Case for Improvement
How to Improve
Measures
Changes
Tools
Literature
Other
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Case for Improvement
This is the charter used to set more than thirty teams on a quest to learn how to apply the science of reliability to health care: all patients can always expect to receive evidence-based, effective care when they need it.
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How to Improve
Presentation by Roger Resar and Frank Federico at the April 2007 International Forum.
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Segmentation as a strategy in reliability design is producing some promising results.
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Improving reliability in key clinical areas requires change in an organization’s culture and infrastructure to support working across traditional department/unit barriers to develop an overall system of changes to improve reliability. As part of the IHI IMPACT Innovation Community on Improving Reliability in Key Clinical Areas, this document describes who should be part of a hospital's reliability team as well as key roles and responsibilities.
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Measures
This presentation focuses on measuring process reliability in health care — that is, failure free performance over time.
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Changes
Improving the reliability of health care delivery requires deliberate designs and changes. This change package was developed as part of IHI's IMPACT Community on Designing for Reliability in Clinical Processes.
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Delivering reliable health care requires deliberate designs to achieve the desired levels of reliability. This presentation summarizes the reliability model and change concepts that IHI is using to guide 36 teams through the journey of improving reliability in five clinical areas.
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Tools
Working in segments is a key part of applying reliability science. This presentation explains how to identify segments and provides instructions for using the Segment Design Table tool.
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The purpose of the diagnostic is to get a clearer understanding of local failure modes which contribute to patients not receiving the recommended care based on evidence in the current design for the particular diagnosis of interest. These directives were given to teams participating in IHI's IMPACT Innovation Community on Improving Reliability in Key Clinical Areas.
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This standing order set developed by Ridgeview Medical Center is designed for adult patients whose diagnosis upon admission is pneumonia. This protocol is initiated by an ED or unit nurse and is diagnosis driven. It consists of a checklist to address all CAP Core Measures. It requires a physician to sign off at the end; and if an alternative to the default is required, the physician must provide the order set.
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A template for the application of reliability concepts to heart failure, developed by the IHI Innovation Team and faculty.
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Literature
This bibliography was prepared for the Institute for Healthcare Improvement's Innovation Community on Improving Reliability in Key Clinical Areas.
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Other
This one-day seminar provided an overview of the key concepts of reliability science and highlighted how organizations working with IHI’s IMPACT network will be applying these key concepts to improve outcomes.
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Slides and audio file to accompany the May 19, 2004 IHI "Beyond IMPACT" Conference Call on Reliability, led by Roger Resar of Mayo Health System.
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Presentation by Don Berwick and Tom Nolan at the Institute for Healthcare Improvement's 15th Annual National Forum on Quality Improvement in Health Care (December 2003 in New Orleans, Louisiana, USA).
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