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• Novel Quality Improvement Method to Reduce Cost While Improving the Quality of Patient Care
  This article describes continuous value management (CVM), an approach developed by IHI in partnership with NHS Highland that is derived from Lean accounting and employs quality improvement (QI) methods, to assist health systems to decrease operating costs and reduce or repurpose resources to improve efficiency.
• WIHI: Let's Get to Work on Waste in Health Care
  October 3, 2019 | One third of annual health care spending is atrributable to waste. What is the root cause of non-value-added waste, and how can health systems reduce it?

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• Achieving Hospital-wide Patient Flow
  This white paper guides health care leaders and quality improvement teams through an in-depth examination of a system-wide view of patient flow within (and outside) the hospital, including high-leverage strategies and interventions to achieve hospital-wide patient flow.
• Care Coordination Model: Better Care at Lower Cost for People with Multiple Health and Social Needs
  This white paper outlines methods and opportunities to better coordinate care for people with multiple health and social needs, and reviews ways that organizations have allocated resources to better meet the range of needs in this population. The elevated cost of care in this population offers a tremendous opportunity to craft a service delivery plan that meets their needs more effectively at a significantly lower cost.
• Hospital Inpatient Waste Identification Tool
  The Hospital Inpatient Waste Identification Tool provides a systematic method for hospital frontline clinical staff, members of the financial team, and leaders to identify clinical and operational waste and subsequently prioritize and implement waste reduction initiatives that will result in cost savings for the organization.
• Increasing Efficiency and Enhancing Value in Health Care: Ways to Achieve Savings in Operating Costs per Year
  This white paper proposes a set of steps health care organizations can undertake to systematically identify and eliminate inefficiencies to create a portfolio of work leading to a 1 percent to 3 percent savings in operating costs per year.

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• WIHI: Let's Get to Work on Waste in Health Care
  October 3, 2019 | One third of annual health care spending is atrributable to waste. What is the root cause of non-value-added waste, and how can health systems reduce it?
• WIHI: What's in a Name? Health Care's Chief Quality Officer
  January 25, 2018 | A health care system's Chief Quality Officer oversees efforts to create and sustain transformative change on multiple fronts, including patient and worker safety, overall quality of care, moving from volume to value, and more.
• What If We Flipped the Patient Discharge Process?
  At Sheffield Teaching Hospitals in the United Kingdom, an improver came up with the idea of assessing frail elder patients’ needs in patients’ homes instead of at the hospital. One PDSA cycle led to another, and another. Eventually, 10,000 patients got home 3 to 4 days faster in one year.
• WIHI: Improving the Rate of Recommended Care: Looking Back and Looking Ahead
  January 12, 2017 | A study published in 2003 reported that adults in the US receive only about half the care that’s recommended to prevent, treat, and manage some 30 leading causes of illness and death. Has the situation improved? Not nearly enough.
• WIHI: Getting Right Care, Right!
  October 1, 2015 | There’s growing awareness of the need to curb health care’s overuse of interventions that lack a strong evidence base, unnecessarily subject patients to potential harm, and are more expensive than equally effective, cheaper alternatives.
• WIHI: Bundles and Buy-In for Value-Based Care
  March 12, 2015 | There’s no question that public and private payers in the US are moving towards more global payment arrangements with health care providers. But the picture of how health care delivery systems take up the challenge is still coming into focus.
• WIHI: The Ups and Downs of Health Care Costs and Reform
  February 12, 2015 | Against the backdrop of the Affordable Care Act and other significant US initiatives, this WIHI touches on recent progress with efforts to achieve better care and lower costs, global payments and various payer-led financial efforts designed to improve health care delivery, statewide reforms, Medicaid expansion, and more.
• WIHI: Better Care and Better Value for Hip and Knee Replacement
  October 23, 2014 | The frequency of a surgical hip and knee replacement that has comparatively low rates of harm and complications brings new scrutiny of performance and opportunities for improvement.
• WIHI: Preventing Financial Harm to Patients: The Costs of Care Initiative
  August 21, 2014 | On this WIHI, learn about an innovative effort in the US to help caregivers make more high-value decisions that can protect patients from unnecessary care and expenses.
• WIHI: From Prehospital to In-Hospital: The Continuum for Time-Sensitive Care
  July 24, 2014 | In this WIHI, we discuss the dramatic changes underway with emergency medical services (EMS) in both the US and globally.
• WIHI: Slowdown in the Growth of US Health Care Spending
  July 11, 2013 | This WIHI examines indications that pressure from both public and private payers, reinforced by reimbursement reforms rolling out in the Affordable Care Act, may be making a dent in the growth of the country’s health care spending.
• WIHI: Clinicians and Financial Staff Can Improve Quality and Lower Costs, Part 2
  February 21, 2013 | This WIHI discusses cost reduction and quality improvement strategies that two organizations — Northeast Health and Hackensack University Medical Center — used to improve their bottom lines without sacrificing patient care.
• WIHI: Employers and Employees Can Improve Quality and Lower Costs: Stories from the Front Lines, Part 1
  February 7, 2013 | This WIHI discusses what promises to be the next wave of employer engagement in improving health and controlling health care costs in the US, including taking a deeper dive into the underlying, often chronic health conditions affecting today’s employees.
• WIHI: Navigating the Elections with a Clear-Eyed View
  October 12, 2012 | This WIHI focuses on ways to help you navigate this US election cycle with a clarity of purpose that health care improvement requires more than ever in these tumultuous times.
• WIHI: Pioneering ACOs: What Do We Know So Far?
  September 27, 2012 | This WIHI discusses a major study of the factors enabling accountable care organizations (ACOs) to get up and running and to successfully implement new forms of care delivery, as well as examples of early adopters of the ACO concept.

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• Novel Quality Improvement Method to Reduce Cost While Improving the Quality of Patient Care
  This article describes continuous value management (CVM), an approach developed by IHI in partnership with NHS Highland that is derived from Lean accounting and employs quality improvement (QI) methods, to assist health systems to decrease operating costs and reduce or repurpose resources to improve efficiency.
• 10 IHI Innovations to Improve Health and Health Care
  This curated publication highlights 10 ideas that have emerged from IHI's systematic 90-day innovation approach, including reflections on the Triple Aim, the concept of a health care Campaign, the Breakthrough Series Collaborative model, and other frameworks and fresh thinking that have been replicated around the world.
• A Simple Way to Involve Frontline Clinicians in Managing Costs
  This article describes the building blocks of a value-management system in health care. The approach that IHI co-developed includes a simplified method to understand quality, cost, and workforce capacity on a weekly basis; a visual management system to present and analyze this data regularly; and daily, point-of-care communication to support continuous improvement.
• Personalized Perfect Care
  The authors propose measuring quality from the patient’s perspective as an expression of his or her personalized health needs. The Personalized Perfect Care Bundle combines several distinct measures into one and is scored as “all-or-none,” with the patient’s care being counted as complete if he or she has met all of the quality measures for which he or she is eligible.
• Avoiding Overuse: The Next Quality Frontier
  In this editorial, IHI President Emeritus Don Berwick makes the case that quality of care — that is, better matching care to needs, and practice to science — is central to addressing underuse of effective care and overuse of ineffective care. The editorial accompanies the "Right Care" series of articles that explores medical underuse and overuse worldwide.
• New Payment Models Drive Value
  Standardizing processes, enhancing efficiency of care delivery systems, and optimizing capacity across care delivery systems are all essential in driving value and preparing care teams for managing patients in a bundled payment program.
• This Coalition of 20 Companies Thinks It Can Change US Health Care
  Based on IHI’s learning from work with employers to improve health care, this article offers five strategies to help employers — like those in the recently formed Health Transformation Alliance — achieve better care and better health for their employees, while also lowering costs (the Triple Aim).
• Applying Radical Redesign Efforts
  MemorialCare Health System's (California) strategy to provide high-quality care, reduce waste, and keep costs in line demonstrates three of the ten “New Rules for Radical Redesign in Health Care” developed by IHI Leadership Alliance members: standardize what makes sense; make it easy; and return the money.
• Medicare at 50: Reflections from Former CMS Administrator Donald M. Berwick
  IHI President Emeritus Don Berwick comments on the 50th anniversary of the US Medicare program, including the shift to payment based on the quality of care provided to patients, and the role of accountable care organizations (ACOs) in improving quality of care and reducing costs.
• The Employer-Led Health Care Revolution
  Intel is using Lean improvement methods to manage the quality and cost of its health care suppliers in Portland, OR. Their Healthcare Marketplace Collaborative model holds potential for employers, with their large purchasing power, to take the lead in securing better health for local populations and lowering costs for employees and companies alike.
• Patient-Reported Measures
  Patient-reported measures help clinicians and patients assess whether a patient’s symptoms, lifestyle, daily activities and functional status have improved as a result of care provided, and are a mechanism for patients to have a voice in their treatment planning and decision making based on their own self-assessments.
• Health Care, the Whole Person, and Community Engagement: Church Health Center of Memphis, Tennessee
  The Church Health Center in Memphis, Tennessee, is committed to encouraging healthy living for individuals as well as communities. Their work provides an inspiring example of a community that is working toward achieving the Triple Aim.
• Enhancing Prehospital Emergency Care
  This article makes the case that earlier prehospital interventions can positively affect downstream hospital patient outcomes and costs of care, describes how emergency medical services (EMS) are increasingly becoming part of an integrated care system, and discusses the expanded role of ambulance services and paramedics to increase access to care.
• ACOs: A Step in the Right Direction
  Accountable care organizations (ACOs) can be a step forward in the journey toward aligning payment and delivery mechanisms to achieve better care and better health at lower costs. This article includes recommendations that may serve to accelerate our collective efforts toward achieving cost- and quality-related improvements at scale.
• Eliminating Waste in US Health Care
  This article focuses on reducing costs in health care through waste reduction in six key categories that are estimated to comprise more than 20 percent of total health care expenditures.
• To Reconcile Mission and Margin, Deliver Better Outcomes at Lower Costs
  This article gives an overview of value-based health care delivery (using time-driven activity-based costing) and highlights the partnerships among the Harvard Business School, the Institute for Healthcare Improvement, and various orthopedic surgical groups.
• Appropriate Use of Medical Resources
  This white paper from the American Hospital Association (AHA) focuses on drivers of health care utilization and includes a "top five" list of hospital-based procedures and interventions they recommend should be discussed by patients and physicians before proceeding.
• Mobile Clinic in Massachusetts Associated with Cost Savings from Lowering Blood Pressure and Emergency Department Use
  A study of 10,509 patient visits to the Family Van, an urban mobile health clinic in Massachusetts, found that screenings and counseling resulted in significant reductions in high blood pressure from 2010 to 2012. The researchers argue that mobile health clinics are an effective delivery model for underserved communities with poor health status and frequent use of emergency departments.
• Preventing Infection After Hip and Knee Replacements
  IHI's Project JOINTS initiative is helping to speed the adoption of proven practices to prevent surgical site infections (SSIs) after hip and knee replacement surgery. This article describes simple, affordable, evidence-based practices organizations can put into place to reduce such infections.
• Enhancing the Effectiveness Effectiveness of Follow-Up Phone Calls to Improve Transitions in Care: Three Decision Points
  This study used a nonsystematic review of the literature focused on the use of telephone follow-up to improve postdischarge processes and reduce avoidable readmissions, and examined use of such calls among organizations participating in the STate Action on Avoidable Rehospitalizations (STAAR) initiative.