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For more information about IHI’s work in Europe, please email:

Chesley Rappleye

Our Work

IHI provides strategic guidance, tactical designs, and quality improvement capacity building that helps our partners in Europe reach their boldest aims. We also provide diagnostic services to ensure we can learn the most together and provide a platform for sharing knowledge from and with others. Together with our European partners, we are testing the next wave of innovations in safety, early child health, transitional care, and mental health that could be deployed in health systems around the world.

Over the past decade, IHI’s work in Europe has been focused primarily on increasing improvement capability and capacity, improving patient safety in health care, and achieving the Triple Aim for populations.

IHI has supported numerous efforts in Europe to build the capacity and capability to implement quality improvement programming at scale. For more than 20 years the annual International Forum on Quality and Safety in Healthcare, co-sponsored by IHI and BMJ Publishing Group, has contributed to capacity building for the Europe and beyond with around 3,000 participants each year. IHI is pleased to host, alongside regional partners, educational trainings in Europe.


Some Highlights of IHI’s Work in Europe

IHI Health Improvement Alliance Europe
The IHI Health Improvement Alliance Europe is a coalition of progressive leaders who are united for change, driven by collaboration, and focused on achieving health and health care results in Europe. The group aims to improve work processes, create new delivery models relevant to European health systems, and achieve best health and best care at affordable cost in the face of changing demographics, increasing chronic illness, escalating costs, and shrinking government and regional budgets.

NHS Scotland
NHS Scotland was the first health service in the world to adopt a national approach to improving patient safety. In 2007, the Scottish Government and Quality Improvement Scotland selected IHI as its partner to co-design and implement the Scottish Patient Safety Programme (SPSP), with the aim of steadily improving the safety and reliability of hospital care across the country using evidence-based tools and techniques to improve everyday health care systems and processes. Having achieved impressive reductions in mortality from this first phase of work, SPSP continues with the Scottish Government setting an even more ambitious aim to reduce mortality by 20 percent by the end of 2015. In an expanded partnership with NHS Scotland, IHI continues to work on improving patient safety in adult mental health care, and maternal and child care in both hospital and primary care settings.

NHS Scotland and Scottish Government: Early Years Collaborative
Leveraging the Triple Aim for Populations, the Early Years Collaborative (EYC) seeks to make Scotland the best place in the world to grow up in by improving outcomes, and reducing inequalities, for all babies, children, mothers, fathers, and families across Scotland to ensure that all children have the best start in life and are ready to succeed. The EYC expands IHI’s work into settings that are not traditionally associated with improving health care. Working with the Scottish Government and teams from local communities comprising varied public agencies, from housing and policing to education and social care, the IHI team is providing technical assistance and helping to support the bold aim of making Scotland the best country in the world to grow up in.

Qulturum, Region Jönköping County, Sweden
One of IHI’s most long-standing Strategic Partnerships in Europe is with Qulturum, the Center for Learning and Innovation in Healthcare, which first began its association with IHI through participation in the Pursuing Perfection initiative in 2001, the goal of which was to demonstrate that high levels of performance, in all dimensions of quality, throughout an entire organization or system of care. The new processes and concepts from Pursuing Perfection helped lead to advances across Jönköping County’s health care system and, in turn, other organizations participating in the initiative learned from the county. As the only participating health care system with fully integrated services and a single payer for all of its services, the county demonstrated the gains that are possible when innovative design meets rational resourcing. IHI and Qulturum continue to work in partnership to build capacity and capability, improve patient safety, and to pursue the Triple Aim.

East London NHS Foundation Trust, England
IHI is pleased to be working with East London NHS Foundation Trust, one of the leading mental health trusts in England and a center of excellence for innovation and improvement. With a population of 750,000 which is one of the most culturally diverse and in one of the most deprived areas in the country, East London is working with IHI to support their efforts to build capacity and capability to implement quality improvement programming at scale and support their ambitious aim to provide the highest quality mental health and community care in England by 2020 through reducing harm and providing right care, right place, right time.

The Gulbenkian Foundation, Portugal
A charitable foundation established in 1956 in Portugal with cultural, educational, social and science interest, the Gulbenkian Foundation is committed to transitioning today’s hospital-centered and illness-based system to one that is person-centered and health-based, in which citizens are partners in health promotion and health care. In close partnership with the Foundation, in 2015 IHI began providing technical assistance and quality improvement coaching to a large-scale patient safety improvement program across 12 hospitals in Portugal, using a collaborative learning system focused on reducing hospital-acquired infections in prototype units by 50 percent over three years.

In Safe Hands, Norway
The Norwegian Directorate of Health’s national patient safety program, In Safe Hands, aims to give patients, users, and their families the world’s safest health and care services. Through a combination of quality improvement and patient safety trainings and strategic guidance and support, IHI and the Directorate of Health work together to support the ambition of In Safe Hands to obtain transformational results.

NHS England and Picker Institute Europe
The NHS England Patient Experience division and Picker Institute Europe are working closely with IHI on patient-centered co-design and the application of reliability science to support the development and implementation of Always Events® to pilot populations, with the long-term aim of spreading this work to health trusts across England.

South London and Maudsley NHS Foundation Trust, England
A provider of mental health and substance misuse services to seven London boroughs with a combined population of over 2 million people, South London and Maudsley NHS Foundation Trust is committed to improving the lives of people and the communities they serve while promoting mental health and wellbeing for all. They are working with IHI to build capacity and capability for improvement within their organization while driving for results, innovation, and data optimization.

International Forum on Quality and Safety in Healthcare
Since 1995, IHI and the BMJ Publishing Group have co-sponsored the annual the International Forum on Quality and Safety in Healthcare. Open to both beginners and those experienced in QI, the conference is held in different locations throughout Europe and offers education on how to improve health; provides a forum for the exchange of sound, practical ideas on improving health care; provides a setting for deep discussion and shared learning among those charged with leading improvements in health care; and builds the research base of methods to improve health care.



Completed Projects and Initiatives

Department of Health, Social Services and Public Safety, Northern Ireland
The Northern Ireland Department of Health, Social Services and Public Safety are committed to improving health and health care for the people of Northern Ireland. Working together with IHI and two provider sites, East Belfast Integrated Care Partnership and South Eastern Health and Social Care Trust, IHI is providing quality improvement coaching aimed at improving health outcomes for patients using the IHI Triple Aim framework — the simultaneous pursuit of better care for individuals, better health for populations, and lower per capita costs — and testing scale-up methods.

Imagine Program, The Netherlands
In partnership with CBO, IHI supported efforts to improve person-centered care, specifically in shared decision making and reducing readmissions through the Imagine program, involving 13 participating hospitals in a nationwide large-scale change effort.

Patient Safety Efforts, South West of England
In 2009, NHS South West Quality and Patient Safety Improvement Programme (QPSIP) launched with the overall aim of dramatically improving patient safety across the South West of England over five years. IHI provided technical assistance and quality improvement training to support their ambitious vision that “all hospitals in the South West will be safer for patients and will have a standardized mortality ratio among the lowest in England.” In 2010 NHS South West expanded this work across the continuum of care with a focus on mental health and the health of the community, while continuing to drive forward the acute care work. IHI supported this work in two ways: providing subject matter expertise as faculty and advisors, and developing the capacity of the NHS South West core team to enable them to design and lead a Breakthrough Series Collaborative. With the reorganization of health care in England in 2013, the newly formed South of England launched an Improving Safety in Mental Health collaborative, with IHI providing executive leadership and measurement support. In February 2015, IHI ran an Advanced Safety Programme for the South West Academic Health Science Network.

Patientsikkert Sygehus, Denmark
Between January 2010 and December 2012, five hospitals in Denmark embarked on an extraordinary effort to optimize patient safety. The Danish Safer Hospital Program (Patientsikkert Sygehus) was supported by the Danish Society for Patient Safety (DSPS) and the Danish Regions in partnership with IHI. The selected hospitals committed to becoming the safest hospitals in Denmark, with a goal of reducing mortality by 15 percent and harm by 30 percent. The initiative focused on reducing the number of cardiac arrests, eliminating hospital infections, reducing pressure ulcers, and preventing medication errors. The results were shared and disseminated to be an inspiration for the country's other hospitals and the legacy of Patientsikkert Sygehus has resulted in the launch of additional programs to improve patient safety in mental health, community care, and perinatal care nationwide.

Region Sjaelland, Denmark
One of five regions in Denmark with a population of 821,000, Region Sjaelland aims to create a health care system of the highest standard. To support this goal, they participated in the IHI Triple Aim Improvement Community and continue to implement the Triple Aim framework — the simultaneous pursuit of better care for individuals, better health for populations, and lower per capita costs — across the region.

The Health Foundation’s Safer Patients Initiative, UK
Funded by The Heath Foundation, the Safer Patients Initiative (SPI) launched in 2004 and was the first major improvement program to address the issue of patient safety in the UK. It was complex and large-scale in its approach to improvement, recognizing that change needed to take place across whole organizations and systems rather than focusing on individual incidents. In 2006, a further 20 hospitals joined the program for phase two, which ran for 20 months. The phase two hospitals worked in pairs to share safety improvements and build on the learning from phase one. The program generated considerable learning and had a significant effect and influence on participating hospitals and their staff, on patient care, and on the wider NHS system.

The Health Foundation Quality Improvement Fellows, UK
From 2004 to 2014, up to five senior clinically-qualified National Health Service professionals per year, with a track record of achievement in quality improvement, spent one year at IHI in Cambridge, Massachusetts, as The Health Foundation Quality Improvement Fellows. Many fellows have returned to senior leadership positions in the UK, and IHI retains close links to its fellows, some of whom continue to partner as faculty with IHI in programming around the world.