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Wave 2: Learning Session 2
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Transcript of Wave 2: Learning Session 2
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Apr 10, 2023 2
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New Approach to Controlling SuperbugsVirtual Learning Session 2
The Discovery Phase
Agenda:1. Welcome and Introductions
2. The Discovery Phase
3. Discovery and Action Dialogue
4. Improvisation
5. Wise Crowd
6. TRIZ
QUICK POLL
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’sPositive Deviance-the 6 D’s
1. Define: the problem and a successful outcome
2. Determine: if there are any “positive deviants”
3.3. Discover: uncommon practices/behavioursDiscover: uncommon practices/behaviours
4. Design: activities enabling others to access and practice new behaviours
5. Discern: effectiveness of activities or project through ongoing monitoring and evaluation
6. Disseminate
• Discover uncommon practices/behaviors enabling the PDs to outperform/find better solutions to the problem than others in their “community”
Discover
PD Tools
• Kick offs • Improvisation• Sharing Stories• Discovery and Action Dialogues• TRIZ• Improv• Wise crowds• Social Network Analysis• Ethnography
• Emphasizes hands-on learning
• Focuses on actionable behaviours
“it is easier to act your way into a new way of thinking than to think your way into a new way of acting”
Using an inquiry based process: DAD
Discovery and Action DialoguesHow They Work
• Group selects a specific problem
• The group as a whole identifies what the solution looks like including key measures of success
What this looks like:• 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
• Be sure not to ignore little changes, suggestions and adaptations that emerge
• Answers and successful strategies that emerge will differ by organization, unit etc…
• Provide feedback to others and rapidly act on suggestions or communicate why they can’t be acted on
• Try not to be silent or wishy-washy on suggested actions
1. How do you know or recognize when ____ the problem selected is present?
2. How do YOU contribute effectively to solving the problem?
3. What prevents you from doing this or taking these actions all the time?
4. Is there anyone you know who is able to frequently___ solve the problem, overcoming barriers?
5. Do you have any ideas?6. What needs to be done to make it happen? Any
volunteers?7. Who else needs to be involved?
Tips for FacilitatorsDo:
• 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
Do Not:• Answer questions that have not been asked• Miss opportunities to “catch butterflies” – record
actions to be taken by participants• Come away with a to-do list for yourself• Avoid 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
QUICK POLL
ImprovMohammad Salhia
Toronto Western Hospital
“Act your way into a new way of thinking…”
ImprovizationAn Approach for
Practicing Positive Deviance
Our Road to ImprovDiscovery & Action
Dialogues
Departmental Improv (e.g. General Surgery Unit)
Site-Wide Improv Day
Improv Day at Toronto Western Hospital
Discovery & ActionDialogues
Departmental Improv (e.g. General Surgery Ward)
Site-Wide Improv Day
• Players (cast)
• Planted core group; audience
participation
• Artistic Director
• Can instruct Players to “play up” certain
behaviours; sentiments
• Keep the element of surprise/improv
3. Site-Wide Improv
Lights… Camera… Discovery & Action!
Improv DayDiscovery & Action
Dialogues
Departmental Improv (e.g. General Surgery Ward)
Site-Wide Improv Day
• Four 45 minute sessions
• Agenda per session
• Introduction: What is PD; Why Improv?
• Set-up improv
• Discussion DAD
Core Group Member
Residents
ICPs; Nursing; Government
Lessons Learned
• Less can be more
• Provide very basic scenario outlines
• ID player; their relationships
• 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
TRIZ the power of creative destruction
• 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
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 Coaching Call: Monday October 28th 1pm EST
• Next Learning Session: Monday November 15th 12pm EST
www.stopsuperbugs.com
QUICK POLL