The Institute for Healthcare Improvement (IHI) offers this summary of valuable content you may have missed (or may want to revisit) from last year to help you get 2023 off to a good start. We’ve reviewed the many blog posts, publications, and other resources IHI produced or contributed to on a range of topics. Here, in no particular order, are some of the most popular highlights that we hope you will find helpful, thought-provoking, or inspiring.

Rethinking Quality Improvement

• Quality: What’s Love Got to Do With It? — In a piece that gave a nod to both Tina Turner and Avedis Donabedian, IHI President and CEO Kedar Mate, MD, asserted that QI tools are both necessary and insufficient to improve health and health care worldwide.
• Quality Improvement is “Kindness with a Strategy” — According to Amy Chidley, a Quality Improvement Advisor with Birmingham and Solihull Mental Health Foundation Trust in Birmingham, England, “For people in health care, QI empowers them to take their caring further than individual patients.”
• What Kind of Quality Department Best Supports Whole System Quality? — The IHI Innovation Team offered some of the keys to successfully organizing quality departments.

Advancing Safety

• Avoiding “Drift” into Harm — In this Healthcare Executive article, Patricia McGaffigan, RN, a vice president at IHI and president, Certification Board for Professionals in Patient Safety, presented specific steps leaders can take to reinforce effective safety practices and address workarounds that may unintentionally result in harm.
• “Relationships Eat Culture for Breakfast” and Other Safety Leadership Lessons — Jeff Salvon-Harman, MD, IHI’s Vice President of Safety, said, “I believe it’s those personal connections, the individual and team/group relationships, that ultimately support the shared belief system we call culture.”
• The Criminalization of Medical Errors Should Be a Wake-up Call for Health Care Leaders — After a nurse was charged with reckless homicide and impaired adult abuse after administering the wrong medication that led to the tragic death of a patient, IHI’s Kedar Mate addressed the risks to patient safety when medical errors are criminalized and outlined alternatives. He wrote, “[Health care leaders] are uniquely positioned in our communities and organizations to make clear . . . that the placement of blame on an individual is not sufficient to solve for system-level problems.”
• Alleviating the Burden of Documentation to Focus on What Matters — Patient safety is often cited as the reason for documentation, but some research indicates that burdensome documentation is associated with increased medical errors, mistakes in documentation, and burnout among health care providers. The Danish Society for Patient Safety described what happened when one municipality in Denmark used their improvement science expertise to change their documentation culture.

Taking Equity to the Next Level

• Weaving Equity Into Every Step of Performance Improvement — The NYC Health + Hospitals System shared a list of equity considerations to think about at every step of a performance improvement project because work designed without an intentional focus on equity may foster intervention-generated inequalities that further disadvantage historically oppressed and exploited groups.
• Racism in healthcare was exposed by the pandemic. How can we improve? — In a wide-ranging conversation on the WGBH News show, “Greater Boston,” IHI’s Kedar Mate talked about health inequities and possible solutions, clinician burnout, staffing shortages, and the stigma around mental illness in the medical community.
• Using Quality Improvement to Address Racism — Racism is undoubtedly one of the hardest challenges to face in the workplace, especially among helping professionals who may find its existence difficult to acknowledge or overwhelming to address. After two years of embracing the discipline of using QI methods to address racism, a team in the UK has seen a reduction in staff-reported incidences of racism by an impressive 90 percent.

Points to Ponder

• On the Quintuple Aim: Why Expand Beyond the Triple Aim? — IHI’s Kedar Mate makes the case for adding to the Triple Aim both a fourth aim of workforce well-being and safety and a fifth aim of advancing health equity because we cannot achieve high-quality care for all without them.
• Are We Inadvertently Contributing to Discrimination Against Older Adults? — Research on public perceptions indicates that aging is misunderstood in America and that misperceptions create obstacles to productive practices and policies. According to Moira O’Neil, Senior Vice President of Research Interpretation at the FrameWorks Institute, health care providers and others can benefit from using evidence-based communications strategies to change the narrative about aging.
• What a Patient Advocate Wants You to Know About Co-Designing Care — When her daughter was diagnosed with cystic fibrosis 18 years ago, Lindsay Deveaux was not familiar with the term “patient-centered care.” All she knew was that she appreciated when clinicians treated her with respect, welcomed her questions, and valued her role as an informed advocate for her child. “Well-rounded quality care cannot happen unless you, the provider, and the patient are working in partnership,” Deveaux said.
• Why Asking “What Matters To You?” Matters — In 2012, a trailblazing article ushered in the practice of asking, “What matters to you?” to foster shared decision-making. IHI’s Kedar Mate reflects upon his initial skepticism about this idea and on what these words have meant — to him as a clinician and to many patients and health professionals — over the past decade.
• And, finally, the 2022 IHI Forum keynotes from Kedar Mate (“A Certain Kind of Fire”) and IHI President Emeritus and Senior Fellow Don Berwick (“Salve Lucrum”) offer ideas, inspiration, and examples to follow to improve health and health care worldwide in the coming year.