© 2017 Primary Care Commissioning CIC

Story boards

Now Time +1 Time + 2

Time + 3 Time + 4 Desired state

Overuse always wastes resources and can cause harm

Higher Lower POINT OF OPTIMALITY

BENEFIT

HARMResources

ECONOMICVALUE

Benefit – harm

Effect Size

© 2017 Primary Care Commissioning CIC

Stages, processes & change interventions (Buchanan)

Stage Pre-contemplation

Contemplation Preparation Action Maintenance

Actions Communicate issues

Encourage awareness of issues

UnderstandDebate

Focus energy on enthusiasts

Listen to objectors

Communicate success of similar changes elsewhere

Highlight benefits

Emphasize consequences of do nothing

Emphasise individual participation

Address concerns

Emphasise individual participation

Establish teams to develop plans

Encourage mutual support networks

Identify training and resource needs

Be visible

Provide support, training and resources

Link new converts to experienced peers

Ensure benefits are measured and communicated

Remove processes and protocols that support old practices

Support development of networks and community practices

Devolve responsibility and decision making to lowest levels possible