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Addressing Institutional Racism in Healthcare Organizations
This article presents strategies in five core areas to guide health care leaders as they seek to address institutional racism in their organizations.
Leading Quality Across a System
This article describes five core drivers for effective health care chief quality officers (CQOs) in their role of overseeing and aligning quality efforts within and across health care systems.
Invite the Next Generation to Lead
Reflecting on lessons from 10 years of the IHI Open School, this article shares five practical ideas for how can health care organizations can engage the next generation of health professionals as powerful change agents and leaders.
Leadership and Vision for a Culture of Safety
Leaders seeking to transform their health care organization’s culture would do well to commit focused attention on six key areas described in this article.
Leading a Culture of Safety: A Blueprint for Success
Creating a culture of safety in health care settings has proven to be a challenging endeavor, and there is a lack of clear actions for organizational leaders to take in developing such a culture. This guide provides chief executive officers and other health care leaders with a useful tool for assessing and advancing their organization’s culture of safety, and can be used to help determine the current state, inform dialogue with the board and leadership team, and help leaders set priorities.
Moral Choices for Today’s Physician
In this essay, Don Berwick considers moral choices physicians face personally, organizationally, and globally and exhorts them to understand that the health of humanity depends on their speaking out against the social injustice of overpricing drugs and services, mass incarceration, and the lack of environmental responsibility.
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.
Health Care Leaders: "Bill or No Bill, We Still Have Work to Do"
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).
Breaking the Rules for Better Care
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.
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.
Restoring Joy in Work for the Healthcare Workforce
While burnout in the health professions is alarmingly high, restoring joy in work is more than just reducing burnout. This article describes four key steps that leaders can take to restore, foster, and nurture joy in the health care workforce.
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.
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."
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.
10 New Rules to Accelerate Healthcare Redesign
This article describes ten "new rules" that were developed and are being tested by members of the IHI Leadership Alliance as a set of guiding principles to help accelerate their progress toward delivering on the full promise of the Triple Aim. The authors also provide brief case examples demonstrating how Alliance member organizations are enacting some of these rules.
Governing for Improved Health
Hospital trustees play an important role in community health. Health care organizations need to see themselves as part of a larger health care continuum, and a key asset within their communities to promote and ensure health.
Change from the Inside Out: Health Care Leaders Taking the Helm
Drawing on the thinking and vision of the newly formed IHI Leadership Alliance, this article describes a set of emerging care design principles to usher in unprecedented performance, driven less by laws, regulations, and payment changes and more by innovations and true collaborations with patients, workforces, and communities. The authors note that simultaneously delivering better care and better health at lower per capita costs cannot be done without the courage and commitment of leaders in health care.
Escape Velocity: Going from Incremental to Exponential Results in Achieving the Triple Aim
To escape the powerful forces that bind us to current models of care, IHI authors propose that we need inspired leadership and an ambitious aim — and we must accelerate the pace of improvement in health care and innovate with communities and organizations to improve health, improve the care experience, and reduce costs (the Triple Aim).
Harvard Medical School Academic Innovations Collaborative: Transforming Primary Care Practice and Education
The goal of the two-year Harvard Medical School Academic Innovations Collaborative (AIC) was to transform primary care education and practice by engaging hospital- and community-based primary care teaching practices in building highly functional teams, managing populations, and engaging patients. The AIC built on models developed by Qualis Health and the Institute for Healthcare Improvement, optimized for the local academic medical center context.
Leading Improvement in Population Health
The new mental models for leading population health require leaders to blend the best of their capability to manage health care delivery performance and quality improvement with a set of skills that are about co-production — that is, forming productive relationships with community partners and with patients, families, and the broader population.
Doing Right by Our Patients When Things Go Wrong in the Ambulatory Setting
The PROMISES Project (Proactive Reduction of Outpatient Malpractice: Improving Safety, Efficiency, and Satisfaction) released this statement, suggesting that disclosure and apology are essential first steps to learning from medical errorsthat may have harmed patients and families. The accompanying "Guidelines for Responding to Adverse Events" present practical tips and FAQs.
Making Improvement Interventions Happen — The Work Before the Work: Four Leaders Speak
IHI Senior Fellow Paul Batalden asked four expert leaders how they prepare for making improvement interventions in health care happen. What they reveal provides inspiration, guidance, and practical knowledge.
High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs
Leaders at all levels in care delivery organizations, not just senior executives, are struggling with how to focus their leadership efforts and achieve Triple Aim results — better health, better care, at lower cost — for the populations they serve. High-impact leadership is required. This white paper presents three interdependent dimensions of leadership that together define high-impact leadership in health care: new mental models, High-Impact Leadership Behaviors, and the IHI High-Impact Leadership Framework.
Promising Care: How We Can Rescue Health Care by Improving It
This book collects 16 landmark speeches given by Donald M. Berwick (including all of his speeches delivered at IHI’s annual National Forum on Quality Improvement in Health Care from 2003 to 2012) that clearly show why our medical systems don’t reliably contribute to our overall health. Berwick offers a vision for making our systems better — safer, more effective, more efficient, and more humane.