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• Organizational Trustworthiness in Health Care
  The Institute for Healthcare Improvement partnered with the American Board of Internal Medicine Foundation to identify key organizational-level drivers and change ideas that repair, build, and strengthen trust between health care organizations and clinicians, and between health care organizations and the communities they serve. This report describes a theory of how to repair, build, and strengthen trust, presented as a three-step approach with specific change ideas and associated measures for improvement.
• Telemedicine: Ensuring Safe, Equitable, Person-Centered Virtual Care
  This white paper describes a framework to guide health care organizations in their efforts to provide safe, equitable, person-centered telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.
• 100 Million Healthier Lives Engaging People with Lived Experience Tools
  This collection of resources, developed as part of the 100 Million Healthier Lives initiative, provides key information and tools to support communities and organizations to authentically engage people with lived experience in co-design and implementation efforts.

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• WIHI: Women in Action: Paving the Way for Better Care
  December 20, 2018 | Whether it’s blowing the whistle on the dangerous levels of lead in drinking water in Flint, Michigan, championing the healing powers of dance and movement in hospitals, or shining a human spotlight on disease outbreaks throughout the world, this special edition of WIHI features a panel of outstanding women who are creatively and effectively reshaping caregiving.
• WIHI: Connecting Patient Experience to Culture and Strategic Aims
  August 9, 2018 | Most hospitals are understandably preoccupied with patient experience scores. But can those same scores help guide an organization to the aims and values it hopes to achieve?
• WIHI: Practicing More Careful and Thoughtful Diagnosis
  February 8, 2018 | What's next when the diagnosis process is causing as many problems as it's trying to solve?
• WIHI: The Careful and Kind Patient Revolution
  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
  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?
• WIHI: Greater Satisfaction, Outcomes, and Savings with Self-Administered Care
  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.
• WIHI: Creating Age-Friendly Health Systems
  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?
  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
  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.
• WIHI: Practicing Respect and Preventing Harm
  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?
• WIHI: Engaging and Supporting Family Caregivers
  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
  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?
• WIHI: The New World of Co-producing Health and Health Care
  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
  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.
• WIHI: New Tools and Thinking for Shared Decision Making
  January 28, 2016 | If you work in primary care today, odds are good that you’re seeing patients with multiple chronic conditions. Even if a provider and patient work together to choose the right medications and agree on making some lifestyle changes that will improve health, the best-laid plans often fall apart.
• WIHI: Realizing “What Matters” (to Patients and Families)
  January 14, 2016 | A few years ago, IHI and others began suggesting to providers that instead of routinely asking patients “What’s the matter with you?” they should begin asking “What matters to you?”
• WIHI: Medicare Reimbursement and Meaningful Conversations about End-of-Life Care
  November 19, 2015 | This WIHI explores whether the new US Centers for Medicare & Medicaid Services payment options to reimburse practitioners for talking with Medicare recipients about end-of-life care preferences make advance care planning more likely to happen and encourage health professionals to gain the necessary skills for such discussions.
• WIHI: Getting Right Care, Right!
  October 1, 2015 | There’s growing awareness of the need to curb health care’s overuse of interventions that lack a strong evidence base, unnecessarily subject patients to potential harm, and are more expensive than equally effective, cheaper alternatives.
• WIHI: The Echo Effect of Project ECHO's Access to Specialty Care
  July 9, 2015 | There’s telemedicine, and then there’s Project ECHO. What began in 2003 as a process for improving access to treatment for people in New Mexico suffering from Hepatitis C, now offers support and learning for 30 different diseases and conditions, impacting patients in some 22 states.
• WIHI: Disability Competent Care
  June 11, 2015 | A lot of progress has been made the past several decades for people with disabilities. But, there are still barriers and biases that prevent disabled individuals from leading full lives and fully accessing health care.

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• 100 Million Healthier Lives Engaging People with Lived Experience Tools
  This collection of resources, developed as part of the 100 Million Healthier Lives initiative, provides key information and tools to support communities and organizations to authentically engage people with lived experience in co-design and implementation efforts.

first < > last

• Organizational Trustworthiness in Health Care
  The Institute for Healthcare Improvement partnered with the American Board of Internal Medicine Foundation to identify key organizational-level drivers and change ideas that repair, build, and strengthen trust between health care organizations and clinicians, and between health care organizations and the communities they serve. This report describes a theory of how to repair, build, and strengthen trust, presented as a three-step approach with specific change ideas and associated measures for improvement.
• Telemedicine: Ensuring Safe, Equitable, Person-Centered Virtual Care
  This white paper describes a framework to guide health care organizations in their efforts to provide safe, equitable, person-centered telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.
• 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.
• 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.
• 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.
• Personalized Perfect Care
  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
  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
  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
  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
  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.
• The Value of Teaching Patients to Administer Their Own Care
  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
  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.
• Reliably Addressing "What Matters" Through a Quality Improvement Process
  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
• Supporting the Supporters: What Family Caregivers Need to Care for a Loved One with Cancer
  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
  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.
• Essentials for Improving Service Quality in Cancer Care
  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.
• When the Customer Is Stressed
  This article uses the example of cancer care to illustrate four guidelines for better design of high-emotion services (i.e., those that elicit strong feelings like fear and anxiety): identify emotional triggers, respond early to intense emotions, enhance customers’ control, and hire and rigorously train people who can communicate respectfully.
• "Conversation Ready": A Framework for Improving End-of-Life Care (Second Edition)
  This white paper presents a framework built on five core principles to help health care organizations and clinicians develop reliable processes to engage patients in conversations about their wishes for end-of-life care, steward that information, and provide respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.