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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 discusses what YOU and YOUR COMMUNITY want and need, 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! Many of these materials refer specifically to Spark experiences, but can also be used for planning Ignite experiences.

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

You may want to plan on hosting only one Spark event and then actively pursuing the ideas that emerge from it

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

You may want to plan for as much 3C programming as possible, including multiple Spark experiences, etc.

You may also want to supplement 3C experiences with complementary options

You aim to enhance your fundamental operations

You may want your initial plan to include ideas for how to weave the improved relationships and human connections developed during the Spark experience into specific, on-going activities or processes, such as quality improvement or diversity and equity initiatives

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

You may want to plan and conduct a range of activities, in addition to Spark experiences

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 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

While not required, we recommend bringing 3C Experiences first to generalists, such as family medicine and primary care practitioners. Why? They have pre-existing longitudinal relationships with their patients. They also have referral relationships with specialists, and can help spread the word afterwards. Would you rather launch 3C at tertiary and specialty care practices? This can have benefits as well. 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/or oncology. These units tend to have longer patient-clinician relationships, which are valuable to the 3C experience. 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 by spreading the word about their experience. Who should participate? Spark participants can be focused on clinical, research, or educational aspects of care, but they should ALL see and interact with patients. At academic medical centers, some institutions have found that it works well to start with clinical faculty, and then expand to include research and education faculty.

Unit Characteristics to Consider

Don't know how to decide what unit to work with first? Going to “trouble spots” that need attention is one approach. These could be units, departments, practices, or clinics that require significant administrator attention, and get the most complaints from patients and each other. Another approach is to begin with units that are shining stars, inspire others, and have prestige, yet require a great deal of care. These could even overlap! A third option is to start with the most innovative units, department, practices, or clinics – so long as they’re not so innovative that others will dismiss them! Or you may want to focus on areas of the institution that have been especially challenged during COVID, and thus might benefit the most from dedicating time to relationship and empathy

Helpful Vanguard Characteristics

It will smooth your path to first implement 3C with people who have demonstrated that they have independence and 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 control over 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.

In addition to Spark experiences, you may want to expand your 3C experience to include Ignite as well. 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
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