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Improving Behavioral Health Care in the Emergency Department and Upstream
This white paper provides actionable guidance for hospital emergency departments and their community partners to create a compassionate, seamless, and effective system of care for mental health and substance use disorder patients who present to the ED.
Framework for Effective Board Governance of Health System Quality
This white paper presents an actionable framework with the core processes needed for effective board governance of all dimensions of health system quality; an assessment tool; and support guides for three central knowledge areas for trustee oversight of quality.
IHI Psychology of Change Framework
This white paper is a guide for all leaders interested in understanding the underlying psychology of change and leveraging its power to impact quality improvement efforts: to achieve breakthrough results, sustainably, at scale.
IHI Innovation System
Drawing on IHI's nearly 30 years of experience with innovation, this white paper provides a detailed description of IHI’s innovation system, including 90-Day Learning and Testing Cycles, and describes how a health care organization might create its own internal innovation system that focuses on improving health care delivery.
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.
IHI Framework for Improving Joy in Work
With burnout and staff turnover in health care continuing to rise at alarming rates, this white paper describes four steps leaders can take to improve joy in work; a framework with nine critical components for ensuring a joyful, engaged workforce; key change ideas; and measurement and assessment tools.
A Framework for Safe, Reliable, and Effective Care
The framework described in this white paper brings together the strategic, clinical, and operational concepts that are critical to creating a "system of safety" that achieves safe, reliable, and effective care.
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.
Achieving Health Equity: A Guide for Health Care Organizations
This white paper presents a framework for health care organizations to improve health equity in the communities they serve, guidance for measuring health equity, a case study of one organization that has strategically integrated health equity throughout its system, and a self-assessment tool for organizations to gauge their current focus on and efforts to improve health equity.
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.
"Conversation Ready": A Framework for Improving End-of-Life Care (Second Edition)
This white paper presents a framework built on five core principles to help health care organizations and clinicians develop reliable processes to engage patients in conversations about their wishes for end-of-life care, steward that information, and provide respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.
Comparing Lean and Quality Improvement
This IHI white paper provides detailed descriptions of Lean and the IHI approach to quality improvement, including the basic concepts and principles of each approach, how they are similar and different (in history and approach), and for what purposes each approach is the most appropriate.
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.
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.
Using Care Bundles to Improve Health Care Quality
This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.
Care Coordination Model: Better Care at Lower Cost for People with Multiple Health and Social Needs
This white paper outlines methods and opportunities to better coordinate care for people with multiple health and social needs, and reviews ways that organizations have allocated resources to better meet the range of needs in this population. The elevated cost of care in this population offers a tremendous opportunity to craft a service delivery plan that meets their needs more effectively at a significantly lower cost.
Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care
This white paper presents a framework centered on five primary drivers of an exceptional experience of care that hospitals can use to design, test, and implement changes, weaving them into the fabric of daily work to achieve outstanding results. Tips on how to get started, exemplars from a variety of hospitals, and references for further evidence and guidance are also included.
Hospital Inpatient Waste Identification Tool
The Hospital Inpatient Waste Identification Tool provides a systematic method for hospital frontline clinical staff, members of the financial team, and leaders to identify clinical and operational waste and subsequently prioritize and implement waste reduction initiatives that will result in cost savings for the organization.
The Pursuing Perfection Initiative: Lessons on Transforming Health Care
This paper describes the learning from the eight-year Pursuing Perfection initiative, whose goal was to learn if and how health care organizations could make dramatic improvements in performance across the organization. Select innovations and results stemming from the initiative are presented.
Respectful Management of Serious Clinical Adverse Events
This white paper introduces an overall approach and tools designed to support two processes: the proactive preparation of a plan for managing serious clinical adverse events, and the reactive emergency response of an organization that has no such plan.
Reducing Costs Through the Appropriate Use of Specialty Services
This white paper describes a framework that primarily focuses on changing professional practice culture by engaging physicians in developing and implementing practice standards that will work best in local circumstances.
Increasing Efficiency and Enhancing Value in Health Care: Ways to Achieve Savings in Operating Costs per Year
This white paper proposes a set of steps health care organizations can undertake to systematically identify and eliminate inefficiencies to create a portfolio of work leading to a 1 percent to 3 percent savings in operating costs per year.
Using Evidence-Based Environmental Design to Enhance Safety and Quality
The purpose of this white paper is to show health care leaders how, evidence-based environmental design interventions can measurably enhance the care they provide.
Planning for Scale: A Guide for Designing Large-Scale Improvement Initiatives
This white paper may be used as a preparation tool by those that are planning to take effective health care practices from one setting or isolated environment and to make them ubiquitous across a health care system, region, state, or nation.
Whole System Measures
This white paper describes and promotes the use of a system of metrics, called the Whole System Measures, to measure the overall quality of a health system and to align improvement work across a hospital, group practice, or large health care system.