
Expert Meetings
Identify Change Concepts
Pre work
LS 1 P S A D
LS 2
Holding
the
Gains
Spread
LS 3
Collaborative Teams
Supports: s/ visits/ reports/ sponsors / meetings/ assessments / conference calls

5. Success factors “Ripe topic” ....tension exists to improve it
Clear charter/aims/ targets
Teams have will & resources
Sponsors involved
Fluid boundaries for roles
Knowledge & skills in topic area
Action oriented – lots of testing - PDSA

6. Success factors
Measurement system that connects testing to tracking progress
Understand systems of care
Great Learning Sessions
Robust Actions Periods
Good communication systems
Oversight –tracking progress/participation/shared learning

7. Campaign CollaborativeTeams

8. Why Do Collaboratives work?
Networked community effects
Effective, horizontal pathways
Supported by the Model
Connected by the Model
Forms a community (Learning Sessions)
Reframes a social problem
Owned by teams/ frontline staff/sectors

9. Why Do Collaboratives work?
Uses multiple interventions to change practice
Empowers everybody
Resets norms and rituals
Puts the patient & families in the centre of care
Uses data as a disciplinary force

10. 20,000 Days Campaign Dashboard May 2012
Comments: Cumulative bed day saving as at 31st of May is 5921.
Comments: The graph shows the difference between the Predicted and actual cumulative bed days.
Comments: There were no Dot days in May. The last Dot day was on 03/04/2012
Dashboard Summary: Cumulative bed day saving of 5921 is a reflection of the difference between actual bed day usage and the predicted growth. This is reflection of the system as whole.
All graphs show normal variation
20,000 Days Campaign Dashboard May 2012
Comments: Admissions are stable and only normal variation exists.
Comments: Unplanned readmissions are stable and only normal variation exists.
Comments:
Comments:
Comments: ALOS is stable and only normal variation exists.
Version: 1.0
Dated: 18/06/2012
Contacts
Campaign Manager : Diana Dowdle
Clinical Leader: David Grayson
Improvement Advisor: Ian Hutchby & Prem Kumar

11. Model for Improvement Act Plan Study Do
What are we trying to accomplish?
How will we know that a change is an improvement?
What change can we make that will result in improvement
Model for Improvement
Act
Plan
Study Do
Improvement Guide, Chapter 1, p.24
Appendix C, p. 454

12. Why do collaboratives work?
Uses “quality” improvement model
Is there a problem?
How big is the problem?
Look how we solved the problem
Is the problem under control?
Increases accountability at all levels
Without supervision
Rewards community membership
Enables wider community