14 Steps From Pilot to Large-Scale Improvement in Healthcare

Establishing a method for scaling up successful pilot projects can help spread innovations and improve healthcare on a large scale, according to a discussion paper by participants of the Value Incentives Learning Collaborative of the Institute of Medicine.

In the discussion paper, "From Pilots to Practice: Speeding the Movement of Successful Pilots to Effective Practice," the authors examined case studies of projects piloting new healthcare delivery models, identified barriers to scale-up and suggested strategies for overcoming these barriers. The authors created a list of questions pilot projects should consider during initial planning, evaluation and spread of the initiative, if it is successful. The questions correspond to the following steps of developing a pilot:


Planning and starting pilots
1. Plan the pilot process.
2. Build the pilot on existing knowledge.
3. Start as soon as possible and learn quickly.
4. Adapt the project to learn over time.

Accessing the necessary data
5. Identify needs.
6. Account for regulatory and organizational challenges.

Assessing success
7. Identify measures that matter.
8. Identify appropriate methods for assessing success.
9. Evaluate how the pilot works in diverse environments.
10. Ensure evaluation answers the needs of decision-makers.

Scale-up and spread
11. Understand reasons the project might spread.
12. Outline the incentives and environmental factors that could promote adoption.
13. Identify how the project can adapt.
14. Form a learning community.

More Articles on the Institute of Medicine:

5 Ways Routinely Collected Data Supports a Learning Healthcare System
6 Steps to Implement Healthcare Decision Aids for Shared Decision-Making

Report: Geographic Medicare Spending Gaps May Be Due to Waste, Overuse

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