IHI Open School Courses Find a Home in Home Care Association

March 2013

Gina Balkus, CEO of the Home Care Association of New Hampshire, will be the first one to admit it’s difficult to be a student again.

“It’s hard to get into that study mode,” she says. “But I’m working at it. I’m taking the classes, too.”

About 40 home health nurses, therapists, and clinical directors are also taking the classes – the IHI Open School courses – with Balkus and Polly Campion, MS, RN, the leader and facilitator of the group. Many of the professionals, mostly in their 40s and 50s, Balkus says, haven’t been to school in a long time.

“Sometimes they groan about the length of a module or getting through one of the tougher ones, but they are so excited to be learning,” Balkus adds. “The energy in the room when we all get together is palpable. I wish we could package it up and share it. It’s so exciting to see.”

Balkus and Campion, along with the organization’s board, are pioneering an effort to increase quality improvement and safety knowledge among those responsible for QI in the Association’s 40 member agencies.  The QI Scholars Initiative kicked off last September and runs through this June, with participants taking two IHI Open School courses each month.

“Home health agencies are critical partners in the continuum of care,” Balkus says. “Being sure that our staff has the quality improvement and patient safety tools they need to make changes along the way – and to be a partner in the overall transformation of health care – is really, really important.”

That’s why Balkus was so excited to bring the plan for the initiative to her board last summer.

“Our members identified this as a priority themselves and the IHI Open School was a perfect resource,” she says.

The IHI Open School offers 19 online courses on topics including quality improvement, patient safety, leadership, population health, and patient-and-family-centered care. Courses, which are available for free to students, residents, and faculty, are available by subscription for health professionals and organizations. The board at the Home Care Association of New Hampshire approved the purchase of 50 licenses, which cost $3,000.

“Even though we have 40 agencies, we have a very small budget,” Balkus says. “We’re very lean.”

To help defray the cost of the initiative, participants had to pay a small fee. In exchange, they will earn their IHI Open School Certificate in Quality & Safety – provided they complete the 16 required courses – and get to join monthly learning sessions in Concord, the state capital. Campion, who worked at Dartmouth-Hitchcock Medical Center in Lebanon for two decades in quality and safety leadership roles, leads the group through exercises that tie together the courses and home health-specific scenarios.

“Open School courses mostly have a hospital focus and they aren’t always applicable to the home care setting,” Campion says.

She weaves home care scenarios within the structured two-and-a-half-hour meetings. (View a sample agenda below.)

HomeHealthAgenda.png“The agenda usually includes a review of the previous month’s content and highlights from the current month, with an emphasis on small group discussion,” Campion says.

Campion, who has participated in many IHI activities in her career – including courses, collaboratives, and the National Forum – has found the online modules to be very accessible for professionals. Balkus, meanwhile, points to the broad, general curriculum as an important benefit.

“In the past, group QI initiatives we’ve been involved with haven’t succeeded because the specific topic may not have been a priority for every agency at that time,” she says. “The Open School courses don’t lock us into a particular QI initiative. This way, people can learn at their own pace and apply it to their own priorities.”

Successes are already popping up around the state.

“One clinical director told me this week that she’s using the PDSA tool to improve scheduling in her agency,” Balkus says. “She’s already doing tests of change. It’s exactly what this program is all about.”

To keep momentum going between meetings, Balkus sends a monthly newsletter (see below for an example) that includes handouts, minutes, and agendas. There’s also an expectation, she says, that those who attend the meetings will share the knowledge within their agencies.


NewsletterNHHomeCare.png“Since they do a lot of their work independently, they have to be very intentional about coming together with other members of the agency,” Balkus adds. “It’s harder for them.”

So far, they are happy with the direction of the program. They will be tracking attendance rate (at meetings), completion rate (of courses), and taking pre- and post-surveys to measure the success, but Balkus and Campion are already busy thinking about a potential second phase starting this summer. The excitement and energy from the first group of participants has a lot to do with the future plans.

“They are eager, eager learners,” Campion says. “There’s a lot of passion, energy, and desire to provide the best possible care. It’s very clear that the will is there.”

Editor’s Note: To learn more about the QI Scholars Initiative, contact Gina Balkus.

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