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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.
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.
Project JOINTS: What Factors Affect Bundle Adoption in a Voluntary Quality Improvement Campaign?
This article examines how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign — Project JOINTS, an IHI-led initiative — could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty).
Did a Quality Improvement Collaborative Make Stroke Care Better?
In this study, 24 NHS hospitals in the Northwest of England were randomly allocated to participate either in Stroke 90:10, a quality improvement collaborative (QIC) based on the IHI Breakthrough Series (BTS) model, or in a control group giving normal care. Some aspects of stroke care modestly improved during the collaborative.
Understanding Bundles: An IHI Faculty Conversation
IHI faculty for the Rethinking Critical Care seminar discuss and try to clarify some important and often misunderstood points about implementing care bundles (such as the Ventilator Bundle and the Central Line Bundle).
Remeasure Lactate If Initial Lactate Was Elevated Goal
Compliance with this element in the Severe Sepsis Bundles (as part of the 6-Hour Septic Shock Bundle) is defined as the percent of patients following septic shock or lactate ≥4 mmol/L (36 mg/dl) identification for whom the lactate was repeated during the first 6 hours after presentation.
Compliance with Severe Sepsis Bundles (with the Goal of Reducing Mortality)
Measuring compliance with the Severe Sepsis Bundles will allow your team to judge how well your institution is performing in achieving the goal of 100 percent compliance with all Severe Sepsis Bundles elements.
Severe Sepsis Bundles
The Severe Sepsis Bundles include the Severe Sepsis 3-Hour Rescuscitation Bundle and the 6-Hour Septic Shock Bundle. The Severe Sepsis Bundles have been revised in conjunction with the updated 2012 International Guidelines for Management of Severe Sepsis and Septic Shock.
Reliability: Severe Sepsis Bundles
The percent of cases of severe sepsis and/or septic shock for whom all applicable Severe Sepsis Bundles elements are completed.
WIHI: A Partnership to Reduce Deaths from Sepsis
January 24, 2013 | This WIHI explores how North Shore–Long Island Jewish Health System has reduced its sepsis mortality rate significantly, and what others can learn from their progress.
How-to Guide: Prevent Obstetrical Adverse Events
This How-to Guide describes the essentials elements of preventing obstetrical adverse events, including the safe use of oxytocin and key evidence-based care components in the IHI Perinatal Bundles.
Profiles in Improvement: Katharine Luther, Vice President, IHI
IHI Vice President Kathy Luther describes her career in health care quality improvement, and how her current IHI work includes getting finance and clinicians to work together to impact cost and quality.
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.
A Team Gives Mobility to Ventilated Patients
Patients in critical care are usually kept immobile and heavily sedated, but there’s growing evidence that mobility can help a patient's long-term recovery.
Zero VAP Rate in the ICU by Reducing Time on Sedation
Mercy Hospital (Buffalo, New York, USA) has sustained zero ventilator-associated pneumonias in the ICU by reliably implementing the IHI Ventilator Bundle, with a special focus on reducing the amount and duration of sedation for patients on ventilators in the ICU.
Impact of the ventilator bundle on ventilator-associated pneumonia in intensive care unit
This article examines the adoption of the ventilator bundle elements to prevent adverse events in ventilated patients, including ventilator-associated pneumonia, in 415 ICUs in 250 US hospitals.
Passport Exclusive: Taking Steps to Improve Patient Mobility
This video describes the effects of early activity for patients in the intensive care unit.
Passport Exclusive: Developing, Testing, and Locally Adapting Sedation Protocols
In this video, IHI faculty member Dr. Terry Clemmer details the steps to develop and test a sedation protocol at your organization.
Passport Exclusive: The Sepsis Bundle
In this video, IHI faculty member Dr. Sean Townsend gives an overview of the Sepsis Bundle and how to get started on this work.
Passport Exclusive: Providing Reliable Perinatal Care by Using Clinical Bundles
In this video, Sue Leavitt-Gullo, MS, RN, Director for IHI, reviews providing reliable perinatal care through usings clinically proven bundles.
Central line bundle implementation in US intensive care units and impact on bloodstream infections
This study examines the extent of adoption of Central Line Bundle elements in US intensive care units and determines their effectiveness in preventing central line-associated bloodstream infections.
JAMA Patient Page: Ventilator-associated pnuemonia
This resource presents information on risk factors, prevention, diagnosis and testing, and treatment of ventilator-associated pneumonia.
Annotated Bibliography for Preventing Ventilator-Associated Pneumonia
This annotated bibliography presents selected literature for the elements of the IHI Ventilator Bundle and preventing ventilator-associated pneumonia.
How-to Guide: Prevent Ventilator-Associated Pneumonia (Pediatric Supplement)
This How-to Guide specifically tailored for pediatrics describes key evidence-based care components for preventing ventilator-associated pneumonia.
Annotated Bibliography for Preventing Central Line-Associated Bloodstream Infections
This annotated bibliography presents selected literature for the elements of the IHI Central Line Bundle and prevention of central line-associated bloodstream infections.