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Resource Center > System-Level Toolkit > Spreading Change > Spreading Change at the Provider Level

System-Level Toolkit

Spreading Change at the Provider Level

Adding New Providers

Most systems that we have worked with have opted for a slow diffusion model and added a small number of providers to their learning collaborative process every 6-12 months. Some have used the same selection process that they used to select their first group of providers, others have been less selective and opened the process to anyone that expressed interest. If you have very successful providers in your first cohort, it is possible to spread the techniques faster by using them as peer mentors to facilitate the learning process for more people at one time than a coach would be able to cover.

Once you have a cadre of experienced successful organizations, it is time to begin spreading process improvement to the whole system. The successful agencies can become the sales force for your efforts. Have them share their stories at conferences and at provider association meetings. They can help recruit new providers to your learning collaborative and they can act as peer mentors for people just beginning.

The learning collaborative can be the mechanism to engage new providers. Depending on the size of your network and the success of your original group, you may want to set up multiple collaboratives with the experienced providers acting as peer mentors and facilitators for the new collaboratives. Or you may choose to expand more gradually and add another 6-10 providers to your existing collaborative.

Ultimately, you want all of the providers in the network to develop the capacity to implement rapid improvements within their treatment programs. You can make the spread as rapid or as slow as you have capacity to move.

Peer Mentoring

Peer mentoring is a way of using your first cohort of successful providers to recruit and train the next cohort. There has been wide variation in the ways that state or systems managers have used peer mentors. In Iowa they were responsible for recruitment. They presented at statewide conferences and told the story of the changes that they made. In Maine, peer mentors were used in the same way that coaches had been used in the first cohort. They were assigned to specific providers and coached them through the learning process. The peer mentors used the more experienced coaches as support for the coaching role. In this way spread can happen more rapidly.