Roles in a Breakthrough Series Collaborative

The Institute for Healthcare Improvement developed the Breakthrough Series Collaborative model to help health care organizations make "breakthrough" improvements by creating a structure in which organizations can easily learn from each other and from recognized experts in topic areas where they want to make improvements. A Breakthrough Series Collaborative is a short-term (6- to 15-month) learning system that brings together a large number of teams from hospitals or clinics to seek improvement in a focused topic area. [Learn more: The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003. Available at:

Each Breakthrough Series Collaborative has a Chair who leads the overall Collaborative. The Chair is typically a well-respected, well-known leader in the field with deep knowledge, depth of experience, and sincere passion about the topic. The role of the Chair is to create a shared vision and provide intellectual leadership for the topic, to assist in forming and guiding the Planning Group, and to assist the Improvement Advisor to develop the conceptual framework and measurement system. The Chair leads and teaches at the Learning Sessions, coaches and mentors organizations and Senior Leaders to achieve goals, and reviews Collaborative progress. Generally one person serves as a Collaborative Chair. This establishes the Chair as the overall leader of the Collaborative and helps delineate clear lines of accountability and expectations. Some Collaboratives have Co-chairs. This arrangement can be helpful when the Collaborative focus is a topic that crosses multiple professional areas, such as improving health care for children in foster care. Co-chairs can lend multiple perspectives, build credibility with teams and divide the work. However, having Co-chairs can increase the workload for Collaborative Staff, who will have to manage multiple relationships and determine each Chair’s responsibilities.

The Executive acts as the liaison between the Collaborative and the sponsoring organization. The Executive is charged with maintaining the alignment between the Collaborative aim and the sponsoring organization’s priorities.

The Faculty must be well versed in the evidence base for the chosen topic, but primarily they must have practical experience in the development of a successful program. The Faculty should mirror the professional roles and types of organizations of the participating teams. The Faculty require excellent communication, coaching, and problem-solving skills to work with a wide variety of teams.

The Chair is supported by the CollaborativeStaff, which consists of a Project Coordinator, Project

Manager, Project Director, and Improvement Advisor.

The Project Coordinator handles the logistics of meetings, calls, and provides support for the Faculty and teams.

The Project Manager has expertise in project management and develops and manages the timeline for the Collaborative, the budget and contract work, and ensures timely deliverables.

The Project Director is responsible for the oversight of the Collaborative, coaching the Chair and Planning Group in the Breakthrough Series methodology, managing prework development, recruiting teams, and coaching teams on the Model for Improvement. The Project Director coordinates the work of the Chair and Planning Group to develop the curriculum for the Learning Sessions and Action Periods. The Project Director works with the Improvement Advisor to track team and Collaborative progress, compiles and reviews monthly Collaborative reports, and coaches teams at Learning Sessions and during Action Periods.

The Improvement Advisor is an expert in improvement theory and methods and is responsible for the measurement strategy in the Collaborative. The Improvement Advisor designs a measurement system and coaches teams regarding measurement. The Improvement Advisor also teaches and coaches the Planning Group and teams on application of the Model for Improvement, and recommends strategies to achieve Collaborative goals.

The Planning Group consists of practitioners and researchers often selected from the Expert Meeting, who have significant experience in implementing and studying innovations in the field. This group of participants is convened at the beginning of the Collaborative to set the charge for the teams (this group includes the Chair, Improvement Advisor, Project Director, and Executive). Because they develop the “conceptual framework,” one or more must have hands-on experience with existing best practices. Other experts may be utilized as guest faculty at Learning Session or on conference calls but are not permanent members of the Planning Group.

The Collaborative teams are the focus of the Collaborative. They do not talk about changes; they implement them. There are three critical components that should be represented on each team: Team Leader (someone with authority to make decisions and remove barriers when necessary), Technical Expert (someone who does the work and has the practical and content experience), and the Day-to-Day Leader (someone to act as team manager). Teams may include a number of others who participate as changes are planned, tested and implemented.

The Senior Leader role is critical to the success of a Collaborative team. The Senior Leader is the visionary for each Collaborative team and is someone who works at an organization-wide level. This person ensures that the work of their Collaborative team is aligned with the organization’s strategic goals, promotes the work of the Collaborative team within their organization or system, monitors the progress of the team, and facilitates the spread of the improvements throughout the organization.

Detailed Descriptions of Collaborative Staff Members

Executive

This position is responsible for working with Collaborative clients and communicating client needs and expectations to the Collaborative staff. The Executive has responsibility for maintaining alignment between the Collaborative and the sponsoring organization’s priorities. The Executive reports regularly to the sponsoring organization on the success and needs of the Collaborative.

Collaborative Roles

  • Establish high-level deliverables and timeframes
  • Establish and communicate scope of Collaborative
  • In most cases, serve as lead for Planning Group throughout the Collaborative
  • Identify and recruit the Chair and assist Chair in recruiting additional Planning Group members
  • Contribute to the development of Learning Collaborative documents and materials (e.g., charter, conceptual framework, educational and other materials)
  • Attend Learning Sessions and coaching calls as needed
  • Participate in Milestone Calls and monitor teams’ progress towards Collaborative aim
  • Participate in Collaborative close-out activities, as needed

Manage the Planning Group relationship

  • Select Planning Group members

Project Director

This position is responsible for working closely with the Chair to facilitate the participation of experts, design and plan Learning Sessions, and coach Collaborative teams.

Collaborative Roles

  • Understand the aims and scope of the Collaborative
  • Participate in decisions regarding dramatic changes to scope of Collaborative
  • Keep appropriate staff informed of Collaborative development and progress
  • Contribute to the development of Collaborative progress reports
  • Develop and communicate tactics for carrying out dissemination of Collaborative results
  • Participate in Collaborative kick-off activities

Support recruitment by interacting with client and interested teams

  • Work with Chair to plan and lead Planning Group calls
  • Orient Planning Group to the Collaborative process and their roles and responsibilities
  • Coordinate Planning Group involvement in the Collaborative
  • Coordinate development of objectives for Learning Sessions
  • Coordinate and contribute to the development of Collaborative documents and materials
  • Lead development of Learning Session agendas
  • Guide development of Learning Session materials
  • Provide final approval for all Learning Session materials
  • Develop Learning Session evaluation
  • Teach and train at Learning Sessions

Plan and lead team conference calls

  • Evaluate progress of Collaborative teams
  • Oversee development of Collaborative team progress reports
  • Identify and implement strategies to enhance Collaborative teams’ improvement, including coaching, communicating, and providing support
  • Participate in Collaborative close-out activities

Project Manager

This position works closely with all Collaborative staff to ensure that the Collaborative plan (e.g., scope, timeline, budget, and deliverables) is understood and implemented. This position is responsible for facilitating changes to the Collaborative plan and communicating those changes to the entire Collaborative staff.

Collaborative Roles

  • Develop timeline for Collaborative
  • Develop a work plan that describes critical Collaborative activities and deadlines for Collaborative
  • Establish a weekly Collaborative staff meeting
  • Communicate deadlines and deliverables to Collaborative staff
  • Alert Project Director and Executive when Collaborative progress is threatened
  • Ensure that Collaborative progresses in a timely manner
  • Plan, facilitate, and document Collaborative staff meetings
  • Document key decisions, activities, “lessons learned,” and Collaborative evaluations
  • Develop and submit progress reports to Collaborative funders and key stakeholders
  • Oversee budgets and contracts
  • Plan and facilitate Collaborative kick-off activities
  • Ensure development of Learning Session working agenda
  • During Learning Sessions, function as “stage manager” (responsible for understanding the flow of the day using a working agenda and answering questions regarding logistics)
  • Lead and facilitate Collaborative close-out activities

Project Coordinator

This position supports the work of the Project Director and Project Manager.

Collaborative Roles

Schedule Collaborative activities according to timeline (e.g., calls, meetings, etc.)
  • Participate in Collaborative kick-off and Collaborative staff meetings
  • Manage documentation of Collaborative activities
  • Collect, document, and maintain information about Collaborative participants and key stakeholders
  • Identify and communicate logistical information to Collaborative participants (e.g., meeting dates, locations, agendas, times, call-in numbers, travel planning, etc.)
  • Make hotel and travel arrangements
  • Coordinate with external Planning Group regarding Learning Session materials
  • Produce Learning Session materials
  • Oversee registration and logistics at Learning Session
  • Distribute, collect, and summarize Learning Session evaluations
  • Monitor and support participant team participation (e.g., send reminders, track conference call attendance)
  • Document Collaborative team conference calls
  • Maintain Collaborative website, Extranet, and listserv, as appropriate
  • Participate in Collaborative close-out activities
Improvement Advisor

This position works closely with the Project Director to develop the measurement and reporting strategy for Collaboratives. The Improvement Advisor also contributes to development of aims, measures and changes, assists in tracking Collaborative progress, and teaches and trains Collaborative teams about improvement.

Collaborative Roles

  • Participate in kick-off and staff meetings, as required
  • Teach at Expert Meeting, Planning Group Meeting, and Learning Sessions
  • Working with Collaborative staff, develop measurement strategy

Participate in Collaborative team conference calls

  • Participate in close-out activities
  • Support Project Director in interpreting data reports
Chair

This position is responsible for leading the Collaborative and guiding the Planning Group and its participants.

Collaborative Roles

Recruit experts for Expert Meeting
  • Select Planning Group members with the Executive
  • Contribute to development of conceptual framework and measurement strategy
  • Provide leadership to Planning Group
  • Manage faculty with Executive and Project Director
  • Play an active role in Learning Sessions
Respond to questions posted on listserv
  • Work with Senior Leaders, as appropriate

Participate in dissemination of Collaborative results and findings

Planning Group Member

The Planning Group is responsible for supporting the teams with their knowledge and expertise in the Collaborative subject area.

Collaboratives Roles

  • Work with the Project Director to the develop Collaborative
  • Participate in the coaching of Collaborative teams, as needed
  • Participate on Collaborative listserv
  • Participate in Learning Sessions
  • Participate in Planning Group calls
  • Participate in Collaborative calls, as needed
  • Review Collaborative team reports
  • Participate in dissemination of Collaborative results and findings

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