1
Fostering Changeto successfully introduce and scale up provenhealth policies and practices
Lourdes de la Peza
Bangkok, 2010
2
Change is NOT Easy
Vitamin C and scurvy
Hand washing
Family planning
Vaccinations
3
Change is NOT Easy
Change DOES NOT happen because….
Researchers say it is beneficial
“Evidence” shows a practice can work
New guidelines are promulgated
4
An effective process for change is a criticalsuccess factor for:
Adapting
Implementing
Scaling up
Sustaining
best practices
The Science of the Diffusion ofInnovation:
5
The 3 Main “Clusters of Influence”in the Diffusion of Innovations by Everett Rogers
Perceptions ofthe Innovation
Characteristics ofAdopters
Contextual factors
6
First Cluster: Perceptions of the Innovation
Five most influential properties of aninnovation
1.Perceived Benefit
2. Compatibility
3.Complexity
4.Trialability
5.Observability
PERCEPTION is the key word
7
Second Cluster: Characteristics of Adopter
Innovators2.5%
EarlyAdopters13.5%
EarlyMajority34%
LateMajority34%
Laggards16%
8
Third Cluster: Contextual Factors
Organizational culture
Incentives
Management and leadershippractices
9
A Proposal for Marriage…
10
Phases: Guide to Fostering Change
Preliminary Phase: Forming the Change Coordination Team
Phase I: Defining the Need for Change
–Identify the problem and the benefit
Phase II: Planning for Demonstration and Scale up
–Select a change agent
–Identify, analyze and choose relevant effective practices
–Make a plan to implement and monitor change
–Make preliminary choices for scale-up
11
Phases (cont’d)
Phase III: Supporting the Demonstration
–Create and maintain an environment to encouragechange
–Use the plan to continually assess, monitor and modify
Phase IV: Going to Scale
–Evaluate
–Engage commitment of stakeholders
–Select an implement strategy
–Measure and communicate results
12
Virtual Fostering Change Program
Part I: Create anaction plan tointroduce a bestpractice
Part II: Introduce abest practice
Part III: Create a planto scale up
Part IV: Implementaction plan
13
