Resource Center

In 2001, the Institute for Healthcare Improvement (IHI) developed the “bundle” concept in the context of an IHI and Voluntary Hospital Association (VHA) joint initiative — Idealized Design of the Intensive Care Unit (IDICU) — involving 13 hospitals focused on improving critical care. The goal of the initiative was to improve critical care processes to the highest levels of reliability, which would result in vastly improved outcomes.

Despite significant efforts to improve the care provided to patients in clinics and office practices, it is still not nearly what it should be. Patients often cannot access or do not receive the care necessary to ensure positive health outcomes. Compounding this, the structure of service delivery, traditional workforce roles, and the reimbursement system all create barriers to making widespread improvements to primary care. A different system is needed, one that is reliable, proactive, efficient, and engages patients in ways that ensure the best outcomes.

The Pursuing Perfection initiative was an eight-year demonstration program (2001 through 2008) funded by the Robert Wood Johnson Foundation (RWJF) in the US. Supported by technical assistance from the Institute for Healthcare Improvement (IHI), the initiative’s goal was to learn if and how health care organizations could make dramatic improvements in performance across the organization, resulting in a considerably more efficient and effective health care system.

Because waits, delays, and cancellations are so common in health care, patients and providers assume that waiting is simply part of the care process. But recent work on assessing the reasons for delays suggests otherwise.

This IHI white paper describes and promotes the use of a system of metrics, called the Whole System Measures, to measure the overall quality of a health system and to align improvement work across a hospital, group practice, or large health care system.

This IHI white paper aims to support those that are planning to take effective health care practices from one setting or isolated environment and to make them ubiquitous across a health care system, region, state, or nation. It is a preparation tool which is meant to guide conversation and thinking prior to the launch of a large-scale improvement effort (i.e., one that seeks to stimulate change in complete, geopolitical areas through mobilization of hundreds or thousands of constituent organizations).

Reviews of perinatal care have consistently pointed to failures of communication among the care team and documentation of care as common factors in adverse events that occur in labor and delivery. They are also prime factors leading to malpractice claims.

The model described in this white paper represents the Institute for Healthcare Improvement’s best current assessment of the components of the safest and most reliable system of perinatal care. The four key components of the model are:

In 2008 Don Berwick, Tom Nolan, and John Whittington first described the Triple Aim of simultaneously improving population health, improving the patient experience of care, and reducing per capita cost. The Institute for Healthcare Improvement (IHI) developed the Triple Aim as a statement of purpose for fundamentally new health systems that contribute to the overall health of populations while reducing costs. The idea struck a nerve.

An interprofessional and interdisciplinary group of friends and colleagues with a common passion for interprofessional education for collaborative patient-centered practice (IECPCP) and the GRIN working group met in Toronto, Canada, in May 2012. Participants were identified for this orientation meeting to ensure representation by educators, clinicians, graduate students and international collaborators. Our aim was to discuss how the research agenda for IECPCP might be advanced with an emphasis on the nurturing and development of new researchers in the field.

The increasing focus of WHO Member States on primary health care (PHC) is seen as a means to achieve equitable, fair, affordable and efficient care. From the many approaches taken to PHC around the world, it is clear that major policy commitments will be required and that these will need to be accompanied by the active and collective involvement of stakeholders, particularly the health and social care professions, through informed and manageable implementation processes.