IHI's 90-Day Learning Cycle

IHI’s 90-Day Learning Cycle is one of our primary engines for research and development at the Institute. This process is designed to provide a reliable and efficient way to research innovative ideas, assess their potential for advancing quality and safety in health care, and bring them to action. IHI has built a small Innovation Team with dedicated resources to support the 90-Day Learning Cycle process, and that team begins at least five new projects every 90 days (in what we call a “Wave” of projects). Projects are selected by IHI’s senior leaders and partners and are based on both IHI’s strategic plan and the needs and suggestions of our partners throughout health and health care.

Scoping and approaching unique problems is a challenge for every organization — today’s health care challenges demand new solutions. Engaging with IHI’s Innovation Team on a 90-Day Learning Cycle is ideal for a partner who has limited resources to dedicate to the challenge that needs solving. A 90-Day Learning Cycle classically produces a theory for the underlying problems that are hindering progress and a blueprint for how an organization can begin to test their way to a fully implementable solution.


For each 90-day innovation project, the Innovation Team and faculty work together on three distinct phases of work:

  • Phase 1 (Scan): The initial 30 days of the project is spent scanning the literature and conducting verbal bibliographic inquiry with key experts and innovators pertinent to the question that is posed. We emphasize learning from health and health care but also from other fields where appropriate. The project team assesses the current landscape to understand all dimensions of a problem or an issue. At the end of the first week, a complete project charter is produced, including the intent and aim of the project and expected deliverables. By the end of the first 30 days, a description of the current environment, a set of prevailing theories and mental models about how others have approached the problem before and an annotated bibliography are produced. In addition, a set of detailed specifications for an innovative solution are offered which informs the next phase of the effort.
  • Phase 2 (Focus): The subsequent 30 to 45 days are focused on formalizing a set of theories that may respond to the specifications identified in the first phase. During this time, we will begin to validate these theories at the point of care and refining ideas about what actually works. Health care organizations, and, in some cases, organizations outside the field are enlisted as potential prototype sites to help further develop ideas. A key activity at this stage is describing the key components of the system that perform “to specification.” A goal of this phase is transitioning from an early descriptive theory about how a new idea works to a normative theory that can be tested and provides a more thorough understanding. IHI believes that one way to make this transition is to create a driver diagram — a tool to conceptualize an issue, describe its system components, and demonstrate a pathway to achieve outcomes.
  • Phase 3 (Summarize and Disseminate): The final 15 to 30 days of a 90-Day Learning Cycle is used to complete the validation of the theory developed and to prepare a final summary of what was learned and developed during the cycle. The purpose of the summary materials is to enable development and testing of possible prototypes. Additionally, a synthesis of the work is required in order to hand off the final product to a testing or implementation team. 90-Day Learning Cycles are aligned by calendar year quarters (January to March, April to June, July to September, October to December), and we would enter any prospective partner into the next available quarter.

To learn more about IHI's Innovation system and how to develop your own internal Innovation managemnt process, we encourage you to read our Innovation white paper. ​