Learning Network

Module Objectives

 By the end of this module participants will be

able to:
 Define learning network
 Discuss goals of a learning network
 Discuss structure of a learning network
 Describe the key elements of a learning network
 Discuss phases of a learning process among the
members of a learning network
Introduction

 What is a learning
network?
 What Learning
Networks do you know
in the health system?
 Time: 3 minutes
 What is a learning network?

 Sometimes called “learning collaboratives” or

“improvement collaboratives”
 Networks of health facilities/communities
 Usually over a defined time period: 12-18
months
 Common aim across the teams
 Review of progress
 Joint learning and peer support
 Goal of a Learning Network

 To get results – improving outcomes and key

processes
 To close the gap between usual practice and the
best care for a specific topic
 To foster peer learning by bringing different
facilities together
 Brings the ‘right’ people together
 leaders to front line providers and community
members: all to work for the same purpose
Learning network in Ethiopia context

 Existing Learning
Networks:
 EHAQ for Hospitals

 EPAQ for Health

Centers
 Woreda based review
meetings
 Catchment area
meetings
 Learning Network (… Cont’d)

 Learnings is essential to close the gap between

usual practice and the best care for a specific
topic
 Opportunities for learning:
 Within one facility – when different team members
come together on morning sessions or other meeting
arrangement, they learn from each other
 Across multiple facilities – review meetings,
EHAQ/EPAQ cluster meeting
 Across levels of the health system – HEWs with HCs,
HCs with Hospitals, with woreda/regional leadership
Features of Effective Learning Network

 Clear common aim towards which the

participants of the learning network are focusing
 Defined for a definite time on a specific priority
topic
 Uses structured approach for improvement
 Multi-disciplinary teams from participating
facilities involved
 Culture of honest exchange of ideas, progress,
challenges, and learning for improvement
 Structure of Learning Network

 A learning network could be established by:

 Pulling members from institutions with same purpose or
objective for improvement for a defined population
 Those members can include both health facilities and
administrative structures
 Current learning networks within Ethiopia do reflect this
arrangement
 Structure (… Cont’d)

 The structure of the learning network includes

sequential quarterly review meetings with action
period activities supported by coaching visits
 These components of the structured are adapted
forms of existing structures:
 Review Meetings – adjusted as learning sessions

 Supervisor Visits – adjusted to be inclusive of

coaching and mentoring on QI and clinical processes
 Structure (… Cont’d)

General Structure of a Learning Network

Determine AP1 AP2 AP3 AP4

Priority Topic
for the Network

Conduct RM1 RM2 RM3 RM4

Compile
Baseline
and
Assessment
disseminat
Support: QI coaching integrated with e lessons
clinical mentorship
Prepare a
comprehensive
plan for the
learning One Year (adjust if
network more time needed)
 Learning Network: Planning

 Identify the participants or the members of the network

 Based on the purpose of the network

 By considering the natural relationship and mandates of

the members
 Prepare a schedule and deliverables of the review
meetings
 Set priority for improvement in the year (defined time)
 Gap between knowledge and practice

 Priority for both patients, providers and leaders

 Planning (… Cont’d)

 Plan for baseline assessment and routine monitoring of

progress
 Set indicators

 Develop/adapt baseline data collection tools

 Assign required resources to run the review meetings

and coaching visits
 Identify coaches

 Mobilize and allocate budget

 Learning Network: Baseline Assessment

 Assess the status of inputs, processes and outcomes of

the network focus area among participating facilities
 Based on the gap identified prepare an action plan to fill
the gaps in inputs (skills, supplies …)
 Use the assessment result to guide selection of
improvement topics
 The assessment results should be owned by the facilities
themselves
 Learning Network: Review Meeting

 Quarterly review meetings will be used as learning

opportunities / sessions
 The model for improvement will be used as a framework
to guide the learning process
 Teams will be required to share their improvement
process across time using the framework
 Learning will be facilitated with the principle of “all teach
all learn” approach
 Learning Network: Action Period

 Action periods is the period between review meetings

 Teams will test new change ideas to achieve their aims
 Teams will monitor progress using pre-defined set of
indicators (for aim) and indicators related to the change
idea
 Coaching visits will be arranged to support facility teams
while they execute their QI projects
 Coaching will focus on:
 Use of QI tools, concepts and methods
 Clinical mentorship to build clinical skills
 Data tracking
 Learning Network: Data Tracking

 Real time data will be tracked by each member

 Data will be shared among participants as a learning tool
to understand progress collectively
 Core indicators for processes and outcomes of care will
be tracked regularly mostly using run chart with relevant
annotations
 Data quality will be a focus area as decisions will depend
on high quality data
 Documentation of changes being tested and QI team
meeting notes
 Learning Network Structure

General structure of a Learning Network

AP1 AP2 AP3 AP4

Determine
Priority Topic
for the Network
RM1 RM2 RM3 RM4
Compile
Conduct and
Baseline disseminat
Assessment Support: QI coaching integrated with e lessons
clinical mentorship
Prepare a
comprehensive
plan for the
learning One Year (adjust if
network more time needed)
 Group Exercise: Instructions

 Create groups of four to six participants

 Task:
A. Develop an action plan to run a learning network in a Woreda
 Fist explore the different opportunities within the Woreda that could
be adjusted into a learning network format
B. Develop an agenda for a 2-day review meeting based on the
scenario for first review meeting and second review meeting
 It should also describe in details the QI tools and when the team
will apply or use them.
 The QI team should also have a PLAN for at least 2 PDSAs by the
end of a 2-day RM that they will test during the Action Period
 Prepare for report out
 Time: 120 minutes
 Group Exercise: Scenario-Malnutrition

Based on the ENHQS, your team identified that Ethiopia

has the highest rate of malnutrition in Sub-Saharan Africa,
affecting 40% of the country’s children. Your aim is to
reduce child mortality through the prevention and
management of severe acute malnutrition from 50% to
20% in 10 facilities within the next 15 months. Your team
had some funding from the region to support your learning
collaborative in 10 facilities in two Woredas.
 Summary

 A Learning network is a short-term (12-18 mon.)

arrangement that brings together a large number of
teams from health facilities and health administrations to
seek improvement in a focused topic area
 The overall goal of a learning network is to get results
and to close the gap between usual practice and the
best care for a specific topic
 Learning opportunities exist within the system and they
could be easily adjusted to be effective by changing
them into a typical learning session formats