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Wave 3: Learning Session 2


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Wave 3: Learning Session 2

  1. 1. New Approach to Controlling Superbugs Virtual Learning Session 2 The Discovery Phase
  2. 2. Agenda: <ul><li>Welcome and Introductions </li></ul><ul><li>The Discovery Phase </li></ul><ul><li>Discovery and Action Dialogue </li></ul><ul><li>Improvisation </li></ul><ul><li>Wise Crowd </li></ul><ul><li>TRIZ </li></ul>
  3. 3. The Premise Of Positive Deviance <ul><li>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 </li></ul>
  4. 4. Positive Deviance-the 6 D’s <ul><li>D efine: the problem and a successful outcome </li></ul><ul><li>D etermine: if there are any “positive deviants” </li></ul><ul><li>Discover: uncommon practices/behaviours </li></ul><ul><li>D esign: activities enabling others to access and practice new behaviours </li></ul><ul><li>D iscern: effectiveness of activities or project through ongoing monitoring and evaluation </li></ul><ul><li>D isseminate </li></ul>
  5. 5. PD Tools <ul><li>Kick offs </li></ul><ul><li>Improvisation </li></ul><ul><li>Sharing Stories </li></ul><ul><li>Discovery and Action Dialogues </li></ul><ul><li>TRIZ </li></ul><ul><li>Wise crowds </li></ul><ul><li>Social Network Analysis </li></ul><ul><li>Ethnography </li></ul>
  6. 6. “ Act your way into a new way of thinking…” Improvization An Approach for Practicing Positive Deviance
  7. 7. Our Road to Improv <ul><li>Discovery & Action </li></ul><ul><li>Dialogues </li></ul>Departmental Improv (e.g. General Surgery Unit) Site-Wide Improv Day
  8. 8. Improv Day at Toronto Western Hospital
  9. 9. <ul><li>Players (cast) </li></ul><ul><ul><li>Planted core group; audience </li></ul></ul><ul><ul><li>participation </li></ul></ul><ul><li>Artistic Director </li></ul><ul><ul><li>Can instruct Players to “play up” certain </li></ul></ul><ul><ul><li>behaviours; sentiments </li></ul></ul><ul><ul><li>Keep the element of surprise/improv </li></ul></ul>
  10. 10. Lights… Camera… Discovery & Action!
  11. 11. Core Group Member
  12. 12. Residents
  13. 13. ICPs; Nursing; Government
  14. 14. Lessons Learned <ul><li>Less can be more </li></ul><ul><ul><li>Provide very basic scenario outlines </li></ul></ul><ul><li>Use artistic director to uncover interesting themes. </li></ul><ul><li>Take advantage of multi-disciplinary group </li></ul><ul><ul><li>Have a DAD! </li></ul></ul><ul><li>Follow-up with participants – they may have different perspectives/ideas for next improv </li></ul>
  15. 15. Discovery and Action Dialogues: <ul><li>15-20 minute sessions </li></ul><ul><li>Ideally done right on the unit </li></ul><ul><li>Include those that want to be involved </li></ul><ul><li>Encourage a multidisciplinary group </li></ul><ul><li>Facilitator runs through a series of questions that affirm the problem, identify barriers, uncover existing solutions, generate ideas/actions </li></ul>
  16. 16. Discovery and Action Dialogues: How They Work <ul><li>Group selects a specific problem </li></ul><ul><li>The group as a whole identifies what the solution looks like including key measures of success </li></ul>
  17. 17. <ul><li>How do you know or recognize when ______ is present? </li></ul><ul><li>How do YOU contribute effectively to solving _____? </li></ul><ul><li>What prevents you from doing this or taking these actions all the time? </li></ul><ul><li>Is there anyone you know who is able to frequently overcome barriers? </li></ul><ul><li>Do you have any ideas? </li></ul><ul><li>What needs to be done to make it happen? Any volunteers? </li></ul><ul><li>Who else needs to be involved? </li></ul>
  18. 18. Tips for Facilitators <ul><li>Do : </li></ul><ul><li>Hold the dialogue in the participants’ local context – e.g. the unit </li></ul><ul><li>Make impromptu invitations as you enter </li></ul><ul><li>Designate a scribe to take notes </li></ul><ul><li>Start with the purpose, We are here to stop… </li></ul>
  19. 19. <ul><li>Do: </li></ul><ul><li>Give questions back to the group-wait 20 seconds for a response </li></ul><ul><li>Encourage everyone to speak </li></ul><ul><li>Work through all questions without worrying about the order </li></ul><ul><li>Demonstrate genuine curiosity in everyone’s contributions </li></ul>
  20. 20. <ul><li>Avoid: </li></ul><ul><li>Answering questions that have not been asked </li></ul><ul><li>Missing opportunities to “catch butterflies” – record actions to be taken by participants </li></ul><ul><li>Coming away with a to-do list for yourself </li></ul><ul><li>Responding positively or negatively to contributions-let the group sift through their own assessments </li></ul>
  21. 21. <ul><li>Always remember: </li></ul><ul><li>“ Nothing about me without me” </li></ul>
  22. 22. Take 5 <ul><li>Questions? </li></ul><ul><li>Experience with DAD? </li></ul><ul><li>Outcomes? </li></ul>
  23. 23. Wise Crowd
  24. 24. TRIZ “ theory of inventive problem solving” <ul><li>Define an unwanted result e.g. hospital acquired infections </li></ul><ul><li>Design a system that would reliably create the unwanted result </li></ul><ul><li>Compare the adverse system to the current system </li></ul>
  25. 25. Example <ul><li>Design a system where you will reliably infect 100% of patients with a superbugs within a few days of admission </li></ul>
  26. 26. Next Steps <ul><li>Continue to work on core team and “launch” </li></ul><ul><li>Start using the DAD process and other methods on the floors </li></ul><ul><li>Begin to think about data collection </li></ul>
  27. 27. <ul><li>Next Learning Session : Monday February 7th 1 pm EST </li></ul><ul><li>Next Coaching Call : Monday February 14th 1pm EST </li></ul><ul><li> </li></ul>