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Play 2: Using a Change Model

Using a Change Model


Implementing S·BI·RT requires complex practice change in most systems. It is a layered process, touching the system at multiple points. It is critical to your S·BI·RT implementation success and sustainability that your team addresses planning and implementation issues together systematically, and that your team is in agreement about decisions. Using a change model as a framework for implementation will help your team reach its goals and measure success faster and more effectively.

Purpose of Play 2 Identify and agree on the change model the team will use to implement S·BI·RT. The change model defines the processes you will use to adopt and adapt S·BI·RT, that is, bring the clinical material of S·BI·RT into your practice and make it fit your unique setting.
Definitions A change model is a road map that will help you and your team visualize how you will reach your goal. The change model proposed in this Playbook has been developed by a team of experts and tested in many settings.
Team members See Play 1.
Measure(s) The team has agreed to, understands, and will utilize the change model.


Recommended Approach

  • If the team has already identified a change model for improving practice, adopt it and agree to use it. Examples of change models are available in Appendix C and Appendix D.
  • Reviewing and understanding the change model WITH YOUR TEAM before the team begins the work of implementing S·BI·RT provides a baseline understanding for the process the team will follow to get to goal.
  • If the team does not currently utilize an evidence-based model for practice change, we suggest that the team adopt the Clinical Microsystems Model and seek training and support for utilizing the model from the Center.

Keep In Mind

  • A model is a blueprint for action, providing guidelines for how to effect change.
  • Adoption of a model of practice change that can be applied to other system issues is an additional benefit of S·BI·RT implementation for your practice site.
  • Regardless of the change model used, the process of improvement builds on an understanding of the “current state”. Thus, improvement work for S·BI·RT must start with an assessment of your organization’s specific processes related to screening: Why do you do it? Who does it? What does your patient population look like? What is the current flow of the work process and screening process and tools? What data are you using to measure screening and substance use screening?

Corresponding Appendix Section(s)

Appendix C – Site Plan-Do-Study-Act (PDSA) Example
Appendix D – Clinical Microsystems: A Model for Improvement

» Continue to PLAY 3: Developing A Plan