All | IHI - Institute for Healthcare Improvement

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Ethiopia Health Care Quality Initiative: Design and Initial Lessons Learned

The Ethiopian Federal Ministry of Health and IHI co-designed a three-pronged approach to accelerate health system improvement nationally, which included developing a national health care quality strategy, building quality improvement (QI) capability at all health system levels, and introducing scalable QI collaboratives across four regions.

The Scottish Improvement Journey: A Nationwide Approach to Improvement

Learn about Scotland’s 10-year effort to apply quality improvement on a national scale to improve patient safety, including an in-depth review of the successful Scottish Patient Safety Programme, and further QI efforts that spread across Scotland into new social policy areas such as children’s services, education, and justice.

10 IHI Innovations to Improve Health and Health Care

This curated publication highlights 10 ideas that have emerged from IHI's systematic 90-day innovation approach, including reflections on the Triple Aim, the concept of a health care Campaign, the Breakthrough Series Collaborative model, and other frameworks and fresh thinking that have been replicated around the world.

Does a Quality Improvement Campaign Accelerate Take-up of New Evidence? IHI’s Project JOINTS

IHI’s Project JOINTS initiative engaged a network of state-based organizations and professionals in a six-month QI campaign to promote adherence to three evidence-based practices to reduce surgical site infection (SSI) after joint replacement.

Ensuring Healthcare Improvements Stick

This article describes six management principles, leadership practices, core competencies, and mental models that all play a role in generating and sustaining improvement.

Can a Quality Improvement Project Impact Maternal and Child Health Outcomes at Scale in Northern Ghana?

This paper discusses the impact of a scale-up phase of Project Fives Alive! to improve maternal and child health outcomes, which used quality improvement methods to identify barriers to care and care-seeking, and then identify, test, implement, and scale up simple and low-cost local solutions to address the barriers. The project and this approach demonstrated improved outcomes at scale.

Lessons in Leadership for Improvement: Kaiser Permanente’s Improvement Journey Over 10 Years

Kaiser Permanente (KP) has achieved impressive improvements in quality of care over the past decade — a testament to their engaged and effective leadership and staff, and also due in part to a unique 10-plus-year collaboration with the Institute for Healthcare Improvement (IHI) that accelerated improvement at KP, greatly informed IHI’s own learning, and helped KP build system-wide capacity for improvement.

A Framework for Scaling Up Health Interventions: Lessons from Large-Scale Improvement Initiatives in Africa

Scale-up of complex health interventions to large populations is not a straightforward task. This article details a sequence of four steps for taking a health intervention to full scale, properties that facilitate adoption of the new ideas, and the infrastructure required to support the scale-up.

A Two-Way Street: What the United States Can Learn from Resource-Limited Countries to Improve Health Care Delivery and Reduce Costs

This article highlights five key ideas for "bidirectional innovation," gathered from the experience of health care providers and health system managers in resource-limited countries, that may have a meaningful impact on health care quality and safety if applied in resource-rich countries.

Lessons Learned from Ghana's Project Fives Alive! A Practical Guide for Designing and Executing Large-Scale Improvement Initiatives

How do you set up a large-scale improvement project for success? After seven years of rapidly and successfully scaling up high-impact maternal and child health interventions across Ghana using a quality improvement approach, the lessons learned from Project Fives Alive! are documented in this practical guide. Topics include project design, day-to-day project management and leadership, building QI capability, managing complex partner relationships, and deploying a core set of balanced metrics.

The Importance of Context in Implementation Research

The authors present a framework for implementation science, a review of published HIV/AIDS protocols for complex interventions, a case study, and preliminary recommendations that can be used to characterize context when reporting interventions and describing how context can be accounted for in implementation strategies.

Project JOINTS: What Factors Affect Bundle Adoption in a Voluntary Quality Improvement Campaign?

This article examines how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign — Project JOINTS, an IHI-led initiative — could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty).

Promising Care: How We Can Rescue Health Care by Improving It

This book collects 16 landmark speeches given by Donald M. Berwick (including all of his speeches delivered at IHI’s annual National Forum on Quality Improvement in Health Care from 2003 to 2012) that clearly show why our medical systems don’t reliably contribute to our overall health. Berwick offers a vision for making our systems better — safer, more effective, more efficient, and more humane.

Using Quality Improvement Methods to Test and Scale Up a New National Policy on Early Post-natal Care in Ghana

This initiative demonstrates the utility of a quality improvement (QI) approach in testing, implementing, and subsequent scaling up a national policy for early post-natal care in a resource-constrained setting, and provides a model to accelerate the achievement of the Millennium Development Goals in Ghana and other resource-poor countries.

Joint Learning Network for Universal Health Coverage Update

This report from the Joint Learning Network highlights the network's unique collaborative model to ensure universal health coverage in low- and middle-income countries, some early results, and innovative tools and approaches to address priority areas such as expanding coverage, utilizing information technology, and improving and/or maintaining quality.

A Quality Improvement Model for the Rapid Scale-up of a Program to Prevent Mother-to-Child HIV Transmission in South Africa

This article describes how a group of NGOs and government partners jointly developed the "Accelerated Plan" (A-Plan) to successfully improve services at health care facilities in South Africa to prevent mother-to-child transmission (PMTCT) of HIV.

Crossing the Quality Chasm in Resource-Limited Settings

This perspective piece discusses why scale-up is the foundation necessary to deliver effective health care to the poor and describes a vision for a global quality improvement movement in resource-limited areas.

Network Theory: IHI 90-Day R&D Project Final Summary Report

This IHI 90-Day R&D Project includes a thorough literature review on the topics of network theory, network terminology, and social network analysis; personal interviews with network experts across many disciplines; and a draft framework for an enhanced network.

Tried and Tested: Models for the Scale Up of HIV Prevention, Treatment, and Care from South Africa and Beyond

The "tried and tested" models described reflect the range of great work being done frontline nurses and doctors to prevent HIV infection and mother-to-child prevention of HIV.

Large-scale improvement initiatives: A scan of the literature

This article reviews the literature on large-scale improvement initiatives and identifies four primary drivers.

How healthcare providers in America can teach lessons on quality improvement

This article outlines six common themes observed in US health care organizations that have successfully combined quality improvements with savings to the bottom line.

The Pursuing Perfection Initiative: Lessons on Transforming Health Care

This paper describes the learning from the eight-year Pursuing Perfection initiative, whose goal was to learn if and how health care organizations could make dramatic improvements in performance across the organization. Select innovations and results stemming from the initiative are presented.

Options for Large-scale Spread of Simple, High-impact Interventions

The World Health Organization Patient Safety Programme and the Harvard School of Public Health commissioned the United States Agency for International Development’s Health Care Improvement Project (HCI), managed by University Research Co., LLC (URC), to present its understanding of and experience with the effective adoption of simple, high-impact interventions, such as the Surgical Safety Checklist.

Planning for Scale: A Guide for Designing Large-Scale Improvement Initiatives

This white paper may be used as a preparation tool by those that are planning to take effective health care practices from one setting or isolated environment and to make them ubiquitous across a health care system, region, state, or nation.

A Framework for Spread: From Local Improvements to System-Wide Change

A key factor in closing the gap between best practice and common practice is the ability of health care providers and their organizations to rapidly spread innovations and new ideas.