WIHI - A Podcast from the Institute for Healthcare Improvement

One of the biggest ongoing challenges facing health and health care quality improvers is moving from small-scale successes to large-scale ones. That’s why it’s incredibly inspiring to learn from initiatives like Project Fives Alive! that are cracking the code.

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 took a good, hard look at what difference this effort is making to patients and providers alike on the July 9, 2015, WIHI: The Echo Effect of Project ECHO’s Access to Specialty Care.

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 authors into our studio to discuss their analysis for the June 25 WIHI: The IHI Triple Aim: Lessons from the First Seven Years.

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.

Leonard Berry 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?”

Oregon’s latest efforts to provide better care and value to nearly one million Medicaid recipients is through Coordinated Care Organizations. Enabling policies and legislation have been several years in the making, and the careful shaping of the program is leading to some impressive results.

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?

Where is progress being made to reduce instances of C. difficile, and where does more aggresive work need to be done?

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.

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.