1. Scaling Up and Spreading Change Jane Taylor, Ed.D. Improvement Advisor to SCCM

2. 2 Scale Up and Spread Implementation – Making change permanent on a pilot site or units Scale Up – Overcoming systemic barriers that emerge while implementing – Overcoming infra-structure issues that would inhibit implementation and spread Spread – Replication of change(s) with other people and other sites

3. 3 Examples from Sepsis Screening and Response Implementation – Screening of every patient every shift – Requires incorporation in flow – Simulation of response – Role clarity – Job description changes – Training and new hire orientation – Policy and procedure – Standardization and specification – Documentation – Protocols and nurse driven protocols

4. 4 Scale up Infra-structure issues – No place to document screening for data capture and communication Systemic barriers

5. 5 Spread Moving across from pilot unit to all medical surgical units Moving to hospitals within the healthcare system

6. 6 Thank You