My Great American Adventure – Yvonne and the IHI

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Yvonne Coghill continues her journey to focus on diversity issues. In this latest blog series, Yvonne visits the Institute of Health Improvement (IHI) in Boston, USA. This is the ninth part in the series.

I was thinking the other day that I hadn’t really explained in my earlier blogs what the Institute for Health Improvement (IHI) is; what it does and more to the point what I’m doing here. The IHI is an independent, not-for-profit organisation helping to lead the improvement of health care throughout the world. Founded in 1991 by Dr. Don Berwick, the IHI is based in Cambridge (Boston) Massachusetts, it works to accelerate improvement by building the will for change, cultivating promising concepts for improving patient care, and helping health care systems put those ideas into action. The Strategic aims of the organisation are:

  1. To optimise healthcare delivery systems – Encourage, empower and enable health care delivery systems to provide truly value based care that ensures the best health outcomes at the lowest cost
  2. Drive the triple aim for populations – Strive to achieve the Triple Aim, simultaneously improving the health of the population, enhancing the experience and outcomes of the patient and reducing per capita cost of care for the benefit of communities
  3. Realise person and family centred care – Usher in a new era of partnerships between clinicians and individuals where the values, needs and preferences of the individual are honoured. The best evidence is applied, and the shared goal is optimal functional health
  4. Build improvement capability – Build improvement capability into every organisation, health care executive, and professional, while driving innovation to dramatically improve performance at all levels of the healthcare system

It aims to do all this through the science of improvement. I remember when I first heard about the IHI. It was back in 1994/5 when I was working in Harrow, we signed up to become a part of a primary care collaborative.  We were trained in ‘improvement methodology’ and learned to make small changes in systems which would lead to a measurable improvement in patient experience. As part of that we experimented with the Plan Do Study Act cycle (PDSA). The NHSI link below will give you more information on this methodology which originated in the car manufacturing industry.

Plan Do Study Act

I recall we made small changes to the way patients received information on their blood and other results, instead of having to make an appointment to come in and see the doctor, if the test was normal the nurse would ring the patient, thus reducing waiting lists for small things like blood results. Another change we made was to the appointment booking system. Instead of patients booking appointments weeks ahead, there was a first come first served process, no appointments were made in advance unless they were essential. These small changes did make a difference to patient care and patient satisfaction; I was so taken with this new exciting methodology that I became a member of the National Primary Care Development team led by Sir John Oldham. At the time I knew very little about the IHI or Don Berwick. For a small organisation employing 120 staff, the IHI’s reach and influence is enormous. It does this by nurturing and maintaining partnerships with hundreds of faculty members offering comprehensive programs that aim to improve the lives of patients as well as running an international and national forum to which thousands of healthcare professions attend every year.

I was invited to the IHI by its CEO, Maureen Bisognano, after I spoke at the IHI board at their international forum in Paris earlier this year. IHI realise the importance of a diverse and fully inclusive workforce to be able to deliver high quality care for all members of the population and asked me to support their diversity and inclusion council in being able to deliver on some of their diversity objectives.

Follow Yvonne on Twitter @YvonneCoghill1