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Background

“The U.S. Agency for Healthcare Research and Quality created the Health Care Innovations Exchange to speed the implementation of new and better ways of delivering health care.” – AHRQ Health Care Innovations Exchange

In its initial years, the Innovations Exchange focused on content development by building a collection of over 600 innovation profiles and 1600 QualityTools across a variety of settings, populations, disease and clinical categories, care stages, organizational processes, and other dimensions. The Innovations Exchange has since become the nation’s largest publicly accessible, Web-based collection of evidence-rated health care delivery innovations. To explore how these innovations and tools could be actively used by the masses for greater improvements in health care quality and reductions in racial and ethnic disparities, the Innovations Exchange began to turn its attention to speeding uptake. Over the past year, AHRQ/Westat has explored promising ways of assisting innovators with scale up and spread (SUS) efforts and making it easier for adopters to share, learn about, and implement these new approaches to health care service delivery.

Recent AHRQ/Westat activities on scale up and spread have included the following:

  • Panel at 4th Annual NIH Conference on the Science of Dissemination and Implementation: Policy and Practice (March 2011): “Spread Models and Lessons: Learning from the AHRQ Health Care Innovations Exchange.” Mary Nix, Project Officer, chaired the panel and provided an overview of the Innovations Exchange. Veronica Nieva, Project Director, described major models of spread based on both the literature and the profiles represented in the Innovations Exchange collection. Innovators Bruce Leff, MD, of Johns Hopkins University School of Medicine and Tracy Novak, MHS, of Johns Hopkins Bloomberg School of Public Health outlined their efforts to spread their innovations, which are profiled in the Innovations Exchange.
  • AHRQ Health Care Innovations Exchange Round Table on Scale Up & Spread (May 2011): AHRQ and Westat worked together to design and produce the Round Table, consisting of an on-line discussion on scaling issues, and an in-person, daylong event. Invited participants, included a diverse group of health care innovators and potential stakeholders for health care innovations (e.g., payers, government and private funders, foundation officials, and researchers). We used a set of innovative activities to surface ways in which the Innovations Exchange could support scale up and spread efforts. These activities included:
    • The Scale Up & Spread Round Table and On-Line Discussions: For several weeks prior to the Round Table, Westat hosted a knowledge sharing platform that provided participants with the opportunity to join Web-based discussions led by provocateurs (recruited from the Innovations Exchange Expert Panel and others) on major questions related to the role of the Innovations Exchange in promoting SUS, which would help inform the Round Table discussions. The questions were:
      1. What resources can the innovations exchange provide innovators to help them to scale up and spread?
      2. How can the Innovations Exchange support potential adopters, especially those focusing on the underserved?
      3. How can the Innovations Exchange act as matchmaker between innovators and solution seekers/potential adopters?
      4. How can the Innovations Exchange help develop and disseminate newknowledge about SUS, and integrate this knowledge into its Web site content?
      We also provided an array of background resources on the topic of SUS and invited participants to share their general thoughts and interests on spread. 
    • The Scale Up and Spread In-person Event. The daylong event was divided into three major sections. The morning was devoted to a Fishbowl session, in which three innovators presented their innovations and spread plans to a reactor panel, in front of the entire group of participants. In the afternoon, smaller groups discussed the four major questions that had been the focus of the on-line discussions. The day ended with a “3X5” exercise to identify the most striking ideas generated during the day.
      • Fishbowl: Three Innovations Exchange innovators made 10 minute presentations to a 5 member Fishbowl Panel, consisting of different kinds of health care experts who infrequently exchange perspectives: a health care payer, foundation executive, hospital executive (C-suite administrator), community health care organization leader, venture capitalist, and an entrepreneur. The panel posed questions and offered guidance to the three Innovations Exchange innovators. This dynamic session identified a range of important and generalizable challenges to SUS and provided “case studies” for further discussion in the Four Corners exercise.
      • Four Corners break-out sessions: Provocateurs and Westat staff led sessions on the four major questions first addressed in the pre-event Web site.
      • 3 X 5 Exercise: Participants were asked to identify and rate the “best ideas of the day”, in an interactive exercise using 3 X 5 cards.