In Latin America, IHI's work focuses on improving patient safety, building the capability of health care professionals to improve, and supporting entities in pursuing the Triple Aim (better health, better care, lower costs).
Some of our work in Latin America is highlighted below.
Reducing Hospital Induced Infections in 120 Public Hospitals in Brazil
In partnership with the Ministry of Health and the 5 excellence hospitals (Hospital Albert Einstein, Hospital Moinhos de Vento, Hospital Sírio Libanês, Hospital do Coração, Hospital Oswaldo Cruz) (PROADI) Brazil, in early December 2017, we successfully began a project with 120 public hospitals all across Brazil with an aim to reduce the number of VAP, CLABSI and CAUTI by 50%. With exciting results from our first 18 months of the Collaborative, the project is looking to start its second phase continuing the work in the reduction of those hospital induced infections in the 120 public hospitals.
Parto Adequado Phase II
Building on the work of Projeto Parto Adequado, which successfully increased the rate of vaginal birth from 21.6% to 38% over 18 months in 26 public and private hospitals, IHI and Brazil’s Hospital Israelita Albert Einstein have received $1.5 million in funding from Merck for Mothers for Phase II of the project to spread the methods used and lessons learned to an additional 114 hospitals across Brazil. Projeto Parto Adequado is now adding a component of reducing maternal mortality in 25 public hospitals, an addition to Parto Adequado called, Abraço de Mãe.
Ciência da Melhoria na Pratica (CMP) Professional Development Program (ANAHP).
Throughout IHI’s experience, we have found that
professional development programs help to lay the foundation for ensuring
patient safety throughout a system. IHI is offering this professional development program to build capacity to 30 teams (gaining
knowledge and tools) and increasing capability (applying this learning to daily
work for improvements) to the association of private hsopitals in brazil (ANAHP).
Latin American Forum
In August 2015, Hospital Israelita Albert Einstein (HIAE) partnered with IHI to host the 1st Latin American Forum on Safety and Quality in Healthcare in São Paulo, Brazil. Health care professionals and leaders from across the region convened for the largest health care quality and safety conference in Latin America to share learnings and new ideas, and to discuss contemporary health challenges in Latin America. In October 2016, we celebrated the 2nd Latin American Forum on Quality and Safety in Mexico City with HIAE and the Mexican Ministry of Health. In 2017, the 3rd Latin American Forum returned to São Paulo, Brazil, on August 28-30, where the event will be hosted in close collaboration with HIAE. In 2018, we convened our 4th Latin America Forum in Cartagena, Colombia with nearly 2,000 people in attendance. In 2019 we held our 5th Latin America Forum in São Paulo, Brazil with nearly 3,000 people.
Especialista em Melhoria / Experto en Mejora Continua
The Especialista em Melhoria (EM) in Portuguese and the Experto en Mejora Continua (EMC) in Spanish are open enrollment improvement capability programs catering to health care professionals interested in or actively leading improvement initiatives. These 10-month programs offer in-depth content and immersion into improvement methods, with three face-to-face Learning Sessions hosted locally in Portuguese-speaking and Spanish-speaking countries. Between these face-to-face interactions there are Action Periods with monthly hour-long virtual Learning Sessions. Most importantly, beyond learning and practicing improvement concepts and theories, all participants are expected to invest a significant amount of time during Action Periods developing and implementing results-oriented improvement projects, with aims related to their organization’s strategic priorities.
St. Jude's Collaborative
The Mexico in Alliance with St. Jude Golden Hour Collaborative (MAS+ Collaborative) is the result of a joint effort between the St. Jude Global Mexico Regional Program team and the Institute for Healthcare Improvement (IHI). The MAS+ Collaborative integrates 23 Mexican hospitals and 148 health professionals in an 18-month Quality Improvement Collaborative modelled around IHI's Breakthrough Series (BTS) Model with the overall aim of reducing treatment-related morbidity and motality amongst children with cancer. The aim of the first phase (Golden Hour) of the MAS+ Collaborative is to increase the percentage of febrile Pediatric Hematology-Oncology (fPHO) patients who present to the emergency department who receive the first dose of antibiotic within 60 minutes from the initial assessment across 23 participating hospitals of Mexico from a baseline of 39% to 80% by the end of November of 2020.
Eleven months into the implementation of the Collaborative, participating hospitals have reported 1,073 fPHO visits, of which 781 (73%) received antibiotics within 60min. The mean time to antibiotic administration has decreased from 148 minutes at baseline to 68 minutes during the implementation period and the mean proportion of fPHO patients receiving antibiotics in ≤60min has increased from 39% at baseline to 72%.
Patient Safety in Action
In many cases, Latin American health care organizations cannot afford to send representatives to Boston to attend IHI’s flagship Patient Safety Executive Development program. In these cases, IHI offers a four-day immersion program delivered locally. The Latin American Patient Safety in Action program focuses on patient safety fundamentals and on the practical application of improvement methods to alleviate and/or resolve patient safety issues. Initial tests in Brazil with the Hospital Moinhos de Vento (HMV) and the Hospital do Coracao (HCor) indicate that this model works best when coordinated through a local hosting organization, collaborating with their quality and safety teams to select topic areas and participants, both internal and external to the hosting organization.
Developing Improvement Capability Throughout Latin America
At the request of health care organizations and systems throughout Latin America, we have delivered onsite, contextualized training experiences for health care professionals, such as the "Curso Intensivo de Seguridad del Paciente" (CISP) and the "Ciencia da Melhoria na Pratica" (CMP). In 2014-2015, the first-ever fellow from Brazil, sponsored by the Hospital Israelita Albert Einstein, spent one year at IHI as part of the IHI Fellowship Program.
IHI Open School in Latin America
A wide variety of
IHI Open School courses are currently available in both
Portuguese. The IHI Open School community in Latin America has grown from 10 to 6,000 people, who have collectively taken over 100,000 online courses through the Open School. There are three Regional Chapter Leaders for the Open School in the Latin America region: Dr. Ezequiel Garcia, Director del Instituto de Efectividad Clínica Sanitaria (IECS) en Argentina; Dr. Rodrigo Poblete, Director de Calidad y Seguridad Asistencial de la Red Salud UC-Christus, Pontificia Universidad Católica de Chile; and Dra. Vanessa Vizcarra, Directora de Programación y Evaluación en la Secretaria de Salud Jalisco en Mexico.
Latin American Fellowship
The Hospital Israelita Albert Einstein is committed to building tremendous capability to drive improvement at all levels of their organization. Their capability building strategy includes the IHI Fellowship program, offering high-potential individuals within their organization the opportunity to immerse themselves at the deepest possible level in IHI’s improvement approach for a full year. Antonio Capone was the first to complete the IHI Fellowship in 2015. In September 2016, there were four Fellows from HIAE: Leonardo Jose Rolim Ferraz, Thais Galoppini Felix, Fernanda Paulino Fernandes, and Gustavo Faissol Janot de Matos.
Completed Projects and Initiatives
1st Latin American Forum on Quality and Safety in Healthcare
In August 2015, Hospital Israelita Albert Einstein (HIAE) partnered with IHI to host the 1st Latin American Forum on Safety and Quality in Healthcare in São Paulo, Brazil. Health care professionals and leaders from across the region convened for the largest health care quality and safety conference in Latin America to share learnings and new ideas, and to discuss contemporary health challenges in Latin America.
Adiós Neumonias, CLICCS
Based on the success of the virtual, voluntary, and multicountry collaborative initiative Adiós Bacteriemias, Adios Neumonias applies the same quality improvement and patient safety methodologies to a new cohort of ICUs across Latin America, this time seeking to reduce the rate of ventilator-associated pneumonia (VAP).
Agencia de Calidad en la Educacion is a project stemming from the significant results in improving the quality of children’s education in Chile through Un Buen Comienzo (UBC). The Agency for Quality in Education, a division of Ministry of Education, approached IHI with the opportunity to scale up quality improvement to additional regions of Chile, with a focus on the second grade. The current work includes building internal team capacity for quality improvement, prototyping and testing in 74 schools across five regions, and designing for future scale-up. The activities mainly focus on building improvement capability within the organization and in the field, through implementation experience and professional development opportunities, as well as a results-oriented Collaborative.
Adiós Bacteriemias, CLICCS
The international initiative Adiós Bacteriemias — promoted by the International Consortium for Innovation, Quality and Safety in Health (CLICSS), which was co-founded by IHI — aimed to reduce the rate of central line-associated blood stream infections in Latin American intensive care units (ICUs) through the implementation of evidence-based interventions using the Model for Improvement, and multi-country collaborative work. IHI played a key role in the planning and execution of these efforts alongside other organizations dedicated to quality improvement.
In January 2018, IHI began a quality improvement collaboration with the Interamerican Development Bank, the Ministry of Social and Economic Inclusion and the Ministry of Health for the country of Ecuador. The nine-month collaboration seeks to build improvement capability for health care and education professionals across the state focusing on the chronic diseases and the improvement of language capability for children ages 0-3. Ecuador Improvement Capability Program (Ecuador)
Campeche Improvement Capability Program (Mexico)
In March 2017, IHI began a quality improvement collaboration with the Ministry of Health for the state of Campeche in Mexico. The nine-month collaboration seeks to build improvement capability for health care professionals across the state.
National Quality Strategy, Mexico
In collaboration with the
Secretaria de Salud in Mexico, IHI provided strategic guidance and advising on the third iteration of a national quality strategy for the Mexican healthcare system.
1st Latin American ‘Encuentro’ on Quality and Patient Safety, Colombia
In June 2012, IHI collaborated with Centro de Gestión Hospitalaria and Ministerio de Salud y Protección Social, Républica de Colombia, to offer the 1st Latin American Gathering ('Encuentro') on Quality and Patient Safety (1er Encuentro Latinoamericano de Calidad y Seguridad del Paciente), in Cartagena, Colombia. A key focus of the conference, which featured several key IHI faculty, was to introduce the Triple Aim framework to the region, and to provide support for continued efforts to build improvement capability and improve patient safety in Colombia.
HIAE-IHI Patient Safety Symposium, Brazil
Co-sponsored by the Hospital Israelita Albert Einstein and IHI, the Patient Safety Symposium was a three-day event in São Paulo, Brazil, to discuss the implementation and scale up of patient safety programs globally, with the intention of stimulating ideas for the work ahead in Brazil as part of the country’s efforts to improve patient safety. The event took place on November 3, 2013, and involved a variety of experts in health, patient safety, and quality improvement.
Latin American Summit on Quality and Safety Towards Population Health, Mexico
IHI was honored to support the National Academy of Medicine and the Ministry of Health in Mexico in their journey to develop a new National Quality Strategy for health care. The strategy strives to improve the responsiveness of health care organizations and further improve safety, preventive care, and outcomes for the most common clinical problems such as diabetes, hypertension, and maternal mortality. The key component IHI’s support for this work was providing guidance and access to quality improvement leaders and experts from around the world at the Latin American Summit on Quality and Safety Towards Population Health, whose theme was “Catalyzing the Improvement of Health Systems,” held in July 2013 in Mexico City.
Salus Vitae Collaborative, Brazil
Associação Congregação de Santa Catarina (ACSC), a philanthropic health care system that promotes health, education, and social services in Brazil, led a patient safety collaborative aiming to reduce hospital acquired infections within 14 ICUs. IHI partnered with ACSC in this work to provide technical and strategic guidance for this 18-month project focused on strengthened quality improvement capability and improving patient safety in Brazil.
Sepsis Collaborative with Associação Congregação de Santa Catarina
In partnership with Associação Congregação de Santa Catarina, this 18 month collaborative to reduce Sepsis in the 14 hospitals in ACSC by 30% is an ambtious goal to reduce one of the most deadly diseases in hospitals in Brazil. With nearly 670,000 cases every year in the country, this collaborative is looking to innovate how Sepsis care and bundles are applied in the Brazilian context.
Un Buen Comienzo, Chile
Un Buen Comienzo (UBC) is an interdisciplinary early childhood development project in deprived areas of Santiago and the Sixth Region of Chile. This work is connected to the Triple Aim area of focus, more specifically population health linked to early years development. In 2011, UBC enlisted IHI to support their work using quality improvement methodology, and to design and provide assistance with executing a collaborative strategy to engage a stakeholders (parents, children, school principals, teachers, regional educational authorities, and others) in the implementation and spread of improvement strategies to reach very specific developmental aims. IHI’s support also included training key Fundacion Oportunidad representatives in the IHI Improvement Advisor Professional Development Program, access to IHI Open School online courses for local stakeholders, and providing improvement experts to support the team through regular meetings and coaching sessions.