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: Saving Lives by Design: Lessons for All from Ghana's Project Fives Alive!

    Date: July 23, 2015

     
    Featuring: 
    • L. Nneka Mobisson-Etuk, MD, MBA, MPH, Executive Director of African Operations, Institute for Healthcare Improvement
  • Sodzi Sodzi-Tettey, MD, MPH, Director, Project Fives Alive!, Senior Technical Director, Africa Region, IHI
  • Pierre Barker, MD, Senior Vice President, Institute for Healthcare Improvement
  • Nana A.Y. Twum-Danso, MD, MPH, Founder & CEO, MAZA; Former Senior Program Manager, Gates Foundation; Former Director, Project Fives Alive!
  • Kavita Singh Ongechi, PhD, Research Assistant Professor, Gillings School of Public Health, University of North Carolina at Chapel Hill
    •  
    One of the biggest ongoing challenges facing health and health care quality improvers is moving from small-scale successes to large-scale ones. This turns out to be far more complicated than originally thought, no matter what aspect of improvement you’re working on. That’s why it’s incredibly inspiring to learn from initiatives that are cracking the code — moving beyond barriers one deliberate step at a time, to impact the health and health care of thousands and potentially millions for the first time.
     
    One such initiative has been unfolding in the African nation of Ghana since 2008, where there’s now an amazing story to tell about reductions in mortality in children under five years of age in 134 or 80 percent of the nation’s public-sector hospitals. Important lessons learned from this initiative, known as Project Fives Alive!, have been captured in a recently published practical guide. On this WIHI, we assembled an outstanding panel to talk and walk us through the critical aspect of adaptive design that has made Project Fives Alive! so successful.
    1 hr 4 min
  • WIHI: The Echo Effect of Project ECHO's Access to Specialty Care

    Date: July 9, 2015

     
    Featuring: 
    • Sanjeev Arora, MD, FACP, FACG, Director, Project ECHO (Extension for Community Healthcare Outcomes), Department of Internal Medicine, UNM School of Medicine
  • Donald M. Berwick, MD, MPP, FRCP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement
    • There’s telemedicine, and then there’s Project ECHO. Founder and director, Dr. Sanjeev Arora, makes the distinction so we don’t miss what’s groundbreaking about Project ECHO’s approach. While telemedicine focuses on bridging geographic divides that can separate patients from needed specialists, Project ECHO is on a mission to bridge divides within the provider community itself that prevent medical expertise from being shared and distributed more widely.
     
    With Project ECHO, primary care doctors and others working in underserved, isolated, or small community settings use videoconferencing to advance their skills and ability to handle complex cases because of what they learn from specialists some distance away. The goal is both simple and profound: a “democratization of knowledge” so that patients anywhere can receive the best care from the doctor or health care practitioner they have easiest access to, not the one they don’t. 
     
    What began in 2003 as a process for improving access to treatment for people in New Mexico suffering from Hepatitis C, now offers support and learning for 30 different diseases and conditions, impacting patients in some 22 states. A lot of observers believe Project ECHO’s approach to expanding access to specialty care is disruptive in the best sense. That’s why this WIHI took a good, hard look at what difference this effort is making to patients and providers alike.
    59 min
  • WIHI: The IHI Triple Aim: Lessons from the First Seven Years

    Date: June 25, 2015

    Featuring:

    • John Whittington, MD, Lead Faculty, IHI Triple Aim; Senior Fellow, IHI
  • Trissa Torres, MD, MSPH, FACPM, Senior Vice President, IHI
  • Kevin Nolan, MA, Associates in Process Improvement; Senior Fellow, IHI
  • Ninon Lewis, MS, Executive Director, Triple Aim for Populations, IHI
    • It’s never been easy to define an overall strategy for the transformation of US health care. And that may explain why the Triple Aim has been so resonant with so many. In part it’s the simplicity of a three-part framework to achieve better care, better health, at lower per capita costs. It’s also the goals themselves. The idea of simultaneously improving the care of individual patients, improving the health of larger populations, and bringing health care costs down, first conceived by the Institute for Healthcare Improvement (IHI) in 2008, now defines the pursuits of health care systems and communities in many parts of the world, but especially here in the US.
     
    Fast forward to June 2015 and Milbank Quarterly​ has just published the first major harvesting of lessons learned over the past seven years of work on the Triple Aim, drawing on IHI’s engagement with some 141 organizations across a wide array of settings. We brought the article authors into our WIHI studio to discuss their analysis.
    1 hr 3 min
  • WIHI: Disability Competent Care

    Date: June 11, 2015

    Featuring:

    •  Gilbert Salinas, MPA, Chief Clinical Officer, Rancho Los Amigos National Rehabilitation Center
  • Christopher Duff, MDiv, Executive Director, Disability Practice and Policy Consultant
  • Regina Estela, MPA, Chief Operating Officer, Independence Care System
  • Rachael Stacom, MS, AnP-BC, MSCN, Senior Vice President, Care Management, Independence Care System
  • Rebecca Bills, MSW, LICSW, Clinical Manager, Medica Health Plan

    • A lot of progress has been made the past several decades for people with disabilities. But, there are still barriers and biases that prevent disabled individuals from leading full lives and fully accessing health care. For those with physical disabilities, once you get beyond basic accommodations such as parking spots, ramps, and wide corridors, myriad processes at hospitals and office practices don’t always factor in how someone, say confined to a wheelchair, may need to navigate much of it differently — with more time allotted to see a provider, access to multiple providers in one visit as opposed to multiple appointments, and greater attention to the special burden of waits and delays.
     

    The good news is that these sorts of issues are now being more regularly identified and targeted for improvement. Disability community advocates, health systems, health plans, consultants, and government agencies have been looking hard at what constitutes disability competent care. We found out who's helping to raise the bar on best practice in health care for people with physical disabilities on this WIHI.  

    1 hr
  • WIHI: Now What? Best Practices for Newly Diagnosed Cancer Patients

    Date: May 21, 2015

    Featuring:

    • Leonard L. Berry, PhD, University Distinguished Professor of Marketing, Mays Business School, Texas A&M; IHI Senior Fellow
  • Pat Rutherford, RN, MS, Vice President, Institute for Healthcare Improvement
  • Jeffrey Landercasper, MD, FACS, Gundersen Health System
  • Robert Anthony Chapman, MD, Senior Staff Physician, Medical Oncology, Henry Ford Hospital

    • When someone is first diagnosed with cancer, those first few days and weeks can be terribly disorienting. Even when health care professionals and staff try to provide clear information about next steps, the person who’s supposed to be taking everything in may be severely distracted. This can be true no matter what type of cancer; but when the news is especially frightening, we can all appreciate why, for some patients, nothing computes. Are there particular ways the health care system can behave, best practices that can be deployed, to ease this initial, hard part of the cancer journey? Yes, say a growing number of cancer treatment providers and patients and observers.

     
    We have well-known marketing and health care service expert Leonard Berry to thank for helping us shape and anchor this WIHI; Len has spent the past year interviewing more than 350 patients, family members, oncologists, and others to get to the heart of current problems and missteps when it comes to supporting those who are newly diagnosed with cancer. As Len puts it, “A cancer diagnosis is a fireball that turns a patient’s and family’s lives upside down. How can we improve the overall experience? What are the possibilities to ease the path in these first, highly emotional days?” 

    58 min
  • WIHI: Leaning In: Oregon's Coordinated Care Organizations

    Date: May 7, 2015

    Featuring:

    • Chris DeMars, MPH, Director, Systems Innovation, Oregon Health Authority- Transformation Center
  • Ronald Stock, MD, MA, Director of Clinical Innovation, Oregon Health Authority-Transformation Center
  • Trissa Torres, MD, MSPH, FACPM, Senior Vice President, IHI

    • Far from the epicenter of Washington, DC, and the federal government’s efforts to expand health insurance coverage and usher in health care delivery and payment reform, states are moving ahead with amazing innovations of their own these days. Medicaid waivers, which offer states running room to experiment with public dollars, are one big reason. And one big example of what’s possible is unfolding in Oregon.

    No stranger to trail-blazing with transformative ideas and initiatives, Oregon’s latest efforts to provide better care and value to nearly one million Medicaid recipients the focus of this WIHI. The groundwork and the enabling policies and legislation for Coordinated Care Organizations (CCOs) have been several years in the making, and the careful shaping of the program is leading to some impressive results.

    You'll hear about the money, the care, the innovative use of community health workers, and just how 16 CCOs across Oregon function as one system on this great episode of WIHI.

    1 hr 1 min
  • WIHI: Reducing Risks and Defects with Help from the Front Lines

    Date: April 23, 2015

    Featuring:

    • Andrea Kabcenell, RN, MPH, Vice President, Institute for Healthcare Improvement
  • Steven J. Spear, PhD, MS, Senior Lecturer, MIT Sloan School of Management; Senior Fellow, IHI
  • Alexia Green, PhD, RN, FAAN, Professor and Dean Emerita, Texas Tech University Health Sciences Center
  • Roger Resar, MD, The Mayo Clinic Health System; Senior Fellow, IHI

    • As health care quality improvement has matured, it’s common to hear the phrase, “Quality is everyone’s responsibility.” But what does that mean more precisely, and how does the concept apply day-to-day? How feasible is it for those on the front lines of delivering care to not just detect defects in systems and processes, but also solve many of them, right then and there? It turns out this is quite doable, especially if frontline staff and providers are empowered to do far more than patch up problems AND if they can count on operational guidance and leadership from others, including middle managers.

    The goal is first and foremost to reduce harm to patients and improve safety, but in the process it’s also about raising joy in work and frontline confidence to address problems as they emerge and create replicable solutions as part of daily work. Learn how to "See, Solve, Share, and Lead" on this valuable WIHI episode.
    1 hr 1 min
  • WIHI: All Hands on Deck to Reduce C. Difficile

    Date: April 9, 2015

    Featuring:

    • Dale Gerding, MD, Professor of Medicine, Loyola University Chicago Stritch School of Medicine; Research Physician, Edward Hines Jr. VA Hospital
  • Jason Leitch, PhD, MPH, National Clinical Director, Healthcare Quality, Scottish Government
  • Alan Whippy, MD, Medical Director of Quality and Patient Safety, Permanente Medical Group, Northern California
  • Don Goldmann, MD, Chief Medical and Scientific Officer, Institute for Healthcare Improvement
    What was your reaction when you heard the news that Clostridium difficile (C. diff) infected far more people in 2011 than first reported by the US Centers for Disease Control and Prevention (CDC)? Writing in the New England Journal of Medicine at the end of February, the CDC updated its own prior calculations to report that the burden of infection in 2011 was 80% higher than previously stated. In total an estimated 453,000 people were afflicted with C. diff in 2011; C. diff was a factor in some 29,000 deaths.
     
    Our reaction here was, among other things, to schedule a WIHI and to touch down with some people who can help us make sense of the numbers and the health care and community settings contributing to them. And, more importantly, to check in on where progress is being made to reduce instances of C. diff and where much more aggressive work needs to be done. While there are indications that hospital-onset C. diff is declining in the US, no one is satisfied with the pace of change.
     
    WIHI host Madge Kaplan assembled a solid panel to discuss the issues. Dale Gerding walks us through the latest epidemiological research on C. diff, proven reduction strategies, ongoing challenges with antibiotic stewardship, and where trend lines are moving in the right direction. Jason Leitch gives us the view from the UK, and Scotland in particular, where concerted interventions have led to an 82% decline in cases of C. diff in hospitals among people over 65. Alan Whippy tells us about important work at Kaiser Permanente, where significant progress has been made, too, and adherence to best practices is crucial so problems can't creep back in. And, IHI's Don Goldmann helps us appreciate why it's important to stay focused on acute care settings, even as we grow appreciate the value of prevention and detection of C. diff across the continuum of care and the community.
    1 hr 3 min
  • WIHI: The Managers and Management We Need to Improve Care

    Date: March 26, 2015

    Featuring:  

    • David Munch, MD, Senior Vice President and Chief Clinical Officer, Healthcare Performance Partners
  • Stephanie Calcasola, MSN, RN-BC, Director of Quality and Medical Management, Baystate Medical Center
  • Kedar Mate, MD, Senior Vice President, Institute for Healthcare Improvement (IHI)

    • No one’s capabilities and talent should be wasted when it comes to improving health and health care for those we serve. We know you agree. Health care leaders have an incredibly important role to play in driving improvement initiatives in their organizations. So do people on the frontlines of care. What we aren’t as articulate about is the role that middle managers play. You know, the people with the job titles of House Supervisor or Shift Supervisor or Team Lead or Manager of the PACU (Post Anesthesia Care Unit). A growing number of experts say we can’t afford to ignore how people in these jobs are essential to improvement, too. 

     
    WIHI host Madge Kaplan is joined by one of those experts, Dr. David Munch, who led the discussion on this WIHI. IHI’s senior innovation and improvement capability expert, Dr. Kedar Mate, and Baystate Medical Center’s Stephanie Calcasola, also helped us look at what middle managers do, now, on behalf of quality improvement – and what they could do more of, if their contributions and unique positioning in the organization were better utilized and understood. Especially when it comes to making improvement endeavors operational and sustainable.

    1 hr
  • WIHI: Bundles and Buy-In for Value-Based Care

    Date: March 12, 2015

    Featuring:
    • Mark P. Jarrett, MD, MBA, Chief Quality Officer, Sr. Vice President & Associate Chief Medical Officer, North Shore-LIJ Health System
  • Susan Browning, MPH, FACHE, Vice President, Neurosciences, Head & Neck Surgery/ENT and Ophthalmology, North Shore-LIJ Health System
  • Katharine Luther, RN, MPM, Vice President, Institute for Healthcare Improvement
  • Mark Hiller, MBA, Vice President for Innovative Solutions & Leader, Premier Bundled Payment Collaborative, Premier
  • Alice Ehresman, RN, Healthcare Quality Specialist, Baystate Health
    •  
    Are your care teams ready for value-based payments? Does everyone understand the relationship between better patient care and potential savings? Are there some new skill sets and mindsets required of doctors and nurses and support staff that need to be called out and called for, rather than just taking everyone’s buy-in and readiness for granted?
     
    There is more than a few questions to answer, and there’s no question that public and private payers in the US are moving towards more global payment arrangements with health care providers. But the picture of how health care delivery systems take up the challenge is still coming into focus. Forming or becoming part of an accountable care organization (ACO) has been one dominant response. And a growing number of health care organizations are redesigning common patient care procedures in order to enter into agreements that reward value over volume, and that tie payment to successful deployment of specific bundles of care.
     
    It’s tempting to think of all this rejiggering as resting heavily on a hospital’s or office practice’s CFO or whoever draws up contracts with payers. But there’s so much more to it. We assembled a terrific panel, with leaders from pioneering health systems like North Shore-LIJ and Baystate Medical Center, to guide us through the challenges and triumphs in this new phase for health care payment and delivery.
    1 hr 2 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…