Implementing behavioural change within your organisation to incorporate a diagnostic driven approach

Now that you may have changes that you wish to make in your personal practice and across your healthcare setting, it is important to make sure these are carried out effectively.

Having an understanding of behaviour change and some of the related techniques is key to implementing successful change.

It is important to understand what you are trying to change before creating a plan. What behaviours are you trying to change? What will it take to bring about the desired change? Broadly, what type of intervention approaches might be relevant? What are the barriers to change?

One of the common approaches used is PDSA cycles and the Model for Improvement which is something many organisations, including the NHS, use to help plan and implement lasting change. It consists of:

Plan – Propose the change to be tested or implemented

Do – Carry out the test or change and collect data (before and after the change)

Study – Analyse the data collected and compare results, reflect on the impact of the change

Act – Based on the results, plan the next change cycle or full implementation

Click here to look at this approach in more detail and have a go at filling out the PDSA form yourself.

This technique is often used to test an idea by trialling a change on a small scale and assessing its impact, building upon the learning from a previous cycle in a structured way before wholesale implementation.

When planning a change in practice, another technique you may want to consider is the AACTT framework – Action, Actor, Context, Target, Time.

This allows for very specific changes to be planned – who is carrying them out, when, where, how often and with whom should it be performed?

Click here to read more about this technique.

While these techniques are important to understand, you must be able to apply the learning to your own setting.

Power distance and hierarchy vary between settings and countries, and this can impact how work is done.

It has been found that healthcare professionals often use ‘socially constructed knowledge’ – this means their choices can be based on personal and colleague experience, or through the influence of senior clinicians. In some cases, senior clinicians have much more individual power over decisions, and in others decision making can be much more collective.

In either situation, using the PDSA cycles or the AACTT framework can help you build evidence to support positive change in your healthcare setting.

If you would like to learn more about Behaviour Change (in the context of antimicrobial stewardship), the following courses may be of interest:

• Utilising Social Science and Behaviour Change in Antimicrobial Stewardship Programmes: Improving Healthcare
• Tackling Antimicrobial Resistance: A Social Science Approach