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This Week at the Institute for Healthcare Improvement
November 24, 2014
A Personal Story of Flipping Primary Care

Achieving the Triple Aim (better experience of care, better population health, lower per capita costs) requires not just innovations in care and new models of delivery, it also requires a completely new mindset. In last year’s opening keynote at the IHI National Forum, Maureen Bisognano described experiments in education to “flip the classroom,” and urged the audience to “flip health care” in similar ways. Now, in a new article published in the journal Healthcare – “Flipping primary health care: A personal story” – authors Dr. Kedar Mate (SVP, IHI) and former IHI Fellow Gilbert Salinas describe Mr. Salinas’ experience of “flipping” his primary health care, which required looking at all the elements of the clinic visit and deciding which ones could be done at home. Mate and Salinas report on the outcomes, the enabling factors, and the lessons to be learned broadly for anyone undertaking patient-centered redesign of primary care. 

Tips to Make Health Technology Safer

The use of health technology has grown exponentially in the past few decades, and the proliferation and complexity of this technology has led to new risks to patient safety. The Institute of Medicine (IOM) discussed this issue in their report, "Health IT and Patient Safety: Building Safer Systems for Better Care," and concluded that achieving better health care requires “a robust infrastructure that supports learning and improving the safety of health IT.” A new interview with IHI Executive Director and patient safety expert, Frank Federico, describes the keys to success for using health technology safely. He discusses some common safety risks such as clinical alarm safety (now a Joint Commission National Patient Safety Goal), poor training and support systems for new users of technology, and workarounds. Federico also participated in a recent WIHI on the topic, and helped develop the content for the upcoming IHI Expedition on Improving Patient Safety with Health Technology.

New Whiteboard Videos on the Science of Improvement

IHI’s Executive Director for Performance Improvement, Robert Lloyd, PhD, has been busy at his trusty whiteboard, helping to explain various aspects of the science of improvement. The IHI Open School recently posted several new short videos, including “Family of Measures,” in which Lloyd explains the different kinds of measures essential to quality improvement (using patient falls as an example). In “Cause & Effect Diagrams,” Lloyd walks through the commonly used “fishbone” or Ishikawa diagram. And in a two-part video, “Divergent and Convergent Thinking,” he describes how to open up minds and spur creativity through brainstorming and other techniques (divergent thinking), and then find affinities to narrow down a bunch of ideas to a few (convergent thinking) that can then be tested using PDSA cycles. Don’t forget to browse all of the videos (18 and counting) Lloyd has produced with the IHI Open School. 

IHI Focus Area Spotlight

Improvement Capability: How Implementation Science Can Improve Global Health

Person- and Family-Centered Care: Being Mortal: Medicine and What Matters in the End

Patient Safety: The Impact of QI on Surgical Safety

Quality, Cost, and Value: Balancing Improvement and Cost Reduction: This Isn’t a “QI Project”

Triple Aim for Populations: A 3.0 Health System Framework

look for
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Environmental Sustainability and the Triple Aim, a new post to the Healthier Hospitals Initiative's blog by IHI Senior Fellow Blair Sadler

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Going to IHI's National Forum on December 7-10? Don't forget to download the IHI Forum app (IHI Onsite), your all-in-one event guide on your mobile device

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The Beryl Institute's "On the Road with Virginia Mason Health System" visits with CEO (and IHI Board Chair), Dr. Gary Kaplan (above), and team to look at how they've become a leader in patient experience improvement

Who's at ihi
Professor Sir Brian Jarman, OBE, FRCP, FRCGP, IHI Senior Fellow and former Head of the Division of Primary Care and Populations Health Sciences in the Faculty of Medicine at Imperial College, London, is visiting IHI this week.
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