WIHI - A Podcast from the Institute for Healthcare Improvement

Date: June 11, 2015

Featuring:

•  Gilbert Salinas, MPA, Chief Clinical Officer, Rancho Los Amigos National Rehabilitation Center

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.  

Date: May 21, 2015

Featuring:

• Leonard L. Berry, PhD, University Distinguished Professor of Marketing, Mays Business School, Texas A&M; IHI Senior Fellow

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.

Date: May 7, 2015

Featuring:

• Chris DeMars, MPH, Director, Systems Innovation, Oregon Health Authority- Transformation Center

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.

Date: April 23, 2015

Featuring:

• Andrea Kabcenell, RN, MPH, Vice President, Institute for Healthcare Improvement

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.

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

Date: March 26, 2015

Featuring:  

• David Munch, MD, Senior Vice President and Chief Clinical Officer, Healthcare Performance Partners

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. 

Date: March 12, 2015

• Mark P. Jarrett, MD, MBA, Chief Quality Officer, Sr. Vice President & Associate Chief Medical Officer, North Shore-LIJ Health System

​Date: February 26, 2015

Featuring:

• Adebisi Alli, DO, MS, Chief Resident in Quality & Patient Safety, Department of Internal Medicine, Banner-University Medical Center, Phoenix VA Healthcare System

Thirty-two abstracts and 56 posterboards were shared at IHI’s 20th Annual Scientific Symposium this past December. At the end of the day, the audience voted three of these as the best for clarity of presentation and strength of research. We gathered the leaders of the teams behind the winning presentations to talk about their work on this WIHI.

IHI’s Senior Scientist Gareth Parry, who runs the Scientific Symposium, kicked off our discussion with some framing about the state of health and health care improvement science in the US and globally. He also set the stage for us to hear about the three winning presentations of exemplar initiatives: a multi-year effort at Seattle Children’s Hospital to improve the care pathways for children suffering from chronic asthma; the successful implementation of new processes at Cincinnati Children’s Hospital Medical Center to reduce discharge-related waits and delays for children with complex medical problems and illnesses; and the creation of a medical resident-led consultation team at a Veterans Administration Medical Center to increase the number of error reports submitted by residents and to ensure that safety concerns are addressed.

Date: February 12, 2015

Featuring:

There are lots of health care issues to speculate about in the coming year. Here in the US, the ongoing expansion of health insurance coverage is an ambitious work in progress that continues to face plenty of political and legal headwinds. And then there’s the still glaring and still growing $3 trillion national price tag of US health care. Some are encouraged that health spending is slowing, but do we have any strong evidence that improvements in the quality of care, safety, and IT, coupled with payment reforms that increasingly tie reimbursements to quality and value, are key factors?

Fortunately, our guests on this WIHI, Don Berwick and David Cutler, bring important improvement, policy, and economic perspectives to the table to help make sense of the current environment and what’s ahead.

Against the backdrop of the Affordable Care Act and other significant initiatives, our guests offered their assessments of recent progress with better care and lower costs, and where efforts need to continue to yield even bigger benefits. We also touched upon the following: global payments and the various payer-led financial carrots and sticks in play right now designed to improve health care delivery; the state of statewide reforms, Medicaid expansion, and community-led, population health-driven experiments; and the bright spots and storm clouds on the horizon with respect to policy makers, politicians, and the public where there are still major divides.

Date: January 29, 2015

Featuring:

• Catherine Craig, MPA, MSW, Independent Consultant; Faculty, Better Health and Lower Costs for Patients with Complex Needs, IHI

 A relatively small percentage of the US population accounts for the largest share of health care costs. Everyone knows who we're talking about, right? Well, not exactly. Broad assumptions (e.g., high utilizers of the emergency department) and sweeping generalizations often substitute for more robust inquiries and analysis designed to better pinpoint a hospital or clinic's patients with unmanaged, complex health problems. And, without this specificity, it's hard to know who will benefit most from additional supports and interventions.