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"Conversation Ready": A Framework for Improving End-of-Life Care
This white paper presents a framework built on five core principles to help organizations begin the process of becoming "Conversation Ready" — that is, to develop reliable processes to engage patients in conversations about their wishes for end-of-life care, steward that information, and then respect those wishes at the appropriate time.
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.
A Framework for Spread: From Local Improvements to System-Wide Change
A key factor in closing the gap between best practice and common practice is the ability of health care providers and their organizations to rapidly spread innovations and new ideas.
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.
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.
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.
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.
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.
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.
Engaging Physicians in a Shared Quality Agenda
This white paper presents a framework on which hospital leaders might build a written plan for physician engagement in quality and safety.
Execution of Strategic Improvement Initiatives to Produce System-Level Results
This paper describes the essential elements for strategic improvement: Will (the will to improve), Ideas (altneratives to the status quo), and Execution (implementing a portfolio of projects that get results).
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.
Going Lean in Health Care
Lean management principles have been used effectively in manufacturing companies for decades, particularly in Japan. IHI believes that lean principles can be successfully applied to the delivery of health care.
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.
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.
Idealized Design of Perinatal Care
Reviews of perinatal care have consistently pointed to failures in communication among the care team and documentation of care as common factors in adverse events that occur in labor and delivery. This white paper provides detail about IHI's Idealized Design process and examines some of the initial work of the Idealized Design of Perinatal Care innovation project.
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.
IHI Global Trigger Tool for Measuring Adverse Events (Second Edition)
This white paper provides information on the development and methodology of the IHI Global Trigger Tool, enabling the ability to accurately identify adverse events and measure the rate of adverse events over time.
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.
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 White Papers
IHI’s Innovation Series white papers are designed to share the problems IHI is working to address; the ideas, changes, and methods we are developing and testing to help organizations make breakthrough improvements; and early results where they exist.
Improving the Reliability of Health Care
This white paper describes principles and strategies used successfully in other industries to help evaluate, calculate, and improve the overall reliability of complex systems, and explains the application of reliability principles to health care.
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.
Innovations in Planned Care
IHI is developing and testing a new design for the delivery of primary care for all patients, which reaches high levels of effectiveness, efficiency, and patient-centeredness. This design is based on the idea that in order to ensure reliable care delivery, every patient should have a plan for his or her care.
Leadership Guide to Patient Safety
This white paper presents eight steps that are recommended for leaders to follow to achieve patient safety and high reliability in their organizations.