Implementation Cautions
From: M. D. Anderson Department of Performance Improvement
Date: January 15, 2008

Narrator: In this segment we bring in a team that is working in the theme of the webcast itself, that being implementation, and have them come and explain their story. We're breaking tradition this time (usually we bring in someone with a “been there done that t-shirt”), well this time we're bringing in someone who has a “being there doing that” t-shirt on. Today we have Marilyn Dawlett of Cytopathology, she's a cytotechnologist. What I enjoyed about her team presentation is that it included not just her area but quite a few areas. Marilyn, could you tell the folks a little bit about your story there?

Marilyn Dawlett: Sure, we're focusing on survey question number 41, and that is: Teamwork across departments is good. We actually had a 49% unfavorable response to that. So, from that our aim is to decrease the occurrence of incorrect specimen routing, which is a problem that involves many different departments. We are hoping that by involving the difference departments of the various clinics, transportation and laboratory medicine we can work on teamwork and communication with them to improve this problem and decrease the occurrence of incorrect specimen routing.

Narrator: Ok, were there some challenges along the way as far as the implementation itself?

Marilyn Dawlett: Yeah, we've had some problems. I think primarily working in a clinical environment you're always going to have a problem with competing priorities - and with that, limited resources and especially personnel, so it's very difficult to pull yourself away from routine clinical work that has to get done according to a certain deadline to work on this extra project. In addition to that, it's also really a challenge to get enough managerial support to put all these changes we want to put into effect.

Narrator: So here, if it were just within your own department you could probably deal with that whenever it goes beyond just your department. It takes quite a bit more effort.

Marilyn Dawlett: That would make it more simple.

Narrator: Ok, some advice as far as how you're going to proceed given where you are from now?

Marilyn Dawlett: From the beginning, it's probably a very good idea to keep your aim as precise and focused as you possibly can. Then from there, break it down even further into small manageable steps that you can tackle one by one on a smaller scale - so you can accomplish one thing and move on to the next. Then over time step by step you'll have all these accomplishments that will ultimately get you to your implementation goal.

Narrator: Excellent! Ok, so what are your next steps as far as moving your implementation forward?

Marilyn Dawlett: The next thing we need to do is start bringing in all the parties that are involved in our implementation plan so the different departments need to come in. First we need to bring in our manager. We're going to schedule a meeting with our division administrator, who has already heard about our project, and she seems to be excited about it - so we're going to bring her in. Actually, her role will be very important in bringing all of laboratory medicine together.

Narrator: Ok.

Marilyn Dawlett: And from there we'll schedule meetings with the other areas such as transportation and different clinic representatives.

Narrator: Ok, alright, so from this I see that everyone can benefit from having your specimens routed to the right place, not having to call up for things and that kind of stuff, correct?

Marilyn Dawlett: All of these mistakes happen. It's very time consuming to go back and correct it and redeliver this, so ultimately we're going to have a positive impact on patient care.

Narrator: Excellent, excellent. Ok, so if you want to sit there and leave some pieces of advice, what would you leave them with?

Marilyn Dawlett: I would definitely recommend that people - like I said before - break your project down into small steps. Be very organized with it, and anticipate interruptions.

Narrator: Ok.

Marilyn Dawlett: And then if you're organized and have small steps to follow you can always return to that.

Narrator: Ok.

Marilyn Dawlett: And be able to complete them. Also, make sure that all your coworkers, your staff, understand the purpose of the change. If they understand it, then they will be happy to provide their support and enthusiasm to complete it.

Narrator: Alright doesn't sound like you're going to give up.

Marilyn Dawlett: We are definitely going to see it through.

Narrator: Ok well what I'd like to do now is switch over. We usually do the top ten David Letterman pieces of insight. So if you would help me out with that. Right now we're going to come back to (if you would) back to this within the studio itself. Go ahead and call in right now at 3-9651 right after the top ten, and then we'll get Marilyn back in the studio to answer some of your questions.

So this is going to be the top ten. I actually developed these after overhearing a friend plan her wedding. So truly if you had a wedding that came off just perfectly and that kind of stuff, doing implementation plans should be no problem at all. So these are the top ten implementation mentalities needed for success.

Implementation mentality # 10.

Marilyn Dawlett: It looks upstream and downstream to those impacted and integrates accordingly.

Narrator: # 9:.

Marilyn Dawlett: It surfaces resistance, then tries to disarm it.

Narrator: # 8.

Marilyn Dawlett: It communicates until the ranks are overdosed with what to expect, how to do it, and what to avoid.

Narrator: # 7.

Marilyn Dawlett: It is porous to input on what is going wrong.

Narrator: # 6.

Marilyn Dawlett: It is flexible and adapting to varying what is planned inline with reality.

Narrator: # 5.

Marilyn Dawlett: It knows the mission critical aspects and protects them with necessary support.

Narrator: # 4.

Marilyn Dawlett: It leaves little for chance.

Narrator: # 3.

Marilyn Dawlett: It looks at road blocks, as license to be creative.

Narrator: # 2.

Marilyn Dawlett: It keeps management apprised of how it can help or what to prepare for.

Narrator: Drum roll….. # 1.

Marilyn Dawlett: It's not a matter of if we will be successful - just a matter of when.

Narrator: Excellent, ok well listen, will you come back to the studio and answer some of the questions for us here?

Marilyn Dawlett: I'll be back.

Narrator: Excellent, well we'll return back to the studio.