Wave 3: Learning Session 2
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Wave 3: Learning Session 2






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  • Solutions before our eyes What enables people to find these solutions? Findings are accessible to all
  • Six D’s – See Handbook

Wave 3: Learning Session 2 Wave 3: Learning Session 2 Presentation Transcript

  • New Approach to Controlling Superbugs Virtual Learning Session 2 The Discovery Phase
  • Agenda:
    • Welcome and Introductions
    • The Discovery Phase
    • Discovery and Action Dialogue
    • Improvisation
    • Wise Crowd
    • TRIZ
  • The Premise Of Positive Deviance
    • No matter how bad things are, there are always people in the group that do a better job, despite having access to the same resources
  • Positive Deviance-the 6 D’s
    • D efine: the problem and a successful outcome
    • D etermine: if there are any “positive deviants”
    • Discover: uncommon practices/behaviours
    • D esign: activities enabling others to access and practice new behaviours
    • D iscern: effectiveness of activities or project through ongoing monitoring and evaluation
    • D isseminate
  • PD Tools
    • Kick offs
    • Improvisation
    • Sharing Stories
    • Discovery and Action Dialogues
    • TRIZ
    • Wise crowds
    • Social Network Analysis
    • Ethnography
  • “ Act your way into a new way of thinking…” Improvization An Approach for Practicing Positive Deviance
  • Our Road to Improv
    • Discovery & Action
    • Dialogues
    Departmental Improv (e.g. General Surgery Unit) Site-Wide Improv Day
  • Improv Day at Toronto Western Hospital
    • Players (cast)
      • Planted core group; audience
      • participation
    • Artistic Director
      • Can instruct Players to “play up” certain
      • behaviours; sentiments
      • Keep the element of surprise/improv
  • Lights… Camera… Discovery & Action!
  • Core Group Member
  • Residents
  • ICPs; Nursing; Government
  • Lessons Learned
    • Less can be more
      • Provide very basic scenario outlines
    • Use artistic director to uncover interesting themes.
    • Take advantage of multi-disciplinary group
      • Have a DAD!
    • Follow-up with participants – they may have different perspectives/ideas for next improv
  • Discovery and Action Dialogues:
    • 15-20 minute sessions
    • Ideally done right on the unit
    • Include those that want to be involved
    • Encourage a multidisciplinary group
    • Facilitator runs through a series of questions that affirm the problem, identify barriers, uncover existing solutions, generate ideas/actions
  • Discovery and Action Dialogues: How They Work
    • Group selects a specific problem
    • The group as a whole identifies what the solution looks like including key measures of success
    • How do you know or recognize when ______ is present?
    • How do YOU contribute effectively to solving _____?
    • What prevents you from doing this or taking these actions all the time?
    • Is there anyone you know who is able to frequently overcome barriers?
    • Do you have any ideas?
    • What needs to be done to make it happen? Any volunteers?
    • Who else needs to be involved?
  • Tips for Facilitators
    • Do :
    • Hold the dialogue in the participants’ local context – e.g. the unit
    • Make impromptu invitations as you enter
    • Designate a scribe to take notes
    • Start with the purpose, We are here to stop…
    • Do:
    • Give questions back to the group-wait 20 seconds for a response
    • Encourage everyone to speak
    • Work through all questions without worrying about the order
    • Demonstrate genuine curiosity in everyone’s contributions
    • Avoid:
    • Answering questions that have not been asked
    • Missing opportunities to “catch butterflies” – record actions to be taken by participants
    • Coming away with a to-do list for yourself
    • Responding positively or negatively to contributions-let the group sift through their own assessments
    • Always remember:
    • “ Nothing about me without me”
  • Take 5
    • Questions?
    • Experience with DAD?
    • Outcomes?
  • Wise Crowd
  • TRIZ “ theory of inventive problem solving”
    • Define an unwanted result e.g. hospital acquired infections
    • Design a system that would reliably create the unwanted result
    • Compare the adverse system to the current system
  • Example
    • Design a system where you will reliably infect 100% of patients with a superbugs within a few days of admission
  • Next Steps
    • Continue to work on core team and “launch”
    • Start using the DAD process and other methods on the floors
    • Begin to think about data collection
    • Next Learning Session : Monday February 7th 1 pm EST
    • Next Coaching Call : Monday February 14th 1pm EST
    • www.stopsuperbugs.com