Please wait while you are being redirected ...
This site is best viewed with Internet Explorer version 8 or greater. Check your browser compatibility mode if you are using Internet Explorer version 8 or greater.
Log In / Register
Newsletter Sign Up
Newsletter Sign Up
Sign up for IHI's Email Services
Improving Health and Health Care Worldwide
Engage with IHI
Vision, Mission, Values
Science of Improvement
How to Get Involved
In the News
All Topics A-Z
Quality, Cost, and Value
Triple Aim for Populations
IHI National Forum
Passport to IHI Training
WIHI Audio Program
Certified Professional in Patient Safety (CPPS)
IHI Open School
How to Improve
IHI White Papers
Audio and Video
Engage with IHI
Engage with IHI Overview
506 items found
Use SHIFT+ENTER to open the menu (new window).
Highly Adoptable Improvement: A Practical Model and Toolkit to Address Adoptability and Sustainability of Quality Improvement Initiatives
This article presents the Highly Adoptable Improvement Model, a practical model and supporting tools developed on the basis of existing theories to help quality improvement (QI) programs design more adoptable approaches that lead to more sustainable improvement.
Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human
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.
10 IHI Innovations to Improve Health and Health Care
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
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
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.
Personalized Perfect Care
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.
A Framework to Guide Practice Facilitators in Building Capacity
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.
Evaluating Complex Health Interventions: A Guide to Rigorous Research Designs
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.
Does a Quality Improvement Campaign Accelerate Take-up of New Evidence? IHI’s Project JOINTS
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.
Better Care for Complex Needs
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.
Reliably Addressing "What Matters" Through a Quality Improvement Process
A practical quality improvement approach can help to ensure that processes are in place to assist nurses in devoting time to reliably inquire about “what matters” to each patient at every encounter
Ensuring Healthcare Improvements Stick
This article describes six management principles, leadership practices, core competencies, and mental models that all play a role in generating and sustaining improvement.
Whole System Measures 2.0: A Compass for Health System Leaders
This white paper presents Whole System Measures 2.0, a set of 15 measures to help health care system leaders and boards better understand their organization’s current (and desired) performance across three (Triple Aim) domains: population health, experience of care, and per capita cost.
Four Steps to Sustaining Improvement in Health Care
To learn how to build systems that sustain improvement, IHI studied health care organizations that were able to achieve standout results and then build on them. This article highlights four steps, derived from insights from their work, on how to get started with introducing new standard work processes for point-of-care staff.
Triple Aim in Canada: Developing Capacity to Lead to Better Health, Care, and Cost
This article reports on the work of nine Canadian health care organizations to embed the Triple Aim (better care, health, and cost) across Canada. The nine sites participated in IHI’s Triple Aim Improvement Community in order to build a solid Triple Aim infrastructure, develop quality improvement capacity, and foster a culture of health care improvement.
Building a Culture of Improvement at East London NHS Foundation Trust
East London NHS Foundation Trust (ELFT) in the UK provides mental health and community services to a diverse and largely low-income population. By establishing an organization-wide culture of continuous improvement, and integrating quality improvement methodology and training at every level of work, ELFT has significantly reduced incidents of inpatient violence and improved staff satisfaction, among other achievements.
Can a Quality Improvement Project Impact Maternal and Child Health Outcomes at Scale in Northern Ghana?
This paper discusses the impact of a scale-up phase of Project Fives Alive! to improve maternal and child health outcomes, which used quality improvement methods to identify barriers to care and care-seeking, and then identify, test, implement, and scale up simple and low-cost local solutions to address the barriers. The project and this approach demonstrated improved outcomes at scale.
Methods for Reducing Sepsis Mortality in Emergency Departments and Inpatient Units
North Shore-LIJ Health System (now Northwell Health) launched a strategic partnership with the Institute for Healthcare Improvement to accelerate the pace of sepsis improvement, focusing initially on sepsis recognition and treatment in emergency departments (EDs). The health system reduced overall sepsis mortality by approximately 50 percent in a six-year period and increased compliance with sepsis resuscitation bundle elements in the EDs and inpatient units in 11 acute care hospitals.
This white paper presents a framework that health care organizations can use to sustain improvements by focusing on the daily work of frontline managers, supported by a system of standard tasks and responsibilities for managers at all levels of the organization.
Lessons in Leadership for Improvement: Kaiser Permanente’s Improvement Journey Over 10 Years
Kaiser Permanente (KP), the largest managed care organization in the US, has achieved impressive improvements in quality of care over the past decade — a testament to their engaged and effective leadership and staff. Kaiser's achievements also owe a great deal to a unique 10-plus-year collaboration with the Institute for Healthcare Improvement (IHI) — a strategic partnership that accelerated improvement at KP, greatly informed IHI’s own learning, and helped KP build system-wide capacity for improvement.
Radically Redesigning Patient Safety
Standardize what makes sense. Customize to the individual. Change the balance of power. These are three of the “10 Rules for Radical Redesign in Health Care,” developed by IHI Leadership Alliance members, that are particularly applicable to improving patient safety.This article highlights organizations that are using these rules to make care safer.
Era 3 for Medicine and Health Care
In this article, Don Berwick presents nine changes he believes are needed for health care to transition into what he calls era 3, "guided by updated beliefs that reject both the protectionism of era 1 and the reductionism of era 2."
Improving the Health of Populations
With the rapid growth of accountable care organizations, health care delivery organizations are expanding their scope of accountability and changing how they identify and define their immediate goals and longer-term aspirations. Yet the terms to describe this approach — “population health” and “population management” — are often used interchangeably. This article makes the case that a common language is needed, provides clarification around terminology, and offers five questions for health care leaders to explore.
This Coalition of 20 Companies Thinks It Can Change US Health Care
Based on IHI’s learning from work with employers to improve health care, this article offers five strategies to help employers — like those in the recently formed Health Transformation Alliance — achieve better care and better health for their employees, while also lowering costs (the Triple Aim).
A Framework for Scaling Up Health Interventions: Lessons from Large-Scale Improvement Initiatives in Africa
This article details a sequence of four steps for taking a health intervention to full scale, properties that facilitate adoption of the new ideas, and the infrastructure required to support the scale-up. Two case studies present national-scale initiatives in Ghana and South Africa that used early iterations of this framework to scale up evidence-based interventions to improve maternal and child health.