Quality Improvement Zone

Be very clear about exactly what you are spreading and all the ingredients that made it work in its original setting.

What are the core characteristics of the idea? Which characteristics can you not change without fundamentally impacting its effectiveness? What elements can you adapt to fit the new context you are spreading to?

How well do you understand the system and the various forces for and against the change?

Once you know what the change is and what your system is, you are starting to make some progress with your spread plan. You can get an idea of what your target population is and you can set a spread aim to help you measure progress.

Your system will look different depending on your role. If you are a CEO your system will be the organisation you run. If you are a departmental manager, your system could be a department within an organisation.

It's essential to allow new cycles of testing every time we move to new areas. In complex systems, no two areas will have identical procedures, conditions and culture. Every area will present the opportunity to build new knowledge. You won’t know what you don’t know unless you allow this to happen.

This does not mean new spread sites will test and learn at the same rate as the original site.  You should be able to speed up the process as you spread because you are building knowledge all the time. You'll be able to see what works and what doesn’t in all the different contexts and conditions in your system.

This term describes the building blocks of your spread plan. The scalable unit is the smallest representative facsimile of the system that you are spreading to.

If your system is a school, is it one class or year group? If it’s a hospital then it could be a ward or department. If your system is a whole country then your scalable unit might be an entire school or hospital.

Identifying your scalable unit helps you to develop your spread aim. For example, you might plan to spread to three classes by December and then a further six by March.

Tapping into the power and connectivity of organisational networks as well as the formal hierarchy is a very important element of spread. Identifying who the key individuals are in the informal networks and the hierarchy is an important first step.

Understand how to construct and tell the story of your improvement. It is a very useful way to engage human beings in new ideas and ways of working. Using aspects of social movement theory can help you to do this to generate the will and action required to make spread successful.