Since 2018 IHI has been engaged in a multi-year strategic partnership with Safer Care Victoria (SCV), a peak state authority for quality and safety improvement in health care. IHI is supporting SCV in its efforts to deliver safer, more effective, and person-centered health care across Victoria. To accelerate the pace of improvement, IHI is assisting SCV to deploy a strategy to achieve Whole System Quality, build multi-level capability across the health sector, and deliver measurable results through the application of improvement science. 

IHI is also supporting SCV’s work to achieve system-wide transformation by designing and implementing initiatives to improve health outcomes in priority areas, including maternal and newborn health, delirium, heart failure, health worker well-being, Age-Friendly Health Systems, patient flow, and residential care for children and young people.

In 2020, the COVID-19 pandemic devastated nursing homes across the country, disproportionately affecting residents and staff. The United States Agency for Healthcare Research and Quality (AHRQ), Project ECHO (Extension for Community Health Outcomes), and IHI established the National Nursing Home COVID-19 Action Network. This initiative sought to increase access to best-practice knowledge around COVID-19 infection control, answer questions about context-specific implementation, and encourage peer learning — thus providing both knowledge and emotional support for nursing home staff. 

IHI was recruited as a core partner to develop a curriculum for infection control and quality improvement. By the end of the program’s second wave in March 2021, more than 30,000 individuals at 9,058 nursing homes had participated. Participants joined from all 50 states, the District of Columbia, and Puerto Rico. Most of those who participated were either nursing home administrators or registered nurses.

Through a partnership with the Ethiopian Federal Ministry of Health, (FMoH) with the support of the Bill & Melinda Gates Foundation and Margaret A. Cargill Philanthropies, this multi-year initiative was created to foster a culture of quality throughout the Ethiopian health system and reduce maternal and neonatal mortality.

IHI and FMoH co-designed a three-pronged approach to accelerate health system improvement nationally, which included developing a National Health Care Quality Strategy (NHQS) that built on existing quality and equity initiatives in Ethiopia, launching and testing a scalable model of the health system improvement in health facilities and communities linked by learning Collaboratives, and strengthening and developing a sustainable Ethiopian health care quality culture and capability across the health system.
 
The NHQS was launched in 2016 and governance structures were established at the federal, regional, and sub-regional levels to oversee implementation. A total of 212 federal, regional, and woreda managers have been trained in context-specific QI methods, and a national FMoH-owned in-service curriculum has been developed. Four improvement Collaboratives and several improvement capability-building programs have been completed with high fidelity and acceptability that have resulted in over 16,000 health care professionals capacitated on quality improvement and over 1,200 quality improvement coaches developed. Additionally, 70% of Ethiopian health care facilities reported improvement in at least one service coverage outcome, while 90% report adherence to the labor and delivery clinical bundle. About 102 change ideas for maternal and newborn health were tested and a change package was developed, with 83 successfully tested ideas.

The initial successes observed are attributable to the FMoH’s commitment to implementing the initiative, the active engagement of all stakeholders, and the district-wide approach utilized. Challenges included weak data systems and security concerns. The second phase — in 26 district-level Collaboratives — is underway for the period 2021 to 2025.