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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.
IHI Global Trigger Tool for Measuring Adverse Events (Second Edition)
This white paper provides information on the development and methodology of the IHI Global Trigger Tool, enabling the ability to accurately identify adverse events and measure the rate of adverse events over time.
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.
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.
The Employer-Led Health Care Revolution
Intel is using Lean improvement methods to manage the quality and cost of its health care suppliers in Portland, OR. Their Healthcare Marketplace Collaborative model holds potential for employers, with their large purchasing power, to take the lead in securing better health for local populations and lowering costs for employees and companies alike.
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.
Profiles in Improvement: Enrique Ruelas, MD, IHI Senior Fellow
Dr. Ruelas talks about his pathway from medicine to improvement, his experience leading large-scale change to improve health care in Mexico and Latin America, and his work with IHI.
Reducing Inappropriate Medication Use by Implementing Deprescribing Guidelines
This case study from the IHI/Commonwealth Fund International Program for US Health Care System Innovation describes how a multidisciplinary team of clinical experts in Ottawa, Canada, created a credible, low-cost process for developing and implementing evidence-based deprescribing guidelines and tools for assessing, tapering, and stopping medications that may cause harm or no longer benefit patients.
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.
Experience-Based Co-Design of Health Care Services
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.
Discharge to Assess: “Flipping” Discharge Assessment from Hospital to Home
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.
IHI White Papers
IHI’s Innovation Series white papers are designed to share the problems IHI is working to address; the ideas, changes, and methods we are developing and testing to help organizations make breakthrough improvements; and early results where they exist.
IHI Innovation System
Drawing on IHI's nearly 30 years of experience with innovation, this white paper provides a detailed description of IHI’s innovation system, including 90-Day Learning and Testing Cycles, and describes how a health care organization might create its own internal innovation system that focuses on improving health care delivery.
WIHI: What Can You Learn in 90 Days? IHI’s Innovation Process
March 22, 2012 | This WIHI describes IHI's 90-day R&D process, highlighting the core components, resources, and the steps necessary for an effective 90-day process, as well as the kinds of innovations IHI has put to the test using this process.
Lessons in Leadership for Improvement: Kaiser Permanente’s Improvement Journey Over 10 Years
Kaiser Permanente (KP) has achieved impressive improvements in quality of care over the past decade — a testament to their engaged and effective leadership and staff, and also due in part to a unique 10-plus-year collaboration with the Institute for Healthcare Improvement (IHI) that accelerated improvement at KP, greatly informed IHI’s own learning, and helped KP build system-wide capacity for improvement.
Addressing the Opioid Crisis in the United States
This IHI Innovation Report discusses key reasons why current efforts to reduce prescription opioid use and misuse in the US have thus far been largely ineffective in stemming the crisis; highlights gaps in current efforts that underscore the need for a coordinated and collaborative community-wide approach; identifies four primary drivers to reduce opioid use; and proposes a high-level construct for a system approach at the community level to address the US opioid crisis.
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.
Optimizing Patient Flow: Moving Patients Smoothly Through Acute Care Settings
In this white paper, IHI offers perspectives on the impediments to timely and efficient flow of patients through acute care settings.
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.
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: The Newest Innovator on the Block: Center for Medicare and Medicaid Innovation
February 24, 2011 | Learn about the Center for Medicare and Medicaid Innovation and the prospects for seeding much more robust work with both new payment and service delivery models.
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.
Respectful Management of Serious Clinical Adverse Events
This white paper introduces an overall approach and tools designed to support two processes: the proactive preparation of a plan for managing serious clinical adverse events, and the reactive emergency response of an organization that has no such plan.
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.
Pursuing the Triple Aim: Seven Innovators Show the Way to Better Care, Better Health, and Lower Costs
This groundbreaking book examines how leading US organizations are demonstrating breakthrough remedies to some of the toughest and most expensive challenges in health care, showing the way toward a health care system for the nation that improves the experience and quality of care while at the same time controlling costs.