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Discharge to Assess: “Flipping” Discharge Assessment from Hospital to Home
Current average rating is 0 stars.
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.
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.
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
Current average rating is 0 stars.
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.
Experience-Based Co-Design of Health Care Services
Current average rating is 0 stars.
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
Current average rating is 0 stars.
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
Current average rating is 0 stars.
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
Current average rating is 0 stars.
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
Current average rating is 0 stars.
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
Current average rating is 0 stars.
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.
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.
Patient Safety in the Home: Assessment of Issues, Challenges, and Opportunities
Current average rating is 4 stars.
Based on a scan of peer-reviewed and grey literature and subject matter expert interviews, this report examines challenges related to patient safety in the home, including fragmentation of care; household hazards; ill-prepared family caregivers; limited training and regulation of home care workers; inadequate communication among patients, caregivers, and providers; and misaligned payment incentives.
Evaluating Complex Health Interventions: A Guide to Rigorous Research Designs
Current average rating is 0 stars.
This publication describes a range of research design approaches that can be used to enhance the rigor of evaluations, thereby improving the quality of the evidence upon which decisions are made and ultimately improving the public’s health.
Health Care Providers Must Act Now to Address the Prescription Opioid Crisis
Current average rating is 0 stars.
While a community-wide approach is also needed to effectively address the opioid crisis, the authors describe some key actions that both providers and organizations can take to begin making a difference, including changing provider prescribing practices.
Health Care Leaders: "Bill or No Bill, We Still Have Work to Do"
Current average rating is 0 stars.
In this NEJM Catalyst article, several members of the IHI Leadership Alliance write, “Bill or no bill, we still need to move forward and continue our focus on improving health and health care for our patients and our communities while reducing costs” (the IHI Triple Aim).
The Value of Teaching Patients to Administer Their Own Care
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Some patients are learning how to administer their own treatments outside of the health care setting — from pain management, to dialysis, to intravenous antibiotics. This article describes five keys to a successful approach to implementing patient-administered self-care and provides examples of organizations that have established such initiatives.
Patient-Administered Self-Care
Current average rating is 3 stars.
For specific procedures and treatments, health care providers can train individuals to administer their own self-care, on their own time, without supervision or dependence on a licensed professional. Patient-administered self-care can occur either in traditional health care facilities or another location of the patient's choosing outside of a facility.
Does a Quality Improvement Campaign Accelerate Take-up of New Evidence? IHI’s Project JOINTS
Current average rating is 0 stars.
IHI’s Project JOINTS initiative engaged a network of state-based organizations and professionals in a six-month QI campaign to promote adherence to three evidence-based practices to reduce surgical site infection (SSI) after joint replacement.
Breaking the Rules for Better Care
Current average rating is 0 stars.
IHI Leadership Alliance member organizations asked their patients and staff, “If you could break or change any rule in service of a better care experience for patients or staff, what would it be?” This article summarizes the most frequent suggestions.
Better Care for Complex Needs
Current average rating is 4 stars.
For individuals with complex health and social needs, high utilization rates (and their associated costs), poor outcomes, and low satisfaction scores indicate that current care systems are not meeting their needs. This article describes five key priorities for health care leaders to consider as their organizations endeavor to improve care for high-need, high-cost individuals.
  
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