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Before You Start

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We’ve learned that people bring 3rd Conversation to their community for a variety of reasons. It’s important that your team discuss what YOU want, BEFORE you dive into logistics and event planning, so you’re sure to GET what you want. And while NO practice is simple, if you’re in a complex system, such as an academic medical center, you’ll have many layers to consider, both for strategy and for logistics. You’ll want to tackle that thoughtfully and in advance. This page offers considerations and guidance as you start these more strategic conversations. Perhaps your first strategic move could be to invite others to join in these conversations. That can be a powerful way to grow your team of 3C champions!

Planning for 3rd Conversation:
Keeping Your Organization’s Goals in Mind


Following are some ways you and your leadership may want 3rd Conversation to fit into or influence your health care system or practice. We recommend dedicating conversations to figuring this out before you have your 3rd Conversation Experience(s), then revisiting the conversation afterwards.

Some ideas include:

You want change in your institution to be discrete
 

So you just want one Spark event and to pursue the ideas that emerged from it

You aspire to infuse relationship, connection, and bi-directional empathy among all the humans in your institution.
 

So you want as much 3C programming (Spark, etc.) as you can pull off.

So you want to supplement 3C with complementary options.

You're aiming to enhance your fundamental operations
 

To weave relationship and human connection into specific, on-going activities or processes, you will select one/some such activity or process and do so (e.g., QI, DEI).

You want relationship and human connection to be woven throughout policies, activities, programming, and more. 

So you will plan and conduct a range of activities to achieve that.

Academic Medical Centers - Considerations for Spread


Academic Medical Centers and health systems are complex institutions that are complicated to navigate. Crafting a successful plan for a culture-changing initiative will take thoughtful planning. We hope your team will benefit from discussing the considerations below as you plan the launch and spread of 3rd Conversation (3C) at your institution. While these ideas come from extensive experience catalyzing change in institutions like yours, you will want to adapt them to your institution and culture. Starting with the most innovative units, department, practices, or clinics, those willing to try something new, may also help get things up and running – so long as they’re not so innovative that others will dismiss them! Areas of the institution that have been especially challenged during COVID might benefit the most from dedicating time to relationship and empathy

Where to Start
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There are good reasons to bring 3C Experiences first to generalists, such as family medicine and primary care practitioners. Importantly, they have longitudinal relationships with their patients. They also have referral relationships with specialists, so can help spread the word afterwards. There are also good reasons to start at tertiary and specialty care practices. Their greater resources and visibility tend to give them increased influence within institutions, so getting them on board early might help 3C take root and grow more quickly. If you decide to pursue specialty practices first, consider beginning with cardiology, orthopedics, and oncology. Starting with a Practice Plan will give you a silo in which to test and prove both Spark and Ignite experiences. Then those participants can act as ambassadors, bringing the experience out across silos. Welcome clinical, research, and education faculty alike, but be sure that all Spark Experience participants see patients. Some institutions find that it works well to start with clinical faculty, who can then smooth the way to research and education faculty.

Unit Characteristics to Consider
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Going to “trouble spots” that need attention can be a thoughtful way to start. These could be units, departments, practices, or clinics that require significant administrator attention, and get the most complaints from patients and each other. Or they could be units that are shining stars, inspire others, and have prestige, yet require a great deal of care. These could even overlap! Starting with the most innovative units, department, practices, or clinics, those willing to try something new, may also help get things up and running – so long as they’re not so innovative that others will dismiss them! Areas of the institution that have been especially challenged during COVID might benefit the most from dedicating time to relationship and empathy

Helpful Vanguard Characteristics
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It will smooth your path to start with people who have demonstrated that they have the independence to do what they want to, with the least interference from higher leadership in the health system or university. These are often people who are favored for the money they bring in or for how they advance other institutional priorities. You’ll want influencers on your side early, people who can get others to follow suit. It’s worth noting that: ​ You can’t always tell who has real influence in your institution, even with clues to position and rank from the organizational chart. Influencers tend to be those with access to money and hiring, and to control the nature of the work in the institution. Influence may also come from more subtle variables, so consider, for instance, people who are sources of information for decision makers. Going to the influencers across boundaries within Practice Plans will also be important, so they can create a "wide bridge" so others will participate.

Ignite
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As you contemplate hosting Ignite Experiences for senior administrators and clinicians, consider whether you will create the most system-wide impact by holding them in discrete units or by opening participation up to all clinicians and institution-level C-Suite members, even if divisions may be very different or have faced very different COVID/other experiences