Tackling Spread

							What do we mean by Spread ?

     Overcoming the ‘Islands of
       Improvement’ effect !
           Chris Fearns
Spread:
 Is the extent to which learning and change
 principles have been adopted in other parts
 of the organisation OR other organisations,
 that could benefit from them

 Spread means that learning which takes
 place in one organisation is actively shared
 and acted upon by others
    Key Concepts in spreading good
        ideas for improvement
The activity of spread:
• involves identifying the key learning and the change
  principles that are emerging from your improvement
  work

• purposefully creating conditions that accelerate the
  adoption of the key learning throughout the local NHS.

• Measure of success - becoming ‘Common Knowledge’
     Spread is the result of the process of Adoption
     Spread                            Adoption
• Push ideas outward to      • Pull ideas into myself
  others                     • My agenda at the
• my agenda at the             sharp end of
  centre of larger org         delivering care
• Use of organisational      • Use of social systems
  structure and hierarchy      to communicate about
  to communicate about         change
  change                     • a focus on
• a focus on tools,            relationships and
  techniques and               facilitation
  processes
      Rogers 5 Key ‘Attractive
      Factors’ for spread ideas:
• clear advantage compared with current
  ways
• compatability with current systems and
  values
• simplicity of change and its implementation
• ease of testing before making a full
  commitment
• observability of the change and its impact
       Spread and reinvention
• Ideas commonly go through a process of
  ‘reinvention’ as they spread
• Often necessary to allow others to adapt the
  ideas to their local situation
• Because of this it is essential to think of
  disseminating change principles rather than
  specific ways of doing things
 CHD Collaborative programme
• Work to ‘spread’ improvement ideas
• Ultimate success determined by whether or
  not others ‘adopt’ the ideas
• What do you want others to adopt ? -
  encourage the adoption of change principles
• Who would actually benefit from your
  change ideas - target these people?
• Adopters will refine and improve our ideas
        Infrastructure for Spread
•   Does the team require access to resources?
•   Are staff with appropriate new skills available?
•   Do we need to provide training?
•   Are new policies required (e.g. HR policy)?
• Do existing information systems support the
  change and if not, what are the resources and time
  scales required to modify them?
• Are there other barriers that the team is
  encountering that may require the intervention of
  relevant senior leaders?
                  Next steps:
• Plan a strategy for how we will attempt to engage
  individuals, groups and organisations in the
  adoption of change principles

• Each project to outline its own plan based on the
  principles of ‘pull rather than push’

• Agreeing how we will engage people observing
  the process, tools and benefits without having to
  commit to change immediately

• Identify the infrastructure to support spread