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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.
Achieving Hospital-wide Patient Flow
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.
A Simple Way to Involve Frontline Clinicians in Managing Costs
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.
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.
Avoiding Overuse: The Next Quality Frontier
In this editorial, IHI President Emeritus Don Berwick makes the case that quality of care — that is, better matching care to needs, and practice to science — is central to addressing underuse of effective care and overuse of ineffective care. The editorial accompanies the "Right Care" series of articles that explores medical underuse and overuse worldwide.
New Payment Models Drive Value
Standardizing processes, enhancing efficiency of care delivery systems, and optimizing capacity across care delivery systems are all essential in driving value and preparing care teams for managing patients in a bundled payment program.
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).
Applying Radical Redesign Efforts
MemorialCare Health System's (California) strategy to provide high-quality care, reduce waste, and keep costs in line demonstrates three of the ten “New Rules for Radical Redesign in Health Care” developed by IHI Leadership Alliance members: standardize what makes sense; make it easy; and return the money.
Medicare at 50: Reflections from Former CMS Administrator Donald M. Berwick
IHI President Emeritus Don Berwick comments on the 50th anniversary of the US Medicare program, including the shift to payment based on the quality of care provided to patients, and the role of accountable care organizations (ACOs) in improving quality of care and reducing costs.
The Employer-Led Health Care Revolution
Intel is using Lean improvement methods to manage the quality and cost of its health care suppliers in Portland, OR. Their Healthcare Marketplace Collaborative model holds potential for employers, with their large purchasing power, to take the lead in securing better health for local populations and lowering costs for employees and companies alike.
Patient-reported measures help clinicians and patients assess whether a patient’s symptoms, lifestyle, daily activities and functional status have improved as a result of care provided, and are a mechanism for patients to have a voice in their treatment planning and decision making based on their own self-assessments.
Health Care, the Whole Person, and Community Engagement: Church Health Center of Memphis, Tennessee
The Church Health Center in Memphis, Tennessee, is committed to encouraging healthy living for individuals as well as communities. Their work provides an inspiring example of a community that is working toward achieving the Triple Aim.
Enhancing Prehospital Emergency Care
This article makes the case that earlier prehospital interventions can positively affect downstream hospital patient outcomes and costs of care, describes how emergency medical services (EMS) are increasingly becoming part of an integrated care system, and discusses the expanded role of ambulance services and paramedics to increase access to care.
ACOs: A Step in the Right Direction
Accountable care organizations (ACOs) can be a step forward in the journey toward aligning payment and delivery mechanisms to achieve better care and better health at lower costs. This article includes recommendations that may serve to accelerate our collective efforts toward achieving cost- and quality-related improvements at scale.
Eliminating Waste in US Health Care
This article focuses on reducing costs in health care through waste reduction in six key categories that are estimated to comprise more than 20 percent of total health care expenditures.
To Reconcile Mission and Margin, Deliver Better Outcomes at Lower Costs
This article gives an overview of value-based health care delivery (using time-driven activity-based costing) and highlights the partnerships among the Harvard Business School, the Institute for Healthcare Improvement, and various orthopedic surgical groups.
Appropriate Use of Medical Resources
This white paper from the American Hospital Association (AHA) focuses on drivers of health care utilization and includes a "top five" list of hospital-based procedures and interventions they recommend should be discussed by patients and physicians before proceeding.
Mobile Clinic in Massachusetts Associated with Cost Savings from Lowering Blood Pressure and Emergency Department Use
A study of 10,509 patient visits to the Family Van, an urban mobile health clinic in Massachusetts, found that screenings and counseling resulted in significant reductions in high blood pressure from 2010 to 2012. The researchers argue that mobile health clinics are an effective delivery model for underserved communities with poor health status and frequent use of emergency departments.
Preventing Infection After Hip and Knee Replacements
IHI's Project JOINTS initiative is helping to speed the adoption of proven practices to prevent surgical site infections (SSIs) after hip and knee replacement surgery. This article describes simple, affordable, evidence-based practices organizations can put into place to reduce such infections.
Enhancing the Effectiveness Effectiveness of Follow-Up Phone Calls to Improve Transitions in Care: Three Decision Points
This study used a nonsystematic review of the literature focused on the use of telephone follow-up to improve postdischarge processes and reduce avoidable readmissions, and examined use of such calls among organizations participating in the STate Action on Avoidable Rehospitalizations (STAAR) initiative.
Healthy Employees, Lower Premiums and Costs
Employers, providers, and health plans have a new shared aim of collaboratively working together to improve the health of employees and reduce health care costs.
A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost
This white paper provides suggested measures for the three dimensions of the Triple Aim, accompanied by data sources and examples, and describes how these measures might be used along with process and outcome measures for particular projects to create a learning system to achieve the Triple Aim.
Can Sustainable Hospitals Help Bend the Health Care Cost Curve?
This study tracked sustainability practices at nine hospitals and health systems over five years, and revealed significant savings in waste management, energy use, and operating room supply procurement.
More Quality Measures versus Measuring What Matters: A Call for Balance and Parsimony
The authors propose a policy that quality measurement should be parsimonious: to measure quality, outcomes, and costs with appropriate metrics that are selected based on needs of patients, providers, and payers.
Eliminating Waste Without Hurting Quality
This article describes IHI's work with health systems to help them identify and remove waste from their operations.