New Approach to Controlling SuperbugsVirtual Learning Session 2

The Discovery Phase:Using Discovery and Action Dialogue

Liz RykertLeah Gitterman

Agenda:1. Welcome and Introductions2. The Discovery Phase3. Using Discovery and Action Dialogues4. Participant Break-out Sessions5. Larger Group Discussion6. Next Steps

Interacting in WebEx

Apr 10, 2023 3

Be prepared to use:

• Pointer

• Raise your hand

Welcome Teams!

The Premise Of Positive Deviance

No matter how seemingly intractable a problem, in every community there are individuals whose uncommon practices/behaviours enable them to find better solutions to problems than their neighbours who have access to the same resources.

Positive Deviance

Determine

Discover

Design

Define

DiscernDisseminate

• Discover uncommon practices/behaviors enabling the PDs to outperform/find better solutions to the problem than others in their “community”

Discover

What We Must Do What We Must Not Do

What Will Emerge in

Unique Forms

Use inquiry based process Discovery and Action Dialogues

Ignore little changes, suggestions, and adaptations that emerge from discovery dialogues

Answers and successful strategies that emerge will differ by organization, unit etc..

What We Must Do What We Must Not Do

What Will Emerge in

Unique Forms

Feed back to others and rapidly act on suggestions or communicate why they cannot be acted upon

Be silent or wishy-washy on suggested actions

Strategies for how this will happen will vary between organizations

• Emphasizes hands-on learning • Focuses on actionable behaviours

“it is easier to act your way into a new way of thinking than to think your way into a new way of acting”

Discovery and Action Dialogues-how they work

• Group selects a specific problem

• The group as a whole identifies what the solution looks like including key measures of success

What this looks like:

• 15-20 minute sessions • Ideally done right on the unit• Include those that want to be involved• Encourage a multidisciplinary group• Facilitator runs through a series of questions that

affirm the problem, identify barriers, uncover existing solutions, generate ideas/actions

Sample Questions

1. How do you know or recognize when ____ the problem selected is present?

2. How do YOU contribute effectively to solving the problem?3. What prevents you from doing this or taking these actions all

the time?4. Is there anyone you know who is able to frequently___ solve

the problem, overcoming barriers?5. Do you have any ideas?6. What needs to be done to make it happen? Any volunteers?7. Who else needs to be involved?

Tips for Facilitators

Do:• Hold the dialogue in the participants’ local

context – e.g. the unit• Make impromptu invitations as you enter the

area• Designate a scribe to take notes• Start with the purpose, We are here to stop…

Do:• Give questions back to the group-wait 20

seconds for a response• Encourage everyone to speak• Work through all questions without worrying

about the order• Demonstrate genuine curiosity in everyone’s

contributions

Do Not:• Answer questions that have not been asked• Miss opportunities to “catch butterflies” –

record actions to be taken by participants• Come away with a to-do list for yourself• Avoid responding positively or negatively to

contributions-let the group sift through their own assessments

Always remember:

“Nothing about me without me”

Take 15 Practice a Discovery and Action Dialogue

• One faculty member per group• Choose a facilitator and scribe• Use questions provided• Assign roles to everyone in the group (nurse,

doc, environmental services, allied health…)

Report Back:

Tell us how it went

Quick Poll:1. Do you feel you have enough information to

lead a DAD in your setting and help others to lead one?

2. Have you registered for the CoP?3. Would you like a follow-up call to assist you

to register with and navigate the CoP?

Next Steps

• Continue to work on core team and “launch”• Start using the DAD process on the floors• Follow up regularly with staff after the DAD’s• Begin to think about data collection

• Faculty office hours: every Monday from 1-2pm EST

• Next learning session: July 12th, 1-2pm EST• Community of Practice