Learning communication techniques is important for spread and safety

I'm freshly back from a fabulous 2 day masterclass with a group who actively particiapted in developing their own communication skills. This was more than ideas on how to develop a technical communication plan. This was a group of individuals who spend time in front of video cameras and then assessed their own performance - with the aim of giving each other feedback and consequently improving their skills.

So often when communication is mentioned in the context of spreading good practice we default to "how to develop a communication plan". Yet I know from working with this groups, as with other groups I encounter, that it is only when we get to the finer details of communication and behaviour does anything really change.

Communication itself is an important topic. There is oodles of research about which demonstrates the link between communication and performance, communication and financial outcomes, communication and patient outcomes. In the current copy of International Journal for quality in Healthcare there is another excellent research report demonstrating how communication is linked to medical disputes.

My feeling is we can get further in the goal of spreading good practice when we pay attention to the details, like how individuals communicate with one another and resist the temptation to focus only on technical planning.

I also suggest we can stop researching the link between communication and outcomes and focus on making the desired communication changes.

Turn any URL into an RSS Feed using Feedbeater

I use RSS Feeds as a way to receive information as it is updated on websites and without having to resort to filling my email inbox with more messages. They go directly to my Reader (I use Google) and when I am ready I browse through what I have received.

One of the annoyances I have is how many websites seem not to have RSS Feeds. Many of these are in healthcare and the quality improvement world where there is interesting content but the site hasn't been updated to provide feeds.

I use http://www.feedbeater.com to create my own feed for the site and then register it directly into my Reader. It is simple, takes less than 15 seconds and then I am receiving updates when they happen and I'm not reliant of having to remember to go back to the website to check.

Why are RSS Feeds important for the spread of good practice? One main reason is they spread your information to those who want to receive it without you sending out newsletters. I can then forward info etc. If you're not providing an RSS Feed then those of us who want info need to take this extra step by using something like Feedbeater.

Mapping the spread of good practice by geocoding

One of the dimensions often forgotten when we're measuring the spread of good practice is place / geography. There is much theory about how messages spread location by location. If you're curious to provide visual mapping techniques to go along with your results charts, then geocoding is useful.

There are many websites that provide the ability to turn an address into its longitude and latitude reference, and then place a pin on a map to show where it is (geocoding). A new website is now available where you can map multiple places (show in groups to distinguish between the timing of an adoption of a good practice).

http://www.batchgeocode.com/ is where you can upload your addresses (a fun thing to do is to take your Outlook address book, file as they suggest and then upload - you get to see where in the world your contacts are!). A map is produced and you can then file this so you can embed it in a website or even create google earth files.

It is a one page process that is not difficult to do if you follow the directions carefully.

If you come up with ideas on how to use this in your improvement work then I'd love to hear about.

The fallacy of the tipping point

A few years ago I had my own epiphany when debating with someone the value of the concept of the "tipping point" when applied to social change processes.

Most of the research literature as well as the populist books subscribe to the notion that when you get the write idea and it tweaks opinion leaders and the target population, then it will spread automatically once it has reached its tipping point which can be anywhere from 15 - 30% of the total population.

All well and good though this research is descriptive; namely it describes something that has happened. It is not inherently predictive. Many people have written books and articles with their ideas on how to take the descriptive lessons and apply then predictively. However, there are very few longitudinal studies which chekc these implemented efforts with what actually happens.

If you do want a predictive method then there have been a number of formula around for 70 or so years all of which can be used to guide you in your implementation efforts.

Another fundamental issue is the tipping point usually refers to transformational innovation. It is when something quite new and novel gets adopted by others. It has little or no relevance for communities where incremental improvement is underway. Some studies make a point of assuming that innovation is the same as improvement, and they can thus include all innovation spread and adoption research into their models and theories. However, I beg to differ. Anyone who has a strategy of incremental improvement I suggests avoids using the tipping point as a planning tool.

I've written before about the concept of opinion leadership and my ambivalence about it (see earlier blog posts). The tipping point is fairly well predicated on the theory of opinion leaders yet there is much research to demonstrate the wekness in this model.

Yes, you may see many charts showing what looks like an S-curve in the adoption of an idea. However, my first question is to ask what was the total population, namely to how many peopel did you intend this idea to spread? ONce you have the total population you will most likely notice that what you are seeing as an S-curve may not be much mroe than the variation you might get in the early phases of adoption.

Next time I read a strategy and implementation plan that says something like "Once 25% of the population has adopted the change the rest will pick it up" I will continue to be sceptical.

Use blogs to develop communities of practice

Use blogs to help knowledge flow and communities of practice to develop One of the great ways to reduce email is to use collaborative systems that enable project teams to work together, to share all their files and choose how they wish to remain in contact.

Dave Snowden has written an article in KMWorld about how blogging can help communities of practice as well as this use of virtual teaming. His perspective is how these methods can help knowledge flow around an organisation and how communities of practice can develop, thus embedding knowledge and helping sharing.He has a number of tips of how blogging can be used http://www.kmworld.com/Articles/News/News-Analysis/%3CI%3EEverything-is-fragmented%3C-I%3E%E2%80%94Building-CoPs-for-knowledge-flow--49849.aspx

Synchronous learning is important for large scale change

I've always felt that the paradigm of learning, how we learn, the fact we have different styles etc., is a crucial theme for spreading good practice across systems, in large scale transformational change.

Some of us like to learn through theoretical experiences whilst other of us prefer a more interactice and discussive type process. There's an interesting article in "Chief Learning Officer" which I think closely relates to the problems we grapple with in healthcare in scaling up change across lots of people and organisations.

The article looks at the difference between synchronous (do together, discuss, meet, talk) and asynchronous (email, read alone) activities. It looks at how the learning process is effectively part of the outcome of any change.

I'll not repeat the article; have a look here for the whole thing -
http://www.clomedia.com/features/2008/July/2276/index.php?pt=a&aid=2276&start=0&page=1