Sustainability and Spread

A Panel Discussion

Issues That Affect Sustainability

• Turnover of provider or staff

• Over-extension of the team champions

• Irregular or non-existent team meetings

• New quality initiative becomes organizational focus (resources, support)

• New processes dependent on a person instead of implemented changes

What did your Community Health Center do to sustain the improvements and outcomes of

the Collaborative?

To sustain, how did you…..

• Orient new providers/staff to new processes?• Educate new providers/staff regarding the models--

performance improvement and chronic care model• Secure senior leader support, organizational focus• Support provider and staff champions• Assure changes are process-related not person-related• Maintain the registry data and monthly reports• Schedule team meetings• Other

What type of spread did your CHC plan?

Explain your strategy for selection of the first spread site?

• Provider to provider

• Clinic to clinic

• Disease to disease

• System to system

How did you manage the spread population registry and data?

• Expansion of software (DEMS) and hardware amongst

• Definition/reporting of Spread Population versus POF and measures

• Reports—how often, what’s included, sent to whom

• Comparing/sharing of data (providers, clinics)

What did you do to promote support from system sponsors?

• The Senior Leader

• The Board

• Provider Physicians

• Management

• Staff

• Others

How did you obtain the additional resources needed to

support spread?• I.S. staff (data entry and system support)

• Trainers

• Physician educators/champions

• Equipment/supplies

• Space

• Time for meetings, training and planning

• Other

What was your spread communication strategy?

• Newsletter describing:– The urgency or need for change– Changes tested and implemented– New learnings from staff/providers

• Publishing the outcomes/measures• Reports at management, physician meetings• Staff testimonials at staff meeting• Presentations at Board meetings• Other

How did you educate new team members in the following areas?

• Chronic Illness Model

• Use of the DEMS

• Performance Improvement Model

• Disease expert knowledge (disease)

• New changes, new processes

• Other

How did you achieve collaboration amongst the spread

sites? • Weekly planning meeting of the system spread team• Monthly conference calls for all team members at

spread sites• Planned learning sessions amongst spread teams• Use of the list serv• Contributions for monthly report from all spread

teams• Informal networking or mentoring process• Other

What particular barriers did you your CHC overcome during the

spread process?

What advice would you give teams anticipating or managing

spread?

Each team will have the next ten minutes to discuss potential or

real spread activities and identify the two issues that present the

largest challenge