Institute for Healthcare Improvement

A Transatlantic Review of the NHS at 60

Wed, 02 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.

The new challenge in patient safety: Transforming leadership infrastructure through widespread board engagement

Tue, 01 Jul 2008 13:30:15 GMT

It is time to take leadership improvement in health care to an even higher level. The Institute for Healthcare Improvement (IHI) is asking the nation’s hospitals to do something even more transformative in the remaining months of the 5 Million Lives Campaign: By December 2008, double the number of hospitals whose boards have committed to making harm reduction a top priority.

Taming the technology beast

Mon, 30 Jun 2008 16:14:56 GMT

This editorial comments on the report by van der Togt and colleagues on electromagnetic interference (EMI) from radiofrequency identification (RFID) technologies affecting other medical equipment in intensive care units such as infusion pumps, external pacemakers, and mechanical ventilators. The investigators found 22 of 34 EMI incidents were hazardous. Berwick points out that another important lesson of the study is that physicians and other health care decision makers should tame technology, not avoid it.

Unit-based clinical pharmacists’ prevention of serious medication errors in pediatric inpatients

Fri, 27 Jun 2008 20:14:44 GMT

This study measured rates of serious medication errors in three pediatric inpatient units (intensive care, general medical, and general surgical) before and after introduction of unit-based clinical pharmacists. The authors conclude that a full-time unit-based clinical pharmacist substantially decreased the rate of serious medication errors in a pediatric ICU, but a part-time pharmacist was not as effective in decreasing errors in pediatric general care units.

May I have the envelope please?

Tue, 24 Jun 2008 18:13:48 GMT

This article introduces the idea of applying the aviation concept of performance envelopes — testing and defining the outer limits of safety — in health care. The author proposes that there are two health care safety envelopes to be considered: 1) the boundaries of caregivers (human factors) that are defined by their skills, knowledge, and human capabilities, and often impacted by fatigue, the work environment, and distractions; and 2) the system or systems that the caregiver is operating within.

Management Lessons from Mayo Clinic: Inside One of the World's Most Admired Service Organizations

Mon, 23 Jun 2008 16:11:00 GMT

This book describes how Mayo Clinic, a complex service organization, fosters a culture that exceeds customer expectations and earns deep loyalty from both customers and employees. Includes how Mayo Clinic implements and maintains its strategy, adheres to its management system, executes its care model, and embraces new knowledge.

Reducing VAP for Long-Term Mechanical Ventilation Patients using the Ventilator Bundle

Mon, 23 Jun 2008 15:15:00 GMT

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.

Strong roots: Oregon hospital a pioneer in patient-centered Planetree concept

Fri, 20 Jun 2008 20:54:10 GMT

A small rural hospital creates a more healing environment for patients and families using the Planetree model. Planetree is a growing movement to transform the health care experience by considering every aspect from the patient’s perspective.

Nevada RNs prevent pressure ulcers

Fri, 20 Jun 2008 20:44:28 GMT

Clinical educators at one hospital in Nevada have begun to work with nurses to improve pressure ulcer care. These nurses are learning more about how to identify skin conditions early, stage wounds, assess risk for skin breakdown, and intervene to prevent pressure ulcers from developing.

Texas hospitals reduce VAP

Fri, 20 Jun 2008 20:27:00 GMT

Not that long ago, nurses considered ventilator-associated pneumonia (VAP) an accepted risk for critically ill patients requiring mechanical respiratory support, but no more. Nurses have learned that their consistent efforts can decrease the risk of the potentially lethal, nosocomial infection.

Author in the Room

Thu, 19 Jun 2008 21:00:17 GMT

In partnership with JAMA, this program is designed to bring clinical evidence into practice by connecting practitioners to authors of JAMA articles.

Missouri Baptist Medical Center: Where the Raw Mortality Rate Dropped 22 Percent Between 2002 and 2006

Thu, 19 Jun 2008 19:31:32 GMT

At Missouri Baptist Medical Center, they call it “putting it all together,” the ability to take the kind of multi-faceted approach to improving safety that results in reduced mortality rates.

Cracking the Code to Hospital-Wide Patient Flow July 2008

Thu, 19 Jun 2008 13:34:13 GMT

Flow is a property of the entire system and can only be optimized at the system level. Through IHI’s work with hundreds of institutions, a framework has evolved that allows for an organized approach to improving the system of patient flow.

Cracking the Code to Hospital-Wide Patient Flow February 2009

Thu, 19 Jun 2008 13:34:00 GMT

Managing Hospital Operations January 2009

Wed, 18 Jun 2008 20:43:35 GMT

A five-month interactive program to help health care leaders improve operations by learning about and applying management techniques and strategies not traditionally used in health care.

Applying Queuing Theory to Health Care: Managing Random Demand in a Fixed Capacity Environment June 2008

Mon, 16 Jun 2008 16:45:02 GMT

Queuing theory is a powerful tool that can be applied to health care settings to solve the relationship between random customer demand and fixed capacity. There are different models designed to solve different types of problems, and the key to success is applying the right model in the right setting.

Reducing Birth-Related Trauma and Liability Exposure

Thu, 12 Jun 2008 17:49:00 GMT

Lehigh Valley Hospital and Health Network (Allentown, Pennsylvania, USA) reduces birth-related trauma through their work as part of a Perinatal Innovation Community.

From the Top: The Role of the Board in Quality and Safety

Wed, 11 Jun 2008 20:52:00 GMT

Led by experts in governance and quality, this program will help improve the capability of your organization's board to oversee quality and safety endeavors.

Medication List and Perioperative Patient Instructions

Wed, 11 Jun 2008 19:17:00 GMT

A sample medication list to be used with patients pre- and postoperatively; developed by Contra Costa Regional Medical Center (Martinez, California, USA).

10th Annual International Summit on Redesigning the Clinical Office Practice

Wed, 11 Jun 2008 17:48:57 GMT

The Summit is a world-class conference featuring the best ideas and faculty on areas that are ripe for improvement within the office practice and outpatient settings.

AnMed Health Medical Center: Where Coordinated Care Yields Better Outcomes for Heart Attack Patients

Tue, 10 Jun 2008 20:27:00 GMT

Each year, more than a million Americans have a heart attack — also known as an acute myocardial infarction, or AMI. A third of them don’t survive. Optimal AMI care includes a specific series of steps and components, and timing is key.

Contra Costa Regional Medical Center: Where the Rate of VAP Dropped By More Than 90 Percent Through Collaborative Efforts

Tue, 10 Jun 2008 19:00:00 GMT

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

Tue, 10 Jun 2008 18:55:00 GMT

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.

Nebraska Medical Center: Where the Hospital Avoided Estimated Expenses of $3.6 Million Over Two Years by Preventing Pressure Ulcers

Tue, 10 Jun 2008 17:56:00 GMT

Pressure ulcers, commonly known as bedsores, used to be regarded as an unfortunate but sometimes unavoidable result of hospitalization. Fortunately, all that is changing, thanks to new understanding about how to prevent pressure ulcers.

Profiles in Improvement: Doug Bonacum of Kaiser Permanente

Mon, 09 Jun 2008 14:46:00 GMT

Who's improving health care? People are. Listen to the story of Doug Bonacum of Kaiser Permanente.

Achieving the Triple Aim: The Simultaneous Pursuit of Excellent Health, Ideal Care, and Controlled Costs June 2008

Fri, 06 Jun 2008 19:14:38 GMT

This ground-breaking two-day seminar will provide health care professionals with the opportunity to learn a specific framework for achieving the Triple Aim and to develop a plan for applying the framework to their own organizations.

IHI Open School for Health Professions

Fri, 06 Jun 2008 18:03:17 GMT

The IHI Open School for Health Professions aims to advance quality improvement and patient safety competencies in the next generation of health professionals worldwide.

Reliability in Planned Care: Office Practice Redesign

Thu, 05 Jun 2008 19:13:44 GMT

Seeking to achieve both high reliability of evidence-based care and improved satisfaction for patients and staff, the office practice at CareSouth Carolina, Inc. (Hartsville, South Carolina, USA) initiated changes in both clinical and administrative that led to a cascade of positive effects in reliability of care and satisfaction of patients and staff.

Quality improvement: How can we improve patients' care?

Wed, 04 Jun 2008 20:17:22 GMT

A group of health professions students from seven countries participated in the International Forum on Quality and Safety in Health Care, held April 2008 in Paris. Each day the students met to reflect on key topics discussed in the sessions they attended. This article provides a summary of some take-home lessons on topics such as improvement methodologies, effective teamwork and communication, and involving students early in quality improvement.

Veterans Affairs New Jersey Health Care System: Where Patients Have Easy Access to Appointments

Wed, 04 Jun 2008 18:28:00 GMT

Once notorious for long wait times for appointments, the Veterans Health Administration worked with IHI for years on a massive initiative to improve access to timely appointments across more than 1,800 primary care, audiology, cardiology, eye care, orthopedics and urology clinics.

Fairview Health Services: Where Medication Reconciliation Improves Safety and Avoids Additional Costs

Wed, 04 Jun 2008 17:58:00 GMT

Medication reconciliation is complex on a system level, particularly as patients move in and out of the hospital. Using a combination of electronic medical records, inpatient pharmacy systems, and pharmacy technicians, Fairview has achieved an average 90.6 percent success rate for outpatients in its 60-some clinics, and an average success rate of 74.1 percent for inpatients across its seven hospitals.