Confront barriers to change in ED

Whenever emergency departments run into barriers, they sought help from the planning group and other EDs in the collaborative. The following strategies were recommended by IHI:

• Lack of time: Teams are given the key changes. Measurement is simple but useful. Team meetings are kept to a minimum, with the focus on adaptation of the changes. A flexible model is used to guide the improvement efforts. Work is shared.

Resistance to change: Clear communication of goals and progress. Identification of a physician champion. Influence of the experts from the planning group. Creation of opportunities for participation. Ongoing promotion of the project.

Support from senior leaders: Require a senior leader to sign the organization’s application and pledge support. Teams make ongoing presentations to leadership groups explaining the impact of the project on clinical outcomes, patient satisfaction, and cost. Organizational leaders receive a monthly newsletter from the collaborative summarizing progress.

Support from other departments: Staff from other departments are brought into the project. Focus is on patient care goals. Rela-tionships are built. Assistance is sought from senior leaders.