Langley J, Beasley C. Health Information Technology for Improving Quality of Care in Primary Care Settings. Prepared by the Institute for Healthcare Improvement for the National Opinion Research Center under contract No. 290-04-0016. AHRQ Publication No. 07-0079-EF. Rockville, Maryland: Agency for Healthcare Research and Quality; July 2007.

This report examines the link between health information technology (IT) and quality improvement in a range of primary care settings. The report finds that most current health IT systems have a long way to go before they encompass the functionality that would support robust ongoing improvement of care. Health IT adoption must go hand-in-hand with the implementation of a robust care model and the routine use of solid improvement methods by clinicians and other staff.

Bergeson SC, Dean JD. A systems approach to patient-centered care. Journal of the American Medical Association. 2006 Dec 20;296(23):2848-2851

Providing care centered on patients' needs and expectations is a key attribute of quality care. Unfortunately, despite the intent and efforts of many to improve patient centeredness, the quality of patient- clinician relationships, patient access, and continuity of care appear to be worsening in the US and lag behind other countries. Clinicians do not consistently address patients’ concerns, do not always assess patients’ beliefs and understanding of their illness, and often do not share management options with patients. In this Commentary, the authors propose four specific changes that should help the medical profession meet patients' needs.

Boushon B, Provost L, Gagnon J, Carver P. Using a virtual breakthrough series collaborative to improve access in primary care. Joint Commission Journal on Quality and Patient Safety. Oct 2006;32(10):573-584.

The Institute for Healthcare Improvement pioneered the Breakthrough Series (BTS), a short-term improvement project that convenes, in three face-to-face meetings, hospital or clinic teams to make rapid, significant improvement. A virtual BTS (VBTS) was tested with 20 organizations using a well-established topic: improving access and efficiency in primary care. This VBTS took place by Internet and telephone, using Web-based collaboration software and audioconferencing. The results teams achieved in the VBTS were similar to results from face-to-face meetings.

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Walley P, Silvester K, Steyn R. Managing variation in demand: Lessons from the UK National Health Service. Journal of Healthcare Management. Sep 2006;51(5):309-322.

The UK National Health Service (NHS) provides a prime example of a system that has experienced the consequences of not managing variation in demand and what impact this has on health care processes, having suffered from excessive waits for a prolonged period. The authors discuss important lessons that have emerged from collaborative work to manage variation in the NHS, including understanding and measurement of demand, capacity planning, segmentation and streaming of work, process design, capacity yield management, and measurement of variation.

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Schoen C, Osborn R, Huynh PT, et al. Taking the pulse of health care systems: Experiences of patients with health problems in six countries. Health Affairs. Nov 2005; [Epub ahead of print].

This paper reports on a 2005 survey of sicker adults in Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States. Sizable shares of patients in all six countries report safety risks, poor care coordination, and deficiencies in care for chronic conditions.

Kilo CM. Transforming care: Medical practice design and information technology. Health Affairs. 2005 Sep-Oct;24(5):1296-1301.

This article discusses how system design knowledge coupled with advances in information technology can be used to transform care delivery in the clinical office practice.  It shows how one innovative medical practice has reduced unnecessary office visits and improved continuity for patients with chronic conditions.

Kilo CM, Leavitt M
Chicago, Illinois: Health Information Management and Systems Society and the Institute for Healthcare Improvement; 2005

The book, edited by Mark Leavitt, MD, PhD, Chief Medical Officer for HIMSS, and Charles Kilo, MD, MPH, CEO of GreenField Health, includes chapters by leading authorities on medical practice redesign and performance improvement as well as experts in health care information technology. The book also includes case studies that provide valuable real-life insights into the use of information technology along with workflow improvement to produce higher quality care. Content developed as part of IHI's Idealized Design of Clinical Office Practices is also highlighted.

Valenti WM, Bookhardt-Murray LJ. Advanced access scheduling boosts quality, productivity and revenue. Drug Benefit Trends. 2004;16(10):510, 513-514.

Traditional scheduling systems waste resources by managing demand instead of treating patients; lead to dissatisfied patients, staff, and care providers; and may contribute to patients missing their appointments.  This article describes how advanced access works to increased productivity, revenue, and staff and patient satisfaction while also improving the quality of patient care.

Miller RH, Sim I. Physicians’ use of electronic medical records: Barriers and solutions. Health Affairs. 2004;23(2):116-126.

This article reports on the close link between quality improvement and physicians’ use of an electronic medical record (EMR).  It also suggests policy interventions to address barriers to physician use of the EMR including providing work/practice support systems, improving electronic clinical data exchange, and providing financial rewards for quality improvement.

Lacy NL, Paulman A, Reuter MD, Lovejoy B. Why we don't come: Patient perceptions on no-shows. Annals of Family Medicine. Nov 2004;2(6):541-545.

This article describes a study which tried to identify the reasons patients in an urban family practice setting give for not keeping scheduled appointments.