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  • Congratulations on Year 1 of 100 Million Healthier Lives!
    the costs associated with health care This became the Triple Aim and as we began to engage organizations in improving the experience of care improving the health of a population and reducing per capita costs we realized that health care can only do so much We need to continue to improve quality and safety in health care However improving health to prevent the need for health care and the associated costs by improving care and addressing the social determinants of health is an essential element of the path forward So in many ways the Triple Aim has become a framework for us to think about addressing all the determinants of health It is clear that doing so requires a broad collaboration that extends far beyond the walls of health care and far beyond the walls of IHI An example of this kind of collaboration can be seen in Scotland s Early Years Collaborative After successfully applying the methods and tools of improvement to dramatically improve the safety of health care in Scotland leaders there decided to use the same methods and tools to pursue the ambitious aim of making Scotland the best place for any child to grow up These leaders immediately set about engaging and creating relationships with every sector of society social care housing policing education and others The success of this initiative hinges on everyone coming together around a shared aim and recognizing that only by working together can this aim be reached At IHI we wanted to take the lessons we learned in our work and the lessons from our friends and partners and leverage them to pursue the Triple Aim for everyone We knew that what we ve all been doing wouldn t be enough After all every system is perfectly designed to get the results it gets So we started with a metaphor Escape Velocity that described the need to break free of the gravitational pull of the status quo We developed a vision to fundamentally transform the way the world thinks about and acts to improve health and wellbeing As we engaged with individuals and organizations outside of health care who already were working to improve health we realized we needed something bigger than a project bigger than an initiative what we needed was a movement That movement is 100 Million Healthier Lives We started by doing one of the things we think IHI does best we convened We reached out to our partners who helped us prototype the Triple Aim We reached out to new partners ones with direct experience in improving health And with the help of an initial guiding coalition we convened more than 200 individuals and organizations for a multi day meeting to launch this new movement On October 8 2014 at 2 52pm everyone in the room made a commitment Together we would help 100 million people live healthier lives by 2020 The energy in the room that day was palpable There was a real sense that all

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=81ca4a47-4ccd-4e9e-89d9-14d88ec59e8d&ID=74 (2016-02-01)
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  • Congratulations on Year 1 of 100 Million Healthier Lives!
    and to reduce the costs associated with health care This became the Triple Aim and as we began to engage organizations in improving the experience of care improving the health of a population and reducing per capita costs we realized that health care can only do so much We need to continue to improve quality and safety in health care However improving health to prevent the need for health care and the associated costs by improving care and addressing the social determinants of health is an essential element of the path forward So in many ways the Triple Aim has become a framework for us to think about addressing all the determinants of health It is clear that doing so requires a broad collaboration that extends far beyond the walls of health care and far beyond the walls of IHI An example of this kind of collaboration can be seen in Scotland s Early Years Collaborative After successfully applying the methods and tools of improvement to dramatically improve the safety of health care in Scotland leaders there decided to use the same methods and tools to pursue the ambitious aim of making Scotland the best place for any child to grow up These leaders immediately set about engaging and creating relationships with every sector of society social care housing policing education and others The success of this initiative hinges on everyone coming together around a shared aim and recognizing that only by working together can this aim be reached At IHI we wanted to take the lessons we learned in our work and the lessons from our friends and partners and leverage them to pursue the Triple Aim for everyone We knew that what we ve all been doing wouldn t be enough After all every system is perfectly designed to get the results it gets So we started with a metaphor Escape Velocity that described the need to break free of the gravitational pull of the status quo We developed a vision to fundamentally transform the way the world thinks about and acts to improve health and wellbeing As we engaged with individuals and organizations outside of health care who already were working to improve health we realized we needed something bigger than a project bigger than an initiative what we needed was a movement That movement is 100 Million Healthier Lives We started by doing one of the things we think IHI does best we convened We reached out to our partners who helped us prototype the Triple Aim We reached out to new partners ones with direct experience in improving health And with the help of an initial guiding coalition we convened more than 200 individuals and organizations for a multi day meeting to launch this new movement On October 8 2014 at 2 52pm everyone in the room made a commitment Together we would help 100 million people live healthier lives by 2020 The energy in the room that day was palpable There was a real

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=81ca4a47-4ccd-4e9e-89d9-14d88ec59e8d&ID=73 (2016-02-01)
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  • Meet a Regional Leader: Q and A with Luke Lewis
    one of the only fields that allows me to work doing the things I love I have always loved science and I enjoy talking to people and I wanted to spend my life helping others OS Why does quality improvement in health care matter to you LL It s the means to identify and fix major problems that otherwise would not be addressed Most errors are attributable to system design flaws Learn more in PS 100 Introduction to Patient Safety I enjoy quality improvement because it is challenging but rewarding when you get it right The thing that I think is the most important to keep in mind is keeping enough flexibility in the system to allow people to work under all situations That means preventing errors but also not being cumbersome or limiting which can be very challenging OS What has been your best moment with the Open School community LL I have been fortunate enough to have a many wonderful experiences with my local Open School Chapter at the University of Cincinnati but by far what stands out the most is attending the IHI National Forum last year It was amazing to meet students and faculty from other Chapters and hear their stories I was most surprised at how unique each chapter is despite having common goals That experience is largely what drove me to become a Regional Leader I want to facilitate communication and cooperation between Chapters because I believe that each Chapter brings something unique to the table that other Chapters can benefit from OS Tell us something that most people don t know about you LL Most people don t believe this when they first meet me but I am a huge computer geek I enjoy learning about and building computers and working on other microcontroller based projects My favorite project so far was building a 3 D printer from scratch the summer before medical school I haven t printed anything cool with it yet For me it was more about the process of building and programming it than actually making anything but in the future I hope to use it to print things for future projects OS What one piece of advice would you give a new Chapter LL Starting a new Chapter is very exciting and often comes with a rush of great new ideas The founding members are always very committed It s important to recruit new members that are equally passionate to keep the momentum going Keeping a Chapter going let alone starting from the ground up is difficult so you need to find ways to keep energy and motivation high I d also suggest focusing on the basics and doing a few things well early on rather than starting a lot of projects all at once and moving slowly on them Prioritize which projects are most important and knock them out before moving on Tags Regional Open School Leader Quality Improvement Patient Safety Chapter Leader Blog Home Older Average Content

    Original URL path: http://www.ihi.org/education/ihiopenschool/blogs/_layouts/ihi/community/blog/itemview.aspx?List=9f16d15b-5aab-4613-a17a-076c64a9e912&ID=192 (2016-02-01)
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  • Building a Culture of Safety and Improvement in Brazil
    a number of physicians found the purpose of such meetings difficult to understand You are trying to make us feel uncomfortable they complained We are not incompetent It took time for them to view patient safety as a systemic issue and not one focused on individual blame but eventually Dr Capone Neto started to see a gradual culture shift They moved from feeling incompetent to blaming the moderator for exposing them he notes and now to something more positive Eventually the voluntary safety meetings Einstein held grew in size from 20 doctors to 300 individuals filling Einstein s auditorium He credits the reward of seeing results and seeing how improvement projects advance safety for the steady positive shift in attitudes among hospital staff Dr Capone Neto took the experience of making progress at Einstein with him to IHI The fellowship was a transformative experience he says The dynamic environment throughout the year really allowed me to re energize and come to understand how improvement projects are done He describes his participation in IHI s Improvement Advisor Professional Development Program in particular as helping him understand why projects fail He also described how the experience of talking with pioneers and experts in patient safety all over the world while reflecting on the Brazilian context changed his vision for his work He has decided for example that the attitude training and management of hospitals are what really matter to make culture change Now that he is back in Brazil Dr Capone Neto is optimistic about applying what he learned during his IHI fellowship to his home organization Although the magazine America Economia Intelligence named Einstein the number one hospital in Latin America the hospital continues to work toward world class results He looks forward to building on IHI s Strategic Partnership with Einstein The commitment of Einstein s leadership to quality and safety he says has been the driving force behind the cultural changes that continue at his organization In the ICU for example staff now understand the importance of addressing difficult issues and have focused on making their care more patient and family centered Einstein now responds to adverse events by engaging the families through every stage of the process There is transparency and respect in the event of an error says Capone Neto and self reflection from the doctors when errors occur is a big change from only a few years ago In addition to his QI work at Einstein Dr Capone Neto helps future health care providers through the IHI Open School Latin America is now the region with the second highest number of Open School participants and he wants that representation to grow He is starting to engage universities in Brazil to show them the Open School s energy and value Asked to sum up some of what he s learned in the last few years about the challenge of transforming health care Dr Capone Neto remarks Everybody is afraid of things they don t know Until you

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=165 (2016-02-01)
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  • Inside Quality Improvement: How QI Can Improve Screening for Social Determinants of Health
    is what has happened Now that SDHs are clearly visible each patient s needs are discussed as the care team prepares for each day s appointments OS How did you identify a faculty sponsor or mentor and how did they help you succeed LM Our Chapter s faculty advisor was willing to sponsor me and it was a new experience for us both I was the first student in our Chapter to have completed the Practicum click here to learn more about Chapters She was very helpful in reviewing my charter to help clarify my aim and types of measurements She also pitched in with moral support at a crucial point when I was getting frustrated with what I felt was a lack of progress she reminded me that projects like this always take longer than you expect and she suggested a few small nudges I could do to get things rolling again OS What was the biggest surprise in doing the project LM I was quite surprised when the clinic team worked through Plan Do Study Act PDSA cycles much more rapidly than I was anticipating This clinic has a culture of continuous improvement so they are comfortable testing changes as part of their daily lives In the timeframe I expected them to complete one cycle they had already worked through a handful I would call this a happy surprise OS What was the most gratifying part of the doing the project LM It was very gratifying to be able to see the measurable results in the number of SDHs tracked and how many patients had their SDHs documented It was great to see the shift in the control charts because it means the information we wanted to make available to providers is now available OS What did you learn from working on an interprofessional team LM Working interprofessionally isn t new to me but this project just reinforced my prior experience that interprofessional teams have the broadest perspective reach and resources OS If you had the chance to start your project all over again today what would you do differently LM We ran into some communication difficulties that arose because one of the important team members didn t make it to the first team meeting If I were doing this project over again I would take the simple step of confirming prior to each meeting that each team member can still come I would also hold a one on one catch up with a team member who couldn t make a crucial meeting OS How will the improvements you made be sustained over time LM This project is actually continuing in an expanded form through my MPH internship I m working with a different interprofessional team to 1 conduct a listening campaign with community members to identify the strengths and resources the community can bring to meet the SDHs the clinic is now identifying and 2 create a new community health worker role at the clinic We hope

    Original URL path: http://www.ihi.org/education/ihiopenschool/blogs/_layouts/ihi/community/blog/itemview.aspx?List=9f16d15b-5aab-4613-a17a-076c64a9e912&ID=191 (2016-02-01)
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  • How to Get the Most Out of the IHI National Forum: A Student’s Perspective
    her experience at last year s IHI National Forum she remembers how exciting it was to interact with so many others who feel just as passionately about quality improvement QI in health care as she does She met people from all across the globe who are creating positive change in their local communities and shared ideas about leadership and management with influential thinkers in the health care field She came away inspired by those exchanges The individuals I met have taught me that no change is too small and no obstacle is insurmountable she recalls Florentina was able to attend the Forum in 2014 because she submitted the winning essay for the David Calkins Memorial Scholarship Her story described the QI project she launched to reduce the rate of mislabeled specimens in a pediatric intensive care unit and the lessons her team learned about the importance of engaging frontline staff to bring about sustainable change For Florentina the Forum offers limitless opportunities for personal and career development With so many events and topics to choose from students can explore the vast array of QI initiatives happening across health care and gain insight into a specific area of work that sparks their interest For example Florentina attended a session on Lean methodology in the operating room which is an area she is hoping to pursue If you are a full time student all you need to vie for the Calkins Scholarship are a passion for health care quality improvement and submission of a 500 word essay describing a health care improvement project that you would like to undertake or have undertaken The Calkins Scholarship can fund your trip to the Forum and provide you with experiences as powerful as Florentina s This year marks the seventh year that IHI has offered students the chance to win a scholarship to the National Forum in honor of David Calkins Dr Calkins May 27 1948 April 7 2006 MD MPP was a physician teacher health care improvement champion and IHI Fellow who played a key role in the 100 000 Lives Campaign He was devoted to securing the scientific underpinnings of the Campaign and embodied the Campaign s spirit of optimism and shared learning In that spirit we invite students interested in the Calkins Scholarship to submit a brief essay describing a health care improvement project one you would like to undertake or have undertaken Any currently enrolled full time student may apply The scholarship covers the conference fees for the National Forum and reimburses up to 1 000 for travel lodging or other Forum expenditures We look forward to receiving your submissions and seeing you this year at the Forum Tags National Forum Health Professions Education Quality Improvement Improvement Capability IHI Open School Blog Home Older Average Content Rating 0 user Your comments were submitted successfully Please enter a comment Please login to rate or comment on this content User Comments Show More Comments Loading You are about to report a violation of

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=164 (2016-02-01)
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  • Taking Action to Reduce Overuse
    t take that long for more people to recognize the equally damaging effects of overuse In a 2012 article in JAMA Don Berwick and Andy Hackbarth conservatively estimated that overtreatment which the authors define as care that according to sound science and the patients own preferences cannot possibly help them accounted for between 158 billion and 226 billion in wasteful health care spending in 2011 Others approximate that it s closer to a third of health care spending the US wastes up to 765 billion every year on overuse of health care services But the money wasted is the least of it Unnecessary or unwanted medications tests hospitalizations and procedures can result in significant physical and psychological harm to patients And even when patient harm does not occur rampant overuse deprives the health care system of money that could be better spent making sure patients have care they do need and that the nation should be investing in primary prevention Overuse perpetuates the status quo a system devoid of transparency in which clinicians are paid to do more not better and patients are often left to fend for themselves in a convoluted mess of paperwork and difficult treatment decisions We ve got to envision a better health care system A system where less is done to the patient and more is done for the patient where clinicians have the time they need to act as healers and where good quality care is affordable and accessible to all Americans We know that such a system is achievable but it will take real change right now That s why with the help of our RightCare Alliance network the Lown Institute will launch RightCare Action Week October 18 24 a week at the end of October when clinicians all over the US will take action to highlight a specific dysfunction in health care and demonstrate to their colleagues and the public how it can be changed for the better Participants have pledged to engage in a number of different actions all of them intended to shine a bright light on overuse and its effects or an action that can prevent overuse For example during RightCare Action Week medical residents will conduct a RightCare Count tallying every instance of overuse they observe and report back on their experiences during a group storytelling session at the end of the week Other clinicians will spend a day making house calls to patients for whom office visits are particularly burdensome So far hundreds of clinicians around the country have signed up By mobilizing a committed group of change agents to demonstrate what right care should be we will inspire and incite to action stakeholders at every level and grow the movement toward care that is safe effective affordable equitable and respectful of patients values To learn more about RightCare Action Week tune in to WIHI on October 1 at 2 00 PM Eastern Time for a discussion of Getting Right Care Right Tags Quality Cost and Value

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=163 (2016-02-01)
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  • 6 Ways to Make Primary Care Safer
    our EMR noting the reason for referral referring MD notes and level of urgency Me Wow this is amazing I meant it not many sites were this advanced in tracking their referrals I then sat down with the referral manager to learn more Me Your referral system sounds great I am very impressed Tell me about your process Do you close the loop on all these referrals at the practice Referral Manager No there are too many to count I do as many as I can Me Okay that s fair Does your process ensure you are closing the loop on the most serious referrals like the patients referred for diabetes cancer or other worrisome conditions Can you tell the difference between a referral for acne or diabetes in your system Referral Manager No we don t and no we can t Most health care professionals could easily provide examples of harm events in hospitals including wrong side surgeries medication errors falls and pressure ulcers Listing the types of harms that happen in primary care offices on the other hand may prove more challenging because they are more subtle and camouflaged in daily routines Examples include delayed diagnosis because of poor test or referral management treatment or diagnostics that don t follow evidence based protocols and omitted or inadequate medication reconciliation Not fully understanding a patient s needs and the barriers to their best health can also harm patients Sometimes the results of unintended harm to patients in primary care don t appear for years but that doesn t make this issue any less urgent Here are six recommended ways to make primary care safer 1 Improve access Can sick patients in your practice see their primary care provider in a timely fashion Are you providing care that prevents avoidable hospital admissions or readmissions 2 Close the loop on test results Does your practice know if all patients referred for urgent testing have completed that testing Do you review urgent test results in a timely manner Do you clearly convey test results and what they mean to your patients Do you use evidence based medicine to decide whether or not to do further testing 3 Follow through on important referrals Do your patients follow through when you make an urgent referral Do you get information on your patients from the specialists to whom you make referrals and then review it Do you communicate with your patients about specialist assessments and recommendations 4 Build back up systems Do you have a good system in place to follow up on tests and referrals when a clinician is on vacation or unexpected leave 5 Address social barriers to safety Do you assess the social factors that could lead to patient safety events For example do you explain patients conditions and medications in language that is easy for them to understand Do you offer appropriate and competent support for patients with limited English proficiency Do you know whether your patients can afford the medications

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=0f316db6-7f8a-430f-a63a-ed7602d1366a&ID=52 (2016-02-01)
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