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Set-Up for Spread:
Identify Successful Internal and External Sites

Successful sites (e.g., hospital patient care delivery units, departments, or services; physician offices or clinics) are those where the improvements to be spread have been tested and shown to be effective in achieving the desired outcomes. These sites often help to:

  • Explain the benefits of the changes to those in the target population
  • Identify systems issues that, once addressed, can speed the spread of the new ideas to new sites
  • Generate tools and resources to help make the changes easier for new sites to adopt
  • Provide mentors and teachers as a resource for others in the target population who want to learn more about the changes

Tips
  • In some cases, one site may have successfully implemented only some of the changes. If this happens, identify different sites that have implemented other changes, then construct a composite picture of the entire set of improvements to be spread.
  • Successful sites within the organization help to demonstrate that improvements can be made in "an organization like ours."
  • When external examples are used, acknowledge organizational characteristics or cultural differences that may exist. Explain why the external site is a positive example from which to learn, and that changes may need to be adapted to fit the target population's specific characteristics and culture.
  • Develop plans to create high-performing sites as part of the spread strategy if such sites do not exist either internally or externally. These "pilot sites" can be used to introduce and test new improvements as part of the spread strategy.



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