Step 7: Plan for Spread

Depending on how you implemented the core elements, you may need to plan for spread. Do

you need to spread to other physicians, other practices, other specialties, or throughout a

health care system? Create a plan for spread. Who is the target for the spread? Identify your

opinion leaders, messengers, and allies. Is there both senior leadership and front line leadership

for spread? Is improvement methodology understood by the target areas? Allow testing of any

generic tools you’ve created and allow further adapting to the spread practices. You can spread

one element at a time, or all six simultaneously. Identify a spread champion who can help the

other providers and/or practices throughout the process. If possible, target your early adopter

providers or practices first. Find your opinion leaders or influencers to help. Engage both front

line leadership and formal leadership for resources. Identify what measures are needed to

demonstrate successful spread. They may be the original measures, and/or any additional

measures (see here for more information). Use the spread checklist found in the QI Primer.