2023–​2024 Members

• Barts Health NHS Trust, England, UK
• Bedfordshire, Luton, Milton Keynes Health and Care Partnership, England, UK
• Belfast Heath and Social Care Trust, Northern Ireland, UK 
• Cambridge University Hospital, England, UK
• Central and North West London NHS Foundation Trust, England, UK
• Danish Society for Patient Safety, Denmark
• Dartford & Gravesham NHS Trust, England, UK 
• Estonian Hospital Association, Estonia 
• FlaQuM-KULeuven, Belgium
• Guelph Community Health Center, Canada 
• Hampshire and IOW Integrated Care System, England, UK 
• Health and Social Care Quality Improvement (HSCQI), Northern Ireland, UK
• Health Quality BC, Canada
• Imperial College Healthcare NHS Trust, England, UK
• Jesus Seijo Coello Hospital, Venezuela
• Landspitali National University Hospital, Iceland
• Leeds and York Partnership NHS Foundation Trust, England, UK
• London Ambulance Service NHS Trust, England, UK
• Lumell Associates, Sweden 
• Municipality of Aarhus, Department for Health and Care, Denmark
• Newcastle Hospitals NHS Foundation Trust, England, UK
• NHS Ayrshire & Arran, Scotland, UK 
• NHS England, England, UK
• NHS Scotland and Scottish Government, Scotland, UK
• North East London NHS Foundation Trust, England, UK
• Northern Health and Social Care Trust, Northern Ireland, UK
• Northern Ireland Practice and Education Council for Nursing and Midwifery (NIPEC), Northern Ireland, UK
• Plateforme pour l'Amélioration continue de la Qualité des soins et de la Sécurité des patients (PAQS), Belgium
• Public Health Wales, Wales, UK
• Ribera Salud Group, Spain
• Royal Free London NHS Foundation Trust, England, UK
• South Eastern Heath and Social Care Trust, Northern Ireland, UK
• Southern Heath and Social Care Trust, Northern Ireland, UK
• Surrey and Borders Partnership NHS Foundation Trust 
• The County Council of Region Jönköping, Sweden
• The King’s Fund, England, UK 
• Western Health and Social Care Trust, Northern Ireland, UK
• Westminster City Council, England, UK

Advisors

Image

Derek Feeley, former ​President and CEO of IHI, previously served as its Executive Vice President from 2013 to 2015, during which time he had executive-level responsibility for driving IHI’s strategy in five focus areas: Improvement Capability; Person- and Family-Centered Care; Patient Safety; Quality, Cost, and Value; and the Triple Aim. Prior to joining IHI in 2013, Mr. Feeley served as Director General for Health and Social Care in the Scottish Government and Chief Executive of the National Health Service (NHS) in Scotland. In that role he was the principal advisor to the Scottish Government on health and health care policy and on public service improvement. He also provided leadership to NHS Scotland’s 140,000 staff in their delivery of high-quality health and health care. In 2013, Mr. Feeley was made a Companion of the Order of the Bath by Her Majesty, Queen Elizabeth II, in recognition of his services to health and health care.

Image

Pedro Delgado, MSc, Vice President, IHI, has a unique ability to work across cultures, languages, and systems. Based in the United Kingdom, he has been a driving force in IHI’s global strategy. From work on reducing C-sections in Brazil, to improving early years education in Chile, to improving patient safety in Portugal and mental health in London, Mr. Delgado has led the key senio​r relationships and design and implementation of large-scale health system improvement efforts and networks globally. He coaches senior leaders and teams, and lectures extensively worldwide on large-scale change, patient safety, and quality improvement. During his time at IHI, he also facilitated the Quality and Innovation Centers network, which included Kaiser Permanente’s Performance Improvement Institute, Qulturum in Jönköping County (Sweden), and the James Anderson Center for Clinical Excellence at Cincinnati Children’s Hospital. His background is rich in diversity, including a brief period as a professional football (soccer) player, roles in hospital management and large-scale improvement leadership in the UK, and experience working in mental health in Venezuela and the UK. He holds summa cum laude degrees in Psychology and in Global Business, and an MSc in Healthcare Management and Leadership.

Image

Susan Hannah, Senior Director, IHI, has a background in high-care nursing and expertise as a leader for patient safety and clinical improvement in Scottish health care, responsible for the delivery of patient safety in a health system and serving as faculty for the national program. A trained Improvement Advisor, she worked in the Scottish government for six years, performing improvement and leadership roles to influence the adoption of quality strategies and improvement science in government policy teams and across public services. Ms. Hannah led the design and delivery of a national Raising Attainment for All QI Collaborative for Education, later amalgamating this with the Early Years Collaborative to establish and lead the Children and Young People Improvement Collaborative, a large-scale national program that delivers multiagency quality improvement communities working to improve health and achievement outcomes across Scotland.

Image

Angela G. Zambeaux, Director, IHI, has managed a wide variety of IHI projects and programs. Since 2013 Ms. Zambeaux has managed the Always Events program and contributed to the spread of Always Events across NHS England through the publication of a toolkit and coaching of improvement teams. She has worked with The Conversation Project and Conversation Ready projects to help make sure people’s end-of-life care wishes are expressed and respected. As Operational Director for Europe, her role includes project design, delivery, and evaluation. Prior to joining IHI, Ms. Zambeaux provided project management support to a small accounting firm and spent a year in France teaching English to elementary school students.​

Image

Andreia Cavaco, Project Manager, IHI, is experienced in quality improvement projects. Ms Cavaco spent most of her career in the UK, where she was the programme and communications manager for the Patient Safety Collaborative for the Northeast and North Cumbria Academic Health Science Network. She also worked as a senior programme manager at the external quality delivery arm of Northumbria Healthcare NHS Foundation Trust, Rubis.Qi, working with projects across the UK. She is delighted to have joined IHI in May 2022 and to be the Project Manager for the Health Improvement Alliance Europe.

Disclaimer: Consistent with the IHI’s policy, faculty for this program are expected to disclose at the beginning of their presentation(s) any econ​omic or other personal interests that create, or may be perceived as creating, a conflict related to the material discussed. The intent of this disclosure is not to prevent a speaker with a significant financial or other relationship from making a presentation, but rather to provide listeners with information on which they can make their own judgments.

Unless otherwise noted below, each presenter provided full disclosure information, does not intend to discuss an unapproved/investigative use of a commercial product/device, and has no significant financial relationship(s) to disclose. If unapproved uses of products are discussed, presenters are expected to disclose this to participants.​

​While it is widely reported that physicians’ mental health is worsening, barriers to seeking mental health care remain unacceptably high.

In the spring and summer of 2021, representatives from the IHI Leadership Alliance collaborated to identify opportunities for collective and longitudinal action to eliminate physician credentialing- and licensing-related impediments to seeking mental health care. The Help Health Care Heal Coalition is a special interest Call to Action initiative hosted by the IHI Leadership Alliance that was created to collaboratively advance this work.

This action-minded Coalition was convened by IHI faculty leader, Dr. Saranya Loehrer, together with industry expert and co-conspirator, Dr. Eileen Barrett. The IHI Leadership Alliance proudly supports and works to advance the group’s impact.

Remove Barriers to Physicians Seeking Mental Health Care

In January 2022, Modern Healthcare published an article, "The connection between credentialing and physician mental health: a call to action," co-authored by Dr. Eileen Barrett, who serves as faculty for the IHI Leadership Alliance. While health care leaders continue to commend the ways in which physicians and the entire health care workforce have compassionately cared for the sick during the COVID-19 pandemic, below are five concrete actions leaders can take today to support physicians as they continue this vital work. Dr. Barrett co-authored an additional article, "Reducing health care barriers for hospitalists," in collaboration with coalition members oultining further action health care leaders can take.

• Determine how your organization asks questions related to physician mental health on credentialing applications.
• Identify how your state medical board presently asks questions related to physician mental health on licensing applications.
• Advocate for the recommended non-stigmatizing questions and supportive language to be used among healthcare organizations, state medical boards and insurers.
• Identify and mitigate barriers to physicians seeking mental health care.
• Encourage investments in evidence-based research and interventions that promote and protect physician mental health.

Spread This Work in Your Organization

The Help Health Care Heal Coalition has developed slides and talking points that you can use to spread this work in your organization and eliminate barriers to physicians and residents seeking mental health care.

• Help Health Care Heal Coalition Slides
• Talking points when asking an organization to support physicians
• Send this email to your privileging or credentialing office to request changing your application
• Add this slide to any upcoming presentation, on using tools to reduce stigma in medical applications
• Responses to common questions when asking that applications don't stigmatize mental health
• Student presentation to attendings on reducing barriers to mental health care for students and physicians
• Send this email to your Dean of Student Affairs to request not asking about mental health on credentialing applications
• Help Health Care Heal Coalition references and resources

Additional Resources

• Choosing Meaningful Actions to Support Clinicians’ Mental Health
• One Way to Stop Stigmatizing Physicians Receiving Mental Health Care

“You broke the rules for us, and it made all the difference.”

This statement, made by a family member recalling how a nurse “broke” a hospital rule regarding visitation so that a new mom and her baby were able to visit one another inspired an idea. It got members of the IHI Leadership Alliance thinking: How many rules do we currently have in place that were likely created with the best of intentions but don’t benefit patients, families, or staff?

In February 2023, the IHI Leadership Alliance, IHI Health Improvement Alliance Europe, and global members led the third iteration of the "Breaking the Rules for Better Care" initiative, in which leaders were encouraged to ask their patients and staff a simple question: 
 

“If you could break or change one rule in service of a better care experience for patients or staff, what would it be and why?”

More than 100 organizations participated in the Breaking the Rules for Better Care coalition, and in one week over 600 rules were identified. Executive leaders collaborated to solicit and then take action on the myths, habits, and outdated "rules" that get in the way of the care experience.

We have learned from previous Breaking the Rules offerings, that the question is simple, but it takes courage to ask, planning to prioritize, and a commitment to follow up.

Breaking the Rules for Better Care Resource Guide

Host your own Breaking the Rules for Better Care Week. Use this step-by-step guide to get started with planning and hosting a Breaking the Rules initiative in your own organization.

Download the Breaking the Rules Resource Guide

"Rule Breakers": Share Your Ideas

The IHI team is thrilled that you are taking part in Breaking the Rules for Better Care. We are eager to celebrate your efforts and to learn from your experiences and findings. Please complete a short survey to share any ideas, insights, and data from your local Breaking the Rules activities.

Short Survey: Share Your Breaking the Rules Activities

Additional Resources

• Breaking the Rules to Improve Care and Increase Joy in Work and Well-Being
• Breaking the Rules for Better Care 2023: Listen to a recording​ of the January 2023 informational call
• IHI Leadership Alliance New Rules for Radical Redesign
• 10 New Rules to Accelerate Healthcare Redesign
• JAMA Viewpoint: Breaking the Rules for Better Care

Breaking the Rules for Better Care Resource Guide

Learn more about Breaking the Rules for Better Care and download the step-by-step resource guide to plan and host a "Breaking the Rules" initiative in your own organization.

Salve Lucrum: The Existential Threat of Greed in US Health Care

Written by Alliance Senior Advisor, Dr. Don Berwick, this JAMA piece invites discussion and collective actions leaders can take to address the threat of greed in US health care.

American Health Care Is Broken. Major Hospitals Need to Be Part of the Solution.

Written by Alliance Senior Advisor, Dr. Don Berwick, this piece examines the role hospitals need to take to solve the current issues in American health care.

Reducing Mental Health Care Barriers for Hospitalists

Co-authored by Alliance Faculty, Dr. Eileen Barrett, this piece illustrates actions health care organizations can take to reduce mental health care barriers for hospitalists. This piece was a collaboration with members of the Help Health Care Heal Coalition.

Preventing Verbal and Physical Violence across the Health Care Workforce (Toolkit)

IHI Leadership Alliance members prioritized workforce safety and well-being as an urgent priority, leveraging one of their many workgroups to collectively explore this topic, share relevant best practices, and harvest learnings from one another. During the 2021–2022 Alliance year, the Workforce Safety and Well-Being Workgroup homed in on verbal and physical workplace violence in the pursuit of demonstrating alignment of workforce violence prevention and response efforts with advancing system transformation to improve workforce safety and well-being. This toolkit, informed by Alliance members and supplemented with external industry scanning, is intended to be a starting place for health care organizations on their journey to address workplace violence.

COVID Has Made the Office Visit a Dinosaur

Written by Alliance leaders Drs. Doug Eby and Ed McGookin and IHI Executive Drector Jill Duncan, RN, MPH, this piece examines the fate of visit-based medicine and the innovations to the system brought on by COVID-19.

​Under the Cover of COVID-19 News, the Epidemic of Opioid Overdoses Silently Surges

Leadership Alliance Opioid and Substance Use Disorder Workgroup co-leads Mara Laderman, MSPH, Miriam Komaromy, MD; James Moses, MD, MPH; and Mark Jarrett, MD, MBA authored this piece in Becker's Hospital Review highlighting the worsening opioid epidemic, exacerbated by every imaginable challenge brought on by COVID-19.​

Alliance Members Endorse Congressional Action to Safeguard Telehealth Services

On July 16, 2020, IHI Leadership Alliance member organizations endorsed a letter requesting Congressional action to safeguard the sustainability of telehealth care services through continued regulatory adjustments, the establishment of quality metrics to ensure high-quality telehealth delivery, and payment changes.

​Call for Collaboration: Health Care Leaders to the EHR Community to Fight COVID-19

​​​50 leaders representing a diverse cross-section of the global health care delivery community​ signed this document.

A Living Wage for Health Care Workers Is Essential to Achieve Health Equity

This opinion and editorial piece co-authored by Alliance member Stephen Mette, MD; and Alliance faculty Saranya Loehrer, MD, was published by Modern Healthcare on January 9, 2020.​ The piece touches on the IHI Leadership Alliance set of actions that can increase health equity within health systems and communities.​

Call to Action: Reduce Waste in the US Health Care System and Return the Cost Savings to Patients and the Economy

The IHI Leadership Alliance believes that eliminating “waste” in health care is essential to providing care at an affordable cost. To that end, the Alliance Waste Workgroup has developed an audacious aim: Systematically and proactively identify and eliminate 50 percent of non-value-added waste in the US health care system by 2025. Chaired by MemorialCare Health System Chief Transformation Officer, Helen Macfie, and Chief Medical Officer, Dr. James Leo, this Alliance workgroup is calling on health systems and providers to commit to a Call to Action to do our part to reduce waste in the US health care system.

Additional resources:

• Leadership Alliance Waste Portfolio Overview
• “Trillion Dollar Checkbook”: Reduce Waste and Cost in the US Health Care System: An in-depth analysis of significant and in many cases complex opportunities to reduce waste and cost.
• Driver Diagram: Systematically and Proactively Identify and Eliminate Non-Value-Added Waste in the US Health Care System by 2025
• IHI Leadership Alliance Waste Workgroup Driver Diagram Template

Health Systems Try to Trim Waste to Reduce Health Care Spending

A Modern Healthcare piece featuring Jill Duncan, RN, Alliance workgroup co-chair Helen Macfie, PharmD, and several other Alliance members.

How Three Health Systems Are Tackling Waste

A Modern Healthcare piece highlighting stories from Alliance member organizations Bellin Health, Northwell Health, and Providence.

Leadership Alliance Health Equity Call to Action

A Leadership Alliance steering committee drafted this Health Equity Call to Action to reflect Alliance-wide commitment to advancing health equity. Chaired by Dr. Steppe Mette, Chief Clinical Officer for Alliance member UAMS Medical Center, the Committee challenges Alliance members and health professionals nationwide to endorse this Call to Action on the premise that achieving health equity is essential to achieving the full promise of the Triple Aim.