WIHI - A Podcast from the Institute for Healthcare Improvement

To make real progress in patient safety will require redesigning the underlying system of care such that healthcare professionals and institutions providing a continuum of services from prevention to hospice can address multiple conditions and episodes over time. Competing priorities, professional autonomy, solo and small physican practices, disciplinary silos, mis-aligned financial incentives, and inadequate feedback about performance all undermine efforts to create safe healthcare systems. A number of strategic, cultural, techncial, and strucural barriers need to be addressed to assure safer care.

Which way forward for the quality improvement and patient safety movements? Join IHI's President and CEO, Donald Berwick, for a series of conversations with Senior Communications Strategist, Madge Kaplan. Each monthly installment offers Dr. Berwick's latest thinking on the major issues of the day and how health care professionals, health care leaders, and patients and families can bring about significant reform.

Doctors appear to prescribe opioids less often to blacks and Hispanics/Latinos than they do to whites in the emergency department. These differences do not appear to be explained by differences in type or severity of pain.

Which way forward for the quality improvement and patient safety movements? Join IHI's President and CEO, Donald Berwick, for a series of conversations with Senior Communications Strategist, Madge Kaplan. Each monthly installment offers Dr. Berwick's latest thinking on the major issues of the day and how health care professionals, health care leaders, and patients and families can bring about significant reform.

Antibiotics are not so effective in the routine treatment of cases of acute sinusitis even when of probable bacterial origin, and should therefore be used more judiciously and with greater caution. Expectations should not necessarily be for antibiotics but balanced risk assessments and symptom advice are still important. Findings of lack of efficacy for antibiotics should drive a research agenda which aims to identify subgroups that might benefit from their use and/or other types of treatment.

Which way forward for the quality improvement and patient safety movements? Join IHI's President and CEO, Donald Berwick, for a series of conversations with Senior Communications Strategist, Madge Kaplan. Each monthly installment offers Dr. Berwick's latest thinking on the major issues of the day and how health care professionals, health care leaders, and patients and families can bring about significant reform.

Pedometer users increase their physical activity by walking 2000 steps per day more than people who do not use a pedometer - 2000 steps is equivalent to about 1 mile per day or about 100 calories per day. Having a daily step goal is important for increasing physical activity with a pedometer. Pedometer users with any goal?either 10,000 steps per day or an individualized step goal?increase their physical activity whereas those pedometer users without a goal do not. Pedometer users lose weight and lower their blood pressure.

The magnitude of MRSA infection is significant, demonstrating that it is a major healthcare and public health issue. The majority of invasive MRSA infections are healthcare associated; hospitals and other healthcare facilities should make MRSA prevention a priority. MRSA skin infections are common in the community and rarely become life threatening or invasive.

Which way forward for the quality improvement and patient safety movements? Join IHI's President and CEO, Donald Berwick, for a series of conversations with Senior Communications Strategist, Madge Kaplan. Each monthly installment offers Dr. Berwick's latest thinking on the major issues of the day and how health care professionals, health care leaders, and patients and families can bring about significant reform.

Quality Improvement Curricula are often effective in improving learners QI related participation, attitudes and knowledge. QI curricula are less often associated with clinical improvements. Clinical improvements occur more often when learners engage in multiple small cycles of change, and when they have individualized coaching in QI, access to their performance data, and access to pre-developed QI tools.