IHI’s work is guided by a Scientific Advisory Group, an independent group of advisors chartered by IHI’s Board of Directors, which provides expert review and guidance to improve the rigor and credibility of IHI’s results-oriented programs and activities. At a time when IHI is launching an increasing number of complex, large-scale programs that raise important design and evaluation issues, the Scientific Advisory Group provides advice on program design and methodology, measurement, evaluation, and analytic strategy
IHI’s approach to quality improvement has always been multidisciplinary, involving experts, techniques, and tools taken from the social sciences as well as from life sciences and medicine. The diversity and expertise of Scientific Advisory Group members gives IHI a strong foundation to advance the rigor of improvement science and evaluate our own programs and goals. The Scientific Advisory Group comprises five internationally renowned leaders with expertise in various disciplines.
The Group meets twice a year with members of IHI’s executive team and staff and participates by email and telephone in ongoing discussions as prospective programs are reviewed and current work is monitored and evaluated.
|Peter Margolis, MD, PhD,|
Professor of Pediatrics and Director of Research
James M. Anderson Center for Health System Excellence at Cincinnati Children’s Hospital Medical Center
|Mary D. Naylor, PhD, RN, FAAN|
Marian S. Ware Professor in Gerontology
Director of the NewCourtland Center for Transitions and Health
||Nelson P. Repenning|
Distinguished Professor of System Dynamics and Organization Studies
MIT Sloan School of Management
Eric C. Schneider, MD, MSc, FACP
RAND Distinguished Chair in Health Care Quality and Director, RAND Boston
Associate Professor, Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health
Perspectives on the Scientific Advisory Group’s Work
Former group member Harlan Krumholz emphasizes that quality improvement often involves doing research in the “real world” with colleagues from various disciplines. Large improvement programs implemented across multiple settings are likely to yield complex results, with variation due to a myriad of local circumstances. Scientific analysis of these results is challenging but crucial. Krumholz says, “Studying the real world is not as straightforward as testing pills in a laboratory, where you can control all the variables. We want to learn how we can generate the best knowledge from real-world experience. Our inability to control the variables is not a weakness; it’s reality.”
Elizabeth McGlynn points out that IHI has an important role to play, educating health care “improvers” in the effective use of tools and techniques for quality improvement research, about which there is currently little formal guidance available. Many health care organizations lack resources and experience for designing this kind of research. They often look to IHI for direction. McGlynn explains, “There are many tools in the research toolbox. It’s a mistake to believe that there is only one tool that’s always best. We need to help organizations ask, ‘What are the questions we really need to answer, and what are the right tools for answering those questions?’ I think there’s an opportunity for IHI to make a real contribution in this area.”
McGlynn and Krumholz acknowledge the tension between, on the one hand, knowing that some things have obvious value — things we know should be changed tomorrow — and, on the other hand, things we think we understand, but as we look closer, confound our assumptions. Krumholz believes even things that “seem to make sense” deserve greater study. With study, results can be generalized with increased confidence.
IHI Chief Medical and Scientific Officer Don Goldmann, MD, explains that many institutions rely on external advisory boards for honest, informed feedback about programs and research. In IHI’s case, the Scientific Advisory Group helps establish system-level goals and measures to help the organization develop its scientific expertise, capability, and execution, in addition to providing guidance about specific programs.
Goldmann is also enthusiastic about having IHI staff members present their work to the Scientific Advisory Group for feedback. Says Goldmann, “It’s always a good idea to have an external group to whom you can present your work for feedback about how it might be improved. Teams at IHI that have had the opportunity to work with the Scientific Advisory Group are finding this to be new and challenging. The process can’t help but raise the standard of our programs and bring clarity to our work.”