As a graduate student in a business school, I strive to apply what I’ve learned about management science to address problems of importance to society. So needless to say, working on research projects in partnership with the C3N Project and ImproveCareNow (ICN) has been educational and enlightening. Growth of the ImproveCareNow Network has brought both exciting opportunities and new practical challenges, as Sarah Myers discussed in her recent LOOP post. In the spirit of continuous improvement, ICN leaders wanted an enhanced, evidence-based understanding of Learning Labs and other models for collaboration at different levels of scale. And I was thrilled for the opportunity to support this effort.


Many of you will recall a survey distributed last summer by ImproveCareNow. The survey presented a series of questions with two scenarios for network-based group learning, asking respondents to choose the scenario which seemed most conducive to learning and improvement. Those paired scenarios appeared to be very similar; a few respondents even wrote to tell us that the survey was defective, presenting the same question over and over again! But, in fact we were using an advanced and efficient method, the discrete choice experiment (DCE), to collect feedback on strategies for continuous learning from within the network itself. Discrete choice methods – common in marketing research as well as health economics and policy studies – use experimental design to assess the relative importance that customers/end-users place on attributes of a given product, service, or scenario. For example, a DCE for the design of new laptop computers might examine factors such as weight, battery life, memory, and price. Comparison of patient treatment options with DCE might explore tradeoffs between efficacy, cost, and invasiveness.


Our DCE for ImproveCareNow evaluated three group learning techniques: micro-communities called “Learning Labs”, quality improvement curricula, and team-to-team mentoring. As a research team, we are extremely appreciative of the 149 survey respondents representing 63 ICN care centers. We had a response rate of 65%, increasing confidence that our results accurately represented network preferences.


ImproveCareNow Learning Health CommunityOverall, we observed that ImproveCareNow participants preferred mixed Learning Labs (including both novice and experienced care teams) over cohorts of teams with similar levels of experience, sequential curriculum (introduction of topics in a structured succession) rather than a simultaneous overview of QI tools and interventions, and ad hoc mentoring based on focal topics rather than an assigned, permanent mentor team. We also observed interesting variation in preferences across subgroups based on individuals’ time in the network, professional roles, and characteristics of care centers such as patient population size. I am excited to share these results in greater detail – and most importantly, to discuss what we’ve learned with the ICN community – at the upcoming network-wide webinar on Tuesday May 12 (11 ET). Please join us to weigh in!


As improvement networks scale up, it is not enough to do more of the same in a bigger way… Understanding how to adapt structures for continuous learning as networks grow and change is necessary for development of learning health care systems. Engaging network participants to share their collective wisdom is essential for improving what ImproveCareNow does, and also for targeted improvements in costs, care, and outcomes.




published by ImproveCareNow on behalf of Shannon Provost


A picture of Shannon M. Provost - ImproveCareNow CollaboratorShannon M. Provost, MBA, is pursuing a PhD in Information, Risk, and Operations Management in the McCombs School of Business at the University of Texas at Austin and building a program of research around innovation ecosystems, social networks, and the science of improvement. She is also an Assistant Instructor of undergraduate business statistics. Shannon is grateful for learning opportunities which have emerged through her work as a visiting researcher at the James M. Anderson Center for Health Systems Excellence at Cincinnati Children’s Hospital Medical Center and as a member of the Institute for Healthcare Improvement faculty. Personal interests include travel, fashion, literature, beagles, and attempting to play golf.



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