There are so many similarities to travel and journeys in health care improvement. As an improver and innovator, as well as an avid traveler, it’s one of the appeals of this work. I love the big ideas—thinking about new routes to take together, throwing caution to the wind at times, and coming up with new approaches to reaching the destination. But I also understand the importance of a rigorous, time-tested QI process—a road-map if you will—to ground these adventures. So I wholeheartedly embrace the use of measurable goals, especially the 90-day variety. 90-day goals are the way that ImproveCareNow center teams shape and quantify their improvement ambitions—they help them set the course, assess whether they are on the right path, and finally, whether they have arrived in the right place.

Just after the ImproveCareNow Spring Community Conference last month, I wrote about the anxiety and anticipation that can precede such events. As I explained, “what we really want is to have set a scene that will allow all to feel welcome, included, part of the community, free to share their ideas and expertise regardless of role, and that they will leave having felt both delight and full of the “human affections” that are (or should be) the hallmark of a truly collaborative improvement community.”

After the conference, we asked members of the community—from diverse roles and centers—to share their perspectives on how we did. We hope you’ll enjoy their words. I know we all feel the challenge to maintain our momentum and indeed do even better next time and hope you will join us in finding ways to make our next community gathering equally inclusive and participatory – the very best it can be!

At the end of the Spring ImproveCareNow Community Conference, I shared this painting, “You Worry about Its Success” by Hollis Sigler:

I have loved this painting since I first saw it, in part because of the feeling of anticipation that it creates. The description of this painting on the Madison Museum of Contemporary Art website says:

“There is a magical air to the night. It is a moment of expectation. Who is the hostess? Who is the guest? Where are they and when will they arrive? The title of the painting is written in delicate script at the top center of the composition. It is the voice of the hostess who is concerned that all will go right. Her worries become ours in this poignant scene of human affections. The preparations are loving, but the darkened house and absence of any human presence veil our anticipations with anxiety. All may not turn out as expected.”

As you know, the weeks leading up to an ImproveCareNow Community Conference are a few parts busy, a few parts exhilarating, and a few parts stressful (though luckily the ratio changes by the day). There is a lot to do, but our team has done it many times before and indeed our team has grown exponentially as we’ve come to consider the whole community part of the planning process. It’s hard work, but its work we’re doing together and we all look forward to celebrating together once the big event arrives.

We are writing this at the end of another whirlwind year in ImproveCareNow. Just looking at the basic facts and figures, 2015 was much like every year since 2007—successful, busy, and vibrant:

• We continued to improve, with a continued steady increase in our Network-wide remission rate culminating in reaching 80% as of November 2015.
• We continued to grow, welcoming 14 new care centers during the year. We now include a total of 85 centers across the US and UK.
• We impacted the lives of more patients, with 24,000 children and youth with IBD cared for at ImproveCareNow centers. These children are benefiting from our focus on continuous improvement work and evolving pediatric IBD research portfolio.
• We stayed connected and communicated openly, on 10 Network-wide webinars, during 30+ Learning Lab webinars, within nearly 10 focused role-specific groups, and by way of our “virtual commons”. The ICN Exchange had 600+ users “sharing seamlessly and stealing shamelessly” in 2015.
• We continued to test new approaches to improving care and health of all children and youth with IBD, by launching a number (too many to count!) of new initiatives and collaborations, including the COMBINE study, the ImproveCareNow engagement and leadership campaign, and collaborations with CCFA and other external partners.

Much about Thanksgiving is the same year to year. People come together with friends and family and community, often enjoying a large meal together, and spending the day doing something meaningful—whether doing community service; watching football; or sitting around talking, telling stories, and recovering from the large meal. But while many things about this day of togetherness and gratitude remain constant each year, our personal roles may shift. Sometimes we host the meal at our home. We are the “leaders” for the day, developing the menu, doing most of the cooking, deciding when the group will eat, assigning tasks in the kitchen, and choosing which football game will be on. Other times, we are a guest in someone’s home, often traveling some distance, we are told which side dish to bring, when to arrive, and which activities are planned for the day. Sometimes we are grateful to play a supporting role in the production, and other times it can be hard to sit back and watch events unfold differently than they would if we were in charge. Maybe the mashed potatoes don’t taste just like our Thanksgiving memories, maybe our family always took a walk after eating and we’re antsy to do the same, and maybe the wrong football game is on TV (or we just can’t stand watching football at all).  Or maybe it’s just perfect—just the break we needed from running the show – and we bask in the glow of learning new ways of doing things and watching others shine.

The C.S. Mott pediatric IBD team hosted its first engagement meeting. Our first meeting brought together a group of parents, patients, doctors, nurses and improvement coordinators to learn about and share what goes on behind the scenes in our IBD clinic. We designed it as a safe place to ask questions and provide feedback, meet and mingle with others, and (very importantly) gave parents and patients the opportunity to choose if they want to be involved in any of our efforts.

Patients, parents and doctors – we are all humans and want to know each other as such. This has been a common theme that I have seen emerge from Community Conference pre-work and in conversations I’ve had around engagement. Patients and parents want to connect and view their care providers as real people; they want their care team to know who they are beyond just a diagnosis. The focus is on feeling normal and being connected, and how that is defined differs a bit in each case.

Engagement is one of those things that just seems to come naturally to some people. If you believe in something and are excited about it, how can you not share your enthusiasm with others? That’s all engagement is really; sharing stories, passions and successes, and working together toward a mission.

My name is Cori and this is my story of working with ImproveCareNow (ICN) – engaging many different people in an effort to improve care & health for kids with IBD.

About 50 small groups of clinicians/patients/parents brainstorming how to surmount 14 barriers to care #icncc15f

We are just over one week out from the Fall 2015 ImproveCareNow Community Conference (#ICNCC15F). Everyone is getting caught up, re-organized, and starting to set priorities for their improvement work in the coming months.