A key to future success is selecting initial changes that are feasible. Some teams are tempted by the idea of large-scale improvement projects - but feasibility and moderation are sometimes more useful when a project begins. Teams should begin by making changes that are likely to be effective and will quickly begin to improve patient care - and start with providers who want to participate in the improvement effort.
Teams can look to other organizations for ideas for change. This book and the resources listed throughout are excellent places to find ideas. Often, organizations have similar problems - and similar solutions.
In organizations in which a team identifies a laundry list of change ideas, set priorities. There are many strategies for managing and reducing pain - but only a few of these are likely to lead to breakthrough change. Begin by testing these, and save others for future projects.
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.
For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].