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Leading a Culture of Safety: A Blueprint for Success
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Creating a culture of safety in health care settings has proven to be a challenging endeavor, and there is a lack of clear actions for organizational leaders to take in developing such a culture. This guide provides chief executive officers and other health care leaders with a useful tool for assessing and advancing their organization’s culture of safety, and can be used to help determine the current state, inform dialogue with the board and leadership team, and help leaders set priorities.
WIHI: Opioid Crisis - Changing Habits and Improving Pain Management
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January 11, 2018 | As efforts continue to curb the opioid addiction epidemic in the US and reduce deaths from overdoses​, the underlying problem of overprescribing remains very much in the spotlight.
Is Your Organization Highly Reliable?
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This article presents common high-reliability organization (HRO) characteristics that apply to all health care organizations seeking to improve patient safety, and cross-walks them with the IHI Framework for Safe, Reliable, and Effective Care to help leaders build a culture and learning system to support HRO characteristics and safer systems of care.
WIHI: Discovering Your Way to Greatness
Current average rating is 3 stars.
December 21, 2017 | Steve Spear speaks to an audience at IHI's National Forum, drawing on his own life experience and work with multiple industries to point out that better ways to do things are within reach.
Moral Choices for Today’s Physician
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In this essay, Don Berwick considers moral choices physicians face personally, organizationally, and globally and exhorts them to understand that the health of humanity depends on their speaking out against the social injustice of overpricing drugs and services, mass incarceration, and the lack of environmental responsibility.
Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human
Current average rating is 2 stars.
This report assesses the state of patient safety in health care, advocating for a total systems approach across the continuum of care and establishment of a culture of safety, and calling for action by government, regulators, health professionals, and others to place higher priority on patient safety improvement and implementation science.
WIHI: The Careful and Kind Patient Revolution
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December 7, 2017 | Victor Montori argues that it is time for providers to look up from strict protocols and guidelines long enough to get curious about their patients' lives and begin to minimize barriers to better health, not add to them.
RCA2: Improving Root Cause Analyses and Actions to Prevent Harm
Current average rating is 5 stars.
This document examines best practices for using root cause analysis (RCA) to improve patient safety, and includes guidelines to help health professionals standardize the RCA process and improve the way they investigate medical errors, adverse events, and near misses.
WIHI: When Patients Feel as Powerless as Hostages
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November 21, 2017 | Is "hostage" the right way to describe how patients and family members sometimes feel when they're trying to get the care they need?
Measuring Patient Safety in Real Time: An Essential Method for Effectively Improving the Safety of Care
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The continuing evidence of preventable deaths due to medical error has led to recent calls to improve measurement of safety in hospitals. This need can be adequately addressed by harnessing health information technology.
Closing the Loop: A Guide to Safer Ambulatory Referrals in the EHR Era
Current average rating is 4 stars.
The recommendations outlined in this publication are designed to help standardize the ways in which primary care practitioners activate referrals to specialists, and then keep track of the information over time. It describes a nine-step, closed-loop process in which all relevant patient information is communicated to the correct person through the appropriate channels and in a timely manner.
WIHI: Health Care Innovation and R&D: Taking Stock at Ten Years
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November 9, 2017 | The health care quality improvement movement has rallied around some significant innovations over the years, many of which have had a lasting impact.
Discharge to Assess: “Flipping” Discharge Assessment from Hospital to Home
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Discharge to Assess (D2A) (also referred to as "flipped discharge") is a redesign of the care process at Sheffield Teaching Hospitals in the UK that involves assessing a patient’s needs after discharge in the patient’s own home rather than in the hospital. Activities that traditionally happen at the end of a hospital admission are instead performed successfully and safely at home, thus enabling patients who are medically ready to go home earlier and spend less time in the acute care setting.
Liberation in the Exam Room: Racial Justice and Equity in Health Care
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This tool is intended to be used as a starting guideline for individuals in the health care delivery context as they work to identify key areas of focus on racial justice and health equity, serving as a resource to begin conversations with teams within the organization toward developing a deeper understanding of structural racism and its impact on achieving health equity.
Creating Age-Friendly Health Systems: How to Meet the Needs of a Growing Population of Older Adults
Current average rating is 5 stars.
This article explains an emerging care model for older adults focused on the “4Ms” of Age-Friendly Health Systems — What Matters, Mobility, Medications, and the Mentation of older adults — that is in the testing phase at five health systems, as part of the Creating Age-Friendly Health Systems initiative led by IHI.
10 IHI Innovations to Improve Health and Health Care
Current average rating is 5 stars.
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.
WIHI: A New Emergency Checklist for Office-Based Surgery
Current average rating is 5 stars.
October 26, 2017 | While serious harm remains uncommon for outpatient surgeries, adverse events do occur, particularly when anesthesia is involved. A new safety checklist can help clinical teams be better prepared for what to do if something goes wrong.
Achieving Hospital-wide Patient Flow
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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.
How to Attribute Causality in Quality Improvement: Lessons from Epidemiology
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This article proposes quality improvement and implementation initiatives in health care, regardless of scope and resources, can be enhanced by applying epidemiological principles adapted from Bradford Hill Criteria to strengthen evidence of effectiveness.
Are Quality Improvement Collaboratives Effective? A Systematic Review
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In a systematic review of the literature on quality improvement collaboratives, a widely adopted approach to shared learning and improvement in health care, the authors conclude that, overall, the QI collaboratives included in their review reported significant improvements in targeted clinical processes and patient outcomes.
A Simple Way to Involve Frontline Clinicians in Managing Costs
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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.
WIHI: QI Takes on Veteran and Chronic Homelessness
Current average rating is 5 stars.
October 12, 2017 | Using an improvement science approach and campaign-style momentum, one initiative is dramatically increasing monthly rates of housing homeless individuals across the US, including veterans and the chronically homeless.
Experience-Based Co-Design of Health Care Services
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This case study from the IHI/Commonwealth Fund International Program for US Health Care System Innovation describes experience-based co-design (EBCD), developed in the UK, which brings together narrative-based research with service design methods to catalyze a process wherein patients and staff work together to design, implement, and test improvements to health care services.
Reducing Inappropriate Medication Use by Implementing Deprescribing Guidelines
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This case study from the IHI/Commonwealth Fund International Program for US Health Care System Innovation describes how a multidisciplinary team of clinical experts in Ottawa, Canada, created a credible, low-cost process for developing and implementing evidence-based deprescribing guidelines and tools for assessing, tapering, and stopping medications that may cause harm or no longer benefit patients.
Postal Service “Call & Check Visits” for Isolated, Frail Elderly in the Community
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This case study from the IHI/Commonwealth Fund International Program for US Health Care System Innovation describes the "Call & Check Visits” program developed by Jersey Post in Jersey, British Channel Islands, in which postal service workers check on isolated, frail elderly residents in the community, deliver prescription refills, remind clients of upcoming medical visits, and ask about their health and social needs.