Diagnostics for Achieving Organizational Transformation

​​Diagnostics for Achieving Organizational Transformation

Expert Anal​ysis and Recommendations for Improving System-wide Performance

Diagnostics allow IHI to bring our expertise directly to your organization, focusing on high-value opportunities for improvement and offering pragmatic, actionable recommendations. Our diagnostics teams have the know-how to accelerate system-wide improvement in health care organizations, health systems, payer organizations, governments, and regional coalitions.

When IHI engages in a diagnostic, we use our knowledge, experience, and expertise to provide an informed view of where an organization is in its improvement journey and a clear roadmap to achieve higher levels of performance and transformation.

For each engagement, IHI assembles a team of experienced experts. The team visits your organization, assesses the current state of performance, and then works with leaders to articulate actionable recommendations for achieving system-wide improvement in line with your vision, strategy, and goals.

Diagnostics are beneficial to focus improvement efforts to address challenges in a specific area and to accelerate progress toward embedding and ensuring a system-wide culture of continuous improvement.

Onsite Diagnostic Objectives

Diagnostics will help your organization or system:

  • Understand where you are in your improvement journey and how to get where you want to be
  • Leverage existing strengths to plan and execute system-wide improvements
  • Learn from other leaders who have achieved transformation at their organizations
  • Identify key challenges, articulate specific aims to address those challenges, and focus improvement efforts
  • Determine actionable next steps to reach your goals
  • Clarify the role of leadership in improving system-wide performance
  • Build will at all levels to transform the system together
  • Identify opportunities for capability building

Diagnostic Process

Below is a general overview of the sequence of steps during the diagnostic period:

  • Virtual planning and goal-setting meeting with leadership teams
  • Collection of relevant information prior to the onsite visit
  • Pre-visit planning call with leadership team
  • Onsite visit by the IHI diagnostic team to meet with key stakeholders and conduct field observations
  • Presentation of findings and recommendations at an onsite meeting and/or in a written report from IHI

Follow-Up to Diagnostic Process

The findings and recommendations provided by IHI at the conclusion of the diagnostic are intended to be actionable and to help senior leaders further shape strategy and plans for executing on the strategy.

The diagnostic can optionally be accompanied by a few months of strategic guidance. For some, a diagnostic is a starting point for a deeper engagement with IHI to achieve system-wide transformation. Other organizations opt to take the key learnings from the diagnostic and begin their own individual journey of transformation.

Examples of IHI Diagnostics

Quality and Safety Structures Diagnostic

An academic medical center in the US merged a medical school and a tertiary hospital and were seeking ways to ensure cohesiveness and a shared vision, as well as improve performance specifically on national rankings. Leaders approached IHI for help to establish quality and patient safety structures that bridged the academic and health care enterprises. IHI evaluated the data and conducted a site visit, interviewing leaders, managers, and key stakeholders to assess current performance and complete a gap analysis. IHI made recommendations to the board and senior leaders, which became the basis of their quality and safety work for the next five years. As a result, their national rankings improved from the mid- to top quartile, and leaders credit IHI with giving their quality and safety improvement program a structure and a path forward.

Another academic medical center in the US was referred to IHI by the previously mentioned academic medical center. IHI’s diagnostic surfaced strengths and defects in the existing care model and helped refocus efforts on measures. Using these insights, the organization set new aims and strategies for achieving them, implementing a system of control charts, accountabilities, glide paths toward targets, and communication processes for the board, physicians, and frontline staff. The medical center has achieved significant decreases in mortality and readmissions and improvement in all core measures.

Frontline Problem-Solving Diagnostic

An academic medical center in the US, a recognized leader in quality and safety, remained dissatisfied with their rate of improvement and number of adverse events that continued to occur despite focused efforts. They engaged IHI to help determine a way to detect “What will go wrong next?” and prevent it. Through a diagnostic, IHI assisted leaders in implementing a methodology to develop new skills for frontline teams. Focused on surfacing “defects” in day-to-day work that were consistently overlooked, taken for granted, and worked around, frontline teams now take an active role in problem-solving at the point of care. This approach led to countless small changes that added up to significant improvements in the participating units to eliminate “defects” that often occurred daily and could potentially lead to serious events. These improvements greatly impacted the way the organization operates. The medical center’s leaders credit IHI with the key insights that fostered frontline teams’ ability to identify and solve problems in real time and enabled them to become a model for others.

Assessing Improvement Capabilities Diagnostic

IHI undertook an assessment of the Ministry of Health system in a country in the Asia-Pacific region in order to inform a system-wide strategy for building quality improvement capabilities. Through prework, onsite visits, and interviews with leaders, managers, and frontline staff across the system, IHI gained a deep understanding of current strengths and weaknesses which informed a set of recommendations for a path forward. With IHI's support, the system has since developed a sustainable quality infrastructure and has undertaken a system-wide collaborative initiative to reduce harm across its hospitals.


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