According to a viewpoint in the BMJ Quality and Safety, "masterful work requires preparation." Paul Batalden, MD, a physician at The Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H., interviewed four healthcare quality and change management experts about how to tackle the "work before the work," or the things that must be in place for successful interventions to take place.
1. Identify multiple project goals and stakeholders, including goals and stakeholders that may compete or conflict, including their cultural and logistical environments.
2. Decide who the best actors are to lead improvement, and determine a strategy for mobilizing them around a central goal.
3. Understand the scope of the project and have the required resources available.
4. Learn from previous projects: Don't underestimate the value of experience.
5. Communicate an accessible vision of what the improvement will achieve.
6. Take stock of where things have been, where things are and where things are going.
7. Consider how the environment may change as the improvement progresses, and plan for flexibility in timelines and strategies.
8. Focus on the best operational detail possible.
9. Listen to the plan, and listen as the plan unfolds.
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