7.G. Scientific session: The Finnish experiences of using Breakthrough Series for designing new practices

Abstract There are several training models to support the implementation of scientific evidence to improve quality or effectiveness of care. Meanwhile, participatory approaches for workplace-oriented development and design of new practices, processes and services have been increasingly used in health and social care. Implementation research has long discussed the possibility to transfer models to new contexts. Because contexts differ, transferring may require making adaptations to the model, for example, regarding the forms of support or the target group. However, sometimes the model or intervention drifts because of misapplications or abandonment of core components. This session aims at discussing the adaptations of The Breakthrough Series (BTS) in Finland. BTS is the most well-known model for the quality improvement collaboratives (QIC), and it was developed in the institute for Health Improvement (IHI) in 1995. The model is freely available and is widely spread around the world. According to IHI, a BTS process typically lasts 6-18 months. The key elements of BTS are 1) selecting a topic where existing scientific knowledge is sound, but not widely used, 2) group of experts designs the aims, measurement strategies and list of evidence-based changes and 3) provides coaching to 4) multidisciplinary teams from multiple sites. The teams then participate in 5) learning sessions and 6) in active working periods in-between the sessions, the teams test changes in their local settings and collect data to measure these changes while 7) they learn carrying out the Model for Improvement including Plan-Do-Study-Act cycles (PDSA). In 2022-2025, the BTS model was integrated into two national development programs in Finland. The Ministry of Social Affairs and Health mandated that all wellbeing services counties receiving EU Recovery and Resilience Facility funding (2022-2025) participate in BTS, facilitated by the Finnish Institute for Health and Welfare, and develop multiprofessional service chains for vulnerable groups. Secondly, projects funded by the Good Work Programme (2022-2027), initiated by Prime Minister Orpo's Government, were guided by the Ministry to participate in BTS facilitated by the Finnish Institute of Occupational Health, aiming to improve personnel attraction and retention models. The BTS model was chosen as a pedagogical model because it had been used in several projects in Finland to improve the waiting times of health services (2010-2023). However, applying the model for two entirely new purposes required several changes and adaptations. Therefore, the three presentations in the session discuss the history of transferring the model between countries, how its theoretical and epistemological backgrounds have evolved, and what kinds of results and impact the training model's elaborated versions have produced in Finland. Key messages • Training and coaching models tend to adopt culturally convenient and popular theoretical resources while they transfer between countries. • Eclectic combinations of theoretical approaches in training and coaching models both enrich and create incompatible dynamics from the participants’ perspective for learning.