In healthcare there is no shortage of improvement opportunities, but people are often working in isolation. There is often will to act and good ideas to improve, but teams often need support for implementation.
One Sectors' Solution
The Canadian ICU Collaborative was formed in 2003 to address this gap in critical care and since then, has designed and delivered many collaboratives* on over a dozen topics. Teams have been supported to improve sepsis care, transfusion practices, end-of-life care, delirium management and to reduce ventilator associated pneumonia (VAP) and central line associated bloodstream infections (CLA-BSI). Overall, results have been positive. For example, in one VAP and CLA-BSI Collaborative, one team reduced their VAP rate to zero for 14 consecutive months and another team went 13 months without a line infection.
An Example
The most recent initiative was named the "PAD Your ICU" virtual series and was completed in March 2017. It engaged 41 interdisciplinary improvement teams (10 paediatric and 31 adult acute care) to work together to improve the management of pain, agitation and delirium.
In ten months, teams attended five webinars and 11 connection calls where participants were provided with clinical content and advice on improvement science. Teams set specific aims, shared ideas and knowledge, implemented iterative tests of change, measured progress and shared successful approaches for organizational change. Teams stayed connected via an online sharing system.
You can read some of their stories here:
The collaborative approach has provided a platform to connect, learn from others and make substantive improvements in a variety of settings. You might consider joining a collaborative the next time the opportunity occurs!
What You Can Do – Starting Today!
"Participants told us that it was great to talk to their Canadian colleagues who have similar issues and want to make progress."
In the absence of a formal collaborative, here are some ideas to better connect and support implementation:
- Look for other organizations in your community to visit and learn from (including those who may be outside of healthcare),
- Join a list serve or social media platform with others working on the same problem, especially those who are actively working on improvement initiatives
- Review innovative practices from world class organizations,
- Rely on validated improvement approaches,
- Share your data, learning and challenges with those that matter
In closing, we leave you with a final thought from Dr. W. Edwards Deming: "When we cooperate, everybody wins."
*Collaboratives (also known as Breakthrough Series Collaboratives) were designed by the Institute for Healthcare Improvement (IHI) in 1993 and have been successfully applied worldwide to significantly improve quality and safety in healthcare. Guided by a philosophy of "all teach, all learn", multiple organizations come together to make improvements on a specific healthcare challenge. The approach allows teams to address a common problem, to leverage ideas and to share what they learn along the way. The process is based on three to four learning sessions, team action periods and methods for support (coaching calls, measurement help, discussion forum, file sharing, Faculty feedback).
Authors:
Bruce Harries co-founded Improvement Associates in 2000. He is Collaborative Director for the Canadian ICU Collaborative and has advised on several initiatives such as the National ICU Scorecard and Safer Healthcare Now! Bruce is on the board of the Health Quality Council of Alberta (HQCA) and on Faculty of the BCPSQC Quality Academy. He is a graduate of Trent University, the Banff School of Advanced Management and holds an MBA from IMD in Lausanne, Switzerland.
Leanne Couves co-founded Improvement Associates in 2000. Leanne has designed and supported over 20 Breakthrough Series Collaboratives across Canada and has taught at over 70 Learning Sessions. She has led the writing of several improvement guides based on these approaches. Leanne is on Faculty of the BCPSQC Quality Academy. Leanne holds a Bachelor of Commerce degree and Certificate in Adult and Continuing Education from the University of Alberta.
