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WIHI: Strategic Pathways to Population Health
June 7, 2018 | Health systems face numerous challenges in their efforts to improve population health. What makes a comprehensive strategy, and where do health care systems start?
Pathways to Population Health
Accelerate your journey to population health. Pathways to Population Health aims to help health care organizations accelerate their individual and collective efforts to improve health, well-being, and equity within communities.
Integrating Behavioral Health in the Emergency Department and Upstream
This report discusses barriers to integrating behavioral health in the ED; presents the results of a literature scan of existing models to address behavioral health needs in the ED and in communities; and identifies five drivers (emerging from six key themes from existing approaches) that form the building blocks of a theory of change for making improvements in this area.
Creating Age-Friendly Health Systems: How to Meet the Needs of a Growing Population of Older Adults
This article explains an emerging care model for older adults focused on the “4Ms” of Age-Friendly Health Systems — What Matters, Mobility, Medications, and the Mentation of older adults — that is in the testing phase at five health systems, as part of the Creating Age-Friendly Health Systems initiative led by IHI.
Postal Service “Call & Check Visits” for Isolated, Frail Elderly in the Community
This case study from the IHI/Commonwealth Fund International Program for US Health Care System Innovation describes the "Call & Check Visits” program developed by Jersey Post in Jersey, British Channel Islands, in which postal service workers check on isolated, frail elderly residents in the community, deliver prescription refills, remind clients of upcoming medical visits, and ask about their health and social needs.
The Age-Friendly Health System Imperative
The article gives an overview of how five early-adopter US health systems — working in partnership with IHI and The John A. Hartford Foundation as part of the Creating Age-Friendly Health Systems initiative — are testing prototype models for age-friendly care using continuous improvement efforts to streamline and enhance new approaches to geriatric care.
Creating Age-Friendly Health Systems: A Vision for Better Care of Older Adults
This article describes the background, evidence-based changes, and testing, scale-up, and spread strategy that are part of the design of the Creating Age-Friendly Health Systems initiative to improve care for older adults.
WIHI: How to Fail Forward (Quickly) on the Road to Population Health
June 29, 2017 | Learning from failure is an important part of the quality improvement process in health care. Groups focused on improving the health of communities are also discovering the value of "failing forward;" leveraging the learning from failure to accelerate progress.
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.
Improving the Health of Populations
With the rapid growth of accountable care organizations, health care delivery organizations are expanding their scope of accountability and changing how they identify and define their immediate goals and longer-term aspirations. Yet the terms to describe this approach — “population health” and “population management” — are often used interchangeably. This article makes the case that a common language is needed, provides clarification around terminology, and offers five questions for health care leaders to explore.
Healthy Shelby: A Triple Aim Improvement Story
This Triple Aim improvement story examines the work of the Healthy Shelby Initiative in Tennessee, a community pursuing a regional focus to improve population health by linking public health, hospitals, health care providers, social service providers, academic institutions, the faith community, local government, and funders to work together to tackle some of the county’s most critical health problems: infant mortality, chronic disease management, and end-of-life care.
WIHI: Relationships Count: Community Health Workers and Team-Based Care
October 15, 2015 | Community health workers (CHWs) are increasingly being utilized to bridge gaps for patients between health care, home, and the community. This WIHI explores the growing interest in CHWs that is sparking some important discussions and the development of innovative programs.
Signature Healthcare: A Triple Aim Improvement Story
By creating a process to improve care for the frail elderly Medicare population with complex needs, and by building the supporting infrastructure in primary care, Signature Healthcare was successful in decreasing emergency department utilization and reducing acute admissions while maintaining patient satisfaction. The organization was a participant in the IHI Triple Aim Community from 2012 to 2014.
Assessing Community Health Needs
This article presents four practical ways hospital leaders can improve the linkage between the community health needs assessment process, community benefit spending, and efforts to improve population health in the communities they serve.
Guide for Developing an Information Technology Investment Road Map for Population Health Management
This article proposes an organized approach with specific steps to help health care organizations invest in population health management information technology, to enhance their chances for a successful transition from volume-based to value-based care.
Cross-Continuum Collaboration in Health Care: Unleashing the Potential
This articles proposes enabling factors for successful cross-continuum collaboration to ensure that relevant post-acute and primary care, as well as community services and supports, are available in a coordinated fashion to meet the needs of patients across the care continuum.
Can the Accountable Care Organization Model Facilitate Integrated Care in England?
Accountable care organizations (ACOs) in the US, in which groups of providers are responsible for the helath outcomes of a designated population, are regarded as having the potential to foster collaboration across the continuum of care. This article contends that ACOs could have a similar role in England’s National Health Service (NHS), provided that the differences in context are taken into consideration before implementing a similar model, adapted to suit the NHS’s strengths.
Pursuing the Triple Aim: The First Seven Years
The concept of the Triple Aim is now widely used, because of IHI’s work with many organizations and also because of the adoption of the Triple Aim as part of the national strategy for US health care. Drawing on IHI's seven years of experience, this article describes the three major principles that guided the organizations and communities working with IHI on the Triple Aim.
Population Health: Creating a Culture of Wellness
This book offers an educational foundation for both professionals and students on the need for population health management has never been more eminent.