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The framework emerged out of the need to lightly structure site visits. Our goal was to advance strategic thinking and legitimize the ambiguity associated with exploring new territory.  We used this approach for grantee self-assessment, appreciative inquiries regarding their progress, and planning during site visits.  

A Portfolio of Ensemble Learning Approaches

The Difficult is that which can be done immediately; the Impossible that which takes a little longer. George Santayana

Eight learning approaches were employed.  Detailed descriptions follow.

1.

Work-In-Progress Learning Journals

2.

Monthly Conference Calls

3.

Learning Resources Matched to Challenges

4.

Work-In-Progress Group Consultation Process

5.

One-On-One Consultations

6.

Innovation Structures Self-Assessment

7.

Site Visits – Appreciating Progress and Looking Forward

8.

National Diffusion Efforts

The central purpose of the activities was to provide a climate of constant encouragement, open communication among grantees, and in-the-moment advice as the projects unfolded.  As sponsors, we were very open to feedback, adaptation, or dropping activities if they did not work… just as we hoped grantees would as they brought their innovations to life.  In a spirit of improvisation and exploration, we were “beating the path” forward right alongside the grantees.  We believed we would act our way into new thinking rather than think our way into new acting.

1. Work-In-Progress Learning Journals

Our first move was to attract participation through developing a Learning Journal in which the grantees would reflect on the social process of bringing an innovation to life.  Specifically, how was the working team adapting to surprises in the process? We wanted to offer an approach that would help team members make sense of uncertainty and surprise as their projects unfolded [3].

The Scripps team took this on enthusiastically with no small amount of literary flair.  Each member used personal journals, discussed entries within the team, and submitted a “chapter” each month for other grantees.  The twists, turns and drama of medication reconciliation (a very messy patient safety challenge for every health care provider) were shared in the “washing machine” chronicles.

“The last time we checked in with our Medication Reconciliation Technician (MRT) at Scripps- Mercy, the ‘washing machine’ (AKA the Translator) had been turned on, agitation was producing the ‘clean laundry’ of pre-admission

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