A collaborative model to guide program development and change: involving the users

Organizations have different structures and cultures within which to conduct their business activities. Ranging from autocratic and rigid styles to more laissez-faire models, this report describes the program development and change model used by the Missouri Kidney Program (MoKP). Two examples illustrate how involvement of renal community professional staff and MoKP program staff in instituting and modifying program elements help to build in acceptance from the very beginning, avoiding start-up difficulties and miscues on implementation. Examples cited are the inception of the Nutritional Supplement Program and ongoing modification of the Centralized Drug Program's formulary. The Missouri Kidney Program uses a participatory approach to involve the users of service in program design and modification and historically has used this sort of approach with relative success over time.