Institute for Healthcare Improvement

Wanted: A health care system that has your back

Tue, 19 Aug 2008 18:49:43 GMT

What does America need? According to Dr. Donald M. Berwick, President and CEO of the Institute for Healthcare Improvement, one thing we need is a health care system that won’t bankrupt us when we get sick. In this interview Dr. Berwick gives his views on the kind of health care system we could have and the form that health care reform should take.

Out in the field

Tue, 19 Aug 2008 18:34:00 GMT

In this interview Maureen Bisognano, Executive Vice President and COO of the Institute for Healthcare Improvement, talks about the philosophy behind her drive to improve health care. She credits in-the-field observation and international cooperation as the keys to improving health care on a large scale.

Engaging with Physicians in a Shared Quality Agenda September 08

Tue, 19 Aug 2008 15:52:49 GMT

This seminar focuses on how to apply concrete, practical approaches to engage physicians in the quality and safety work of the hospital or other health care system.

Implementation of standard order sets for patient-controlled analgesia

Mon, 18 Aug 2008 21:08:55 GMT

This case study describes the development and implementation of standard order sets to improve the safety of opioid-based patient-controlled analgesia (PCA). Post-intervention assessment showed that the implementation of standard order sets sharply reduced the incidence of PCA-associated respiratory depression. Changing the order sets to improve medication safety did not appear to negatively affect patient satisfaction with pain management.

Profiles in Improvement: Susan Vitolins of Northeast Health

Mon, 18 Aug 2008 14:26:35 GMT

Who's improving health care? People are. Listen to the story of Susan Vitolins of Northeast Health.

My Medication Log

Fri, 15 Aug 2008 22:21:00 GMT

This tool is designed to help patients remember why, when, where, and how to take their medicine(s); developed by New York City Department of Health and Mental Hygiene (New York, New York, USA).

Getting Started Guide: Improving Care for Patients with Heart Failure — Focus on Ambulatory Care

Fri, 15 Aug 2008 16:43:00 GMT

This Guide builds on the promising work in the hospital setting by applying known best practices to the outpatient care of individuals with heart failure, and by highlighting the high-leverage opportunities for improvement in office practices; developed by the Institute for Healthcare Improvement (Cambridge, Massachusetts, USA)

TCAB improvements double nurse time at the bedside: An interview with IHI's Pat Rutherford

Fri, 15 Aug 2008 15:55:37 GMT

A key goal of the Transforming Care at the Bedside (TCAB) initiative is to increase the amount of time nurses spend with patients. Now in its fourth year, Pat Rutherford, vice president at the Institute for Healthcare Improvement (IHI), describes some of the results. Shared with permission of The Business of Caring newsletter.

Pediatric Trigger Toolkit: Measuring Adverse Drug Events in the Children’s Hospital

Wed, 13 Aug 2008 14:57:13 GMT

This tool provides a powerful yet simple method to detect medication-related harm in pediatric inpatients; developed by Child Health Corporation of America (Shawnee Mission, Kansas, USA).

Reengineering the Operating Room to Improve Hospital-Wide Efficiency and Quality September 2008

Tue, 12 Aug 2008 17:36:27 GMT

This two-day seminar provides participants with a set of tools to use and apply in their operating room to reduce costs and improve patient throughput in the hospital. Participants will be guided through a series of topics critical for efficient hospital operations.

Evidence for the impact of quality improvement collaboratives: Systematic review

Thu, 07 Aug 2008 19:58:08 GMT

The authors conclude that the evidence underlying quality improvement collaboratives is positive but limited. They suggest that further knowledge to understand the basic components and success factors is needed. The accompanying Lindenauer editorial states that many improvement collaboratives "have improved care and saved many lives at participating hospitals," and he suggests these positive effects might have been missed due to various factors.

American health care system is in pieces — but some of the pieces are doing remarkably well

Wed, 06 Aug 2008 16:46:26 GMT

Despite the findings of The Commonwealth Fund's 2008 National Scorecard on US Health System Performance, IHI's Joe McCannon and Maureen Bisognano remind us that we can learn from the parts of the system that are performing exceedingly well to make meaningful progress.

Detection of adverse events in surgical patients using the Trigger Tool approach

Mon, 04 Aug 2008 18:18:14 GMT

The IHI Surgical Trigger Tool may offer a practical, easy-to-use approach to detecting safety problems in patients undergoing surgery. The tool can be the basis not only for estimating the frequency of adverse events in an organisation, but also determining the impact of interventions that focus on reducing adverse events in surgical patients.

International Forum on Quality and Safety in Health Care March 2009

Fri, 01 Aug 2008 15:25:00 GMT

The International Forum on Quality and Safety in Health Care, co-sponsored by IHI and the BMJ Publishing Group, is the premier international "gathering" of people committed to improving the quality of health care.

Paper Time Study Worksheet

Thu, 31 Jul 2008 16:32:00 GMT

This tool helps hospitals assess how nurses spend time on the unit during a shift and identify obvious inefficiencies and waste in processes; developed by the Institute for Healthcare Improvement (Cambridge, Massachusetts, USA).

New era of preventing birth-related deaths

Thu, 31 Jul 2008 16:15:30 GMT

Maureen Bisognano, Executive Vice President and COO of the Institute for Healthcare Improvement, talks about the Premier initiative to formalize care practices to eliminate preventable birth-related injuries and deaths. Best practices that have shown encouraging results in smaller-scale efforts at individual hospitals are also discussed.

The Best Practice: How the New Quality Movement is Transforming Medicine

Tue, 29 Jul 2008 15:47:21 GMT

Starting in the late 1990s, reports emerged showing that treatment-related deaths were the fifth leading cause of death for Americans, and hundreds of thousands of patients were being harmed by medical procedures. A group of visionary physicians, led by Donald Berwick and Paul Batalden, embarked on applying industrial quality improvement techniques in health care despite resistance from the medical community. This book tells the story of the burgeoning health care quality movement, and of how the medical landscape is being radically transformed — for the better. *For every book ordered using the Amazon.com link below, IHI will donate 10% of the purchase price to Medically Induced Trauma Support Services (MITSS).

Improving ICU Care: Reducing Complications from Ventilators and Central Lines

Tue, 29 Jul 2008 15:05:09 GMT

To improve safety and reduce complications in the ICU, Cape Coral Hospital (Cape Coral, Florida, USA) focused on improving communication using multidisciplinary rounds and eliminating ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CL-BSI). The result was a significant decrease in these hospital -acquired infections as evidenced by 17 months without a VAP and 19 months without a CL-BSI.

A transatlantic review of the NHS at 60

Tue, 29 Jul 2008 14:49:00 GMT

In his remarks at the 60th anniversary celebration of the UK's National Heatlh Service (NHS) in July 2008, IHI President and CEO Don Berwick comments on the NHS journey to achieve world-class health care excellence and makes ten suggestions for the future.

Clinical microsystems, part 2: Learning from micro practices about providing patients the care they want and need

Mon, 28 Jul 2008 16:08:21 GMT

Small, independent practices — micro practices — are incorporating attributes of successful microsystems such as patient focus, process improvement, performance patterns, and information technology to provide patients with the care they want and need.

Clinical microsystems, part 1: The building blocks of health systems

Mon, 28 Jul 2008 15:58:22 GMT

The body of knowledge on clinical microsystems can guide and support innovation and peak performance. Patients move into and out of an assortment of clinical microsystems such as a family practitioner's office, an emergency department, and an intensive care unit — their own unique "health system." This patient-centric view of a health system is the foundation of second-generation development for clinical microsystems.

Reducing Door-to-Balloon Time for AMI Patients

Mon, 28 Jul 2008 14:12:13 GMT

By focusing on key operational and clinical strategies in the emergency department, Baptist Memorial Hospital–DeSoto (Southaven, Mississippi, USA) reduced door-to-balloon time to less than 90 minutes.

Scholarships for IHI Programs

Fri, 25 Jul 2008 18:50:00 GMT

Enroll for IHI Program

Fri, 25 Jul 2008 18:37:00 GMT

Obtain Continuing Education Certificate

Fri, 25 Jul 2008 16:28:00 GMT

Global Trigger Tool Implementation Toolkit

Fri, 25 Jul 2008 14:24:00 GMT

This compendium of resources was developed by Florida Hospital (Orlando, Florida, USA), or adapted from the Institute for Healthcare Improvement (IHI), in the hospital's implementation of the IHI Global Trigger Tool.

Decreasing Harm to Patients by Standardizing Care

Tue, 22 Jul 2008 15:41:03 GMT

Northeast Health (Troy, New York, USA) decreased harm to patients by standardizing care, including implementation of the Central Line and Ventilator Bundles and formation of a Rapid Response Team.

Hospital boards and quality dashboards

Mon, 21 Jul 2008 22:11:33 GMT

The goals of this study were to assess the content and composition of hospital board dashboards, to examine how board dashboards are created and used by various constituencies in the hospital, and to identify structures and processes related to dashboard systems that most directly influence QI.

Engagement of leadership in quality improvement initiatives: Executive Quality Improvement Survey results

Mon, 21 Jul 2008 22:02:36 GMT

This article evaluates the results of a survey to identify the characteristics of hospital leadership engagement in quality improvement that are most likely to strengthen quality improvement activities within hospitals.

Leaders need dashboards, dashboards need leaders

Mon, 21 Jul 2008 21:52:56 GMT

Performance dashboards are rapidly evolving hospital leadership decision support tools. This article describes market forces that will require hospital leaders to be directly involved in development of such tools.