WIHI - A Podcast from the Institute for Healthcare Improvement

Date: February 13, 2014 Featuring: Tessa Kerby, MPH, Manager, Measurement and Organizational Improvement, HealthPartners Yvonne Coghill, OBE, Senior Program Lead – Inclusion and Coaching, NHS Leadership Academy Dave Johnson, MBA, Regional Clinic Director in Primary Care, HealthPartners Medical Group Donald A. Goldmann, MD, Chief Medical and Scientific Officer, Institute for Healthcare Improvement Andrew Loehrer, MD, General Surgery Resident, Massachusetts General Hospital In theory, quality improvement has the built-in capacity to reduce health care disparities and bridge gaps in outcomes and in the experience of care across race and ethnicity. After all, if you’re reliably implementing proven and effective care processes for patients suffering a heart attack, or having a stroke, or dealing with depression, or struggling with obesity, shouldn’t these interventions lift all boats? Would that it were that simple. Decades of research on health care disparities continue to point out how entrenched the pro

Date: January 30, 2014 Featuring: Michael Leonard, MD, Safe & Reliable Healthcare LLC; Adjunct Professor of Medicine, Duke University School of Medicine Audrey Lyndon, PhD, RNC, CNS-BC, FAAN, Associate Professor, UCSF School of Nursing Jill Morgan, BSN, MBA, NE-BC,Nurse Manager, ICU, UnityPoint Health – St. Luke’s Hospital Ansley Stone, OB Quality Coordinator, Carolinas HealthCare System A few key concepts are ubiquitous in the world of health care improvement, and one of them is most definitely SBAR, an acronym for Situation-Background-Assessment-Recommendation. We have the Navy to thank and Kaiser Permanente’s Doug Bonacum and Suzanne Graham, along with Dr. Michael Leonard, for migrating this structured communication framework into the world of health care more than a decade ago. At its core, SBAR is a way for health professionals to effectively and succinctly convey critical information to one another to protect patient safety. Over time, SBAR has proven useful in a myriad of other ways as well

Date: January 16, 2014 Featuring: Gilbert Salinas, MPA, Director of Patient and Community Relations, Rancho los Amigos National Rehabilitation Center, Kaiser Safety Net Fellow, Institute for Healthcare Improvement Thea James, MD, Emergency Medicine, Boston Medical Center; Director, Violence Intervention Advocacy Program Rachel A. Davis, Managing Director, Prevention Institute Kaile Shilling, Coalition Director, Violence Prevention Coalition (Los Angeles) We’ve just come through a holiday season that’s bitter sweet for some — including families that have lost a loved one because of gun violence. Some incidents garner headlines more than others, due to the sheer magnitude of what’s transpired, the ages of the victims, the incredible shock to an otherwise quiet day in a quiet neighborhood, and the tragic consequences. For those in the trenches of working to reduce gun violence day to day — more often in communities and in health care systems all too familiar with gun-related deaths and injuries — every ev

Improvement Research Meets Patient Experience: Can Applying the Science of Improvement Accelerate Patient-Centered Outcomes? Recorded live at the 19th Annual Scientific Symposium on Improving the Quality and Value of Health Care in Orlando, Florida Date: December 9, 2013 Moderator: Madge Kaplan, Director of Communications, Institute for Healthcare Improvement Panelists: Christian Farman, RN, Ryhov County Hospital, Sweden Peter Margolis, MD, PhD, Professor of Pediatrics, Director of Research, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, OH Libby Hoy, Founder, Patient and Family Centered Care Partners, CA A key development in person- and family-centered care is the growing opportunity for patients to collaborate with improvement scientists on research designed to impact patient experience. No longer just an idea, the ways in which this partnership is currently being explored — and what can make it more possible — was the focus of a panel at the 1

Date: November 21, 2013 Featuring:   Gary R. Yates, MD, President, Sentara Quality Care Network; former Senior Vice President and Chief Medical Officer, Sentara Healthcare Lee Sacks, MD, Executive Vice President & Chief Medical Officer, Advocate Health Care; Chief Executive Officer, Advocate Physician Partners Derek Feeley, Executive Vice President, Institute for Healthcare Improvement Andrea Kabcenell, RN, MPH, Vice President, Institute for Healthcare Improvement IHI has been doing a lot of thinking of late about leaders and leadership… in particular the skills, behaviors, and outlook necessary to steer today's health care organizations toward a very different future. A new IHI white paper (working title: High-Impact Leadership) will be out before the end of the year that captures this complex transition. Among other things, it offers a new framework for leaders who are not just responsible for making change manageable, but enthusiastically supported by all staff. You can get an early look at the

Date: ​​November 7, 2013 Featuring: Gordon Schiff, MD, Associate Director, Brigham Center for Patient Safety Research and Practice, Brigham and Women's Hospital Nicholas Leydon, MPH, Director, PROMISES Project, Massachusetts Department of Public Health Frank Federico, RPh, Executive Director, Strategic Partners, Institute for Healthcare Improvement (IHI) Damian Folch, MD, Family Practice and Lifestyle Medicine (Chelmsford, MA) We don’t typically associate the ambulatory care setting with serious lapses in quality that threaten patient safety. Much of the improvement in recent years targeting outpatient care has focused on access, waiting times, communication, and coordination of care. But these areas ripe for change have often obscured others that, if not handled well, can have even more dire consequences: the ordering of tests, the timely handling and communication of results, and the overall process of making a diagnosis in response to a patient’s symptoms or complaints, including making referrals to

Date: October 24, 2013 Featuring: Kelly McCutcheon Adams, LICSW, Director, Institute for Healthcare Improvement Lauge Sokol-Hessner, MD, Attending Physician, Beth Israel Deaconess Medical Center (BIDMC) Kate Lally, MD, Medical Director of Palliative Care, Kent Hospital and Medical Director, VNA of Care New England Donna L. Smith, MD, MBA, Medical Director of Virginia Mason Clinics at Virginia Mason Medical Center   For over a year, building on others’ great work, IHI has been engaged in two groundbreaking initiatives to reduce the confusion and improve the circumstances that surround end-of-life care for most Americans in the US. The Conversation Project, founded in collaboration with IHI, is a grassroots effort to encourage and enable every one of us to discuss our wishes regarding end-of-life care with our friends and loved ones, long before there’s a medical crisis. The second initiative, Conversation Ready, is designed to capture the ways in which health care organizations can effectively respect a

Date: October 10, 2013 Featuring:​ Ed Wagner, MD, MPH, MACP, Director Emeritus, MacColl Center for Health Care Innovation, Group Health Research Institute Trissa Torres, MD, MSPH, FACPM, Senior Vice President, Institute for Healthcare Improvement Kirsten Meisinger, MD, Medical Director, Union Square Family Health Center, Cambridge Health Alliance Thad Schilling, MD, Medical Director, Patient-Centered Medical Home, Harvard Vanguard Medical Associates-Medford (MA)   What does it take to be a high-functioning primary care practice today in the US? Some 30 sites of all shapes and sizes are in the midst of being studied in hopes of answering this very question. The Robert Wood Johnson Foundation and the MacColl Center for Health Care Innovation selected these practices because of their exemplary and innovative staffing models. Figuring out the best ways to delegate  responsibilities and work as a team is one of the central needs for all primary care providers today, and midway through the project  known as L

Date: September 26, 2013 Featuring: Pat Rutherford, RN, MS, Vice President, Institute for Healthcare Improvement (IHI) Martha Hayward, Lead for Public and Patient Engagement, Institute for Healthcare Improvement (IHI) Kristina Andersen, BSN, RN, SMART Discharge Project Coordinator, Anne Arundel Medical Center Cherry R. Shogren, MSN, RN, Director of Clinical Professional Development, UnityPoint Health (Des Moines, Iowa) We have the Picker Institute to thank for some of our earliest understandings of patient-centered care. Besides coining the phrase itself, Picker was among the first to hold health care accountable for its actions according to principles such as listening to patients, respecting their knowledge and emotional needs, welcoming family and friends into the decision process, and more. To better learn what’s possible and measurable, in 2010 Picker developed Always Events — a set of reliable practices that should happen for all patients, all the time — and a recognition program to spotlight or

Date: September 12, 2013 Featuring: Nancy Oriol, MD, Dean of Students, Harvard Medical School; Co-Principal Investigator, Mobile Health Map; Co-Founder, Family Van, Boston, MA Leonel Lacayo, MD, Gastroenterologist, Glenwood Hospital; Co-Founder, Health Hut, Ruston, LA Anthony Vavasis, MD, Director of Medicine, Callen-Lorde Community Health Center, New York City, NY; Co-Principal Investigator, Mobile Health Map; Board Chair, Mobile Health Clinics Association Jennifer Bennet, BA, Executive Director, Family Van and Mobile Health Map Niñon Lewis, MS, Director, Triple Aim Initiatives, Institute for Healthcare Improvement, Cambridge, MA   What’s the first thing that comes to mind when you spot a mobile health clinic? Good people, probably volunteering their time, traveling to underserved neighborhoods to offer screenings, health education, and some helpful, friendly guidance on where to go for anything more serious or chronic that should be checked out? If this is your impression, it’s fairly accurate. Exc

Date: July 25, 2013 Featuring: Benjamin Miller, PsyD, Assistant Professor and Director, Office of Integrated Healthcare Research and Policy, University of Colorado Denver Brenda Reiss-Brennan, PhD, APRN, CS, Mental Health Integration Director, Primary Care Clinical Programs, Intermountain Health Care Mara Huberlie, MA, Director of Project Implementation & Continuing Education, Greater Nashua Mental Health Center Melissa Merrick, LCSW, CDC I, Administrator/BHC Clinical Supervisor - Medical Services Administration, Southcentral Foundation   The road to recognizing the impact of mental illness on the lives of patients and families, and society as a whole, has been an uneven one in the US. Even as battles are being won for benefit parity, and medications can now alleviate some of the worst suffering, the stigma of suffering from depression or some form of psychosis still has a lot of staying power. And most experts agree the supply of mental health professionals doesn’t begin to match the numbers of pe

Date: July 11, 2013 Featuring: Donald Berwick, MD, MPP, FRCP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement; Former Administrator, Centers for Medicare & Medicaid Services (CMS) David Cutler, PhD, Otto Eckstein Professor of Applied Economics, Harvard University, Harvard Kennedy School of Government, Harvard School of Public Health Amitabh Chandra, PhD, MA, Professor of Public Policy and Director of Health Policy Research, Harvard Kennedy School of Government; Member, Congressional Budget Office’s Panel of Health Advisors   Is the rate of growth of health care spending slowing in the US? And, if so, to what do we attribute this momentous development? Momentous because a lot of health economists and policy makers believe there’s something to the decline besides the impact of the recent US recession. And, for the first time, there are indications that pressure from both public and private payers, reinforced by reimbursement reforms rolling out in the Affordable Care Act, ma

Date: June 27, 2013 Featuring: Ann Hendrich, RN, PhD, FAAN, Senior Vice President, Clinical Quality and Safety; CNO; Executive Director, Patient Safety Organization (PSO), Ascension Health Deborah Morris Nadzam, PhD, RN, BB, FAAN, Project Director, JCR Partnership for Patients Hospital Engagement Network Katherine Luther, RN, MPM, Vice President, Institute for Healthcare Improvement Libby Hoy, Founder and Chief Executive Officer, Patient & Family Centered Care Partners (Long Beach, CA)  When it comes to patient safety and reducing harm, one of the biggest challenges US hospitals face day-to-day is how to maintain a relentless focus on everything that needs to be improved and worked on, simultaneously. Building reliable systems, engaging leaders, insisting on a team-based culture, and ensuring that staff has the necessary improvement skills have become essential underpinnings at every organization. So has joining up with something larger — to keep the pressure on, commit to stretch goals, and benef

Date: June 20, 2013 Featuring: Maureen Bisognano, President and CEO, Institute for Healthcare Improvement (IHI) Jeffrey D. Selberg, MHA, Executive Vice President and Chief Operating Officer, IHI Derek Feeley, Director General for Health and Social Care, Scotland; Chief Executive, NHS Scotland; Incoming Executive Vice President, IHI Carol Haraden, PhD, Vice President, IHI In September 2013, IHI will welcome one of Scotland’s most well-regarded health system improvement leaders to its executive ranks. Derek Feeley is currently Director General for Health and Social Care in the Scottish Government and Chief Executive of NHS Scotland. In this capacity, he has overseen and steered Scotland’s ground-breaking Patient Safety Programme. At IHI, Mr. Feeley will have executive-level responsibility for driving IHI’s strategy across five core focus areas: Improvement Capability; Patient Safety; Person- and Family-Centered Care; Quality, Cost, and Value; and the Triple Aim for Populations. His role will be internat

Date: May 30, 2013 Featuring: Jerry Penso, MD, MBA, Chief Medical and Quality Officer, American Medical Group Association Phil Yphantides, MD, Hypertension and Diabetes Physician Champion, Sharp Rees-Stealy Medical Group Ola Akinboboye, MD, MPH, FACC, Associate Professor or Clinical Medicine, Weill Medical College of Cornell University; Medical Director, Queens Heart Institute; President, Association of Black Cardiologists Bob Mathews, President and CEO, MediSync   In order to improve health outcomes and slow health care spending in the US, much of which is fueled by millions of people with poorly managed chronic conditions, health care providers are rethinking how they engage with patients who are most at risk. Hypertension is a case in point. Left untreated, individuals are on track to develop heart disease, strokes, and more. Yet the US Centers for Disease Control and Prevention (CDC) estimate that 30 million Americans with high blood pressure aren’t receiving the proper care. The reasons are comp

May 16, 2013 Featuring: Mark P. Jarrett, MD, MBA, Chief Quality Officer, North Shore-LIJ Health System Mark J. Solazzo, MBA, Executive Vice President and Chief Operating Officer, North Shore – LIJ Health System  Joseph Cabral, MS, Senior Vice President, Chief Human Resources Officer, North Shore-LIJ Health System Hurricane Sandy first struck the Caribbean and then the entire East Coast of the United States at the end of October 2012. The storm smacked into New York and New Jersey especially hard, impacting millions. The story of how the largest health care system in the region, North Shore–LIJ, operated throughout to ensure patients and staff were protected and supported, under fierce circumstances, is one that communities and hospitals everywhere can learn from. This WIHI features three leaders from NS-LIJ who were responsible for every kind of decision imaginable before, during, and after the storm. Some of the decisions included transferring hundreds of nursing home residents out of harm’s way, ta

Date: May 2, 2013 Featuring: Sharon King, Principal, Starfield Consulting Ltd. Mimi Toomey, MA, Director of the Office of Policy, Analysis and Development at the Administration for Community Living (ACL),  US Department of Health and Human Services   With the aging of the population in many countries, where are the best ideas going to come from to help older people remain in their communities, and among the friends and families — and other seniors — they know best? How can we shift mindsets and models from ones that include endless and expensive health care interventions to a vision that factors in the role that supportive people and support services can play further upstream — to reduce isolation and loneliness, to ensure good nutrition and management of chronic health issues, to prevent avoidable hospitalizations? This WIHI takes a stab at some answers. In South Georgian Bay, a community along the Severn River in Ontario, six organizations have come together to create a web of resources called Home fo

Date: April 18, 2013 Featuring: Susan Hrisos, Senior Research Associate, Institute of Health & Society, Newcastle University (UK) Jane O’Hara, MSc, PhD, Senior Research Fellow, Yorkshire Quality & Safety Research Group, Bradford Institute for Health Research Martin Hatlie, JD, CEO, Project Patient Care; President, Partnership for Patient Safety; Co-founder, Consumers Advancing Patient Safety It’s easy enough to say patients need to be engaged in all levels of their care, including being aware of best practices and anything that could inadvertently result in harm. But what does this actually look like day-to-day, especially in the high-stakes, busy environment of today’s highly complex hospitals? And what good does it do for patients and families to notice and speak up about things if there’s no one on the receiving end trained to respect and act upon the information?  With at least a decade’s worth of ideas and initiatives on patient engagement with patient safety as a backdrop, new research o

Date: April 4, 2013 Featuring: Dorothy Cilenti, DrPH, MPH, MSW, Senior Investigator, North Carolina Institute for Public Health; Clinical Assistant Professor, UNC Gillings School of Global Public Health John Morrow, MD, MPH, Pitt County Health Director; Incoming President, North Carolina Association of Local Health Directors Craig James, MPH, President and CEO, Highlands-Cashiers Hospital   One of the reasons it’s so hard to transform US health care into something that’s safe, value-driven, and patient-centered, but also focused on improving the health of the local community, is that the responsibilities and the responsible parties have grown up completely separately. For example, it is not a naturally occurring event for the local public health department to coordinate its efforts with local hospitals… except in cases of disease outbreaks or disaster. So, imagine how rare it is to sit down together to craft overlapping goals for population health or to hatch new initiatives to keep residents from need

Date: March 21, 2013 Featuring: Sara Rosenbaum, JD, Harold and Jane Hirsh Professor, George Washington University, School of Public Health Kevin Barnett, DrPH, MCP, Senior Investigator, Public Health Institute Jean Nudelman, MPH, Director, Northern California Community Benefit Programs, Kaiser Permanente Northern California Regions   When a US hospital’s not-for-profit status is in the news, it’s usually not a good thing. It typically means someone (often a politician) is questioning whether the hospital’s federal tax exemption is deserved because of business practices, high executive pay, too little charity care, or a perceived lack of commitment to the local community. Sometimes the allegations and heightened scrutiny have been fair, sometimes not. Either way, America’s hospitals have a brand new challenge on their hands: to take newly revised IRS rules governing a hospital’s not-for-profit designation and turn them into meaningful plans to improve, in partnership with other organizations, a community