Rate of Spread

Rate of spread measures assess the extent to which a particular process change is being spread from the local level to the targeted sites. In a spread project, the rate at which successful changes are spread across the system can positively impact the improvement being spread.

Rate of spread measure(s) will differ for each spread effort, depending on the specific improvements made at the local level that are being spread across the system.
Examples of rate of spread measures for projects targeted at spreading different local improvements include the following:
  1. A spread project targeted at reducing adverse drug events could measure the rate of spread of unit briefings that are used to identify unsafe conditions and opportunities for reducing harm associated with medications.
  2. An example of a key process change to support improvement in the care for patients with diabetes at the local level is the use of a flagging system to identify patients needing an HbA1c or LDL at their visit. In this example, the spread project could measure number of targeted sites utilizing a process for flagging charts of patients needing an HbA1c or LDL prior to the patient visit.
  3. Spreading same-day access to all primary care clinics in a medical group will require that all targeted sites eliminate the backlog of appointments scheduled into the future. A rate of spread measure for an access project in primary care could be the percentage of targeted sites actively engaged in working down the backlog.

Spread projects focus on increasing the extent to which process changes that have been successful in supporting improvement at the local level are being utilized in the targeted sites. Once these successful changes are identified, the goal is to spread them to all the targeted sites.
In the example of reducing adverse drug events through the use of unit briefings to identify unsafe conditions and opportunities for reducing harm associated with medications, the goal would be to spread the use of unit briefings to 100 percent of the targeted sites.

Data Collection Plan
Data on the rate at which key ideas or specific changes being spread across the targeted sites may be gathered by sampling from the target sites, obtaining information through conversations or verbal reports, or a more formal measurement system that captures the rate of spread of specific changes within each of the target sites.
In the example of spreading the use of unit briefings, collect data every month on the number of targeted hospitals using unit briefings in one or more units. To capture sample size, also note the total number of targeted hospitals.

Sample Graph



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