Transcript Slide 1

June 25, 2010
A Conference to Advance the State of the
Science and Practice on
Scale-up and Spread of Effective Health
Programs
Informational WebEx Session
Joe McCannon, IHI, Chair
Brian Mittman, PhD, VA/CIPRS, Co-chair
Wynne Norton, PhD, UAB, Co-chair
Funding for this conference was made possible in part by grant 1R13HS019422-01 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed
in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human
Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. The Commonwealth Fund, The Veteran’s
Health Administration, The Donaghue Foundation and The John A. Hartford Foundation also provided meeting support.
Meeting Supporters
• The Commonwealth Fund
• Agency for Health Care Research and
Quality
• US Department of Veterans Affairs
• Donaghue Foundation
• John A. Hartford Foundation
Planning Committee Members
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David Atkins, VA
Anne-Marie Audet, Commonwealth Fund
Chris Bailey, WHO
David Chambers, NIMH
Lindsay DeGennaro, IHI
Denise Dougherty, AHRQ
Don Goldmann, IHI
Chris Gordon, NIMH
Deborah Jenkins, VA
Paul McGann (and designee), CMS
Rashad Massoud, URC
Todd Molfenter, U Wisconsin
John Ovretveit, Karolinska Institute
Marie Schall, IHI
Mary Taylor, Gates Foundation
Today’s Agenda
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Meeting Background
Meeting Objectives
Desired Outputs
Meeting Agenda
Meeting Work Groups
Attendee Role
Non-attendee Role
Questions and Discussion
Background - Why Are We Here?
• We possess an enormous amount of knowledge about
effective practice that is not broadly applied.
• We need to create a system – consisting of diverse
actors - to test, prioritize and spread effective practice
much more quickly and broadly.
• We need to expand our thinking to include new
incentives for change, new methods for spreading
change, new mechanisms for measuring progress, etc.
Background - Why Are We Here?
(cont.)
• To build on the momentum of our prior meeting and a number of
other recent initiatives
• To respond to clear demand (urgent need, reform environment)
• To sharpen a vague research and practice agenda
• To create a community of peers
• To develop a blueprint for action
Why Aren’t We Here?
• To rehash what we know already
• To focus exclusively on theory
• To focus solely on the perspective of one
stakeholder group
• To study scale up without attention to
present context (e.g., recent reform)
Conference Aims
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To review existing knowledge and current practices related to the
scale-up and spread of effective practice in health care and public
health;
To identify key challenges and gaps in current research, policy,
and practice related to scale-up and spread in health care and
public health;
To develop and disseminate a detailed agenda outlining critical
research, policy, and practice initiatives on these topics for the next
five to seven years; and
To launch specific activities to operationalize this agenda, creating
a plan of action to prioritize research, policy, and practice activity
and initiating powerful demonstrations of regional, national, and
international scale-up in health care and public health.
Proposed Deliverables
• Detailed agenda for research and practice
• Refined hypotheses about key factors in scale up
• Refined framework for spreading better practice (and a
list of common barriers)
• A durable learning network (before, during and after)
• A set of “performance challenges”
• Peer-reviewed publication
• Conference presentations
• Proceedings/report of conclusions
Conference Aims
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To review existing knowledge and current practices related to
the scale-up and spread of effective practice in health care
and public health;
To identify key challenges and gaps in current research, policy,
and practice related to scale-up and spread in health care and
public health;
To develop and disseminate a detailed agenda outlining critical
research, policy, and practice initiatives on these topics for the next
five to seven years; and
To launch specific activities to operationalize this agenda, creating
a plan of action to prioritize research, policy, and practice activity
and initiating powerful demonstrations of regional, national, and
international scale-up in health care and public health.
Conference Content
• General meeting overview, logistics,
worksheet, attendee information
• Four commissioned papers (health care,
public health, international, general
framework)
• Five background papers
• Three case studies
• Bibliography
• Database of research and practice
Conference Aims
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To review existing knowledge and current practices related to the
scale-up and spread of effective practice in health care and public
health;
To identify key challenges and gaps in current research,
policy, and practice related to scale-up and spread in health
care and public health;
To develop and disseminate a detailed agenda outlining
critical research, policy, and practice initiatives on these
topics for the next five to seven years; and
To launch specific activities to operationalize this agenda,
creating a plan of action to prioritize research, policy, and
practice activity and initiating powerful demonstrations of
regional, national, and international scale-up in health care
and public health.
Targeted Conference Attendees
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Donors
Payers
Practitioners
Researchers
Policymakers
Media
Industry
Patients and families
Represented Organizations
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IHI
VA
AHRQ
UAB
Commonwealth Fund
Donaghue Foundation
John A Hartford Foundation
Gates Foundation
Robert Wood Johnson Foundation
Social Impact Exchange
Kaiser Permanente
Health Partners
Iowa Health
WHO
US Dept of Education
CDC
CMS
USAID/URC
NIH
NIMH
Canadian Institutes of Health
ABIM
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AHA (HRET)
Georgetown
Harvard
Yale
Johns Hopkins
Stanford
UNC
University of Texas
University of Washington
University of Wisconsin
UCSF
UCLA
Karolinska Institute
Penn State
Michigan Hospital Association (Keystone)
Blue Cross Blue Shield Association
Common Ground
Common Knowledge Associates
CFAR
Expandnet
McKinsey
Et al.
General Agenda
• Revisit core framework (lens)
• Envision the ideal system for scale-up and spread
(identify new levers for change, untapped “abundance”)
• Identify gaps
• Make recommendations for action
• Make commitments to action
Core Framework (Drivers of
Scale-up)
• The current environment for change in which scale up
will occur
• The foundation (or pre-history) for the work in question
• The framing (especially aims) for the work in question
• The nature of the intervention to be spread
• The structural context into which the intervention will be
spread
• The method for spreading new knowledge and executing
change (including the method of evaluation).
General Agenda
• Revisit core framework (lens)
• Envision the ideal system for scale-up and spread
(identify new levers for change, untapped “abundance”)
• Identify gaps
• Make recommendations for action
• Make commitments to action
Meeting Norms
• Hands-on participation (very limited didactic sessions)
• Value creativity
• Value diverse opinion and experience (welcome creative
tension)
• Rapid transition from recommendations to action
Detailed Conference Agenda
Pre-Conference Activity
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June 25 (11:30am eastern) – Pre-conference WebEx session (broad
invitation to attendees and non-attendees, including students, patients,
others)
June 28 – Launch of conference blog/web site
Detailed Conference Agenda
Day 1: July 6th, 2010
• 6 – 8pm
Reception and speakers: Panel discussion (Perspectives on Scaleup from Outside of Health Care and Public Health: Huggy Rao;
Nancy Dixon; Facebook speaker TBD)
Day 2: July 7th, 2010
• 8:00 – 10am
Opening plenary: state-of-the-art review talks by commissioned
paper writers; meeting framework and “charge” to working groups
• 10 – 12:30pm Breakout period #1: Introductions; visioning exercise (each group
selects 15-minute break period within this window)
• 12:30 – 1:30
Lunch
• 1:30 – 5:00
Breakout period #2: Gap analysis and recommendations (how will
we close the gaps between the current state and the future vision)
(each group selects 15-minute break period within this window)
• 5:00 – 6:00
Facilitator/recorder capture notes (Break for others)
• 6:00 – 7:45
Dinner/speakers: Panel discussion (Perspectives on Scale-up from
Within Health Care and Public Health)
Detailed Conference Agenda
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Day 3: July 8th, 2010
8:00 – 8:10am Reconvene and sharpen agenda for day
8:10 – 9:30
Breakout groups review thinking from prior day and prepare
recommendations
9:45 – 11:00 Group report outs
11:15 – 12:30 Open discussion and panel reactors (planning committee)
12:30 – 1:30 Lunch and close: Report back to group on next steps
1:30 – 3:30
Planning committee and follow-up groups meet to plan next
steps
Detailed Conference Agenda
Post-Conference Activity
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July 21 (11:30am) – Post-conference WebEx session (broad invitation to
attendees and non-attendees, including students, patients, others)
Ongoing blog conversation
August 30 – Draft of peer-reviewed paper(s) and draft of proceedings (issue
brief)
Work Group Deliverables
• Pre-conference:
─ Preparatory work sheets
─ Preparatory reading
• At conference/post-conference:
─ Answers to core conference questions
(recommendations)
─ Detailed proceedings (secretaries)
─ Publications (peer review, other) and other
collaborations
Work Group Chairs
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Denise Dougherty, AHRQ
Maulik Joshi, HRET/AHA
Todd Molfenter, University of Wisconsin
Marie Schall, IHI
Jurgen Unutzer, University of Washington
Attendee Assignment
• Complete preparatory reading (Framework
paper and commissioned papers, at least
one case study).
• Complete preparatory worksheet.
• Send in your bio if you have yet to do so.
• Come for the full meeting.
Non-attendee Role
• Tune in often to the conference blog (and
respond to it)
• Tune into post-conference WebEx
session.
• Update us on your work and anything that
we’re missing.
Follow-up to This Session
• Meeting Blog/Web Site launches on
Monday
• Recording of this session available
• Please offer your insight and suggestions
(now or later)
Questions/Discussion
• What else can we do to make this meeting exceptional
(exceptionally compelling and useful)?
• What can we do to guarantee post-meeting action?
• Of the potential deliverables we’ve listed, which are the
most meaningful?
• How can we build a sense of community among
ourselves?
We look forward to seeing you
in two weeks, and welcome
your questions and feedback
in the meantime…thanks!