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Getting Started Kit:Perinatal

Improvement Community

Institute for Healthcare Improvement

Learning Communities are comprised of improvement-minded organizations working together with the Institute for Healthcare Improvement (IHI) to implement best practices and explore innovative solutions to improve care in high-leverage areas. This document is in the public

Perinatal Improvement Community: Getting Started Kit

domain and may be used and reprinted without permission provided appropriate reference is made to the Institute for Healthcare Improvement.

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Table of ContentsStep 1: An Overview of the Learning Community Experience 2

Step 2: An Overview of the Learning Community Charter and Models 5

Step 3: Confirm Sponsor and Create Your Team 11

Step 4: Connect to the Extranet and Join the Listserv 16

Step 5: Perform the Perinatal Deep Dive 18

Step 6: Draft Your Aim 18

Step 7: Participate in Your Learning Community Onboarding Call 21

Step 8: Gain Understanding of the Model for Improvement21

Step 9: Prepare for Your First Learning Session22

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Step 1: An Overview of the Learning Community ExperienceThe collective knowledge of Learning Community participants, coupled with the Institute for Healthcare Improvement (IHI) improvement expertise and guidance, gives organizations a strong framework for taking action and achieving, sustaining, and spreading breakthrough improvements. Participating health care organizations and faculty/staff will work together to improve care and develop the personal leadership skills of our participants. We will strive to have teams meet the goals within 12 months by sharing ideas and knowledge, learning our methodology for change, implementing proven change concepts, and measuring progress. The objective of the Community is action leading to improvement. This is a results-oriented Learning Community.

Methods

The Community involves multiple national and international organizations working together intensely to achieve significant improvements. Over 12 months, teams participate in two face-to-face Learning Sessions, monthly virtual meetings, and maintain continual contact with each other and faculty members through conference calls, listserv discussions, email, individual coaching calls and monthly progress reports.

All information about Learning Sessions, calls, and WebEx presentations will be posted to the Extranet to ensure that the most up-to-date information is available. The link below (Figure 1) outlines the basic structure for the year in your Learning Community. Figure 2 provides a basic outline of how to prepare your team for the year ahead. Please note: This calendar is a working draft and will change in response to participants needs

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Figure 1

Expectations The Institute for Healthcare Improvement and the Community faculty will:

Provide a designated IHI Director and Project Manager, in addition to faculty who have expertise in the subject matter and improvement methods

Provide information on subject matter, application of that subject matter, and methods for process improvement, both during and between Learning Sessions

Support knowledge management of promising changes and action toward results through Community Models i.e. Driver Diagram Change Package, Measurement Strategy, Perinatal Building Blocks

Provide communication strategies to keep teams connected to the Community faculty and colleagues i.e. Monthly Coaching Calls, All Team Content WebEx Sessions, Work Groups, List Serve Discussions, Extranet resources, Learning Sessions

Provide access to IHI Extranet for reporting, resources and communication

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Review team reports and analyze data providing guidance and feedback to individual team improvement efforts and overall Community learning and development.

Foster growth and development of improvement capacity.

Participating organizations are expected to: Connect the goals of the Learning Community to a strategic initiative in their

organization Designate a senior leader to serve as sponsor for the team Provide the resources to support their team, including time to devote to this

effort (the equivalent of approximately 1 FTE for project management for the duration of the Learning Community, weekly team meetings, time for team to run PDSA cycles, for example), and active senior leadership involvement

Share information with the Learning Community through the extranet i.e. posting resources or tools to share with Community and frequent contributions to listserv discussions and questions.

Post monthly qualitative and quantitative reports showing progress and learning toward their aim.

Review and analyze organizational data posted by the team for shift, trends and patterns. The extranet will create graphs and fosters team’s ability to analyze with automated run chart rules.

In alignment with team aim, design and execute tests of change first for learning, then improving and moving to implementation,

Participate in Community Learning Sessions, WebEx presentations and conference calls.

Getting Started Checklist Figure 2

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Getting Started ChecklistA summary of steps to take to get your team started in

the Learning Community!

Review the Getting Started Kit

Confirm Sponsor

Select and identify your local Improvement Team

Connect to the Extranet and Listserv

Perform Deep Dive and Identify Opportunities for Improvement

Draft Your Aim

Participate in Team Onboarding Call


Step 2: An Overview of Learning Community Charter and ModelsRationale

Adverse events during labor and delivery can impose a heavy physical, psychological, and financial toll on the baby, family, care providers, and the community. Sound science that would allow us to deliver the best perinatal care is often known. Evidence-based guidelines for safe practices exist. And yet, application is unreliable.

Momentum however, is building across the country in the perinatal field-- there is no tolerance for elective delivery prior to 39 weeks gestation (misuse), non-medically indicated induction (overuse), and support for spontaneous labor (underuse). A renewed focus on the cost of interventions to the mother and newborn and the outcomes these interventions contribute create is underway

The challenge is to ensure that these guidelines of evidence-based care are applied reliable - to every patient, every time - by an effective, high functioning team in an environment of person centered care.

This Community seeks to meet that challenge.

Mission & Goals Reducing Harm, Improving Care. Supporting Health. The IHI Perinatal Improvement Community provides results-focused improvement opportunities to teams with a wide range of content and improvement experience. Participants start with in-depth diagnostic and goal-setting processes and identify initial areas of focus based on their expertise in the topic and in improvement. Teams engage in rapid testing of changes and process redesign that have been shown to improve care, adapting them to their own settings, and linking measurement to the outcomes.

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Perinatal Improvement Community: Getting Started KitThe core focus of the Perinatal Improvement Community has shifted to include the entire episode of pregnancy- from confirmation until six weeks after delivery. Today, global attention focused on achieving the IHI Triple Aim—better health for individuals, better outcomes for more of the population, at a lower cost has expanded our view.

For Labor and Delivery Units, this expanded focus translates into increased attention on the reliable determination of gestational age, the impact of non-medically indicated inductions, new mandatory reporting on the Perinatal Core Measure Set, and reversing the trend of rising Cesarean rates. In 2013-2014, the IHI Perinatal Improvement Community efforts will center on implementing structures and processes that will lead to improved outcomes in these four areas.

Overarching Goals adopted by the Community:

Reduce harm to 5 or less per 100 live births Zero incidence of non-medically indicated deliveries prior to confirmation of

fetal maturity (39 weeks) Advanced Bundle(s) Composite or Compliance greater than 90% Improve Nulliparous Cesarean Rate to alignment with Healthy People 2020

Goal 100% of the participating teams will have documentation of Person Centered

Care.

Supporting Models

The Perinatal Community provides several knowledge management and improvement tools or methods that support the work of the community. Specifically these tools and methods are the Driver Diagram, Building Blocks, Change Package, The Model for Improvement, and Measurement Strategy. They are listed below with a brief description. Driver Diagram: This driver diagram is a variation of the tree diagram quality tool. Utilized as a Driver diagram, the tool conceptualize an issue and its system components that helps to demonstrate a pathway to achieve the desired outcome. In essence, it clarifys the working theory of improvement.

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Perinatal Improvement Community: Getting Started KitThe Perinatal Driver Diagram presents four primary drivers for reducing perinatal harm (adverse events), improving care, and supporting health: Perinatal Leadership; Reliable Design; Effective Peer Teamwork; and Person Centered Care. (see figure 4)

Figure 4

Building Blocks: The improvement work for the Perinatal Learning Community is strongly focused on changes in structure and process which realistically has taken organizations at least 18-24 months to begin to show results. This premise is built upon the following building block depiction of the work and the time it takes to successfully change the system and engage the team:

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Perinatal Improvement Community: Getting Started KitFigure 5

Change Package: The Perinatal Improvement Community is designed to close the gap between what is known and what is practiced. We know this will require change. We also know that not all change leads to improvement. A change concept is a general notion or approach to change that has been found to be useful in developing specific ideas for changes that lead to improvement. Creatively combining these change concepts with knowledge about specific subjects such as Perinatal Care can help generate ideas for tests of change. A change package is a knowledge management tool that captures these creative and successful ideas for change in an organized and accessible manner around the Perinatal Drivers. (Follow Link to Change Package on extranet)

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Listed below are a few of the promising change ideas from thePperinatal Driver Diagram Change Package:

Implementing the IHI Perinatal Bundles (Advanced Bundles, Vacuum Delivery Bundle, Neonatal Advantage Bundle)

Applying safe and reliable practice to management of the first and second stage of labor

Applying IHI’s Reliable Design Model to organizational specific vital processes Adopting a common language for electronic fetal monitoring and training all

members of the care team together in its use, and linking this standardization to credentialing.

Applying communication techniques such as appropriate assertion, conflict resolution, SBAR (Situation-Assessment-Background-Recommendation), and Crew Resource Management techniques

Adopting processes to understand and honor the woman’s preferences Collaborating with women to better manage and reduce risk

Model for Improvement: IHI uses the Model for Improvement as the framework to guide improvement work. The Model for Improvement,* developed by Associates in Process Improvement, is a simple, yet powerful tool for accelerating improvement. This model is not meant to replace change models that organizations may already be using, but rather to accelerate improvement.

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Perinatal Improvement Community: Getting Started KitModel for Improvement

Setting Aims Improvement requires setting

aims. The aim should be time-specific and measurable; it should also define the specific population of patients that

will be affected.

Establishing MeasuresTeams use quantitative measures to

determine if a specific change actually leads to an improvement.

Selecting ChangesAll improvement requires making

changes, but not all changes result in improvement. Organizations therefore

must identify the changes that are most likely to result in improvement.

Testing ChangesThe Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the

real work setting — by planning it, trying it, observing the results, and

acting on what is learned. This is the scientific method used for action-

oriented learning.

Measurement Strategy: Measurement is a critical part of testing and implementing changes and a key element in the Model for Improvement. Measures tell a team whether the changes they are making actually lead to improvement. There are several types of measures that are used in improvement such as, outcome, process measures, and balancing measures. The Perinatal Community uses these types of measures as well as structure measures. The Perinatal Measurement Strategy document greatly assists teams by identifying and operational defining measures aligned with the community aim and purpose, as well as national efforts. (Link to Measurement Strategy on extranet)

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Step 3: Confirm Sponsor and Create Your Team Confirm Sponsor

Your sponsor may already have been identified on your enrollment form. If so, review the description here to ensure that the sponsor is the right one to support your improvement effort. Active partnership between leadership and the improvement team is needed to achieve results. Our experience shows that a team’s chance of success is greatly increased when a leader in the organization serves as a sponsor for the work by showing interest in the team’s work and providing targeted support for the team’s activities. Leadership involvement is key to improving results for your patients and your organization.

The sponsor is the person who is responsible and accountable to their organization for the performance and results of the improvement team. This person is generally not a member of the improvement team, but is a support for the team to accomplish their aim.

The team’s sponsor is responsible for:

Encouraging the improvement team to set its goals at an appropriate level to meet organizational goals and reaching agreement on the team charter;

Providing the team with the resources needed, including staff time and operating funds, and also a financial team member to help document the business case and help the improvement team with other cost issues;

Making it clear to the team that they have the time, resources, and authority needed to change organizational systems to accomplish their goal. Our experience is that the total resources required to do this work will be at least one full-time equivalent (FTE) for the project management of the project, weekly meetings for the improvement team, time for the core team to attend all Learning Sessions and monthly calls;

Ensuring that improvement capability and other technical resources are available to the team;

Regularly reviewing the work of the team; and

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Developing a plan to spread the successful changes from the improvement team to the rest of the organization, including:

o Communicating what is learned from the improvement work in ways that motivate and mobilize the entire organization.

o Designating someone who will be responsible for leading the activities needed to support spread.

Resources for the team Sponsor include the IHI Leadership White Papers located on IHI.org.

Create Your Team

Including the right people on an improvement team is critical to a successful improvement effort. Teams vary in size and composition. Each organization builds teams to suit its own needs. Below is some specific advice gleaned from successful improvement teams.

Organizational Team: Your organizational improvement team should consist of a core improvement team that leads and manages the core work of the improvement team and other team members who are integrally involved in the current processes within the organization and desire to participate in the improvement effort. Every effort should be made to include those with direct care responsibilities.

Patients and families bring specific expertise to the improvement team. Patients have experience with the system and can identify the needs and wishes of patients from their own perspective. We recommend that each team have a patient on their organizational team and a way to receive feedback directly from patients at their site, such as a Patient Advisory Task Force.

The overall organizational team should large enough to provide valuable diversity and perspectives, but not so large as to make it difficult to get work done. A general rule is for a team to have 6 to 12 members.

Your organizational team should comprise individuals who:

Have a working knowledge of the area selected; Can work together as a functioning team that works at an accelerated

pace; Have time allocated by senior leadership to work on this project, and are

motivated and excited about change and creating new designs; and

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http://www.ihi.org/IHI/Results/WhitePapers/ExecutionofStrategicImprovementInitiativesWhitePaper.htm

http://www.ihi.org/IHI/Results/WhitePapers/SevenLeadershipLeveragePointsWhitePaper.htm,


Can make the work of the team visible to the departments/services that will be involved in the spread by sharing results and inviting other staff members to attend team meetings.

Each organizational team enrolled in the Learning Community may send up to five people to the face-to-face Learning Community Meetings . Additional fees apply for more than five members to attend meetings, except in the case of their team Sponsor or patient or family team members who may attend at no additional charge.

Core Team: Essential to the success of an improvement project is an effective core improvement team. This is the team that will attend Learning Community activities, learn the content, and then, most importantly, learn how to make changes that matter in your organization. This team will learn what changes will lead to breakthrough improvements and what you will want to implement and then spread. The core team should attend all Learning Sessions and participate actively in the project throughout its duration. Organizations whose core team consistently participates in Learning Sessions and other Learning Community events are more likely to achieve significant improvement. Anyone selected to attend a Learning Session should be prepared to work actively on process redesign, as Learning Sessions will be primarily working sessions rather than lecture-type sessions. Every effort should be made to keep the same team members on the team, but there can be benefits to including different staff members to attend the Learning Session.Core Team Criteria: Your core team should have at least one physician and one nurse champion on the team, as well as, representation from three different dimensions: Organizational leadership, Day-to-Day leadership, and Technical expertise. There may be one or more individuals on the team that represent each dimension, and one individual may fulfill more than one role. All three components, as well as, the clinical champions should be represented in order to drive change in your organization.

Organizational Leadership: The sponsor designates a person to provide overall guidance to the team. This team leader is someone with enough clout in the organization to institute change in the system being improved and with the authority to allocate the time and resources necessary to achieve the team’s aim. It is

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important that this person have authority over all areas that are affected by the change. An example of an appropriate system leader is the Medical Director for Obstetrics, or the Director of Women and Children’s Services.

Day to Day Leader: The Key Contact identified on your enrollment form may be the same person who serves as the day-to-day leader for the team, but not necessarily. A day-to-day leader is the critical driving component of the project, ensuring that changes are tested and implemented and overseeing data collection. It is important that this person understands not only the details of the system, but also the various effects of making change(s) in the system. This person also needs to be able to work effectively with the physician and nurse champion(s), other technical experts and leaders. Usually, the day-to-day leader devotes a significant amount of their time to the improvement team’s work, often 30 percent or more. The day-to-day leader should be selected based on the criteria below:

Have a working knowledge of the area selected; Be able to organize and coordinate a functioning team that works at an

accelerated pace; Have skill in project management and assuring things get done Have time allocated by senior leadership to work on this project; Be motivated and excited about change and creating new designs.

Technical Expertise: A technical expert is someone who knows the subject intimately and who understands the affected processes of care. Additional technical support may be provided by an expert on improvement methods who can help a team determine what to measure; assist in design of simple, effective measurement tools; and provide guidance on collection, interpretation, and display of data.

Clinical Champions: These champions should have a good working relationship with colleagues and with the day-to-day leader(s) described above and should be interested in driving change in the system. Look for a physician and a nurse who are opinion leaders in the organization, who others go to for advice, and who are not afraid to implement change.

Organizations that are successful in improvement work typically have very high functioning teams. Although groups are put together on a regular basis and called a “team”, becoming a highly functioning team takes intention, time and support

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What are the attributes of highly-effective teams?Highly-effective teams don’t just happen! Time, cultivation, and attention are needed to create an environment for high-functioning teams. Here is a short list of attributes of highly-effective teams:

The purpose and objectives of the team are clear. The roles of team members are clear. A climate exists that seeks and supports participation of all team members. A climate exists that supports problem solving and learning. Decision making processes are clear. Leaders model a clear conflict resolution process. The team practices good housekeeping: clear agendas, start and stop times, role assignments

(facilitator, note taker, timekeeper). Leadership is distributed and shared among team members. Team members’ strengths are utilized to the fullest. The team encourages risk taking and creativity. The team has a method to assess itself as a team.

Activities to help form a highly-effective team

The following recommendations came from conversations with several successful teams involved in our Improving Perinatal Learning Community. We asked them “What makes a team ‘gel’?” (We defined gelling as “sharing the same goals or vision, agreeing on the processes to implement to meet team goals, communicating openly, learning from data, and getting quality improvement results.”)

Setting Goals:

Align your team’s goals with your organization’s overall aims. Make certain your goals are clear and relevant to both individual and group goals.

Begin each team meeting by reviewing the team’s progress toward your goals. Keep your goals and how to meet them as the team’s primary focus.

Relationship-Building:

Plan an off-site outing or potluck in the first few weeks of launching your improvement project. Break down the day-to-day barriers of the work place and get to know your team members as individuals rather than just by roles.

Learn the details of each team member’s job responsibilities. This will help the team understand each other’s perspectives, constraints, and strengths.

Take steps to share news about (and get recognition for) your team’s work. For example, offer a lunch-and-learn on your early successes or contribute to your organization’s newsletter.

Data Collection:

Combine storytelling with your data to engage both the minds and hearts of others.

Sustaining Results:


Step 4: Connect to the Extranet and Join the Listserv

Learning Community ExtranetThe IHI Extranet is the virtual home for Learning Community documents, logistics, meeting and call information, and more. The Extranet, along with the listserv, is the primary way that IHI will communicate with you. The Extranet is a private website, which is only accessible to your organizations team members, who are participating in the Learning Community.

To access the IHI Extranet

Make sure you are a registered user of www.ihi.org. Only the Key Contact from your team can assign you a role on the Extranet.

If you are a registered user of the IHI.org website:

Go to www.ihi.org/extranet and login with your registered email address and password. Select your Project “Perinatal Improvement Community”

If you are not a registered user of the IHI.org website:

Go to www.ihi.org/extranet and click the “Register with IHI.org” button. Free IHI.org registration provides access to special features available to registered users. Once you have created a user profile with an email address and password on the IHI.org, you will be

automatically returned to the Extranet.

How to Assign Team Roles

As an added security measure, your team’s Key Contact is the only person able to give other team members access to the Learning Community Extranet Project. IHI Staff do not have the capability to do so.

1. Go to www.ihi.org.extranetng and login with your registered email address and password.2. Click on your Extranet Project: “Perinatal Improvement Community”3. Go to the “Team Tab” and select your organization’s name. This is your team’s personal workspace

to post documents, enter data, etc.4. Click on the “Role Assignments” option in the team “Administration” box.5. Select a team role for your colleague from the drop-down list. See below for each description:

Key Contact: The Key Contact manages various team tasks on the Extranet, such as assigning team roles, uploading team documents, and entering and editing the team’s data. Only the Key

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Contact has permission to give other team members Extranet access. However, the key contact may assign another person as a backup key contact so they can have the ability to add others to the extranet.

Data Entry: This participant can enter and edit the team’s measures, reports, results, and has access to the Learning Community project resources.

Member: This participant can view the team’s improvement results, and has access to the Learning Community project resources.

Sponsor: The sponsor can view the team’s improvement results, and has access to the Learning Community project resources.

6. Enter your colleague’s registered IHI.org email address.7. Click the “Assign Role” button to add your colleague to the Extranet.

I. Your Learning Community ListservThis listserv is an email distribution list that provides a convenient method for disseminating information to or soliciting information from your Learning Community colleagues. Once a person joins the Extranet, they will automatically be added to the listserv. The listserv address for your Learning Community is: [email protected]

1. How can my team members send a message to the Learning Community listserv? To send a message using the listserv, send your message to: [email protected] The message will then be sent to everyone on the list.

2. How can my team members respond to a message on the listserv? Replying to the group: Use “Reply to All” to send your message to everyone on the list. Responding to the individual: Use “Forward” if your message is intended for a specific

individual by entering the individual’s email address in the “To” field. Please note: using “Reply to All” will send your message to every listserv member. Please reserve the listserv for information that everyone can benefit rather than for one-to-one communication.

3. How can my team members remove themselves from the listserv? To remove yourself from the listserv, follow the instructions at the bottom of the last listserv

message you received (each person has a unique identifier associated with the listserv which will allow you to remove yourself by clicking the link at the bottom of the email.)

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mailto:[email protected]

mailto:[email protected]


You may also remove yourself from the listserv by going to the “Discussions” tab on the Extranet and selecting the link that says “Unsubscribe” (screen shot below)

Step 5: Perform the Perinatal Deep DiveThe Perinatal Deep Dive will provide your team with a snapshot of the Structure that relate to the Outcome in your organization. It will provide quantitative and qualitative data to your team to inform your Aim- the focus of your work, how you will get there, and how far you need to go by when. It also leads to identification of the improvements needed as they relate to the areas of the driver diagram and help you to focus on improvements in certain areas.

Download the Perinatal Deep Dive Documents

Documents include the Perinatal Deep Dive Structure Tool, Perinatal Deep Dive Structure Audit Tool, Operational Definitions and Local Team Decisions.

One expectation of Learning Community teams is the submission of monthly data. Measurement is an important tool of any effort to improve care. Using data will help you in two areas: identifying problems in your system that can be improved and assessing the results of changes that you will make.

The Perinatal Improvement Community Measurement Strategy (available in the Extranet in the Resources tab of the Measurement & Reporting folder) provides detailed information about each of the requested data measures.

Step 6: Set Your Aim

Each organizational team will set an aim for their work in this Learning Community that is in alignment with the Community Mission and goals. Many teams find it helpful to develop a long-term overarching aim, as well as a short-term aim for your team’s

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work over the next 9 to 12 months in the Learning Community. This short-term aim should be work that will help you achieve your team’s overarching aim.

In the short term aim it helps to focus on specific actions to improve patient care and outcomes, and to define which patients and providers will participate. Your team's aim should also be time-specific, measurable and reflect a level of ambition that is a stretch and matches the capabilities and resources of the team. Create a beginning aim, which your team will further develop and finalize at the Learning Session. Although no Aim is perfect, and the most important factor of an AIM is guidance to your team and communication to your organizational leadership, we have provided a few examples of organization specific short-term aim statements drawn from actual teams to support your AIM development.

Example AIM 1:

Increase our Advanced Augmentation Bundle compliance by 50% by March 30, 2012 and achieve a 95% compliance rate with the Advanced Induction Bundles by December, 2012. Increase our Vacuum Bundle compliance by 50% by July, 2012. By, August 2012 our perinatal harm rate will be 8% or below. By the end of this improvement year (August 2012) we will have two patients as improvement team members.

Example AIM 2:

Overall AimReduce Harm. Improve and maintain Bundle compliance. Improve second stage labor management. Improve safety culture. Maintain past improvements (Perinatal emergency response, teamwork, communication, handoffs, common language)

Goals Perinatal Harm rate at or below 5% by August 2013 Patient Advisory Council established and functional by April 2013 EFW documented consistently and use of Second Stage Algorithm 100% of the

time Zero incidence of elective deliveries prior to confirmed fetal maturity by August

2013

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Example AIM 3:

Continue/sustain improvements in Induction, Augmentation, and Vacuum Bundles to achieve consistent compliance with goal of 95%.

Maintain goal of <5% Harm Spread Initiative of Zero Incidents of Elective Deliveries <39 weeks Decrease Cesarean Rate for Low risk first birth women to within median range

of Healthy People 2020 Goal Explore collaboration of Perinatal and Breastfeeding Improvement efforts and

teams

Tips for setting Aims: Involve the organization’s senior leaders.

Work with the leaders of your organization to align the aim with strategic goals and to identify an appropriate patient population for the focus of the team.

State the aim clearly and use numerical goals.Teams make better progress when they have unambiguous, specific aims. Setting numeric targets clarifies the team’s aim, helps to focus changes for improvement that the team will test, and guides measurement.

Create your team’s aim

Once you have created your team’s aim, please enter the aim statement on your Learning Community’s Extranet project on your team homepage in the Team Profile section.

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Step 7: Participate in Your Learning Community Onboarding Call

An Onboarding Call is a sixty minute call for new teams and the Perinatal Improvement Community project team to review the Learning Community mission and goals, measurement strategy, and monthly activities. The call is also an opportunity to review the Perinatal Deep Dive and plan for the year ahead. There are usually two to eight teams on each of these calls, depending on how many new teams have joined the Learning Community. Please contact your Learning Community’s IHI Project Manager for more information about the call time, date, call-in information, and any required pre-work.

Step 8: Gain Understanding of the Model for Improvement

Between Learning Sessions, participants actively try new ideas within their organizations. Within our Learning Community, we use a simple but powerful approach to improvement called the Model for Improvement. All teams are expected to have a basic understanding of improvement methods at their first Learning Session. We strongly recommend that each member of your improvement team even those with experience in using the MFI, complete one of the following self-study options before the Learning Session:

Open School Model for Improvement Course1. Login / Register at www.ihi.org. 2. Login / Register for the IHI Open School: https://www.ihi.org/users/register.aspx3. Take the Model for Improvement Course: http://courses.ihi.org/course_view/2

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http://courses.ihi.org/course_view/2

https://www.ihi.org/users/register.aspx


4. Each of the 5 lessons will take approximately 15 minutes to complete and you may do so at your convenience.

On-Demand Presentation on the Model for Improvement (please register your email with ihi.org)

An Introduction to The Model for Improvement, features Robert Lloyd, PhDConnection Information

1. Go to http://secure.webex.com/g2.asp?id=RNGI1AEW (Note: There is no "www" in the address)

2. Enter your Email Address.3. Enter Password: odmfirl

Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. San Francisco, California: Jossey-Bass Publishers; 1996. (Note especially the Introduction and Chapters 1-8).

Go to the IHI website: http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods and review the “Getting Started” content.

Step 9: Prepare for Your First Learning SessionThe Perinatal Improvement Community has two Learning Sessions per year. These Community Learning Sessions are an excellent opportunity to experience the “All Teach, All Learn” dynamic and to energize your team’s improvement process. The Learning Sessions create time for sharing successes among teams, interaction with faculty, learning about new changes for testing, solidifying skills in the Model for Improvement, and planning for the team. The Face to Face Meeting is a milestone and whether your team can travel or not, all assignments are applicable to each team and it is strongly recommended that every team complete.

Each organizational team enrolled in the Learning Community may send up to five people to the face-to-face Learning Community Meetings . Additional fees apply for more than five members to attend meetings, except in the case of their team Sponsor or patient or family team members who may attend at no additional charge.

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The steps to prepare for the first Learning Session are as follows:

Make your travel arrangements for the meeting, including flights and/or rental cars, and hotel reservations. Information about the meeting location and hotel room block can be found in the Attendee Logistics Sheet on the Extranet.

Register each of your team’s Learning Session attendees via the online enrollment system (a link to the enrollment system is available in the Attendee Logistics Sheet. Each organizational team is entitled to send up to five team members to each face-to-face Learning Session (see above)

Compile your team’s pre-work including diagnostic, baseline data and/or storyboard as directed by the Learning Community’s Director.

Learning Sessions are “paperless” insofar as each participant does not receive a paper copy of the slides from the plenary and breakout sessions. This is done to reduce paper waste at these Learning Sessions. However, the slides are made available on your Learning Community’s Extranet in advance of the Learning Session, whenever possible. If you have team members whose learning style makes it preferable for them to have paper copies of slides available to them at the Learning Session, please print these in advance and bring them along with you. Key Learning Community documents and any forms that you need to fill out during the Learning Session will be made available to you.

WebEx Software Installation:WebEx Software should be installed on all computers / laptops that will be used for Virtual Learning Community Meetings and monthly calls to ensure that you do not have issues the day of the session.

Pre-Install Instructions

The software installation should take five minutes. If you are unable to pre-install, the software will still automatically install when you join the WebEx session.

Go to the IHI WebEx Home Page at http://ihi.webex.com (Note: no "www"). Click "Set Up" in the left navigation bar

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http://ihi.webex.com/


Select “Training Manager”. Since we will not use Flash or Windows Media files, you do not need to click the "Verify your rich media players" link.

Click the "Set Up" button and the software will install. You will now be ready to use WebEx during your next scheduled call.

If you receive a Security Warning asking if you want to install and run WebEx Client from WebEx Communications, Inc., please select "Yes" (we recommend also checking the box to always trust content from WebEx, which will allow you to transparently receive updates to the software without having to see this warning each time). If you are unable to install the software from within the browser, you will see two links to directly install the software with an installation package; choose the one that matches your browser software (Internet Explorer or Netscape).

If you have any difficulty with the WebEx set-up process, please contact WebEx technical support at 866-569-3239 (option 4)

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Date post:	26-Jun-2020
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