title: Spreading improvement strategies within a large home healthcare organization.
abstract: This article describes the process of the spread of improvement strategies to improve relationships between professional and paraprofessional service providers within a large home healthcare organization and its partnering home health aide vendors. We describe the method for spreading the strategies, which emerged from a learning collaborative, and the successes and challenges of the spread. Two case studies highlight how the attributes of innovations and the methods for spreading them can influence the effectiveness of an improvement effort.
authors.affiliation: Center for Home Care Policy and Research, Visiting Nurse Service of New York, NY, USA. miriam.ryvicker@vnsny.org
authors.forename: Miriam
authors.initials: M
authors.lastname: Ryvicker
authors.forename: Joan
authors.initials: J
authors.lastname: Marren
authors.forename: Sally
authors.initials: S
authors.lastname: Sobolewski
authors.forename: Terese
authors.initials: T
authors.lastname: Acampora
authors.forename: Marki
authors.initials: M
authors.lastname: Flannery
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Buff
authors.forename: Ann Marie R
authors.initials: AM
authors.lastname: Hess
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Rosati
authors.forename: Theresa
authors.initials: T
authors.lastname: Schwartz
authors.forename: Penny Hollander
authors.initials: PH
authors.lastname: Feldman
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D003132:Commerce / Q000458:organization & administration; D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D006699:Home Care Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007373:Interinstitutional Relations; D007400:Interprofessional Relations; D009518:New York; D019982:Organizational Case Studies; D015279:Organizational Culture; D009936:Organizational Innovation; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods*; D000078329:Workforce