What Does Success Look Like?

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From the course by Johns Hopkins University

Designing for Sustainment: Keeping Improvement Work on Track (Patient Safety IV)

16 ratings

Johns Hopkins University

Designing for Sustainment: Keeping Improvement Work on Track (Patient Safety IV)

16 ratings

Course 4 of 7 in the Specialization Patient Safety

Keeping patient safety and quality improvement projects on track, on time, and on budget is critical to ensuring their success. In this course, students will be introduced and given the opportunity to apply a series of tools to guide and manage patient safety and quality initiatives. These include tools for defining what success looks like, developing a change management plan, and conducting a pre-mortem to identify risks for project failure. This course will also provide tools for engaging stakeholders to ensure key players are invested in your project’s success.

From the lesson

What Does Success Look Like?

In this module, learners will develop an understanding of what project sustainment is and why it is important, the potential risks to project sustainment, the importance of planning for sustainment from project inception, types of measures used in quality improvement projects and the attributes of each, how strategies for improvement were developed in two successful large-scale quality improvement initiatives. Learners will become familiar with the issues impacting sustainment and how they may be successfully addressed across the life span of a quality improvement project.

What Does Success Look Like?5:26

Failure to Sustain6:49

TRIP Plus 24:15

Planning Ahead8:41

What Measures?10:22

Examples of Successfully Sustained Projects22:00

Meet the Instructors

Lisa H. Lubomski, PhD
Assistant Professor
Department of Anesthesiology and Critical Care Medicine

So, let's begin with goals and objectives.

My overall goal is to highlight the importance of planning for

project sustainment from the inception of the project.

Specific objectives: By the end of this lecture,

you should be able to define sustainment.

Recognize the reality of risk from project failure.

Identify attributes of successful projects.

Explain the importance of identifying and using sustainable measures.

Explain the importance of identifying

appropriate data sources including people and more material resources,

and appreciate the importance of planning to embed and sustain your change effort.

So, here's a dictionary definition of sustainability.

The ability to be maintained at a certain rate or level.

The avoidance of the depletion of

natural resources in order to maintain an ecological balance.

And even this definition I think it's fairly appropriate for,

what's going on in healthcare?

We have our own delicately balanced ecology.

Sustainability in healthcare occurs when safety innovation is transformed

from a project to becoming part of daily work and daily workflow.

Sustainability happens when improvements in patient outcomes attributed

to new practices are maintained after the initial project implementation ends.

Essential to this is providers who share their expertise and provide

ongoing support to others to execute those changes and to continue to do so.

Sustainability has happened when the project is no longer described as change but rather,

this is how we do things here.

Here's one model from Shediac

and Rizkalla that comes from 1998 which I like quite a bit.

Well, we begin probably at the top with

the project design and factors that are inherent to the implementation.

How do we do it? And we sort of think that's the whole story.

But before that there are factors in

the broader community that dictated implicitly what we do, limited what we do.

There are also factors within the organization that certainly influence us.

Together, we hope to achieve programs sustainability.

We hope to maintain health benefits certainly.

We would like to institutionalize the program within the organization.

And we would like to build capacity within the community to allow that to happen.

The IHI a few years ago created a guide or a white paper on sustaining improvement.

This was based on their review of literature both theoretical and practical.

And their model focuses on daily work for frontline managers and staff.

Key elements of their model are performing daily huddles of

healthcare workers to discuss tasks that needs to be done.

The use of visual boards at the frontline,

so people can see how they're progressing, problem solving,

and escalation protocols, so that if things are not working,

they can move up to the appropriate level where the problem can be fixed.

And the integration of aims and priorities into the entire plan.

A third model is the trip model that is for translating research into practice.

Perhaps more appropriately these days translating evidence into practice,

since not everything we're doing uses research evidence per se.

You've already heard a little bit about this in an earlier lecture.

Crucial to this model are first of all,

assembling the right team to do the work,

summarizing the available evidence,

understanding barriers that you may confront, planning ahead,

and then for ease, engaging first,

then educating, then executing the plan,

and then evaluating what's occurred.

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