IHI White Papers - Institute for Healthcare Improvement

IHI's Innovation Series white papers are designed to share the problems IHI is working to address; the ideas, changes, and methods we are developing and ... Pleasewaitwhileyouarebeingredirected... ThissiteisbestviewedwithInternetExplorerversion8orgreater.CheckyourbrowsercompatibilitymodeifyouareusingInternetExplorerversion8orgreater. 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AFrameworkforSafe,Reliable,andEffectiveCare Theframeworkdescribedinthiswhitepaperbringstogetherthestrategic,clinical,andoperationalconceptsthatarecriticaltocreatinga"systemofsafety"thatachievessafe,reliable,andeffectivecare. Telemedicine:EnsuringSafe,Equitable,Person-CenteredVirtualCare Thiswhitepaperdescribesaframeworktoguidehealthcareorganizationsintheireffortstoprovidesafe,equitable,person-centeredtelemedicine.Theframeworkincludessixelementstoconsider:access,privacy,diagnosticaccuracy,communication,psychologicalandemotionalsafety,andhumanfactorsandsystemdesign. IHIPsychologyofChangeFramework Thiswhitepaperisaguideforallleadersinterestedinunderstandingtheunderlyingpsychologyofchangeandleveragingitspowertoimpactqualityimprovementefforts:toachievebreakthroughresults,sustainably,atscale. AchievingHealthEquity:AGuideforHealthCareOrganizations Thiswhitepaperpresentsaframeworkforhealthcareorganizationstoimprovehealthequityinthecommunitiestheyserve,guidanceformeasuringhealthequity,acasestudyofoneorganizationthathasstrategicallyintegratedhealthequitythroughoutitssystem,andaself-assessmenttoolfororganizationstogaugetheircurrentfocusonandeffortstoimprovehealthequity. WholeSystemQuality Thiswhitepaperdescribesamoreholisticapproachtoqualitymanagementthatintegratesqualityplanning,qualitycontrol,andqualityimprovementactivitiesacrosstheorganization,supportedbyleadershippracticesthatfosteracultureoflearning. IHIFrameworkforImprovingJoyinWork Withburnoutandstaffturnoverinhealthcarecontinuingtoriseatalarmingrates,thiswhitepaperdescribesfourstepsleaderscantaketoimprovejoyinwork;aframeworkwithninecriticalcomponentsforensuringajoyful,engagedworkforce;keychangeideas;andmeasurementandassessmenttools. IHIGlobalTriggerToolforMeasuringAdverseEvents(SecondEdition) ThiswhitepaperprovidesinformationonthedevelopmentandmethodologyoftheIHIGlobalTriggerTool,enablingtheabilitytoaccuratelyidentifyadverseeventsandmeasuretherateofadverseeventsovertime. ImprovingBehavioralHealthCareintheEmergencyDepartmentandUpstream Thiswhitepaperprovidesactionableguidanceforhospitalemergencydepartmentsandtheircommunitypartnerstocreateacompassionate,seamless,andeffectivesystemofcareformentalhealthandsubstanceusedisorderpatientswhopresenttotheED. AGuidetoMeasuringtheTripleAim:PopulationHealth,ExperienceofCare,andPerCapitaCost ThiswhitepaperprovidessuggestedmeasuresforthethreedimensionsoftheTripleAim,accompaniedbydatasourcesandexamples,anddescribeshowthesemeasuresmightbeusedalongwithprocessandoutcomemeasuresforparticularprojectstocreatealearningsystemtoachievetheTripleAim. High-ImpactLeadership:ImproveCare,ImprovetheHealthofPopulations,andReduceCosts Leadersatalllevelsincaredeliveryorganizations,notjustseniorexecutives,arestrugglingwithhowtofocustheirleadershipeffortsandachieveTripleAimresults—betterhealth,bettercare,atlowercost—forthepopulationstheyserve.High-impactleadershipisrequired.Thiswhitepaperpresentsthreeinterdependentdimensionsofleadershipthattogetherdefinehigh-impactleadershipinhealthcare:newmentalmodels,High-ImpactLeadershipBehaviors,andtheIHIHigh-ImpactLeadershipFramework. ComparingLeanandQualityImprovement ThisIHIwhitepaperprovidesdetaileddescriptionsofLeanandtheIHIapproachtoqualityimprovement,includingthebasicconceptsandprinciplesofeachapproach,howtheyaresimilaranddifferent(inhistoryandapproach),andforwhatpurposeseachapproachisthemostappropriate. SustainingImprovement Thiswhitepaperpresentsaframeworkthathealthcareorganizationscanusetosustainimprovementsbyfocusingonthedailyworkoffrontlinemanagers,supportedbyasystemofstandardtasksandresponsibilitiesformanagersatalllevelsoftheorganization. HospitalInpatientWasteIdentificationTool TheHospitalInpatientWasteIdentificationToolprovidesasystematicmethodforhospitalfrontlineclinicalstaff,membersofthefinancialteam,andleaderstoidentifyclinicalandoperationalwasteandsubsequentlyprioritizeandimplementwastereductioninitiativesthatwillresultincostsavingsfortheorganization. AchievingHospital-widePatientFlow Thiswhitepaperguideshealthcareleadersandqualityimprovementteamsthroughanin-depthexaminationofasystem-wideviewofpatientflowwithin(andoutside)thehospital,includinghigh-leveragestrategiesandinterventionstoachievehospital-widepatientflow. IHIWhitePapers IHI’sInnovationSerieswhitepapersaredesignedtosharetheproblemsIHIisworkingtoaddress;theideas,changes,andmethodswearedevelopingandtestingtohelporganizationsmakebreakthroughimprovements;andearlyresultswheretheyexist. FrameworkforEffectiveBoardGovernanceofHealthSystemQuality Thiswhitepaperpresentsanactionableframeworkwiththecoreprocessesneededforeffectiveboardgovernanceofalldimensionsofhealthsystemquality;anassessmenttool;andsupportguidesforthreecentralknowledgeareasfortrusteeoversightofquality. "ConversationReady":AFrameworkforImprovingEnd-of-LifeCare(SecondEdition) Thiswhitepaperpresentsaframeworkbuiltonfivecoreprinciplestohelphealthcareorganizationsandcliniciansdevelopreliableprocessestoengagepatientsinconversationsabouttheirwishesforend-of-lifecare,stewardthatinformation,andproviderespectfulend-of-lifecarethatisconcordantwithpatients’statedgoals,values,andpreferences. IHIInnovationSystem DrawingonIHI'snearly30yearsofexperiencewithinnovation,thiswhitepaperprovidesadetaileddescriptionofIHI’sinnovationsystem,including90-DayLearningandTestingCycles,anddescribeshowahealthcareorganizationmightcreateitsowninternalinnovationsystemthatfocusesonimprovinghealthcaredelivery. OptimizingPatientFlow:MovingPatientsSmoothlyThroughAcuteCareSettings Inthiswhitepaper,IHIoffersperspectivesontheimpedimentstotimelyandefficientflowofpatientsthroughacutecaresettings. WholeSystemMeasures2.0:ACompassforHealthSystemLeaders ThiswhitepaperpresentsWholeSystemMeasures2.0,asetof15measurestohelphealthcaresystemleadersandboardsbetterunderstandtheirorganization’scurrent(anddesired)performanceacrossthree(TripleAim)domains:populationhealth,experienceofcare,andpercapitacost. TheBreakthroughSeries:IHI’sCollaborativeModelforAchievingBreakthroughImprovement IHIdevelopedtheBreakthroughSeriestohelphealthcareorganizationsmakebreakthroughimprovementsinqualitywhilereducingcosts. UsingCareBundlestoImproveHealthCareQuality ThisIHIwhitepaperdescribesthehistory,theoryofchange,designconcepts,andoutcomesassociatedwiththedevelopmentanduseofbundles—asmallsetofevidence-basedinterventionsforadefinedpatientpopulationandcaresetting—andreflectsonlearningoverthepastdecade. CareCoordinationModel:BetterCareatLowerCostforPeoplewithMultipleHealthandSocialNeeds Thiswhitepaperoutlinesmethodsandopportunitiestobettercoordinatecareforpeoplewithmultiplehealthandsocialneeds,andreviewswaysthatorganizationshaveallocatedresourcestobettermeettherangeofneedsinthispopulation.Theelevatedcostofcareinthispopulationoffersatremendousopportunitytocraftaservicedeliveryplanthatmeetstheirneedsmoreeffectivelyatasignificantlylowercost. RespectfulManagementofSeriousClinicalAdverseEvents Thiswhitepaperintroducesanoverallapproachandtoolsdesignedtosupporttwoprocesses:theproactivepreparationofaplanformanagingseriousclinicaladverseevents,andthereactiveemergencyresponseofanorganizationthathasnosuchplan. WholeSystemMeasures Thiswhitepaperdescribesandpromotestheuseofasystemofmetrics,calledtheWholeSystemMeasures,tomeasuretheoverallqualityofahealthsystemandtoalignimprovementworkacrossahospital,grouppractice,orlargehealthcaresystem.    12