The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement

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The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003. (Available on

[Spanish and French translations of this paper are also available. See below.]
IHI’s Innovation Series white papers were developed to further our mission of improving the quality and value of health care. The findings and tools in these reports provide you with an opportunity to understand and evaluate the issues, and begin testing changes that can help your organization make breakthrough improvements.
The IHI seeks to improve health care by supporting change. One of the major ways we do this is via collaborative learning — specifically, using a model for achieving breakthrough improvement that we innovated in 1995 and have been continuously improving ever since, called the Breakthrough Series.
In American health care, the consequences of low quality are severe: high costs (40 percent higher than the next most expensive nation); injuries to patients (between 40,000 and 100,000 Americans dying in hospitals each year due to errors in their care); unscientific care (almost half of all clinically correct care is missing, based on reviews of patient records); and poor service.
The Institute for Healthcare Improvement developed the Breakthrough Series to help health care organizations make "breakthrough" improvements in quality while reducing costs. The driving vision behind the Breakthrough Series is this: sound science exists on the basis of which the costs and outcomes of current health care practices can be greatly improved, but much of this science lies fallow and unused in daily work. There is a gap between what we know and what we do.
The Breakthrough Series is designed to help organizations close that gap by creating a structure in which interested organizations can easily learn from each other and from recognized experts in topic areas where they want to make improvements.
A Breakthrough Series Collaborative is a short-term (6- to 15-month) learning system that brings together a large number of teams from hospitals or clinics to seek improvement in a focused topic area. Since 1995, IHI has sponsored over 50 such Collaborative projects on several dozen topics involving over 2,000 teams from 1,000 health care organizations. Collaboratives range in size from 12 to 160 organizational teams. Each team typically sends three of its members to attend Learning Sessions (three face-to-face meetings over the course of the Collaborative), with additional members working on improvements in the local organization.
Teams in such Collaboratives have achieved dramatic results, including reducing waiting times by 50 percent, reducing worker absenteeism by 25 percent, reducing ICU costs by 25 percent, and reducing hospitalizations for patients with congestive heart failure by 50 percent. In addition, IHI has trained over 650 people in the Breakthrough Series methodology, thus spawning hundreds of Collaborative initiatives throughout the health care world, sponsored by organizations other than IHI.
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