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Integrating Behavioral Health in the Emergency Department and Upstream
This IHI Innovation Report discusses barriers to integrating behavioral health in the ED, and presents 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.
WIHI: Health Care Innovation and R&D: Taking Stock at Ten Years
November 9, 2017 | The health care quality improvement movement has rallied around some significant innovations over the years, many of which have had a lasting impact.
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.
Community-Based Behavioral Health Integration: A Focus on Community Health Workers to Support Individuals with Behavioral Health and Medical Needs
The aim of the IHI 90-day innovation project described in this report was to develop an approach to managing patients with comorbid behavioral health and medical needs in community-based settings. The report identifies four populations who could be well-served by community-based behavioral health integration and potential interventions to support these populations; describes the role and key functions of community health workers; and discusses key areas for future research and improvement.
Gaining Ground: Care Management Programs to Reduce Hospital Admissions and Readmissions Among Chronically Ill and Vulnerable Patients
Preventable hospital admissions and readmissions are indicators of health system fragmentation associated with suboptimal patient outcomes and avoidable costs of care. This synthesis report looks at three case studies that illustrate the potential of care management programs to address this problem by improving care coordination and transitions among high-risk patients.
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.
A Framework for Selecting Digital Health Technology: IHI Innovation Report
The intent of this IHI Innovation Project was to scan for health technology innovations that will provide the greatest value to health systems working to achieve the IHI Triple Aim. Using validated approaches to software selection, we created a Digital Health Selection Framework (DHSF) to guide patients, providers, and payers through the procurement of such technology.
Integrating Behavioral Health and Primary Care: IHI 90-Day R&D Project Final Summary Report
This IHI 90-day R&D project report examines the basic principles underlying existing, exemplary integration models and integrated organizations, identifies the core components required for success, and assesses how (or if) they are operationalized by each of the different models. The aim is to understand the core principles underlying successful integration of behavioral health services into primary care.
Integrating Behavioral Health into Primary Care
This article discusses ideas for overcoming common challenges in treating patients with medical and behavioral issues in a more integrated fashion; presents a set of Collaborative Care Components for Integrated Care that have shown results in reducing cost and improving outcomes and satisfaction; and describes layers of service in full-spectrum integrated care.
Counties of Interest: Achieving Better- or Worse-Than-Expected Health Outcomes: IHI 90-Day R&D Project Final Summary Report
The intent of this project was to identify counties in the US with health outcomes significantly better or worse than one would expect based in their socioeconomic status. Once these counties were identified, we sought to understand what drivers may have led to those results.
Enhancing the Effectiveness Effectiveness of Follow-Up Phone Calls to Improve Transitions in Care: Three Decision Points
This study used a nonsystematic review of the literature focused on the use of telephone follow-up to improve postdischarge processes and reduce avoidable readmissions, and examined use of such calls among organizations participating in the STate Action on Avoidable Rehospitalizations (STAAR) initiative.
STAAR Issue Brief: The Effect of Medicare Readmissions Penalties on Hospitals’ Efforts to Reduce Readmissions
To understand the impact of the Medicare financial penalties for hospitals that have higher than expected rates of 30-day readmissions for select conditions, this Issue Brief synthesizes perspectives from leaders of state hospital associations, quality improvement organizations, and hospitals representing a range of performance and experiences in readmissions and their reduction.
Healthy Employees, Lower Premiums and Costs
Employers, providers, and health plans have a new shared aim of collaboratively working together to improve the health of employees and reduce health care costs.
Recasting Readmissions by Placing the Hospital Role in Community Context
The authors suggest that it is advantageous to view readmissions within a broader systems and community context that effectively engages all stakeholders to cooperatively improve outcomes.
Improving Graduate Medical Education: Innovations in Primary Care and Ambulatory Settings: IHI 90-Day R&D Project Final Summary Report
This report includes best practices and practical examples of graduate medical education programs that are redesigning training to equip residents and students with the skills needed for primary care practice in a rapidly changing US health care landscape.
Approaches to Training Faculty at Academic Medical Centers to Ensure That Clinical Trainees Become Effective Improvers: IHI 90-Day R&D Final Summary Report
This IHI 90-day R&D project focused on assisting academic medical centers and graduate medical education programs in becoming aligned and capable in quality and safety programming.
WIHI: Gaining Ground: Quality Improvement and US Medical Residency
October 25, 2012 | A changing health care system now demands that medical residents not only possess skills to diagnose and treat patients, but also to to improve the quality of care, protect patients from harm, work in multidisciplinary teams, manage care transitions, and more.
Network Theory: IHI 90-Day R&D Project Final Summary Report
This IHI 90-Day R&D Project includes a thorough literature review on the topics of network theory, network terminology, and social network analysis; personal interviews with network experts across many disciplines; and a draft framework for an enhanced network.
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.
An Early Look at a Four-State Initiative to Reduce Avoidable Hospital Readmissions
The STate Action on Avoidable Rehospitalizations initiative (STAAR) has been successful in aligning numerous complementary initiatives within a state, developing statewide rehospitalization data reports, and mobilizing a sizable number of hospitals to work on reducing rehospitalizations.
The Pursuing Perfection Initiative: Lessons on Transforming Health Care
This paper describes the learning from the eight-year Pursuing Perfection initiative, whose goal was to learn if and how health care organizations could make dramatic improvements in performance across the organization. Select innovations and results stemming from the initiative are presented.
Whole System Measures
This white paper describes and promotes the use of a system of metrics, called the Whole System Measures, to measure the overall quality of a health system and to align improvement work across a hospital, group practice, or large health care system.
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).
Innovations in Planned Care
IHI is developing and testing a new design for the delivery of primary care for all patients, which reaches high levels of effectiveness, efficiency, and patient-centeredness. This design is based on the idea that in order to ensure reliable care delivery, every patient should have a plan for his or her care.
Reducing Hospital Mortality Rates (Part 2)
In the first white paper, IHI introduced an analytical tool for understanding hospital mortality rates (hospital standardized mortality ratio, or HSMR). This second white paper presents the experience of hospitals that implemented evidence-based interventions proven to reduce mortality and their early results.