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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.
A Framework for Scaling Up Health Interventions: Lessons from Large-Scale Improvement Initiatives in Africa
Scale-up of complex health interventions to large populations is not a straightforward task. This article details a sequence of four steps for taking a health intervention to full scale, properties that facilitate adoption of the new ideas, and the infrastructure required to support the scale-up.
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.
A Promise to Learn – A Commitment to Act: Improving the Safety of Patients in England
An independent group of experts, chartered to review issues that compromise patient safety in England’s National Health Service (NHS), report ten recommendations to improve systems, safety, and culture in the NHS. These recommendations are broadly applicable to other health care institutions and settings.
A Quality Improvement Model for the Rapid Scale-up of a Program to Prevent Mother-to-Child HIV Transmission in South Africa
This article describes how a group of NGOs and government partners jointly developed the "Accelerated Plan" (A-Plan) to successfully improve services at health care facilities in South Africa to prevent mother-to-child transmission (PMTCT) of HIV.
A Six-Country Collaborative Quality Improvement Initiative to Improve Nutrition and Decrease Mother-to-Child Transmission of HIV
This article is the first report of the effectiveness of using quality improvement in a large-scale multicountry effort in Africa to improve infant survifal by reducing postnatal maternal-to-child transmission of HIV in breast feeding HIV-positive mothers.
Accelerating Global Improvements in Health Care Quality
Many lower-resourced countries, historically focused on expanding access to essential health services, now place a similar priority on higher quality. In this Viewpoint, the authors describe how universal health coverage, a key Sustainable Development Goal, is meaningful only if the access it ensures is to effective and safe health services.
ACOs: A Step in the Right Direction
Accountable care organizations (ACOs) can be a step forward in the journey toward aligning payment and delivery mechanisms to achieve better care and better health at lower costs. This article includes recommendations that may serve to accelerate our collective efforts toward achieving cost- and quality-related improvements at scale.
Applying Quality Improvement Approaches to Reduce Mother-to-Child HIV Transmission and Improve Health and Nutrition Care in Five Countries
This article describes the application of quality improvement (QI) methods, as part of the Partnership for HIV-Free Survival, to support governments and facility staff in five African countries in reducing maternal-to-child transmission of HIV.
Blending Participatory Action Synthesis and Meta-Ethnography: An Innovative Approach to Evaluating Complex Community Health Transformation
This article describes an innovative participatory approach to evaluation of a community transformation initiative, the 100 Million Healthier Lives SCALE (Spreading Community Accelerators through Learning and Evaluation) initiative, that involved up to 18 communities across the US.
Building an Equitable System for Postsecondary Education Transition and Success
Based on IHI’s background in health and health care, we recognize certain similarities between the education and health care sectors, both in terms of their strengths and assets and also some systemic challenges both sectors face. The framework presented in this document focuses on both "Whole Person" and "Whole Community" to guide work to achieve student well-being and community well-being, now and in the future.
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.
Choices for the "New Normal"
The author reflects on the COVID-19 pandemic and six areas where we face decisions about long-term change in the health care system: the speed of learning, standards, working conditions, proximity, preparedness, and equity.
Crossing the Quality Chasm in Resource-Limited Settings
This perspective piece discusses why scale-up is the foundation necessary to deliver effective health care to the poor and describes a vision for a global quality improvement movement in resource-limited areas.
Developing Capacity for Learning Community Systems: Experiences from the 100 Million Healthier Lives SCALE Initiative
This paper explores the capabilities that contribute to community transformation and the common pathways followed by communities in the 100 Million Healthier Lives SCALE (Spreading Community Accelerators through Learning and Evaluation) initiative in their transformation journeys towards a “Culture of Health.”
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.
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).
Ethiopia Health Care Quality Initiative: Design and Initial Lessons Learned
The Ethiopian Federal Ministry of Health and IHI co-designed a three-pronged approach to accelerate health system improvement nationally, which included developing a national health care quality strategy, building quality improvement (QI) capability at all health system levels, and introducing scalable QI collaboratives across four regions.
Evaluating large-scale health programmes at a district level in resource-limited countries
This paper reviews several evaluation designs, proposes a set of principles to capture information on context, and provides an implementation-related example from South Africa to underline the strengths of a proposed tool to systematically monitor changing dynamics in project implementation.
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).
Fostering HIV Program Quality to Achieve Epidemic Impact
The official journal of the International AIDS Society (IAS) – AIDS – has published an open access special supplement this month on the importance of quality improvement in HIV/AIDS care. The supplement was co-edited by IHI Senior Vice President, Dr. Pierre Barker, who also co-authored three articles in the issue.
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.
Impact Evaluation of a Quality Improvement Intervention on Maternal and Child Health Outcomes in Northern Ghana: Early Assessment of a National Scale-up Project
This study of the early phase of Project Fives Alive! to improve key maternal and child health outcomes in Ghana demonstrates that the quality improvement (QI) approach of testing and implementing simple, low-cost, locally-inspired changes has the potential to lead to improved health outcomes at scale both in Ghana and other low- and middle-income countries.
Improvement Report: Advanced Clinic Access Initiative
The Department of Veterans Affairs, Veterans Health Administration, a national public sector health care system in the US consisting of 162 hospitals and more than 850 community and facility-based clinics, improved access resulting in significant decreases in waiting times despite a 23 percent increase in demand for health care services and an increase in supply of only 2.3 percent.