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Highly Adoptable Improvement: A Practical Model and Toolkit to Address Adoptability and Sustainability of Quality Improvement Initiatives
This article presents the Highly Adoptable Improvement Model, a practical model and supporting tools developed on the basis of existing theories to help quality improvement (QI) programs design more adoptable approaches that lead to more sustainable improvement.
How to Attribute Causality in Quality Improvement: Lessons from Epidemiology
This article proposes quality improvement and implementation initiatives in health care, regardless of scope and resources, can be enhanced by applying epidemiological principles adapted from Bradford Hill Criteria to strengthen evidence of effectiveness.
Are Quality Improvement Collaboratives Effective? A Systematic Review
In a systematic review of the literature on quality improvement collaboratives, a widely adopted approach to shared learning and improvement in health care, the authors conclude that, overall, the QI collaboratives included in their review reported significant improvements in targeted clinical processes and patient outcomes.
WIHI: QI Takes on Veteran and Chronic Homelessness
October 12, 2017 | Using an improvement science approach and campaign-style momentum, one initiative is dramatically increasing monthly rates of housing homeless individuals across the US, including veterans and the chronically homeless.
A Framework to Guide Practice Facilitators in Building Capacity
Engaging practice facilitators — individuals trained to build the improvement skills of ambulatory care teams — is an increasingly attractive approach, supported by a growing body of evidence that these facilitators are highly effective. This article lays out a framework to guide practice facilitators in building improvement capacity.
QI 102: How to Improve with the Model for Improvement
IHI Open School online courses are multimedia learning modules that offer continuing education credits and teach practical skills to improve quality and safety in health care.
Evaluating Complex Health Interventions: A Guide to Rigorous Research Designs
This publication describes a range of research design approaches that can be used to enhance the rigor of evaluations, thereby improving the quality of the evidence upon which decisions are made and ultimately improving the public’s health.
WIHI: How to Beat the Boring Aspects of QI
June 14, 2017 | Learning from failure is an important part of quality improvement in health care. But what can we learn from improvement efforts that languish or stall due to the inglorious nature of the work itself?
WIHI: Seven Popular Improvement Tools: How (and When) to Use Them
May 18, 2017 | Make sure you’re getting the most out of key improvement tools like PDSA, run chart and control chart, driver diagram, and more — and know when to use them in your improvement work.
A driver diagram is a visual display of a team’s theory of what “drives,” or contributes to, the achievement of a project aim. This clear picture of a team’s shared view is a useful tool for communicating to a range of stakeholders where a team is testing and working.
Quality Improvement Essentials Toolkit
Download these ten essential quality improvement tools to help you with your improvement projects, continuous improvement, and quality management, whether you use the Model for Improvement, Lean, or Six Sigma.
WIHI: Claiming the Edge with Quality Improvement in Communities
February 23, 2017 | Communities in Wisconsin, Scotland, and Boston are building coalitions to change the trajectory of people’s lives and health for the better. Using quality improvement methods and tools to tackle socioeconomic issues is proving to be a game changer in all three locations.
Ensuring Healthcare Improvements Stick
This article describes six management principles, leadership practices, core competencies, and mental models that all play a role in generating and sustaining improvement.
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.
Triple Aim in Canada: Developing Capacity to Lead to Better Health, Care, and Cost
This article reports on the work of nine Canadian health care organizations to embed the Triple Aim (better care, health, and cost) across Canada. The nine sites participated in IHI’s Triple Aim Improvement Community in order to build a solid Triple Aim infrastructure, develop quality improvement capacity, and foster a culture of health care improvement.
Building a Culture of Improvement at East London NHS Foundation Trust
East London NHS Foundation Trust (ELFT) in the UK provides mental health and community services to a diverse and largely low-income population. By establishing an organization-wide culture of continuous improvement, and integrating quality improvement methodology and training at every level of work, ELFT has significantly reduced incidents of inpatient violence and improved staff satisfaction, among other achievements.
Profiles in Improvement: Dr. Hema Magge, IHI Country Director, Ethiopia
Dr. Hema Magge, IHI Country Director in Ethiopia, is leading a program to reduce maternal and newborn mortality in Ethiopia. IHI and its partners are supporting the Ethiopian Federal Ministry of Health in an ambitious agenda to rapidly close gaps in national health outcomes through the coordination of quality planning, quality assurance, and quality improvement.
Can a Quality Improvement Project Impact Maternal and Child Health Outcomes at Scale in Northern Ghana?
This paper discusses the impact of a scale-up phase of Project Fives Alive! to improve maternal and child health outcomes, which used quality improvement methods to identify barriers to care and care-seeking, and then identify, test, implement, and scale up simple and low-cost local solutions to address the barriers. The project and this approach demonstrated improved outcomes at scale.
WIHI: Five Practical Strategies for Managing Successful Improvement Projects
June 30, 2016 | Whether you're about to manage your first improvement project or your 50th, learn strategies you can test and use immediately, examples you can share with colleagues, and valuable tools for your next quality improvement project.
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.
WIHI: Health Care in Motion: Making Sense of a Moving Picture
May 26, 2016 | This WIHI looks at the current state of quality improvement and the new value-driven initiatives that have health care organizations undertaking unprecedented levels of financial risk and undergoing rapid transformation.
Lessons in Leadership for Improvement: Kaiser Permanente’s Improvement Journey Over 10 Years
Kaiser Permanente (KP), the largest managed care organization in the US, has achieved impressive improvements in quality of care over the past decade — a testament to their engaged and effective leadership and staff. Kaiser's achievements also owe a great deal to a unique 10-plus-year collaboration with the Institute for Healthcare Improvement (IHI) — a strategic partnership that accelerated improvement at KP, greatly informed IHI’s own learning, and helped KP build system-wide capacity for improvement.
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."
WIHI: Making Data Work for Quality Improvement
February 25, 2016 | If you’re going to measure, as we know health care improvers must do, you’re going to generate data. But in a world where there increasingly seems no end to what can be tracked and quantified and analyzed, there’s a real danger of creating a lot more data than you truly need.
WIHI: Morality Matters: How to Reset the Mission of Quality Improvement
February 18, 2016 | What is the “true north” for the health care quality improvement movement? What are the questions leaders and champions of quality and safety initiatives must periodically ask themselves as a natural part of the process of seeking dramatic change? For IHI’s founder, Don Berwick, the questions, and the answers, are often moral ones.