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The What is a Collaborative campaign brings together practitioners to work in a structured way to improve the quality of their service. It involves meetings to learn about best practices, quality methods, change ideas, and share experiences. This model includes five essential features: specified topic, multi-professional teams, improvement model with measurable targets, series of structured activities, and expertise from clinical and quality improvement experts.
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What is a Collaborative? Diana Dowdle Campaign Manager 20,000 Days Campaign
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)
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
IHI Breakthrough Series Model Collaborative Teams Select Topic Pre work P Identify Change Concepts Spread A D P S Expert Meetings Holding the Gains A D LS 3 LS 1 LS 2 S Supports: emails/ visits/ reports/ sponsors / meetings/ assessments / conference calls
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
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
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
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
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 Comments:Cumulative bed day saving as at 31st of May is 5921. 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 DashboardMay 2012 Comments: Unplanned readmissions are stable and only normal variation exists. Comments:Admissions 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
Model for Improvement 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 Act Plan Study Do Improvement Guide, Chapter 1, p.24 Appendix C, p. 454
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