Kauffman Best Practices Project Final Report - The Chadwick Center ...

The IHI Experience
If we want to
speed the pace of
“spread” and close
the gap from the
early adopters to
the traditionalists,
we must understand
the barriers.
Seeking lessons from the experience of others, the Kauffman Best Practices
Project staff also reviewed the diffusion experience in other industries. The
most relevant analogue for the child abuse field proved to be healthcare and the
work in spreading medical best practices. Of particular note is the work of the
Institute for Healthcare Improvement - IHI (www.ihi.org), National Initiative
for Children’s Healthcare Quality (NICHQ), the National Academy of Science’s
Institute of Medicine (IOM), and the National Health Services (United
Kingdom). Our review of the literature on spreading best practices
confirms that a wide gulf in time exists between the development of a
best practice and the adoption of it in everyday practice across the
nation. Using IHI’s model (Berwick, 2003), best practices are developed by
“innovators” and their ideas and models are then implemented elsewhere by
“early adopters” who replicate and adapt the practice for their world. In the
traditional model of “spread”, the experiences of these early adopters are later
implemented by a number of others who, in time, form an “early majority”. As
the practice is widely accepted and becomes commonplace, most others adopt
the practice and are referred to as the “late majority”. The ultimate end of the
continuum are the “traditionalists”, who only begrudgingly adopt the practice
long after it has become commonplace.
FIGURE 2
Homer, MD-NICHQ 2003
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