Our Founders: A Learning Community Takes Shape
IHI began not as an institution, but as a learning community, and that origin continues to shape how we pursue improvement today. In the late 1980s, long before the Institute for Healthcare Improvement (IHI) formally existed, a small group of clinicians, managers, and policy leaders were wrestling with a shared frustration: despite good intentions and a dedicated workforce, health care was causing preventable harm, wasting resources, and falling short of what patients and communities deserved. What brought these individuals together was not a plan to start an organization, but a shared commitment to learning about how health care could be designed differently.
A Community of Founders
IHI’s founders were united by a belief that improvement in health care required more than individual effort or professional excellence. It required changing systems.
Among this group were Donald M. Berwick, MD, MPP, and Paul B. Batalden, MD, along with several other early collaborators who would form a close-knit learning community. They read together, debated ideas together, and tested changes in real-world settings, drawing inspiration from systems thinking, industrial quality methods, and emerging improvement science. Rather than assigning blame for failure, they focused on understanding how systems shaped outcomes. Instead of relying on hierarchy, they emphasized collaboration, curiosity, and shared purpose. These principles became the foundation for what would later be known as the science of improvement in health care.
Turning Learning into Action
A pivotal early catalyst brought together a growing community of innovators around a simple but transformative question: could quality improvement methods from other industries improve health care?
The answer, they discovered, was yes, but only if health care organizations were willing to learn differently. Early convenings resembled study groups more than strategy sessions. Participants shared data openly, tested small changes, learned from failure, and spread what worked. In many ways, the methods IHI would later teach, including Plan-Do-Study-Act (PDSA) cycles, collaborative learning, and real-time testing, were already being practiced by the founders themselves.
From Learning Community to IHI
With early philanthropic support, including funding from The John A. Hartford Foundation, this learning community formalized into the Institute for Healthcare Improvement in 1991.
The creation of IHI was not an end point, but a beginning, a way to bring people together to learn, test ideas, and improve health care in practice. From the outset, IHI was designed to work with health systems, testing changes in real settings and spreading approaches that proved effective, rather than operating as a traditional think tank.
Donald M. Berwick, MD, MPP, Co-Founder
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| Founder Legacy
Berwick served as IHI’s President and CEO for nearly two decades. His leadership helped bring national and international attention to improvement science, patient safety, and system redesign. Concepts such as the Triple Aim and large-scale initiatives like the 100,000 Lives Campaign reflected the founders’ belief that learning, when shared widely, could lead to measurable change. Throughout his tenure at IHI, and in his broader public service roles, Berwick remained closely aligned with the organization’s founding ethos: learning together in service of better care. |
A Living Legacy
The most enduring contribution of IHI’s founders is not a single program or framework, but a way of working.
Today, IHI continues to operate as a learning organization, convening diverse stakeholders, encouraging experimentation, grounding action in evidence, and spreading knowledge across boundaries. The improvement methods taught around the world reflect the same spirit that animated the founders’ earliest conversations: humility, curiosity, collaboration, and a relentless focus on better systems for better outcomes.
Stewarding the Founders’ Vision
IHI’s founders did not set out to build an institution. They set out to learn, and in doing so, they built a movement.
As IHI grew, leadership evolved to steward and scale the founders’ vision. Maureen Bisognano, who succeeded Don Berwick as President and CEO, played a pivotal role in extending IHI’s reach globally while preserving its core identity as a learning community. Under her leadership, IHI expanded its impact, deepened its partnerships, and sustained the founding belief that meaningful change comes from learning together. Subsequent leaders have continued this work, including our current CEO Dr. Sylvia Trent-Adams, guiding IHI through new challenges while remaining anchored in the principles established at its founding.
Learn More About IHI’s Early Years
- IHI’s History
- Timeline of IHI Milestones
- Reflections from Co-Founder Don Berwick: Surprising Things You May Not Know About IHI’s Founding