WIHI - A Podcast from the Institute for Healthcare Improvement

WIHI - A Podcast from the Institute for Healthcare Improvement

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WIHI - A Podcast from the Institute for Healthcare Improvement episodes

  • WIHI: Five Practical Strategies for Managing Successful Improvement Projects

    Date: June 30, 2016

    Featuring:

    • Karen Baldoza, MSW, Executive Director, Institute for Healthcare Improvement (IHI)
  • ​Christina Gunther-Murphy, MBA, Executive Director, IHI
  • Julianna Spranger, University of Wisconsin Health Improvement Coach
    • You have a great idea for an improvement project to reduce infection rates at your organization. You and your team have created a meaningful aim, crafted a useful set of measures, and brainstormed several creative change ideas to test in the coming months. There’s support from leadership, energy from staff, and excitement around every corner. You’re ready to go!
     
    Except for one thing — now you need to successfully manage the project.
     
    Managing a quality improvement project is a critical skill for anyone interested in making care — and systems — better where they work. But for many in health care, project management is not a full-time job. In fact, there’s a sizable gap between coming up with a great idea for a project and guiding a team to successful, meaningful improvements. Bridging that gap is what we discussed on this WIHI.
     
    Whether you're about to manage your first improvement project or your 50th, whether you manage teams of four or teams of 40, this episode of WIHI will show you the strategies you can test and use immediately, examples you can share with colleagues, and valuable tools you can bring to your next quality improvement project.
    59 min
  • WIHI: Nurturing Trust: Addiction and Maternal and Newborn Health

    ​Date: June 2, 2016

     
    Featuring:
    • Helen Bellanca, MD, MPH, Associate Medical Director, Health Share of Oregon
  • Nancy Goler, MD, Regional Director for Early Start, Kaiser Permanente Northern California
  • Daisy Goodman, CNM, DNP, MPH, Perinatal Addiction Treatment Program, Dartmouth Hitchcock Medical Center
  • Marian Bihrle Johnson, MPH, Director of Innovation, Institute for Healthcare Improvement (IHI)
  • Jeffrey Rakover, MPP, Research Associate for Innovation, IHI

    • Addiction is always a complex challenge, but when a woman using substances is pregnant, suddenly two lives are at stake. Despite the difficulty of the situation, people in a position to help can increase the odds of a healthy pregnancy and good birth outcome. That’s the underlying principle behind numerous efforts in the US to reach out to pregnant women with drug dependency and to integrate treatment for addiction with perinatal care.

    Such models are getting more attention because of the current opioid crisis and an alarming rise in neonatal abstinence syndrome. We discussed three particularly promising initiatives with the innovators who developed them on the June 2 WIHI: Nurturing Trust: Addiction and Maternal and Newborn Health.
     
    Update: Hospitals & Health Networks covered the June 3rd WIHI. 
    1 hr 1 min
  • WIHI: Health Care in Motion: Making Sense of a Moving Picture

    ​Date: May 26, 2016

    Featuring:  

    • Don A. Goldmann, MD, Chief Medical and Scientific Officer, Institute for Healthcare Improvement
  • David M. Williams, PhD, Executive Director, Institute for Healthcare Improvement

    • Last month, researchers at Johns Hopkins called upon the US Centers for Disease Control and Prevention (the CDC) to rethink how it classifies the country’s “leading causes of death.” The authors argue that deadly medical errors, conservatively estimated at over 250,000 annually, should be included in the rankings — which would make medical errors the third leading cause of death in the US, just after heart disease and cancer. It’s a provocative idea AND it raises the question: What difference would this make? Would it accelerate efforts to reduce preventable patient deaths? Would it make the problem more prominent and more intolerable, adding urgency to research and public policy?

    IHI's Chief Scientific and Medical Officer Don Goldmann joined us on this WIHI to take a look at the current state of quality improvement and the new value-driven initiatives that have health care organizations undertaking unprecedented levels of financial risk and undergoing rapid transformation. He was joined by IHI's improvement guru, Dave Williams, to engage the audience on why it can be so hard for the US health care system to measure patient-reported outcomes, the proliferation of measures, and whether "value-based" payment can work.
    1 hr 1 min
  • WIHI: Joy in Work: An Antidote to Today's Burnout in Health Care

    Date: May 5, 2016

    Featuring:

    • Derek Feeley, President and CEO, Institute for Healthcare Improvement (IHI)
  • Stephen Swensen, MD, MMM, FACR, Medical Director for Leadership and Organization Development, Mayo Clinic
  • Kathy Kerscher, Team Leader of Operations Primary Care, Bellin Health
  • Joanna D’Aflitti, MD, MPH, Associate Medical Director for Primary Care Quality and Innovation, Boston Medical Center
    • When we hear about physician and staff burnout these days, a lot of attention focuses on the pressures health care is under to deliver much, much better care, much more cost effectively. These pressures and expectations are impacting hospital systems, already busy office practices, and, very importantly, individual practitioners themselves who often feel they’re being asked to do more without the necessary resources. What can make the difference between having the tools and the support to manage new realities vs. being overwhelmed and drained? Plenty —​ and that’s why we hope you’ll listen to this WIHI.
     
    Our panelists have been confronting the problems of burnout and staff frustration head on in their own organizations, and they came to WIHI to share what they’re learning. Joy in Work is a hugely important topic for the health care workforce and for the patients whose care can be compromised when staff aren’t at their best, but it is not about pizza parties and papering over the issues. Instead, it’s about finding new ways to remove day-to day barriers on the job; to improve the systems that are supposed to help with work flow but aren’t always delivering, such as electronic health records (EHRs); and to ensure that leaders at all levels are listening, really listening.
    1 hr 2 min
  • WIHI: The Opioid Crisis: How Health Care and the Community Can Act

    Date: April 21, 2016

    Featuring:

    • Joseph Foster, JD, New Hampshire Attorney General, New Hampshire Department of Justice
  • Joel Hyatt, MD, FAAFP, Emeritus Assistant Regional Medical Director, Kaiser Permanente, Southern California
  • Lindsay Martin, MSPH, Executive Director and Improvement Advisor, Institute for Healthcare Improvement (IHI)
  • Mara Laderman, MSPH, Senior Research Associate, IHI
    • The US is in the midst of a serious opioid addiction epidemic. Driven largely by an explosion of prescribed pain medications, the dramatic rise in addiction and deaths from overdoses (quadruple what they were in 1999, according to the Centers for Disease Control and Prevention) now has the attention of just about every sector of society that can play a role in addressing the problem. This includes innovative approaches coming from law enforcement, local, state, and federal health departments, drug treatment programs, community groups, and health care delivery.
     
    While providers who write prescriptions for painkillers such as OxyContin are under particular pressure to do a much better job assessing a patient’s need for pain medication and risk of becoming addicted, it’s clear there’s no single or simple solution to the current crisis. That’s why IHI’s Innovation team has been scanning for the best practices that comprise a community-driven, integrated, and multi-sector approach. We discussed these elements and the response to the opioid epidemic on this WIHI.
     
    Our guides included Lindsay Martin and Mara Laderman, two members of IHI’s Innovation team, and two people that IHI has learned a lot from; New Hampshire Attorney General Joseph Foster and Kaiser Permanente’s Joel Hyatt. Kaiser Permanente has been working hard to curb opioid prescribing in its system for several years, leveraging every means possible. The work is paying off in dramatic decreases in written prescriptions. In New Hampshire, hit hard by both a heroin epidemic and the opioid prescription crisis, Joseph Foster’s outlook reflects that of many in his government position. He’s attempting to engage the most effective and innovative strategies to impact public health and public safety.
    1 hr
  • WIHI: Breaking the Rules: Lessons from IHI’s Leadership Alliance

    Date: April 7, 2016

    Featuring:

    • Saranya Loehrer, MD, MPH, Executive Director, North America Strategy and Operations, Institute for Healthcare Improvement (IHI)
  • Helen Macfie, PharmD, FABC, Chief Transformation Officer, Certified Lean Leader, MemorialCare Health System
  • Carolyn Candiello, Vice President, Quality and Patient Safety, GBMC HealthCare, Inc.
  • Cate O’Connor-Devlin, RN, BSN, Administrative Director of Patient Throughput/Nurse Safety, GBMC Healthcare, Inc.
  • Rhonda Holden, MSN, CENP, Chief Nursing Officer/Administrator Patient Care Services, Kittitas Valley Healthcare, Ellensburg, WA
  • Cheryl Woodman, ND, MHSc, CHE Chief Strategy Officer, Women’s College Hospital (Toronto, Canada)
    • It started from a very human place. Hospital staff found a way for a new mom recovering in the ICU, and her infant in the NICU, to visit with one another in the aftermath of a difficult birth. When the mom and dad were asked later on about their hospital experience, they singled out this breaking (or bending) of the rules that ensured mother and newborn had time together even while both were in intensive care. That got the hospital, MemorialCare Health System, asking some new questions: What are the rules that both staff and patients continue to run up against? Why do some rules persist, interfering with a more optimal care experience, even after they’ve been relaxed or retired? Are some rules misinterpreted, and still others more like myths that live on just because “we’ve always done it this way?"
     
    The answers were revealing — and got others thinking, too. MemorialCare is part of IHI’s Leadership Alliance; when Alliance members heard about MemorialCare’s experience, they decided to find out what was happening in their own organizations. They did this with a campaign in January 2016 they dubbed “Breaking the Rules.” We learned about the campaign and how Leadership Alliance members came up with nearly 400 rules in need of a second look on this WIHI.
    1 hr
  • WIHI: The New World of Co-producing Health and Health Care

    Date: March 24, 2016

    Featuring:

    • Maren Batalden, MD, MPH, Associate Chief Quality Officer and Associate Director of Graduate Medical Education for Quality and Safety, Cambridge Health Alliance
  • Kathy Sabadosa, MPH, Senior Research Director, Dartmouth Institute for Health Policy and Clinical Practice
  • Sarah Myers, MPH, RN, Executive Improvement Director, ImproveCareNow, Cincinnati Children’s Hospital Medical Center
  • Julie Bass, DO, Medical Director, Pediatric Inflammatory Bowel Disease Program, Children’s Mercy Hospital (Kansas City, MO)
  • Jamie Hicks, RN, Lead Parent of Patient & Family Advisory Council, Children’s Mercy Hospital IBD Program
  • Christina Gunther-Murphy, Executive Director, Institute for Healthcare Improvement (IHI)
    • When we say patients and clinicians should be “co-producing health and health care,” do we really mean it? Dr. Maren Batalden from the Cambridge Health Alliance certainly hopes so. In fact, in her recent article on the subject, she and her co-authors assert that a form of co-production already exists in health care today — in the natural give-and-take between patients and providers around treatment and care decisions; and in the assets that patients and practitioners each bring to the table. But we have yet to realize the full promise of co-production —​ the opportunity to optimize this “collaboration” to achieve much better health and health outcomes. In other words, when patients and providers consciously work together, toward common goals, all kinds of possibilities open up.
     
    Co-production does require a paradigm shift and for medical staff, letting go of seeing themselves as the sole engines and creators of the “product” known as health care. In fact, Dr. Batalden and her co-authors argue, health care isn’t a product at all, but a service which both “sides” engage in and have an opportunity to shape. At its most basic level co-production is an exciting new way to frame mutually respectful, helpful relationships, including among clinical staff. Dr. Batalden says it best: “Health care is not a product manufactured by the health care system, but rather a service which is co-created by health care professionals in relationship with one another and with people seeking help to restore or maintain health for themselves and their families.
     
    These are the conversations and concepts that make up the excellent March 24 WIHI: The New World of Co-Producing Health and Health Care.
    1 hr 3 min
  • WIHI: A New Framework for Safety in Ambulatory Care

    Date: March 10, 2016

    Featuring:

    • Mark Jarrett, MD, MBA, MS, Chief Quality Offer and Senior Vice President, Northwell Health
  • Fran Ganz-Lord, MD, FACP, Director of Ambulatory Quality & Medical Director, Northwell Health Premium IPA Network and Northwell ACO
  • Ann Lewis, CEO, CareSouth Carolina
  • Tejal Gandhi, MD, MPH, CPPS, President and CEO, National Patient Safety Foundation, Lucian Leape Institute, Certification Board for Professionals in Patient Safety
  • Jennifer Lenoci-Edwards, RN, MPH, CPPS, Director, Patient Safety, IHI
    • What comes to mind when you think about patient safety in the ambulatory setting? Infection rates? Probably not. The issues are of course quite different in outpatient care, and that's one reason it's not always obvious to practitioners and staff which of their many daily activities might inadvertently contribute to patient harm. Activities such as failing to follow up on patient referrals, or to communicate test results. Or getting frustrated with the EHR and creating workarounds.
     
    IHI's patient safety leads have been doing a lot of thinking about the need for a new safety framework suited to ambulatory care in order to better highlight the unique fault lines and improvement priorities for this setting. Components of this framework and how they’re being tested and applied, as well as real-world examples from Northwell Health and CareSouth Carolina, are explored on this WIHI.
    1 hr 1 min
  • WIHI: Making Data Work for Quality Improvement

    Date: February 25, 2016

     
    Feauturing:
    • Leonard D’Avolio, PhD, Assistant Professor, Brigham and Women’s Division of General Internal Medicine and Primary Care; CEO and Co-founder, Cyft
  • Kedar Mate, MD, Senior Vice President, Institute for Healthcare Improvement
    • If you’re going to measure, as we know health care improvers must do, you’re going to generate data. But in a world where there increasingly seems no end to what can be tracked and quantified and analyzed, there’s a real danger of creating a lot more data than you truly need. It’s great to have the data, and electronic health records are making it easier to obtain and store tons of information, but now what? How can it be put to good use? Will it make patients safer and healthier? Will it help determine where the gaps are? Reduce visits to the ED? Increase visits to primary care? If you’re starting to wonder what you’re doing with all your data, you might want to listen to this WIHI. 
     
    Our guide for this discussion is someone who’s been doing a lot of thinking, and advising, and writing on the growing focus in health care on data, and the hype that may be getting in the way. Len D’Avolio has spent the past dozen years working to make data useful for hundreds of health systems, health plans, and foundations. He uses the phrase “data thinking” to describe a process that can ensure whatever data you’re generating or mining has a clear purpose and context. Len unpacked this process and connected it to some strong organizational examples and experiences. IHI’s Kedar Mate  joined Len to underscore the need for improvers to “measure what matters” and addressed the challenge of top-down mandates driving agendas and data collection, in the absence of clear plans for how to make the best use of data.
    1 hr 2 min
  • WIHI: Morality Matters: How to Reset the Mission of Quality Improvement

    Date: February 18, 2016

    Featuring:

    •  Donald M. Berwick, MD, MPP, FRCP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement
  • Jessica Berwick, MD, MPH, Internist, Beth Israel Deaconess Medical  Center (Boston)

    • What is the “true north” for the health care quality improvement movement? What are the questions leaders and champions of quality and safety initiatives must periodically ask themselves as a natural part of the process of seeking dramatic change? If you’re IHI’s founder and President Emeritus and Senior Fellow, Don Berwick, the questions, and the answers, are often moral ones. Don is known for reminding improvers at critical moments that whatever they’re working hard on must, finally, come back to the patients themselves and principles of service and healing relationships. When the vision starts to go blurry in a miasma of metrics and measures and monitoring, Don argues, we lose our way.

    In December, Don took to the podium at IHI’s National Forum in Orlando and delivered a keynote calling for what he labeled a “moral era” for the health care quality improvement movement — Era Three. In the keynote, Don outlined five developments from earlier eras that he believes have started to obscure the improvement movement’s sense of purpose: excessive measurement; complex (pay for performance) incentives; preoccupation with money; and professional prerogative. Increasing attention to five activities in Era Three, broadly defined, can help: improvement science; transparency; civility; listening (to patients, family members, and staff); and rejecting greed.

    During this WIHI, Don was joined by his daughter, Dr. Jessica Berwick, an internist at Beth Israel Deaconess Medical Center in Boston, who shared the perspective of a relatively new physician navigating many of the competing forces Don describes in his speech.

    1 hr 1 min

About WIHI - A Podcast from the Institute for Healthcare Improvement

From the publisher's feed

WIHI is an exciting "talk show" program from IHI. It's free, it’s timely, and it’s designed to help dedicated legions of health and health care improvers worldwide keep up with some of the freshest…