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WIHI: The Careful and Kind Patient Revolution
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December 7, 2017 | Victor Montori argues that it is time for providers to look up from strict protocols and guidelines long enough to get curious about their patients' lives and begin to minimize barriers to better health, not add to them.
WIHI: When Patients Feel as Powerless as Hostages
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November 21, 2017 | Is "hostage" the right way to describe how patients and family members sometimes feel when they're trying to get the care they need?
Discharge to Assess: “Flipping” Discharge Assessment from Hospital to Home
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Discharge to Assess (D2A) (also referred to as "flipped discharge") is a redesign of the care process at Sheffield Teaching Hospitals in the UK that involves assessing a patient’s needs after discharge in the patient’s own home rather than in the hospital. Activities that traditionally happen at the end of a hospital admission are instead performed successfully and safely at home, thus enabling patients who are medically ready to go home earlier and spend less time in the acute care setting.
Experience-Based Co-Design of Health Care Services
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This case study from the IHI/Commonwealth Fund International Program for US Health Care System Innovation describes experience-based co-design (EBCD), developed in the UK, which brings together narrative-based research with service design methods to catalyze a process wherein patients and staff work together to design, implement, and test improvements to health care services.
Postal Service “Call & Check Visits” for Isolated, Frail Elderly in the Community
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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.
Personalized Perfect Care
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The authors propose measuring quality from the patient’s perspective as an expression of his or her personalized health needs. The Personalized Perfect Care Bundle combines several distinct measures into one and is scored as “all-or-none,” with the patient’s care being counted as complete if he or she has met all of the quality measures for which he or she is eligible.
The Age-Friendly Health System Imperative
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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
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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.
When Patients and Their Families Feel Like Hostages to Health Care
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A power imbalance often still exists in the patient-provider relationship, particularly when high-stakes health decisions have to be made. This article explores this dynamic, likening it to “hostage bargaining syndrome” — that is, the patient behaves as if negotiating for their health from a position of fear and confusion -- and suggests ways to counteract this behavior.
Respecting End-of-Life Care Wishes
Current average rating is 5 stars.
This article presents five core principles to guide providers and health care organizations in developing more reliable systems to receive, record, and ultimately respect patients’ wishes for end-of-life care.
WIHI: Greater Satisfaction, Outcomes, and Savings with Self-Administered Care
Current average rating is 5 stars.
July 13, 2017 | Patients undergoing dialysis typically do so in a hospital or health care facility. Most people don't question the need to have experienced health care staff on hand or what's considered a safe environment for the treatments. But that might be changing.
The Value of Teaching Patients to Administer Their Own Care
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Some patients are learning how to administer their own treatments outside of the health care setting — from pain management, to dialysis, to intravenous antibiotics. This article describes five keys to a successful approach to implementing patient-administered self-care and provides examples of organizations that have established such initiatives.
Patient-Administered Self-Care
Current average rating is 3 stars.
For specific procedures and treatments, health care providers can train individuals to administer their own self-care, on their own time, without supervision or dependence on a licensed professional. Patient-administered self-care can occur either in traditional health care facilities or another location of the patient's choosing outside of a facility.
WIHI: Creating Age-Friendly Health Systems
Current average rating is 4 stars.
April 20, 2017 | Best practices for older or elderly patients aren’t always top of mind, and practitioners don't always know how they might do things differently. Now, a small group of health systems is about to test some new, evidenced-based interventions that promise to model for the rest of the industry.
WIHI: Who's Your Health Care Proxy?
Current average rating is 4 stars.
April 6, 2017 | Situations may arise when we need a trusted person to communicate with doctors and nurses on our behalf. And, if facing care decisions near the end of life, a trusted health care proxy can play a crucial role in ensuring our wishes are respected.
WIHI: What We're Learning about Patients with Complex Needs
Current average rating is 4 stars.
March 23, 2017 | There’s a lot of attention being paid to developing new models to care for and support patients with multiple, complex health problems. And for good reason.
Reliably Addressing "What Matters" Through a Quality Improvement Process
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A practical quality improvement approach can help to ensure that processes are in place to assist nurses in devoting time to reliably inquire about “what matters” to each patient at every encounter
WIHI: Practicing Respect and Preventing Harm
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February 9, 2017 | Most of us know what it feels like to have an interaction with someone that can feel rushed, incomplete, maybe even abrupt or downright rude. What are the consequences of these encounters?
Supporting the Supporters: What Family Caregivers Need to Care for a Loved One with Cancer
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Patients with cancer who live at home often need to lean on family members for support. Not surprisingly, family caregivers themselves also require support, so that they can be effective and maintain their own well-being. This article presents a four-part framework for supporting cancer patient caregivers.
Building a Culture of Improvement at East London NHS Foundation Trust
Current average rating is 5 stars.
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.
WIHI: Engaging and Supporting Family Caregivers
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October 20, 2016 | A lot has been said and written over the years about the important role family caregivers play on behalf of loved ones with various health conditions and disabilities. But acknowledgment of the estimated 42 million family caregivers in the US alone hasn’t always translated into needed support.
WIHI: Improving Patient Experience: What's Working, What's Not
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October 6, 2016 | With so much focus on improving patient satisfaction scores and patient-centered care, are patients and family members feeling more positive about the experiences they’re having in the US health care system? Are they feeling more connected to their care teams?
Essentials for Improving Service Quality in Cancer Care
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Informed by site visits to cancer care centers and interviews with cancer patients, family members, clinicians, and health care leaders, the authors formulate six essentials for improving cancer care service quality.
WIHI: The New World of Co-producing Health and Health Care
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March 24, 2016 | When we say patients and clinicians should be “co-producing health and health care,” this requires a paradigm shift and, for medical staff, letting go of seeing themselves as the sole engines and creators of the “product” known as health care. What if health care isn’t a product at all, but a service which both “sides” engage in and have an opportunity to shape?
WIHI: Morality Matters: How to Reset the Mission of Quality Improvement
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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.
  
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