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Spreading, scaling up, and sustaining improvements in human services is a complex challenge that many countries, including the UK, USA, and Australia, have been tackling. Despite significant efforts, the sustainability of scaling up local improvements remains low. One reason for this is the traditional, linear approach to spreading improvements, which often overlooks the complexity and evolving nature of healthcare systems.
Implementation is often a weak link in improvement efforts to meet targets. Yet the success and sustainability of change depends on it. The Implementation Playbook is a quick reference guide developed by the World Health Organization (WHO) to facilitate effective health-related implementation efforts.
A core objective of change leadership is to set others up to succeed in your absence. But as we all know, that is a lot harder than it sounds. Research has shown that storytelling has a remarkable ability to connect people and inspire them to take action. “Our species thinks in metaphors and learns through stories,” the anthropologist Mary Catherine Bateson has written. “The harder the situation, the more essential it is.”
Care and service improvement requires the ability to make successful local change, then to transfer this for implementation in other departments and services, or across a whole organisation or sector. However, research shows that highly institutionalised and complex healthcare systems find the spread of transformation difficult, being naturally slow to adapt, innovate, and improve. Change therefore usually happens incrementally and inconsistently, with successful innovation resembling a journey rather than a single event. This is characterised by processes of adoption, implementation, sustaining, spreading, and scaling up.
Managing change remains the most important challenge that leaders grapple with today. By our nature, we resist change and lean towards sustaining the status quo.
Change is scary — and challenging. Maintaining an existing habit is easier than changing it and trying something new means there is a possibility of failure. Most people prefer to stay in their comfort zone than venture into unknown territory however change is where we grow and improve our organisations. So if change is inevitable, how do we deal with it when it happens?
Systems can be complex and change can be difficult. So how can you make it possible?
An introduction into systems thinking and complexity in health.
Systems thinking is a way to maximise program/organisational effectiveness.
This guide suggests a way to use the concept of microsystems to focus the QI process on the locus of responsibility for patient experience, provides an overview of the process of quality improvement, discusses a few well-known models of quality improvement, and presents a few tools and techniques that organizations can use to address various aspects of consumer experience.
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