Spread Change Gradually

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Spread change gradually in a large organization.

Once you have piloted successfully in one site (or with one clinician), try it again with two or three others. By gradually adding clinicians or sites, you can determine the universal barriers and facilitators in your organization. Each successive change team can build on the knowledge of the teams that have implemented before them.

Introduce the new practice in the same way that you did with the pilot site.

Form change teams in the locations or programs that are the next group of new adopters. Make sure they know what the pilot site did that worked and what they did that did not work so they don’t unnecessarily duplicate steps. If you have already decided to change forms or processes, make sure the new teams have a chance to test them before putting them into widespread use.

Gradually spread the technique to all units that you oversee by creating new Change Teams for new projects. Make sure teams are cross-functional so that people learn from each other and so that the ideas generated do not improve the work of one unit and create more work for another.

  1. The team should include members from all areas critical to the functioning of the evidence-based practice. This may include:
    • Workers and supervisors in the unit (e.g., parts of the organization) where the changes will be implemented
    • Others who are affected by the change (e.g., other departmental staff if the change crosses departments, patients, etc.)
    • People with special knowledge about a specific change (e.g., patients, information technology staff, etc.)
  2. Have diverse talents represented. For example, it helps to have people who are creative and insightful and people who can carry ideas through to completion.
  3. Include outside perspectives (customers or someone who doesn’t work in the area).
  4. Keep the size small, no more than seven people—with more than that, the team gets too unwieldy and makes slow progress at best
  5. Send a written invitation. When the team is selected, send a formal letter inviting each person to work on the project(s) selected. This assignment is a temporary, additional job for the person.