Institute for Healthcare Improvement: Improvement Stories

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IHI.org has two types of Improvement Stories:

IHI.org Stories that describe the changes and results in specific organizations.
Improvement Project Reports from IHI.org users that describe improvement projects in their organizations.

We all learn from others' experiences testing and implementing changes in real settings — who should be on the team; what measures were tracked; which changes worked best or didn't work at all; and what lessons were learned.

Improvement Project Reports, submitted by IHI.org users, accelerate our learning. In the spirit of "all teach, all learn," we encourage you to share your Improvement Project Report with the IHI.org community. Please click the Submit an Improvement Report button below.

Choose the story types you would like to see:

Improvement Project Reports
IHI.org Stories

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Improving ICU Care: Reducing Complications from Ventilators and Central Lines
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.

Decreasing Harm to Patients by Standardizing Care
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.

Moving Toward Recovery
Conventional medical wisdom holds that physical activity is not an option for seriously ill patients tethered to life-saving equipment, and it is well-known that prolonged immobility causes severe and durable muscle weakness. Some hospital ICUs are demonstrating that ventilator patients can walk, even with breathing equipment and IV lines in place, and the activity benefits all aspects of their recovery.

Reducing VAP for Long-Term Mechanical Ventilation Patients using the Ventilator Bundle
Coler♥Goldwater Specialty Hospital and Nursing Facility (Roosevelt Island, New York, USA) reduced ventilator-associated pneumonia (VAP) from 2.4 to 1 VAP per 1,000 ventilator days among patients on long-term mechanical ventilators, primarily by implementing elements of the IHI Ventilator Bundle.

Contra Costa Regional Medical Center: Where the Rate of VAP Dropped By More Than 90 Percent through Collaborative Efforts
At Contra Costa, a conscious effort from the top down and the bottom up creates a culture of collaboration and teamwork. Teamwork has enabled improvement of care processes and patient outcomes in many areas, including ventilator-associated pneumonia (VAP).

Johns Hopkins Children’s Center: Where Pharmacists on Rapid Response Teams Boost Effectiveness
At Johns Hopkins Children’s Center, pharmacists play an invaluable role on the Rapid Response Team, helping to prepare medications so nurses can focus on attending to the patient’s immediate needs.

Parkland Medical Center: Where the MRSA Rate Has Decreased for Three Years in A Row
Carefully following proper hand hygience procedures has helped Parkland Medical Center reduce hospital-acquired infections, particularly methicillin-resistant Staphylococcus aureus (MRSA). This has required a relentless attention to a collection of proactive interventions, including environmental decontamination, active surveillance cultures for at-risk patients, and aggressive isolation precautions.

BryanLGH Medical Center: Where One ICU Went 27 Months with No Cases of VAP
BryanLGH Medical Center has decreased the number of ventilated patients getting pneumonia. All this is the result of the hospital’s success over the past few years in its three ICUs by implementing the Ventilator Bundle — a set of proven steps for preventing ventilator-associated pneumonia.

North Carolina Children’s Hospital: Where Parents Are Considered Part of the Medical Team
North Carolina Children’s Hospital gives family members the same direct access to the Rapid Response Team as the rest of the medical staff. Patients and families view the Rapid Response Team as an extension of the clinical team already taking care of their child, a kind of safety net.

Saving Lives: Simple Interventions DO Really Help in the ICU
PeaceHealth/St. Joseph Hospital (Bellingham, WA, USA) implemented the Ventilator and Central Line Bundles, resulting in 4+ months without a ventilator-associated pneumonia and 3+ months without a central line infection.

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