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Human-Centered Design and Performance Improvement: Better Together
Kaiser Permanente, an IHI Strategic Partner, is fusing methods from human-centered design and performance improvement to systematically partner with patients, families, and customers to co-design better care, systems, and programs.
The Scottish Improvement Journey: A Nationwide Approach to Improvement
Learn about Scotland’s 10-year effort to apply quality improvement on a national scale to improve patient safety, including an in-depth review of the successful Scottish Patient Safety Programme, and further QI efforts that spread across Scotland into new social policy areas such as children’s services, education, and justice.
Using Quality Improvement Methods to Combat Poverty: Northeast Wisconsin's POINT Initiative
This case study provides an overview of the Poverty Outcomes and Improvement Network Team (POINT) initiative, a multiyear regional effort to reduce poverty in Northeast Wisconsin by teaching nonprofit organizations how to use quality improvement methods and tools to improve the services they provide to those in the community living in poverty.
Building Improvement Capacity and Capability: A "Dosing" Approach
This article describes the Institute for Healthcare Improvement's "dosing" approach to building improvement capacity and capability by establishing and deploying targeted levels of improvement knowledge and skills throughout an organization.
Integrating Behavioral Health in the Emergency Department and Upstream
This IHI Innovation Report discusses barriers to integrating behavioral health in the ED, and presents five drivers (emerging from six key themes from existing approaches) that form the building blocks of a theory of change for making improvements in this area.
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) has achieved impressive improvements in quality of care over the past decade — a testament to their engaged and effective leadership and staff, and also due in part to a unique 10-plus-year collaboration with the Institute for Healthcare Improvement (IHI) that accelerated improvement at KP, greatly informed IHI’s own learning, and helped KP build system-wide capacity for improvement.