Scaling Up and Spreading Change

Jane Taylor, Ed.D.Improvement Advisor to SCCM

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Scale Up and Spread

• Implementation– Making change permanent on a pilot site or units

• Scale Up– Overcoming systemic barriers that emerge while

implementing – Overcoming infra-structure issues that would inhibit

implementation and spread• Spread – Replication of change(s) with other people and other sites

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Examples from Sepsis Screening and Response

Implementation– Screening of every patient every shift– Requires incorporation in flow– Simulation of response– Role clarity– Job description changes– Training and new hire orientation– Policy and procedure– Standardization and specification– Documentation – Protocols and nurse driven protocols

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Scale up

• Infra-structure issues– No place to document screening for data capture

and communication• Systemic barriers

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Spread

• Moving across from pilot unit to all medical surgical units

• Moving to hospitals within the healthcare system

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Thank You