Why It Matters
Because the lessons learned from Project Fives Alive! about large-scale improvement can apply well beyond maternal and child health or work in Africa.
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Lessons Beyond Africa: Using the Project Fives Alive! Lessons Learned Guide

By Kimberly Mitchell | Wednesday, July 8, 2015

Some people might assume that IHI’s new Lessons Learned from Ghana's Project Fives Alive! A Practical Guide for Designing and Executing Large-Scale Improvement Initiatives publication is not helpful to them if they’re not involved in maternal and child health, or working in Africa, or trying to spread something across an entire country! Not IHI Improvement Advisor Jane Taylor. 


The Lessons Learned from Ghana’s Project Fives Alive! guide has been incredibly useful to me. For each chapter in the guide, I made PowerPoint slides with vignettes for organizations with whom I’m working, and I am using these slides to plan spread work in primary care and in tertiary hospital systems.

For example, I am helping the Surviving Sepsis Campaign with a spread strategy. The project I’m working on focuses on screening patients on medical/surgical units for sepsis and responding appropriately. The chapter in the guide on communication is proving particularly useful because it’s helped us think about where we want to publish, how often, and what audiences we want to target. We want to reach as many professional groups as we can, so we are preparing presentations to the Society of Hospital Medicine and to the Society of Critical Care Medicine, and considering other professional venues as well.

There is also great advice in the guide on creating a website with photos to serve as a resource and inspiration for those engaged in spread. You will also find useful suggestions on how to communicate with stakeholders and targeting messages based on the audience.

As an Improvement Advisor, I can never say enough about data, and the chapters on using measurement and developing quality improvement capability are incredibly useful. One piece of advice that particularly resonated with me is that each spread unit should collect the improvement data six months prior to focusing on spread. What I like about this guidance is that it surfaces any data collection issues early in the work and provides a baseline for measurement, helping the spread units understand where they are as they begin their work so they can set their ambitions for improvement. Often, it can take two or three months before teams are facile with data collection. This advice will help set them up for success.

I bet you will find your own favorite chapters in Lessons Learned from Ghana's Project Fives Alive! And, like me, you may find yourself forwarding a copy to friends, colleagues, and others you work with. It is the most useful resource I have used in a couple of years!


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