Holding the Gains and Spreading Your Improvement

Holding the Gains

Once you have redesigned the process of the discharge care transition throughout your target area, it may be tempting to move on to other issues and to stop monitoring the process. But if you don’t want all your hard work to go to waste, you need to resist this temptation. Do not assume the discharge process is “fixed” simply because you implemented your intervention. To hold and spread the gains you’ve accomplished, you must keep monitoring the process so your improvements will not erode. Although you may be able to reduce the intensity of the monitoring and modification process, some ongoing assessment of how the process is functioning is absolutely necessary. In addition, new findings from research publications, new therapies, and new patient situations arise frequently. The team should remain responsible for monitoring these issues, updating your tools and processes, and revising the intensity of scrutiny based on the stability of your metrics.

TASK A

Schedule regular assessments to monitor and trend your metrics. Schedule interval reviews of the litera¬ture. Schedule sessions to update the protocol/order set.

Spreading the Improvement

Creating breakthrough levels of improvement is hard work, but it also can be exciting and rewarding. Ideally, others will learn from your experience and implement your interventions in their own environment at an accelerated pace while still allowing for customization to account for their own unique setting. The improvement in the discharge transition in your target population can serve as a model for other areas in your organization. The IHI Web site has a detailed discussion of a framework to enhance spread of innovations throughout an organization.

TASK B

Identify the priority areas to “spread” the improvements you have achieved. Review the framework for spread on the IHI Web site. Don’t overlook this significant opportunity.

Download the Task Sheet