Test new processes on a small scale first


New processes designed to improve employee and patient safety should first be trialled on a very small scale before being fully implemented. That is the view of Frank Federico, executive director, strategic partners for the Institute for Healthcare Improvement.

“We coach teams by helping them understand how to test new processes, determine if they are effective, and then implementing those processes as the new way of working,” he said. “Our methodology uses the Model for Improvement developed by Associates in Process Improvement.  All changes should be tested on a small scale: one patient, one nurse, one doctor, one pharmacist.”

He added that this approach is often counter to how many healthcare providers have been taught, many of whom run very large pilots for long periods.  

“Many organisations try to do large pilots – that is they may get an entire wards, two wards or an entire hospital to work on improving the process; they’ll do that for months at a time only to find at the end that they probably don’t have a sustainable change,” he said. “Our method may seem to take more time, but, in reality, the changes put in place using our method have a greater chance of acceptance and sustainability.

“One example is a nurse in a medical surgical unit who found that the nurses on the unit had great ideas on how to improve a process.  By allowing the nurses to test various methods, they found the best way at that time to complete the work - and they owned it because they had developed the process.” 

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