There is sound scientific evidence which tells us that current primary health care practices can be greatly improved, however, there is a gap between what we know and what we do. The Breakthrough Series Collaborative methodology is designed to help organizations close that gap by creating a structure in which teams can easily learn from each other and from recognised experts in selected topic areas.
The Improvement Foundation has adapted the Breakthrough Series Collaborative methodology and applied it as the framework for the Australian Primary Care Collaboratives (APCC) Program.
With the APCC Program:
The Collaborative methodology promotes rapid change. It works because:
Breakthrough Series Collaborative methodology, first developed in the USA by the Instititute of Healthcare Improvement, has been applied to a wide range of management challenges. It was originally applied to healthcare systems in the USA, and has been adopted in other countries, including the UK, Scotland, Canada and New Zealand.
The Collaborative framework, as used in the APCC Program, starts with the selection of Program topics, then Expert Reference Panels (ERPs) are formed to develop aims, measures, change principles' and ‘change ideas' for each topic. This work is then compiled into the Program handbook. Practices that participate in the Program attend an orientation session and a series of learning workshops, undertaking improvement/change activities in their health service during activity periods and collecting monthly data to track their progress.
The ERPs consist of a range of research and clinical experts in each particular topic area of the Program. Their job is to identify the topic aims, measures, change principles, develop strategies and ideas for implementing change and to suggest measures for tracking these changes.
The change principles are milestones that the practice should aim to achieve, while change ideas are the practical steps that can be used to achieve them.
Each topic in the Program has a specific aim. Aims are targets that will assist in achieving the overall objective for the Program. Measures are the data collected for tracking improvements. To view the current Program measures visit http://www.apcc.org.au/about_the_APCC/program_results/program_measures/
Health services that join the APCC Program participate in a ‘wave'. A GP and a staff member from each health service come together with other health services in their wave to participate in the Program. A wave is made up of an orientation session followed by a series of learning workshops. These events are spread out over approximately a nine month period, with activity periods inbetween, and a further 9 months of data submission after the final workshop. There are currently four types of 'waves' in the APCC Program; National and State based; Local; Virtual and combined State & Virtual.
Health services collect baseline data at the beginning of their Program wave. This provides an important snapshot of their position before they begin making improvements. Health services track their improvements through monthly data submissions.
Learning workshops allow participants to hear from topic area and quality improvement experts and actively share knowledge and experiences with their peers in the wave.
These are periods of time between and after learning workshops. They enable the practice team to test ideas using the Model for Improvement and carry out change.
The Model for Improvement provides a framework for developing, testing and implementing changes.
For more information see: APCC Team (ERPs), Model for Improvement, Goals and Aims of the Program, & Program Results
*(Langley, Nolan, Nolan, Norman & Provost (1996) "The Improvement Guide" Jossey Bass, USA)
Last Updated 24 February 2011