Improvement Project Progress on a 1 to 5 scale—Part 1

Starting 20 years ago, my colleagues at Associates in Process Improvement (www.apiweb.org) worked with the Institute for Healthcare Improvement to develop and refine the Breakthrough Series Collaborative method

In a Breakthrough Series Collaborative, 10 to 100 teams work on projects in a common topic area.  As part of the early work, they developed a scale to assess projects progress.

The assessment scale makes it easier for the Collaborative faculty to track progress over the typical 12-15 month Collaborative cycle.

Here’s a 2005 version of the 1-5 scale that has a little more detail, first deployed at IHI in the Improvement Advisor Development Program:

Modest Improvement and Beyond

Level 3, Modest Improvement, represents the transition between initial testing to increase belief and to grow know-how and implementation of changes.

Levels 4 and 5 describe action to sustain and spread useful changes beyond the initial target work system.

The assessment scale uses four core words in improvement that describe different aspects of improvement work:

The transition from testing to implementing is not easy.  It may be impossible if you don’t pay attention to the differences between the two actions.

By support infrastructure, I mean:  (1) Who and how you will monitor that the change is sticking; (2) feedback to your people on how well they are able to use the change; (3) procedure documentation; (4) training designs and delivery for people already in your system; (5) orientation and training for people new to your system.

The API consultants summarize their insights about implementation in Chapter 8 of The Improvement Guide, 2nd edition (https://www.amazon.com/Improvement-Guide-Practical-Organizational-Performance/dp/0470192410/ref=cm_cr_arp_d_product_top?ie=UTF8)

In Part 2 of this post, I’ll discuss a couple of fundamental management methods to support implementation.  I’ll link the discussion to challenges we’re tackling in an oral health improvement collaborative that uses the Breakthrough Series structure.