Comparison of learning and improvement framework pathways
| Pathway | Intended scope of impact | Source of idea | Improvement approach | Support from LN | Expected output | LN approval timing | Design/plan phase participants | Test/learn phase participants | Evaluation of test/learn phase | Share/spread phase participants |
| Network-wide | Many or all LN sites | Ideally from evidence of improved outcome: successful incubator project, review of LN registry data and published research | Rigorous approach including phases for design, testing and learning with a small cohort, spreading to network-wide improvement and sustaining improvement with defined expectations for site participation at each phase | Formal support from experts in QI, data and project management including centralised area for topic-specific learning, facilitating meetings, aggregate and site-level data reporting, and communication to entire LN | All LN sites expected to participate in active improvement; scientific publication expected | Prior to design phase | 1–4 project leaders, 6–10 subject matter experts, LN support staff | 5–10 sites, 1–4 project leaders, 6–10 subject matter experts, LN support staff | If collective improvement in outcomes and high reliability to processes, plan to spread to all LN sites | All LN sites expected to participate in active improvement |
| Incubator | 3–5 sites | Promising idea based on solid theory, often extension of successful single-site project | Project leaders design multisite project using QI methodology (eg, key driver diagram) and then share best practices and learnings during regular calls. | Varies depending on LN resources and leader abilities; may include scheduling meetings, centralised data sharing, providing templates for improvement tools, or ad hoc QI or data coaching | Learnings shared broadly with LN; depending on project outcome, may extend to network-wide project; scientific publication encouraged | After design phase | 1–4 project leaders, LN support staff as needed and able | 3–5 sites, 1–4 project leaders, LN support staff as needed and able | If collective improvement in outcomes and high reliability to processes, consider formal spread via network-wide project or informal spread via share-and-adapt locally activities | Learnings shared broadly with LN |
| Share and adapt locally | Single site | Any LN interaction including formal presentations of research or QI work, informal discussion between sites, etc | Sites learn from each other through various connect and share activities and then adapt ideas back at the local centre. | LN provides multiple opportunities for a variety of connect and share activities. | Successful single-site projects may become incubator or network-wide projects. | None at project initiation | Local team | Local team | LN approval process for formal opportunities to connect and share within LN (ie, poster session); leaders may consider progression to incubator or network-wide project | Any LN participant based on forum for connecting and sharing |
LN, leaning network; QI, quality improvement.