Frequently Asked Questions

Q: How did this start?
A: Built from the work of W. Edwards Deming, Tom Nolan, his colleagues and others, our improvement collaborative model has been perfected the past few years through the work of the Institute of Healthcare Improvement of Boston, MA., and their Breakthrough Service series. With their support and encouragement, we are adopting its use toward improving our economy's unsustainable interaction with our natural environment. Through our collaboratives, we help rapidly spread knowledge that is known about how to be more sustainable, but is not yet widely practiced.

Q: What is a collaborative?
A: Basically, it is a group of people working together toward a common end. There are many types of collaboration, practiced in many forms and at many levels. The variation we are using has been has been refined and targeted through over 20 collaboratives a variety of topics over the past 6 years by the Institute for Healthcare Improvement.

Q: Why do you call it rapid improvement?
A: The key word here is improvement, which we distinguish from change. There can be a lot of change that takes place in an organization, but much too often it has little to do with real, actual, sustained improvement. Our model focuses intently on assuring improvements are embedded in the organization. When that happens in the typical life span of a collaborative (6, 7, 8 or 9 months) it is done so much more rapidly than other methods where changes see-saw back and forth.

Q: Why are you interested in using this model, in particular?
A: Any change can be hard work. Actual improvement in any organization -- the type of improvement that sticks, which customers really notice and which can have a noticeable effect on the bottom line -- is really tough work. This model of change management has a number of both obvious and subtle factors built into it, which help organizations overcome many of the more difficult barriers. These include:

• Targeting a carefully selected collaborative focus, one where "knowledge of how to improve is known, but too little of it is practiced." And selecting target areas that are "ripe for improvement," meaning there is a strong need by leadership to improve in this area. (Ripe does not imply easy. Rather it is a sense of urgency and leadership priority.)
• The infusion of experts -- both in the selected topic area and in change management -- in the dialogue from the start and throughout the work in the organizations.
• Known best practices are seeded into the organizations, and the participants are challenged to adopt them and improve them in their particular unique settings.
• The fact that those joining in on a collaborative are -- by their choice -- willing to share their best ideas, to learn to change and to grow. There is an important readiness for change present.
• Most of the work and learning is done on site in the participating organizations during the three action periods, and ongoing through the coordination, support and coaching.
• There is a clear focus on appropriate testing of improvement ideas in a conservative manner based on simple, proven techniques.
• And peer group pressure, clear deadlines, leadership involvement and the investment in the collaborative all combine to help assure that the theories are indeed turned into breakthrough improvements.

Q: Tell me more about the "simple, proven techniques" you mentioned?
A: Throughout the collaborative, we will be using "The Improvement Guide: A Practical Approach to Enhancing Organizational Effectiveness." It was written in 1996 by five authors, including Nolan, who helped develop this collaborative model with others. The model evolved from their work with Deming and other quality improvement leaders. They also have infused in the model specific and generic "change concepts," proven powerful in helping teams test different approaches.

Q: And how are they proven?
A: There is ample documentation of the breakthrough improvements achieved by many of the some 500 teams that have participated in the IHI collaboratives over the years. IHI has also tracked the learning of the teams as they progressed through a particular collaborative. Explore the details in their web site at IHI.org.

Q: Why are you focusing in particular on improvement in environmental performance?
A:  Two simple reasons: It is the right thing to do today, given the tremendous environmental challenges facing us and our children in the years ahead. Secondly, from a business perspective, it is a field that offers a  financial opportunity. There will be a lot of work to do as our economy works through the transition to a more sustainable structure. Rapid improvement collaboratives help speed the transformation.

Q: Why would a sponsor be interested in this model?
A: Clients of a sponsor -- especially the more advanced ones -- are seeking more efficient and effective means to foster improvements in their organizations, ones which have visible measures of progress and where much of the learning can take place on site. This collaborative approach is a useful vehicle to involve these organizations and spread their excellent work to other clients, rapidly.

Here's what they say

On collaboratives used among 20 hospitals

"Our experience is that this collaborative model with the use of rapid cycle testing has been able to greatly accelerate improvement work. The underpinnings of its success are a very supportive environment, peer influence and people working cooperatively in multi-disciplinary teams. We have four collaboratives underway now involving 46 teams with five more scheduled over the next two years. In each target area where we have a collaborative underway, we show substantial acceleration of improvement."

-- Dr. Andrew L. Kosseff, physician consultant and collaborative coordinator for SSM Healthcare, based in St. Louis with 20,000 employees, 5,000 physicians at 20 hospitals in the Midwest.

On collaboratives use among 20 newspapers

"The Newspaper Association of America developed a process improvement package that we offered member papers across the country. Two years ago, we formally began introducing it one paper at a time. But Lee Enterprises of Davenport, IA. chose a different path. Drawing on the rapid improvement collaborative model, it got all its 20 daily newspapers launched in a few months' time. A common language and shared learning spread quickly among all. People played off each other, comparing results and successes. The quantity and quality of the improvements implemented in Lee have been very impressive. NAA now recommends using the rapid improvement collaborative model as the way to go for the newspaper industry."

-- Chris Sabo, Director, NAA Partners Program, Akron, OH/ Arlington, VA.

On being at one of those papers

"We were one of 20 papers in a Lee Enterprises' collaborative that focused on implementation of a process improvement program. I found the framework and speed of the collaborative rollout helped a lot in getting improvements made down here on the ground. The program had more clout internally than the average project because it was important and visible to leadership. Its flexible structure allowed us to tailor the program to our unique circumstances here. And the speed of the rollout allowed us to get ahead of the grapevine. We gained experience in the program before we heard anything from others that might dampen our enthusiasm. Also, the conference calls among all coordinators at the papers were very, very useful. They kept everyone connected and energized."

-- Marci Rosen, Customer Service Manager and project leader at Madison Newspapers Inc., 650 employees, Madison, WI.