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More from Steven Spear

Solving Workarounds with Steve Spear

How Can You Apply Clinical Skills to QI?

​​​Steven Spear, DBA, MS, Senior Lecturer, Massachusetts Institute of Technology, Senior Fellow, Institute for Healthcare Improvement

Learning Objectives: At the end of this activity, you will be able to:

  • ​Explain a process clinicians can use to improve the systems in which they work.

  • Identify at least two ways systems can fail.

  • Give one example of how a health care organization fixed a broken process.

Description: ​ Clinicians are involved in diagnosing and treating patient’s problems every day. What if these same clinical skills could be applied to another type of problem — problems within the systems of care in which they work? By examining symptoms such as miscommunication, poor coordination, and unnecessary risk, how could they improve experiences for themselves and those around them?

In a new IHI Open School video resource, MIT senior lecturer and IHI Senior Fellow Steve Spear explains why he thinks seven steps needed to care for patients are essentially the same as those needed to fix systems of care. He also shares common trouble areas and gives an example of a successful improvement. 

Discussion Questions:
  1. Of the seven steps Spear lists in his process — problem, examination, diagnosis, plan, implementation, follow-up, repeat — which do you think is the most challenging to complete? Why?
  2. What barriers exist to applying the process Spear teaches?
  3. Spear mentioned the importance of a good “baton pass” to get work done. Can you think of any times you’ve seen dropped baton passes in your daily work? How can you address them? 
  4. Do you think you can apply the process Spear shares to fix a system in your work? Why or why not?
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