"What Matters" in Our Work at IHI

​In honor of "What Matters to You?" Day on June 6, IHI asked our teams to consider what mattered in the work we are doing across North America. We are pleased to see the message of “What Matters” permeating our work.

IHI staff photo 

Medication Optimization

With support from Pfizer Independent Grants for Learning and Change, IHI is working with seven US-based teams on medication optimization. A key driver for this work is engaging with patients in shared decision making about treatment. By understanding what matters to patients, providers are able partner with patients to pursue the course of action best suited to their goals and lifestyle. Understanding patients’ needs and preferences related to side effects, cost, how and when a medication is taken and in what formula, and other considerations is necessary to arrive at the best treatment decision with each patient, including, in some cases, the decision to forego medication therapy.

Maternity Health Outcomes

IHI’s initiative to improve equity, dignity and safety in maternity health outcomes is working to align what matters most to women in the community and connect their beliefs to the health systems that serve them. The IHI Blog post, “How Can You Address Maternal Mortality Disparities?”, acknowledges that women of color have been outspoken about negative experiences and the maternal morbidity and mortality crisis impacting black women in the United States. As we embark on this new initiative, we urge maternal and infant health professionals to partner with women on improvement efforts. This work is funded through a grant from Merck for Mothers.

Pursuing Equity

In April 2019, IHI sunset a two-year initiative called Pursuing Equity. With funding assistance from the Rx Foundation and Bristol-Myers Squibb Foundation, eight participating health care organizations worked with IHI to reduce inequities in health and health care by testing and implementing a comprehensive framework. Some participating teams, like Vidant Health, act as anchor institutions for their communities. They joined Pursuing Equity to better serve their local counties and figure out what mattered to the community and their workforce, which are one in the same. Julie Oehlert, Chief Experience Officer of Vidant Health, describes this further in the IHI Blog post,“Are Love and Empathy the Keys to Health Equity?”, discussing key elements such as pay equity, job requirements, town hall discussions, and authentic community partnership. 

Better Care Playbook

Individuals with complex health and social needs are a heterogeneous population that includes many segments, including older adults, people with multiple chronic conditions, and people with behavioral health needs, among others. However, this diverse population is bound by the fact that current health care systems are failing to meet their needs. The good news is that growing concerns around costs, poor outcomes, and piecemeal approaches to care have given way to a growing movement to address these systemic issues on multiple levels.

The Better Care Playbook, developed by IHI with funding from six partner foundations, represents one step toward redesigned care for people with complex needs. With hundreds of tools and resources to redesign care, the Playbook supports health system leaders and payers in developing a deep understanding of what matters to people with complex needs and to work with these individuals and their families to co-design improved care.

100 Million Healthier Lives

100 Million Healthier Lives is committed to making real-time changes in response to "what matters" in our SCALE Communities at CHILAs, in how we communicate, and in what we require as deliverables. We continue to put equity and dismantling racism and other inequities at the forefront of our work by helping communities and our team become more equitable by using newly developed and existing tools and frameworks. Our tools and framework help communities accelerate their journey toward a culture of health using the Community of Solutions Framework and the Community Transformation Map. As part of the Community Health Accelerators Initiative, we are working to create modules, tools and resources based on an understanding of the learning needs and "what matters" to communities by driving population health improvement efforts.

Pathways to Population Health

IHI is one of five founding partners of the Pathways to Population Health framework, generously funded by the Robert Wood Johnson Foundation. The framework lists key levers, one being “partner with people with lived experience,” which should be leveraged across all four “portfolios” in order to achieve population health. In the context of population health, one should ask patients and community members “What matters to you?” to ensure that improvement and advocacy efforts align with the needs (mental, physical, social, and spiritual) in that population.

Age-Friendly Health Systems

Many older adults face increasingly complex health and health care needs. Health systems are not always organized to reliably meet these needs. The John A. Hartford Foundation and IHI are working with more than 300 teams who are becoming Age-Friendly Health Systems. These teams are reliably practicing the 4Ms — What Matters, Medication, Mentation, and Mobility — an essential set of evidence-based practices to address the needs of older adults.

What Matters is the first of the 4Ms because understanding the older adult’s health and health care goals and preferences is essential to meeting their care needs. What Matters guides all other care. In an Age-Friendly Health System, What Matters to each older adult is identified, understood, and documented, and then acted upon and updated across settings of care following changes in care or life events. At first it can seem inconvenient, even scary, to ask What Matters. IHI, with support from The SCAN Foundation, created a toolkit with very practical approaches for care teams to practice how to ask and act on What Matters to older adults.

Unplanned Acute Events in Seniors

The West Health Institute (WHI) and IHI collaborated directly with six Next Generation Accountable Care Organizations (ACOs) in the Unplanned Acute Events Learning and Action Network (UAELAN) to develop safe, patient-centered alternatives that reduce the need for hospitalization when acute events occur. These alternatives include acute care services at home and special programs in the ED, as well as anticipatory functions such as patient risk-profiling and pre-enrollment programs. All high-quality care is delivered in the context of understanding the individual’s goals, preferences, and values. This care attribute is one of the four core elements describing Age-Friendly Health Systems, focusing on What Matters: know and align care with each older adult’s specific health outcome goals and care preferences, including but not limited to, end-of-life care and across care settings.

The UAELAN teams started their work by crafting a promise to their patients who engage in the alternative care model. In addition to the aims and measures set and used as guides in the improvement, the promises also served as guides to the values and attributes the teams wanted to develop in their alternative care models.

An example from UnityPoint Health shows how home- and community-based health care models like Hospital to Home can be safer, more effective, and more affordable than traditional hospital-based care. Person-centered care like this is essential to helping seniors age successfully, and these kinds of programs address "What Matters" to patients by ensuring they receive the care they need wherever they choose.