From Vision to Reality!!
Elizabeth Bryce, Linda Dempster, and Teresa Zurberg
Quality Forum
February 2015
Hair-brained idea you say?
• Ever think of something way out of the box
and don’t know how to bring it to reality?
• Here is the recipe…
Background
• Middle managers have the ability to make
significant changes in their organizations
• They have their ear to the ground and can see
when changes would have a positive impact
• BUT:
– They have to sell it to the senior levels which may
not be easy.
Objectives for today
1. Some tips on how to get your ‘way out there’
idea accepted
2. Examples along the way- an innovative
approach to reducing C. difficile infections at
Vancouver General Hospital
3. Results of the evaluation/research
4. FinallyThe next generation of ‘way out there’ ideas!!
Issue Sellers
• Issue sellers accomplish their goals;
–
–
–
–
–
Voice ideas and concerns
Timing
Political sensitivity
Interpersonal connections
Rhetorical skill
“Get the boss to buy-in”
HBR, January 2015
John Kotter- new focus on ‘buy-in’
Kotter:
“Good ideas don’t stand up on their own, they
need support. We have all experienced great
ideas – simple and grand – that have got shot
down in public, or behind our backs.”
7 key elements
1.
2.
3.
4.
Tailor your pitch
Frame the issue
Manage emotions
Get the timing right
5. Involve others
6. Adhere to norms
7. Suggest solutions
Source: Susan Ashford, James Detert
HBR, January 2015
1. Tailor your pitch
• Know your audience
Eg. CDI rates high
Morbidity/mortality
Public pressure
Right thing to do!
2. Frame the Issue
• How can the issue be
connected to the
organizational
priorities?
Eg. CDI rates as a ‘P4P’
Provincial priority
1st in Canada
technology- beta site
3. Manage Emotions (on both sides)
YOU
• Generate a POSITIVE
passion
• Manage your own level
of frustration if things
are not happening
quickly
BOSS
• Appeal to current
situation
– Eg. technology only
available now
4. Get the timing right
• Timing is crucial
Eg. CDI- you have tried all
else and continue to see
high rates
- The issue is gaining
momentum in wider
circles
“Catch the Wave”
-consider your timing to
bring an idea/concept
forward.
5. Involve Others
• Tap into others
Eg. CDI- work with
physicians, leaders,
performance
improvement experts,
housekeeping
-information and research
from U.S.
Lab had been using
technology for yearsinclude them as experts
6. Adhere to Norms
• Consider the culture of
your organization and
its norms
Eg. CDI
- informal
discussions about RD
• BUT:
– In presenting to senior
leaders we used a formal
approach and did a
scientific review
– Plus used a rigorous
evaluation criteria
UV Disinfection Technology; RD
• We had already put in
place a decluttering
program as well as an
equipment cleaning
program so the next
step was to evaluate
this new technology
Persistence of MRSA/VRE in patient
rooms after manual cleaning
BEFORE ANY CLEANING
AFTER MANUAL CLEANING
AFTER UVC DISINFECTION
Before manual cleaning (37/61 rooms
positive for MRSA or VRE)
Before vs after manual cleaning (37/61
vs 32/61 rooms positive for MRSA or
VRE , Fisher exact test p=0.4652)
Before vs after UVC disinfection (32/61
vs 5/61 rooms positive for MRSA or
VRE, Fisher exact test *p<0.0001)
Persistence of C. difficile in patient
rooms after manual cleaning
BEFORE ANY CLEANING
AFTER MANUAL CLEANING
AFTER UVC DISINFECTION
Before manual cleaning (7/21 rooms
positive for C. difficile)
Before vs after manual cleaning (7/21
vs 5/21 rooms positive for C. difficile ,
Fisher exact test p=0.7337)
Before vs after UVC disinfection (5/21
vs 0/21 rooms positive for C. difficile,
Fisher exact test *p=0.0478)
Persistence of C. difficile in patient
rooms after manual cleaning
BEFORE ANY CLEANING
AFTER MANUAL CLEANING
AFTER UVC DISINFECTION
Before manual cleaning (7/21 rooms
positive for C. difficile)
Before vs after manual cleaning (7/21
vs 5/21 rooms positive for C. difficile ,
Fisher exact test p=0.7337)
Before vs after UVC disinfection (5/21
vs 0/21 rooms positive for C. difficile,
Fisher exact test *p=0.0478)
CDI Quarterly Rates
7. Suggest Solutions
• Funding ideas
• Innovative ideas for
incorporating the
technology
– Eg. Human Factors and
use in work flows
Capture the Scent
Stage 1
Train
Angus
On to
Clinical
Setting
Then we upped the ante!!
• Meet Teresa Zurberg and Angus:
Who had a really way out there idea!
Use the ‘Buy-In’ Checklist
1.
2.
3.
4.
Tailor your pitch
Frame the issue
Manage emotions
Get the timing right
5. Involve others
6. Adhere to norms
7. Suggest solutions
Source: Susan Ashford, James Detert
HBR, January 2015
Demonstration Time!
Teresa will now speak to how she has trained
her dogs to detect certain scents
She will demonstrate their abilities using 3
identical boxes with a marked scent in only 1 of
the boxes
Over to you Teresa
Audience Participation Time
Team 1
Team 2
Leader ;Team 1 will hide
the marker for Team 2
Leader ;Team 2 will hide
the marker for Team 1
Once Teresa brings in the
dogs and introduces them
then team cheering is
allowed
Questions?
Change Day!
• We pledge:
To be creative and innovative to ultimately
improve healthcare and increase safety for our
patients.