'Go See’ and Implementation

We’re near the end of the latest cycle of our oral health improvement collaborative, discussed in many of my posts over the past three years.  We started in October 2018 and wrap up the end of June 2019.

This year, we revised our requirements, asking each team to practice ‘Go See’ once as a Plan-Do-Study-Act cycle and then to use Go See to help demonstrate implementation of a change.

Participants in our collaborative have now practiced a specific method to learn how care and support tasks occur rather than merely as people think they do.   They know how to advise each other to Go See as a direct step to understand what is working and what is not.

Practice Go See one time

As part of pre-work for the second of our three learning sessions, we asked each team to try Go See.  

We introduced Go See on an all-team call in December. 

To help the teams carry out the test of Go See as a structured Plan-Do-Study-Act cycle, I drafted a generic plan to get them started, shown at the top of this post.  

At the January learning session, each team then gave a one-minute report on their Go See to peers as part of the learning session’s peer-peer team update time.

I’ve shared a pdf of my intro talk slides and the worksheet here.

Use Go See

To achieve level 3 ‘Modest Improvement’ in this year’s 1-5 Project Progress scale, a team must apply Go See to demonstrate implementation of one change in item 3d:

3d. At least one change in the care process has been implemented related to driver P2 Evidence and Risk-based care: (1) evidence of use of the new way of doing work for "every patient every time" and (2) evidence that supervisor or manager observes the new way as part of a regular work review of 5 encounters (using a flow-chart, checklist or SOP to compare plan with actual work.)  ["Go See"]

The collaborative team at Primary Health Care, Inc., led by Dr. Janette Garcia, DDS, and Rebecca Hall, RDH, shared their work to implement ‘same-day’ sealants on a collaborative call last month and at our third learning session in Chicago last week.

As evidence of same-day sealants implementation, they presented two items:  (1) the team wrote a clear statement of workflow to prescribe the use of ‘same-day’ sealants and shared it with staff; (2) clinic data in March show that 90% of eligible children (53 of 59) got their teeth sealed (below; the numbers 1 and 2 indicate annotations not shown here.)

The team also shared Go See notes by Megan Frost, Dental Clinic Manager.  Megan adapted the Go See observation sheet we introduced in January to capture lessons and details about same day sealants; her sheet from the first of her five Go Sees is below.   All five Go Sees showed care aligned with the written workflow.

I agreed with PCH that they have evidence for implementation of same-day sealants; together, we checked the 3d box.

Acknowledgement:  Thanks to the PHC team for sharing their Go See work; it’s been a great pleasure to work with them in our 2018-2019 Sealant collaborative.