Better Ideas for Spreading Changes

The term "better ideas" refers to the set of changes or improvements that have been shown to be successful (i.e., achieved desired results) in a single site or local area within the organization and are now being spread more broadly.

Early in the process to spread new changes, executive leaders with support from others in the organization begin to identify the improvements that will be spread to meet the organization’s strategic goals. The process of sharing the "better ideas" involves not only explaining the new ideas in a way that potential adopters can easily understand, but also demonstrating why the new ideas are better than the old. Before potential adopters are ready to hear details about the new ideas, they must first perceive the relative advantage of the new ideas for their own work. Rogers (1995), Bandura (1986), Prochaska (1995)
Changes for Improvement
Describe the Better Ideas
Describing the better ideas includes explaining the concepts and principles behind the new system and the specific changes needed to achieve the desired results.


The description of the better ideas for spread (i.e., the spread package) comes from the improvements used by the successful site. The experience of the successful site is used to refine and sharpen the set of improvements so that new sites will be able to more easily adopt them. It is the responsibility of the spread agent (working together with the successful site) to harvest what the successful site learned and incorporate this into the spread package for the new sites to use.
Harvesting from the successful site may include:
  • Identifying the improvements that had the greatest impact on results
  • Suggesting a possible sequence for testing the various changes in the package
  • Identifying steps to avoid
  • Collecting any tips or specific tools (data collection forms, surveys, etc.) that were developed that will help the new sites more easily test and implement the changes



  • Leaders of the spread effort organize the "source document" or the spread package that explains the new system by using multiple levels (from general change concepts to more specific ideas). This allows users to interact with the ideas in multiple ways, thereby meeting the needs of individuals with various learning styles. Website applications are especially useful for presenting multilayered ideas since hyperlinks allow the reader to move easily from one level of detail to another.
  • Over time, consider adding examples and tips to the specific change ideas so that new adopters can make the transition from the old way to the new system relatively easily. (Cool, 1997) The spread agent should also develop a system to capture the increasing knowledge base about the spread process on an ongoing basis. (Brown, 2000)

Develop the Case for Better Ideas
Developing the case to spread better ideas involves explaining them in a way that will attract those in the target population to consider adopting the ideas.
Everett Rogers identifies five attributes that affect the rate of adoption of new ideas in a social system: the relative advantage of the changes over the existing system; compatibility with existing values, experiences, and needs; and the complexity, triability, and observability of the changes. In Rogers’ view, demonstrating the benefits of the changes is the most important attribute.
In addition to citing published literature, one of the most effective techniques to demonstrate the benefits of the changes is to share the improvements the successful site made and the results they achieved. The spread agent must work with the successful site to effectively promote its work.
Promote the work of the successful site by including the following:
  • Charts that show the connection between the changes made and the results achieved
  • Patient stories that powerfully illustrate the impact of the new system
  • Testimonials from providers about how the changes benefited both them and their patients

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