Roll it out and forget about it!

Posted on September 21, 2013


As you can see from this graphic, even “tested” best practices roll out on a trajectory. There is no such thing as a completed roll out. The environment must be monitored for conditions that might propel a drift back into unsafe or undesired practices. These drifts usually do not occur because staff refuse to adopt the practice or decide to stop doing it. They occur because of environmental influences.

Roll outs must be constantly monitored until we are sure they are ingrained in the every day workflow and work under most conditions nurses face. Anytime there is a new condition in the environment, practices should be re-examined.

Systems need to be dynamic or they die. change in the environment is good and should be supproted however, a good feedback loop on processes is essential. Some good feedback loops include: safety walkrounds, manager walkrounds, and direct observations with coaching and problem solving (not punnishment).