Healthcare Improvement and Education Improvement--more in common than expected

Like many educators, I used this summer as a chance to take some PD. I had the opportunity to participate in the Institute for Healthcare Improvement’s (IHI) Improvement Coach Professional Development Program. IHI is a nonprofit focused on improving healthcare outcomes by providing training, consultation, and research to governments as well as large and small health organizations across the world. And they happen to be in my backyard of Cambridge, Massachusetts.

Improvement science is their main business--how do we get better so we can do better? Improvement science is all the rage in healthcare with hospital CEOs, doctors, nurses, and training programs for anyone interested in the healthcare field. It’s starting to make its way into education through the Carnegie Foundation’s work on Networked Improvement Communities (they published the 2015 book Learning to Improve: How America’s Schools Can Get Better at Getting Better).

Whether you know about improvement science or not, it will feel very familiar to any educator. It’s basically an inquiry cycle. You focus on a problem and unpack its causes, you come up with a theory about how you could improve it, you try it out, collect some data, review it, and then decide if you should keep going or make another change.

Although the structure was familiar, there were some pieces that really stuck with me and we’re building into our Co-Labs for Innovation model:

  1. There’s a common sense of urgency. We know that time matters and while we’re trying to perfect something that means some students aren’t getting our best. This couldn’t be more true in healthcare where they’re working to reduce misdiagnosis or improve ambulance response times. That sense of urgency is what’s driving them to focus on learning to improve, not designing gold standard research methods. We need to focus on trying something different and we need an environment and community that supports this. Even if something is proven to work, the chances of it working in a particular (fill in the blank--school, classroom, subject, etc.) are slim. A motto that was frequently repeated was, “What can we test by next Tuesday?”

  2. Data collection can be simple and it should be frequent. We can only improve as quickly as we can collect data to tell us if we’re headed in the right direction. There is a place for end of year data and outcome measures, but we miss opportunities to improve if we wait until the end. We have to think about “good enough” measures that will give us an indication of if we’re on track. If those are collected yearly, then we should challenge ourselves to think about how we can collect them monthly instead. And if they’re collected monthly, then we should find a way to get them weekly.

  3. Think about making real, sustainable change rather than just adding “more.” It’s easy to see change if you add more to a problem--more time, more resources, more training. But when that “more” goes away (as it always does because we’re all working with limited time, resources, energy) the change does too. We have to disrupt the process--do something new, switch the order, remove a step. If you think of a flow chart of what you’re currently doing, then real, sustainable change requires you to rework that flow chart.

  4. Change is hard for everyone and that makes it even more important to remember why it matters. One hospital had a “quiet at night” policy. The staff hated having to talk in hushed tones and felt as though upper management was the Quiet Police. In developing their goal for an improvement cycle, however, they honed in on the real focus which was to help patients receive at least six hours of uninterrupted sleep because it was known to greatly improve patient recovery. Being clear on their goal and why it mattered led the team to a whole different set of changes to try rather than focusing on not talking above a whisper. This was also a reminder to me that change is personal and that’s all the more reason why teachers need to be empowered to lead the changes in education.

A teacher recently told me he likes to spend the summer thinking about the pebble in his shoe, that thing from the past year that he didn’t get right and wants to do differently in the new year. I think there’s a lot we can learn from improvement science about how to get better. At the Teacher Collaborative, we believe we can all learn more and be #bettertogether. I can’t wait to see what the educators in this community come up with in the new school year.

Kat Johnston