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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
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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.
Personalized Perfect Care
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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.
Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database
Current average rating is 5 stars.
A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. This article finds a high frequency of blame in a random sample of safety incident reports in the UK, suggesting that there are still opportunities to shift toward a more systems-focused, blame-free culture in health care.
A Framework to Guide Practice Facilitators in Building Capacity
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Engaging practice facilitators — individuals trained to build the improvement skills of ambulatory care teams — is an increasingly attractive approach, supported by a growing body of evidence that these facilitators are highly effective. This article lays out a framework to guide practice facilitators in building improvement capacity.
The Age-Friendly Health System Imperative
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The article gives an overview of how five early-adopter US health systems — working in partnership with IHI and The John A. Hartford Foundation as part of the Creating Age-Friendly Health Systems initiative — are testing prototype models for age-friendly care using continuous improvement efforts to streamline and enhance new approaches to geriatric care.
Creating Age-Friendly Health Systems: A Vision for Better Care of Older Adults
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This article describes the background, evidence-based changes, and testing, scale-up, and spread strategy that are part of the design of the Creating Age-Friendly Health Systems initiative to improve care for older adults.
When Patients and Their Families Feel Like Hostages to Health Care
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A power imbalance often still exists in the patient-provider relationship, particularly when high-stakes health decisions have to be made. This article explores this dynamic, likening it to “hostage bargaining syndrome” — that is, the patient behaves as if negotiating for their health from a position of fear and confusion -- and suggests ways to counteract this behavior.
WIHI: How to Beat Burnout and Create Joy in Work
Current average rating is 5 stars.
September 28, 2017 | Burnout in health care is a big and complex topic. We present an action-oriented framework to help leaders and managers more effectively engage with staff to identify what gets in the way of joy in work, and to develop solutions together.
WIHI: Tuning Up Health System Boards for Patient Safety
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September 15, 2017 | What do we need and expect from trustees of health systems when it comes to their oversight of quality and safety?
Respecting End-of-Life Care Wishes
Current average rating is 5 stars.
This article presents five core principles to guide providers and health care organizations in developing more reliable systems to receive, record, and ultimately respect patients’ wishes for end-of-life care.
WIHI: Pursuing Health Equity with Curiosity: Notes from New Initiatives
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August 24, 2017 | You may have data on outcomes disparities in your health system by race, ethnicity, and other factors. But in what ways is health equity a strategic priority in your organization, and what does health equity look like in your community?
WIHI: Workplace Violence in Health Care Can't Be the Norm
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August 10, 2017 | It's estimated that nearly 50 percent of workplace assaults happen in a health care setting. What solutions are health care organizations putting in place to help deal with this unique and dangerous problem?
  
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