All Teach, All Learn to Impact Health Across the Community

In Slice of PIE, 12 community pharmacy organizations representing over 100 pharmacies in Minnesota are working together to improve individual health and demonstrate economic value through engaging at least 1,000 patients in an initial and at least one follow up pharmacist medication therapy management (MTM) encounter by December 31, 2020. It takes the knowledge and experiences of everyone participating in the learning and action collaborative to reach this bold goal by the end of 2020.

As part of the implementation support discussed in the previous blog post, Slice of PIE has rolled out a learning and action collaborative that runs 18 months (October 2019-March 2021). Collaboratives are a learning and action strategy designed to support organizations committed to achieving sustainable change with implementation of innovations within a thematic area. Through shared learning, participants from a cohort of organizations work to test and implement changes that lead to lasting improvement. Organizations, such as the Institute for Healthcare Improvement, have used the learning collaborative model to accelerate the adoption of strategies to improve patient care. The Slice of PIE Collaborative relies on the tenants of “all teach, all learn,” applying a quality improvement approach to further implement MTM services, dedicated monthly coaching, and expert faculty who are currently in practice.

Knowledge is often not fully valued if it has not been vetted through a rigorous process of review, categorization, and cataloguing before being widely disseminated to a community. In a rapidly changing world, it is critical not to lose sight of the value of practical knowledge and experience and how it can stimulate and support progress toward an aim. The Slice of PIE Collaborative relies on pacing events (in-person and web-based) and action periods to keep a focus on the overall goal of the collaborative and maintain energy and enthusiasm during the difficult work of producing change. “All-teach, all-learn” is a foundational element to the monthly pacing events where teams are in conversation and identifying strategies for practice improvement and implementation and gain an outside experience from experts who are invited to the events. Between each pacing event, each organization is in action on implementing CMM. These spaces of time are critical as this is when implementation, evaluation and refinement of service delivery occurs. Please read the blog post on Implementation Science for more on specific information on implementation strategies in the project.

While a community can offer support to each of its participants, there is also a critical need to provide customized coaching support focused on implementation and organizational leadership. Each participating organization has a dedicated coach who they meet with monthly between pacing events. The coaching model is designed to build relationships with teams, provide support and performance feedback, and use data to inform coaching next steps. Through the coaching process, the coach balances multiple roles of consultant, mentor, and cheerleader as needed with each team.

Throughout the collaborative cycle, participants have access to expert resources including faculty and Field Experts. Faculty from the University of Minnesota School of Pharmacy support pharmacists through case sessions and updates in educational materials on relevant clinical information and guidelines. The Field Experts draw on real-world community pharmacy practice experience to provide guidance and feedback on language, content, and framing for pacing events and project materials and serve as a regular contributor to pacing events.

The learning collaborative model was created to help health care organizations make "breakthrough" improvements in quality while reducing costs. They are rooted in an understanding of gaps that exist between what we know and what we do or between what we aspire to achieve with how we are actually performing. The Slice of PIE Collaborative is engaging community pharmacists across the state of Minnesota in an effort where they are committed to what they aspire to accomplish through MTM service delivery and close the gap that exists between their current work and these aspirations. The power of a learning collaborative is in sharing strategies that work, accelerating action, celebrating successes and producing measurable impact across the community.

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¹The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. Institute for Healthcare Improvement; 2003. Accessed October 31, 2019. http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesI...