Hopefully you've been working your way though a project with the previous 11 episodes and you are excited and curious to get more info. Where to start? I'll have recommendations on potential next steps and some final thoughts on this series as the podcast transitions into its next phase.

Now you've learned so much and you are burning with the need to share it! But how? And where? And why? Well, probably not why. We all know why we share knowledge, because just like love sharing it gets you more of it. But the hows and whys and wheres can be a bit baffling. So lets dive into the formal and informal ways you can help spread the Science of Improvement mindset and start participating in driving improvement in healthcare.

"Culture eats Strategy for breakfast". It sure does. If you are going to be a change agent or leader in your system, you are going to need to manage and develop culture. And any change in culture is going to start with changing yourself and moving away from totally natural and totally understandable reactions to the things around you. Which can be frustrating because that work is never over, so let's get started now!

You can create a good amount of change by yourself, but to really make the earth move you are going to need other people. If you want to be a change leader you need to invest your time in building a team around your change project. And that involves people. And people are often a little tricky to lead, and many of our natural instincts serve to erode team cohesion instead of building it. So let's talk about making connections instead of gaining compliance. Let's explore how to respond to resistance with curiosity. And let's acknowledge that our lens is just that, it's our lens. And it's incomplete, and we need the lenses of other people to get a more complete understanding of what we are trying to improve.

You've done some PDSA's. You've learned a lot. You think you have a pretty good solution figured out to make the process better. Now what? Now you get to scale, and scale can be really difficult because it involves bringing people into the project that may not have the same commitment that you do. And, getting people other than you to engage with an improvement project is the only way to make a large scale impact. So let's go inspire some people!

So you've tested out an idea for change! Now what? You've got a couple of options: test the same thing again, test it with more people or in a different setting, modify it and test again, or throw it in the trash and test out a new idea... and many more! To draw an analogy from schoolyard American Football, it's now 4th down. Are you Kicking or Sticking?

You've got a change idea, now what? Take 6 months and plan a comprehensive in-service for the whole staff? Just wing it yourself on a random day? Something a bit more structured but also fast and nimble? Yeah, probably that third option. Lets explore what that would look like!

How do you know what to change? What needs to happen to make things better? Does "more" see like the right answer? More rules, more people, more effort, more money, etc...? Totally understandable reaction, rarely results in improvement. Today we talk about how to generate change ideas and reshape your work processes to produce tangible improvement that doesn't create extra burdens or put the blame/responsibility on the individuals, but instead goes about building a better system.