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Measuring Complexity: Moving Toward Standardized Measures for the Field of Complex Care
This report describes the current state of quality measurement in complex care, key challenges associated with complex care, current complex care research and measurement development efforts, and eight recommendations for next steps to develop a standard set of quality measures for the field of complex care.
Implementing Daily Management Systems to Support Sustained Quality Improvement in Ambulatory Surgery Centers
IHI's high-performance management system (HPMS) was piloted in several ambulatory surgery centers to understand the applicability of quality control using related practices (e.g., standardized daily huddles, visual management boards), and to understand the approach's impact on sustaining improvement in patient care.
Adopting a Systems Approach to the Opioid Crisis
Rather than a myopic focus on opioid prescription reduction, this article describes five strategies health care leaders can employ to implement a systems approach to timely and effective treatment of opioid use disorder, in tandem with pain assessment and management.
Zero Harm in Health Care
This article describes a comprehensive systems-focused approach to patient safety to achieve the goal of zero harm for patients, families, and the health care workforce. The approach includes four interdependent elements: the psychology of change, a culture of safety, an optimal learning system, and codesigning care and improvement with patients.
Providing Safe, High-Quality Maternity Care in Rural US Hospitals
This IHI Innovation Report examines the challenges and gaps that rural health care organizations in the US face; presents a synthesis of published evidence and effective approaches developed by clinicians and leaders; and describes potential strategies for providing safe, high-quality maternity care in rural areas.
Novel Quality Improvement Method to Reduce Cost While Improving the Quality of Patient Care
This article describes continuous value management (CVM), an approach developed by IHI in partnership with NHS Highland that is derived from Lean accounting and employs quality improvement (QI) methods, to assist health systems to decrease operating costs and reduce or repurpose resources to improve efficiency.
Advancing Safety and Equity Together
There are widespread inequities in health outcomes in the United States based on race, sex, language, and other factors. But there is no such thing as high-quality, safe care that is inequitable. Health systems can leverage patient-safety programs to advance equity.
A Quality Improvement Initiative to Increase the Frequency of Vaginal Delivery in Brazilian Hospitals
Four key interventions implemented with quality improvement (QI) methods in Brazilian hospitals were associated with increased vaginal delivery, suggesting that this approach may help address the global C-section delivery epidemic.
The Role of Racism as a Core Patient Safety Issue
Maternal mortality rates in the US are rising, particularly among black women. This article describes three things health care leaders can do to understand the contributing causes of mortality, including racism, and factors to reduce inequities and improve safety in maternal health.
Ethiopia Health Care Quality Initiative: Design and Initial Lessons Learned
The Ethiopian Federal Ministry of Health and IHI co-designed a three-pronged approach to accelerate health system improvement nationally, which included developing a national health care quality strategy, building quality improvement (QI) capability at all health system levels, and introducing scalable QI collaboratives across four regions.
Factors Influencing a Hospital-wide Intervention to Promote Professionalism and Build a Safety Culture
A three-year qualitative study at an Australia hospital identifies valuable insights into factors influencing implementation of a multifaceted behavior change intervention to promote professionalism and build a culture of safety. The multiple interrelated factors impacting the hospital-wide intervention are discussed and analyzed.
Effective Strategies for Hospitals Responding to the Opioid Crisis
This document provides hospital and health system administrators and leaders with specific improvement ideas for five system-level strategies that address the challenges of preventing, identifying, and treating opioid use disorder.
Improving Behavioral Health Care in the ED and Upstream
Hospitals and communities are partnering to improve patient care and staff safety, while also decreasing avoidable, repeat emergency department visits for individuals with behavioral health and substance use issues presenting to the ED.
Improving Health Equity: Guidance for Health Care Organizations
The eight health system teams participating in the Pursuing Equity initiative share strategies, examples of specific improvements tested, lessons learned, challenges and mitigation strategies, and tools and resources for improving health equity.
Are You Using Data the Right Way?
Health care leaders rely on data to guide decisions, yet when data is misinterpreted it impacts the quality of those decisions. This article discusses using data the right way to inform decisions, including control charts to display and interpret data over time.
Using a Multicountry Learning Network to Harvest and Rapidly Spread Implementation Knowledge to Reduce Mother-to-Child Transmission of HIV
This article describes the value of creating a quality improvement–driven, multicountry learning network to accelerate the pace of improving care systems in Africa to reduce mother-to-child transmission of HIV.
Applying Quality Improvement Approaches to Reduce Mother-to-Child HIV Transmission and Improve Health and Nutrition Care in Five Countries
This article describes the application of quality improvement (QI) methods, as part of the Partnership for HIV-Free Survival, to support governments and facility staff in five African countries in reducing maternal-to-child transmission of HIV.
A Six-Country Collaborative Quality Improvement Initiative to Improve Nutrition and Decrease Mother-to-Child Transmission of HIV
This article is the first report of the effectiveness of using quality improvement in a large-scale multicountry effort in Africa to improve infant survifal by reducing postnatal maternal-to-child transmission of HIV in breast feeding HIV-positive mothers.
Advancing Equity in Health Systems by Addressing Racial Justice
This article describes lessons from IHI’s work with health systems in three settings (the United States, Brazil, and Ethiopia) to advance racial equity.
How One Health System Overcame Resistance to a Surgical Checklist
This article describes three mindshifts for overcoming resistance to change and provides an example of one health system that used this approach to overcome resistance to employing a surgical safety checklist.
Is Your Board Effectively Overseeing Quality?
This article gives an overview of IHI's Framework for Effective Board Governance of Health System Quality and recommends three guiding principles to build improvement knowledge and capacity among board members.
The Answer to Culture Change: Everyday Management Tactics
This article describes the High-Performance Management System, a model developed by IHI to drive sustained value improvement using a clear rhythm of performance measurement and communication via huddles and visual management.
Advancing the Safety of Acute Pain Management
This report specifically and uniquely addresses acute pain management as a patient safety issue, including the overuse of opioids for acute pain. It provides health care safety leaders in hospitals, emergency departments (EDs), urgent care clinics, outpatient surgery facilities, and other acute care settings with specific action steps to improve the safety of acute pain management in their organizations.
Leveraging the Psychology of Change
This article presents an overview of the IHI Psychology of Change Framework with key takeaways for leaders, to help them understand why people resist change and how to activate people to advance and sustain improved care.
Blueprint for Complex Care
This publication assesses the current state of the complex care field and presents actionable recommendations and a common framework for collectively advancing care delivery for individuals with complex health and social needs.