Rolling up your sleeves and improving service

The title of the Oct. 17 installment of the MGH/MGPO Service Improvement Department's Service Learning Series, "Stage IV: Implementing Change: Putting Your Service Vision into Action," describes a crucial moment in a service improvement initiative: the transition from organizing to action. Drawing upon lessons from the three prior stages — assessing, planning and enrolling — facilitator Sandra St. Fleur of the Service Improvement Department provided participants with guidance for launching their service improvement projects.

According to St. Fleur, selecting an appropriate implementation method is important to service improvement success because a good method provides structure for ideas, standards of evaluation and priorities to guide the allocation of resources. The key, she emphasized, is cross-applicability. To create change across an entire department, staff at all levels must be able to identify with an improvement mission and "sign on" to do their part. St. Fleur recommended the FOCUS-PDCA Model, the crux of which is to convene key stakeholders to determine the what, why and how of a serviceimprovement effort.

Employees of the MGH's West End House, a substance abuse clinic, recently implemented this model for their own service improvement project. The completion of a culture walk — a tool introduced in Stage I: Assessing — revealed that the clinic's signage was confusing, its lobby was poorly lit and its furnishings were mismatched. A group of stakeholders determined that the setting was not conducive to patient wellness. A change team was organized, to-do lists were drawn up and distributed by department, and priorities were identified. Members gave estimates of costs and time commitments for completing the items on their lists, and then, beginning with the "quick hits" on their list, coordinated immediate improvements. Meanwhile, resources were allocated to undertake major projects, while methods to measure and verify progress were employed throughout the process. In the end, the West End House enjoyed a successful makeover, with the improvements positively remarked upon by both patients and staff.

The next Service Learning Series, "Stage V: Measuring the Outcomes of a Change Effort," will take place Nov. 14. For more information, contact Cindy Sprogis at csprogis@partners.org or (617) 726-1030.