Early Years Collaborative: Learning Session 4
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Early Years Collaborative: Learning Session 4. A Method to our madness: Our theory of how improvement happens Ninon Lewis and David Williams Institute for Healthcare Improvement. Components of a learning system. System level measures Explicit theory or rationale for system changes

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A method to our madness our theory of how improvement happens ninon lewis and david williams

Early Years Collaborative: Learning Session 4

A Method to our madness: Our theory of how improvement happensNinon Lewis and David Williams

Institute for Healthcare Improvement


Components of a learning system

Components of a learning system

  • System level measures

  • Explicit theory or rationale for system changes

  • Segmentation of the population

  • Learn by testing changes sequentially

  • Use informative cases: “Act for the individual learn for the population”

  • Learning during scale-up and spread with a production plan to go to scale

  • Periodic review

  • People to manage and oversee the learning system

Source: Tom Nolan PhD, Associates in Process in Improvement


Session objectives

Session objectives

  • Explore Stephen Covey’s “Big Rocks Theory” as a guide to understanding how we can prioritize our work

  • Connect the Big Rocks theory to the seven Early Years Collaborative key change areas

  • Explore a four-part execution strategy for EYC improvement efforts within key changes


A method to our madness our theory of how improvement happens ninon lewis and david williams

Place the big rocks first…

Video Credit: The Seven Big Rocks Productivity System


A method to our madness our theory of how improvement happens ninon lewis and david williams

Key Changes


A framework for execution

A framework for execution


Cpp execution strategy

CPP Execution Strategy

  • Setting Breakthrough Performance Goals

  • Developing a Portfolio of Projects to Support the Goals

  • Deploying Resources to the Projects That Are Appropriate for the Aim

  • Establishing an Oversight and Learning System to Increase the Chance of Producing the Intended Results


Setting breakthrough performance goals

Setting Breakthrough Performance Goals

Breakthrough Performance Goal #3

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A method to our madness our theory of how improvement happens ninon lewis and david williams

Portfolio of Measures


Developing a portfolio of projects to support the goals

Developing a portfolio of projects to support the goals

  • A portfolio is a collection of projects that will together move our stretch aims.

  • Your portfolio will be informed by a broad view of what you and other partners can do.

  • There’s a lot in your portfolio already.


Developing a portfolio of projects to support the goals1

Developing a Portfolio of Projects to Support the Goals


Developing a portfolio of projects to support the goals2

Developing a Portfolio of Projects to Support the Goals

Big Aim


Developing a portfolio of projects to support the goals3

Developing a Portfolio of Projects to Support the Goals

Big Rocks


Developing a portfolio of projects to support the goals4

Developing a Portfolio of Projects to Support the Goals

CPP Portfolio of Projects


A method to our madness our theory of how improvement happens ninon lewis and david williams

WORKSTREAM 2 (1 year to 30 months)

R

Theory of what actions will ensure developmental milestones are reached

Theory of what drives developmental milestones

Where project ideas come from!

Improved teamwork, communication, skills and collaboration

2⁰

Aim

1⁰

Poverty

Improved money management

Quality Of Home Environment

Domestic Abuse & Violence

Improved child’s dental health

Societal Issues

Workforce Issues

Improving child nutrition

Transport, Community Capacity & Cultures

Improving brain development and physical play

Children have all the developmental skills and abilities expected of a 27-30 month old

Access To Services

Improved family centred response

Employment

Health

Improved stability / permanence for LAC

Child’s physical & mental health and emotional development

Attachment

Improved early identification

Early Learning & Play

Additional Support

Improved joint working

Detailed Aim:

85% of all children within each CPP have reached all of the expected developmental milestones at the time of the child’s 27-30 month child health review by end-2016

Level of education

Improved sharing of information

Misuse of alcohol & drugs

Improved management, planning and quality of services

Carer’s physical & mental health and skills

Nutrition

Improved leadership, culture and planning

Disabilities & Mental health

Parenting skills & knowledge

Identification & reasons for current resilience

Version: 06/03/2013


Developing a portfolio of projects to support the goals5

Developing a portfolio of projects to support the goals

  • A portfolio is a collection of projects that will together move our stretch aims.

  • Your portfolio will be informed by a broad view of what you and other partners can do.

  • There’s a lot in your portfolio already.

  • Use a driver diagram or logic model to show how the portfolio hangs together

  • You can annotate with system and project measures


A method to our madness our theory of how improvement happens ninon lewis and david williams

Every project wants a charter

Aim Statement:

Improve what?

By how much?

By When

Measure(s)

Percent

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90%

Change Ideas

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Sample project charter located on eyc extranet

Sample project charter (located on EYC Extranet)


At your tables

At your tables…

  • What’s in your CPP’s Portfolio of Projects?

  • What key changes do they belong to?

  • Are there any key changes without project activity?


Cpp staffing

CPP Staffing

  • Deploying Resources to the Projects That Are Appropriate for the Aim

  • Establishing an Oversight and Learning System to Increase the Chance of Producing the Intended Results


Sample cpp staffing model

Sample CPP Staffing model


Sample cpp staffing model1

Sample CPP Staffing model


Sample cpp staffing model2

Sample CPP Staffing model

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Sample cpp staffing model3

Sample CPP Staffing model


Sample cpp staffing model4

Sample CPP Staffing model


At your tables1

At your tables…

  • Considering this model…

    • How are your resources deployed?

    • What are the gaps?

    • What does your CPP need to develop going forward?


Repeated use of the pdsa cycle

1) What are we trying to accomplish?

2) How will we know that a change is an improvement?

3) What change can we make that will result in improvement?

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Repeated Use of the PDSA Cycle

Changes That Result in Improvement

DATA

Implementation of Change

Wide-Scale Tests of Change

Percent

Hunches Theories Ideas

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90%

Sequential building of knowledge under a wide range of conditions

Follow-up Tests

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70%

Very Small Scale Test

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A method to our madness our theory of how improvement happens ninon lewis and david williams

P

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Aim: Big Dot Early Years

Developing parents' skills Project(s)

Early Intervention in Maternity Services Project(s)

Attachment and Child Development beyond maternity services Project(s)

Continuity of care in transitions between services Project(s)

27 - 30 month Child Health review Project(s)


Multiple key changes for a single aim

Multiple Key Changes for a Single Aim

Continuity of care in transitions between services

27 - 30 month Child Health review

Attachment and Child Development beyond maternity services

Early Intervention in Maternity Services

Change Concepts, Theories, Ideas


A method to our madness our theory of how improvement happens ninon lewis and david williams

Thank You!


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