archive-org.com » ORG » I » IHI.ORG

Total: 1209

Choose link from "Titles, links and description words view":

Or switch to "Titles and links view".
  • ICU Liberation: The Power of Pain Control, Minimal Sedation, and Early Mobility
    chapter for the new Society of Critical Care Medicine SCCM book ICU Liberation The Power of Pain Control Minimal Sedation and Early Mobility This invitation gave me a chance to work with my long time mentor and IHI Vice President Andrea Kabcenell on co authoring a chapter called Implementing Standardized Processes Why and How Writing the chapter also allowed me to work with beloved IHI faculty member Dr Terry Clemmer one of the book s editors Topics covered in the book include how to perform a gap analysis delirium in the ICU the need for sleep and ventilator strategies among others I encourage you to review the two freely available sample chapters Sample Chapter Why Sedation Liberation and ICU Mobility Are Important in Outcomes and Costs Sample Chapter Liberating ICU Patients from Deep Sedation and Mechanical Ventilation An Overview of Best Practices I am grateful that SCCM has so thoroughly and practically tackled topics that are dear to me and so important for patients Clinicians and leaders will find the book s many approaches to the challenges of pain control sedation and mobility instructive and inspiring And for those who want to learn more about my interest in this work I invite you to read the blog I wrote earlier this year Tags Mobility in the Intensive Care Unit Delirium Acute ICU CCU Intensive Care Unit Critical Care Unit 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 our Terms of Use All reports are strictly confidential Reason Select One Contains profanity or violence Spam Defamatory Illegal Unlawful Copyright Violation Other Please select a reason for this report Add

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=155 (2016-02-01)
    Open archived version from archive


  • Meet a Regional Leader: Five Questions for Valerie Pracilio
    com OS Why did you go into health care Valerie I always saw myself working in the health care industry During high school I worked in a few outpatient offices but the one that left a lasting impression was a physical therapy practice in New Jersey It was there that I met a woman who was suffering from multiple sclerosis a disease which seemed to cause her mobility to suffer more and more with each passing week Eileen was strong and always brought a positive attitude with her to each session regardless of the pain she was feeling that day She was the first patient that I built a relationship with I looked forward to seeing her each week and hoped that she would gain the strength needed to preserve her mobility It was the opportunity to build a relationship participate in her progress and help her achieve her goals that led me on a path toward a career in health care OS Why does quality improvement matter to you Valerie Health care is founded on an enormous amount of trust that patients place on their health care providers Patients rely on their providers to listen to what they are feeling determine if there is a problem and if so how to manage it That is a huge responsibility and I ve always felt that there was a role for me to play in helping providers to meet those expectations Any disruption in health is difficult to understand and accept but all patients should be able to trust that their provider is giving the best care possible to help them be healthy By focusing on quality improvement I can impact the conditions in which patients receive care and providers administer it to make sure the experience is good all around OS What was your best moment with the Open School community Valerie Watching members of the community learn of an experience where quality was poor and it infuriated them to the point where they turned it into a passion for quality There have been a few of these moments since I got involved OS Tell us something that most people don t know about you Valerie I have edited two texts and authored eight book chapters two of which have been with fellow Regional Leader Andy Carson Stevens OS What one piece of advice would you give a new Chapter Valerie Take advantage of all the IHI Open School has to offer especially the connections to like minded colleagues within your Chapter Region and across the world It is an incredible group and it offers a vast network of colleagues to draw on Use it to your benefit you never know who will be your next mentor colleague or employment contact Tags Chapter Network Chapter Leader Person and Family Centered Care Regional Open School Leader 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

    Original URL path: http://www.ihi.org/education/ihiopenschool/blogs/_layouts/ihi/community/blog/itemview.aspx?List=9f16d15b-5aab-4613-a17a-076c64a9e912&ID=187 (2016-02-01)
    Open archived version from archive

  • One Improvement Scholar’s “Transformative” Experience
    Clinical Learning Environment Review program has launched I recognize that we have a lot to do as clinicians to get our educators up to speed Since I m an educator I wanted to expand my skill set and learn quality improvement to be able to teach it to the next generation Describe your experience as an IHI Improvement Scholar is one word Transformative Okay now tell me more A year before I was a scholar I picked up The Improvement Guide and started taking the IHI Open School courses to try to teach myself I started to work through it on my own applying some of what I was learning with the residents I teach because we were doing QI projects And it was going alright But the skillset you gain in the Improvement Scholars Program and the opportunity to get indoctrinated in the culture of IHI is phenomenal The time I spent at IHI in Cambridge Massachusetts as part of the program was almost overwhelming because I was learning so much but wanted to learn so much more I could see the depth and breadth of IHI s knowledge How have you applied what you learned in the scholars program The first thing I did when I went back to my organization was completely revamp the quality improvement curriculum to follow what I learned as a scholar I had several residents join me on my project and three other resident teams started working on projects on topics of interest to them What did you choose to work on as your project during the scholars program The aim of my project was to decrease mortality from severe sepsis and septic shock My institution identified sepsis as a high value topic and it was my assigned project as I became a scholar We wanted to get ahead on sepsis in part because the quality metrics were coming down the pipeline We used the Model for Improvement and identified our primary and secondary drivers and started to chip away at them one by one How did it go It is definitely tough to influence an entire institution from one department Our biggest challenge has been finding champions in other departments We ve been able to see some pretty decent improvements in all of our outcome metrics and we identified various barriers that have made us scratch our heads For example patients who end up in palliative care are they included in the data set Not included It was great to meet with people at the IHI National Forum in December 2014 to see what they did with these challenges Some institutions included these patients in their data set and their mortality looked similar to ours Others didn t and their mortality looked much better than ours What you measure matters Looking back at what you learned what reflections would you share with others The importance of the work When I was at IHI I had the opportunity to talk to the HR

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=154 (2016-02-01)
    Open archived version from archive

  • Changing Lives by Integrating Behavioral Health into Primary Care
    one place One patient s story helps to illustrate the impact that integrating behavioral health into primary care can have on people s lives A gentleman in his late 40s who d had a tough childhood and early adulthood had been in a gang fight that left him with years of chronic pain Over time his medical provider gave him different treatments including opiates and physical therapy and many of these treatments didn t have much effect His chronic pain was escalating and he was coming to the provider s office in tears Feeling as though he had tried everything else the medical provider asked a behaviorist to do an assessment The behaviorist discovered that this man had an obsessive compulsive disorder OCD and was getting up 50 to 60 times a night to check locks This behavior worsened when his stress increased and his sleep deprivation of course aggravated his stress and his pain The OCD had been untreated his whole life Once this gentleman got on the right antidepressant and received behavioral support his pain decreased dramatically He started sleeping again He said he had never felt so good in his life The medical provider could have just provided more medication more x rays or more lab tests Instead he called upon his behavioral health colleague for assistance and together they helped alleviate years of suffering As we begin to move away from fee for service models and the pressure increases to improve outcomes while reducing costs it is important to remember that an estimated minimum of 50 percent of primary care visits have a behavioral health component These range from mental health diagnoses to the behavioral changes necessary for everything from medication adherence to starting an exercise regimen Developing effective team based fully integrated primary care has never been more important for both patients and providers Tags Behavioral Health Triple Aim for Populations Primary Care 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 by Christopher Echterling 8 17 2015 11 10 08 PM Our health system is in it s 4th year of an expanding effort to deploy behaviorists into our Patient Centered Medical Homes using Pre and Post Doctoral Interns recruited specifically for an interested in working in Medical settings The goal is to have impact in the PCMH in three ways 1 direct short term 1 8 visit motivationally oriented interactions of paitents with behaviorist 2 consultation of medical team with behaviorist for patients they may never see 1 1 and finally 3 increasing the general behavioral skills capability of the PCMH staff through presentation and informal non patient specific consultations The behaviorists have been well received by patients and PCMH and we have been able to negotiate payment into various payer contracts to cover the expenses of the behaviorist thus ensuring sustainability of the model loading Did you find this user comment useful people

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=153 (2016-02-01)
    Open archived version from archive

  • What’s Your Game Changer?
    Dr Arora the visionary founder behind Project ECHO is not just harnessing virtual technology to treat patients he and his team are breaking down long entrenched medical silos that keep what specialists know at arm s length from everyone else This all began because Dr Arora a liver specialist realized back in 2003 that there was no way that thousands with hepatitis C in New Mexico many from small rural communities were ever going to get the treatment they needed and deserved unless specialists like him could mentor a much broader group of practitioners on how to help these patients From the looks of the July 9 WIHI Chat everyone who tuned into the broadcast was equally impressed by the idea that expanding access to treatment by democratizing and generously spreading medical expertise is not only an elegant solution to a shortage of specialists for any given condition it s also a perfect example of a game changer a disruptive innovation in the improvement of health and health care And speaking of game changers I m wondering whether you have the good fortune of being in the midst of one of your own that you d be willing to tell me about Game changers I ve learned about in the past year include a hospital rethinking its decision to lay off members of its cleaning staff and converting their jobs into community outreach workers instead and a health care executive who surprised his staff by distributing to them the financial savings everyone was responsible for because of improved care August is when WIHI takes a break and I scour all my sources for interesting and innovative topics for upcoming shows for the rest of 2015 into 2016 I have some program ideas already in the pipeline but I d really love to know what other game changing health and health care improvements are out there that could be the subject of a future WIHI Merriam Webster defines game changer as a newly introduced element or factor that changes an existing situation or activity in a significant way Does this fit the description of something you re working on or are aware of that s accelerating improvements in health and health care or taking things in an entirely new disruptive direction Please let me know Email me at info ihi org and put WIHI Game Changer in the subject line In the meantime August is a great time to catch up on the WIHI archive I look forward to hearing from you Tags WIHI WIHI Archive Quality Improvement Innovation and Idea Generation Redesign Processes and Systems 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 our Terms of Use All reports are strictly confidential Reason Select One Contains profanity or violence Spam Defamatory Illegal Unlawful Copyright Violation Other Please select

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=152 (2016-02-01)
    Open archived version from archive

  • How to Plan an Interprofessional Conference
    quality improvement and data improvement training techniques and health care simulation Planning a conference of this scope and size was a daunting task However we believe our team succeeded because of our intentional group development organization and planning which started nine months in advance of the event in July of 2014 The vision for our conference was to educate and empower learners to be interprofessional collaborators with each other their patients their communities and their health systems by Disseminating evidence based methods of interprofessional team based care that enhance patient safety Exploring system redesign and opportunities for multiple sectors and professions to interface to design a health services delivery system capable of achieving the Triple Aim Spreading health systems improvement best practices from interprofessional and student led improvement projects We organized ourselves as a team using Marshall Ganz s snowflake model of leadership This model uses a non hierarchical structure that deploys many interdependent leaders who work closely together By distributing the work and the decision making and by relying on each others strengths and resources we made a large scale project feasible for a diverse group of busy students In the end we had participants from the fields of nursing medicine public health health management public administration and pre health students from three Chapters including PSU OHSU the University of Washington and the University of Colorado Here are a few of the things we learned from planning a large scale event Learn more in our full conference planning guide here Establishing a theme and aim for the conference is helpful for guiding all conference decisions Ours was interprofessionalism Teamwork and sharing responsibility is critical for success Sustaining teams over a long period of time nine months in our case takes thoughtful re engagement along the way Delineation of team responsibilities from the start is important to make sure each group is working to their full capacity Increased and targeted advertising is paramount to achieve full participation in all aspects of the conference We also recommend asking attendees for feedback We received some really positive feedback such as this comment from one participant The content was so compelling and interesting The interactivity enhanced learning because hearing something and actually trying it are so different But we also really valued the constructive feedback For example one participant pointed out that there wasn t much promotion of the event in the dental nutrition nursing and pharmacy schools The planning of the conference has been an amazing learning and leadership experience for us and we remain committed to interprofessional collaboration in our future work Interested in planning your own conference We have created a process checklist planning outline and templates to support students in conference and event planning Please see our Conference Resource Planning Document here Adapted from an original post by Kelsey Priest MPH forOHSU s SOM Student Speak Blog on March 18 2015 The West Coast Conference was possible with the generous support of the IHI Open School the PSU OHSU

    Original URL path: http://www.ihi.org/education/ihiopenschool/blogs/_layouts/ihi/community/blog/itemview.aspx?List=9f16d15b-5aab-4613-a17a-076c64a9e912&ID=186 (2016-02-01)
    Open archived version from archive

  • How the IHI Leadership Alliance Inspired My Own Improvement Journey
    re travel but it has a few mile markers I would like to recount Two years ago I applied to the MSW program at Boston College The program was exceptional expensive and most attractively didn t require a GRE The application was in my eyes minimal input for maximal potential output I should pause here and explain that my fear of failure has at times inhibited my ability to put too much effort into pursuing my dreams I did not get into the program I didn t have enough experience Despite feeling crushed like my shoulders were rounding forward as my chest imploded I eventually found the courage to pursue the experience I needed I applied for jobs advocating for and working with vulnerable populations I was particularly excited about one job because it aligned perfectly with my passion for working in a global arena Again I was disappointed This time though the sting of failure really lingered I wasn t used to trying hard for something and not getting it I was afraid of what it said about me that I wasn t able to achieve what I wanted I didn t think I had it in me to fail again Next is the biggest mile marker in my journey I applied for a position at IHI There is no way to summarize how it felt to achieve something I really wanted and really worked for after repeatedly failing More than just a job at IHI I ve been able to push myself to develop new skills try new things and learn new ideas My experience as the project coordinator for the IHI Leadership Alliance in particular motivated my decision to return to school because I realized I want to be like the leaders I was working with on a day to day basis Leadership Alliance faculty members like Don Berwick Derek Feeley and George Kerwin for example taught me what leaders of health care need to do today to truly deliver on the full promise of the Triple Aim tomorrow People like Pierre Barker Steve Swensen and Andrea Kabcenell taught me about how to partner with physicians to reduce burnout It s hard not to listen to these conversations without wondering what you can do to be a part of it The journey of the Leadership Alliance parallels my own in many ways We re both veering off the safe path in pursuit of ambitious results We re both putting our blood sweat and tears into a radical redesign of the status quo We know that the road may not be straightforward and smooth the whole way We know that there are no guaranteed outcomes and the outcomes may not always be what we expect We know that we will sometimes fail Despite that we have found the courage to roll up our sleeves in support of something we re passionate about I have so much faith in the future of the Alliance and the impact it will

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=151 (2016-02-01)
    Open archived version from archive

  • Introducing the Newest Member of the Open School Team
    health management and transitioning from a fee for service model to value based care It was fascinating to learn so much about the business of health care but my heart has always been in population health designing new models of care investing in the health of communities tackling social determinants of health and reforming systems to produce higher quality outcomes Now I m very excited to make a move to an organization that focuses not only on improving health care systems but improving health for all Joining the Open School team gives me the chance to support students in their trajectories toward becoming forces for change in health care equipped with knowledge of topics like patient safety and the Triple Aim a strong foundation in quality improvement and the shared passion that comes from being a part of a huge community of learners One of my first priorities as a new member of the Open School team will be the IHI Change Agent Network including the eight week course Leadership and Organizing to Improve Population Health which will hopefully give me the chance to get to know many of you Other things you should know about me In my spare time I love getting outdoors as much as possible biking hiking swimming running and so on I also love baking and of course enjoying the finished products I m looking forward to the chance for us to get to know each other through the Open School community and the I CAN project Drop me a line any time at bdesmidt at ihi org Tags Chapter Network 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

    Original URL path: http://www.ihi.org/education/ihiopenschool/blogs/_layouts/ihi/community/blog/itemview.aspx?List=9f16d15b-5aab-4613-a17a-076c64a9e912&ID=185 (2016-02-01)
    Open archived version from archive