WIHI - A Podcast from the Institute for Healthcare Improvement
WIHI: Increasing Joy in Work: Notes from a Cardiac ICU Team

WIHI: Increasing Joy in Work: Notes from a Cardiac ICU Team

November 6, 2019

As an organization dedicated to continuous improvement, we hope you will take a moment to give us feedback on this episode of WIHI. Take the 1-minute survey here: ihi.org/PodcastSurvey.

Featuring:

  • Jamie Beach, BSN, RN, Quality Data Manager, Frankel Cardiovascular Center, Michigan Medicine
  • Diane Lopez, RN, MSN, Clinical Nursing Director, Michigan Medicine
  • Jessical Perlo, MPH, Network Director, Institute for Healthcare Improvement

Caregiver burnout is well documented and on the rise. To address some of the underlying issues and improve patient and provider safety, the Institute for Healthcare Improvement (IHI) has developed a framework and set of recommendations known as "Joy in Work." Organizations across the country are testing how to apply the principles with encouraging results. If you want to learn how one clinical team at Michigan Medicine, spearheaded by Diane Lopez with help from Jamie Beach, has changed what was once a toxic culture in a medical unit, this episode of WIHI is for you.

 IHI Joy In Work Tools and Resources:

 The IHI Framework for Improving Joy in Work is the North Star for this work. Other key and helpful materials include:

 Currently, IHI is gearing up for a Results-Oriented Learning Network around Joy in Work. The network will kick off in January 2020. Register here to save your spot in a free informational call with Network faculty on November 15, 2019, at 11:00 AM ET.

Looking for in-person trainings? Join us at this year’s National Forum, where Joy in Work is a featured track. (You can browse all National Forum sessions here.) 

WIHI: Let’s Get to Work on Waste in Health Care

WIHI: Let’s Get to Work on Waste in Health Care

October 3, 2019

October 3, 2019

Featuring:

  • Derek Feeley, President and CEO, Institute for Healthcare Improvement
  • Helen Macfie, PharmD, Chief Transformation Officer, Providence St. Joseph Health
  • Kelly Logue, MA, Senior Director of Affordability, HealthPartners

The notion of waste in healthcare has expanded in recent years. Today, waste encompasses everything from diagnostic errors and hospital-acquired infections to EHR workarounds and staff burnout. Experts suggest this waste in the US health care system totals roughly one trillion dollars per year. And, as Derek Feeley writes in the foreword to the IHI Leadership Alliance’s Call to Action: “The most precious resources – the [health care] workforce’s time, spirit, and joy – are being unnecessarily drained by wasteful processes every day.”

 So, what if this one trillion dollars could be cut in half by 2025? It’s no pipe dream if every health system doubles down. And, this episode of WIHI, Let’s Get to Work on Waste in Health Care, talks about how. Among our panelists, Helen Macfie will trace how the IHI Leadership Alliance waste workgroup arrived at its key interventions and savings calculations in the Call to Action; IHI’s Derek Feeley will share why he’s championing waste reduction in health care; and Joanna Roberts, and Kelly Logue will discuss the encouraging trajectory of current strategies in their organizations. We hope you’ll tune in.  

WIHI: NO LET UP ON SAFETY

WIHI: NO LET UP ON SAFETY

September 19, 2019

September 19, 2019

Featuring:

  • Tejal K. Gandhi, MD, MPH, CPPS, Chief Clinical and Safety Officer, Institute for Healthcare Improvement (IHI)​
  • Rear Admiral Jeffrey Brady, MD, MPH, United States Public Health Service, Director, Agency for Healthcare Research and Quality's Center for Quality Improvement and Patient Safety 
  • Helen Haskell, President, Mothers Against Medical Error and Consumers Advancing Patient Safety
  • Jay Bhatt, DO, MPH, MPA, FACP, Senior Vice President & Chief Medical Officer, American Hospital Association; President, Health Research and Educational Trust

It’s been 20 years since the renamed National Academy of Medicine (former Institute of Medicine) first shined light on the unintended consequences of medical errors in American health care. Their report, To Err is Human: Building a Safer Health System, has served as a catalyst for safety initiatives at health systems, and progress has been made on multiple fronts — from significant reductions in health care - associated infections, to an embrace of quality improvement and patient safety solutions that now encompass the entire continuum of care.

Even with this progress, obstacles to safe and reliable care persist. Systems are confronting a new payment environment, it remains difficult to sustain improvement gains, there are EHR headaches, and ongoing concerns about physician and staff burnout. These are just some of the reasons IHI convened national safety leaders and stakeholders to form the National Steering Committee for Patient Safety (NSC). Co-chaired by IHI and the Agency for Healthcare Research and Quality (AHRQ), the NSC is hard at work on a new National Action Plan it expects to release in early 2020. In light of these developments, and in support of World Patient Safety Day on 9/17, we’re focusing this edition of WIHI: No Let Up on Safety, on the work of the NSC and their bold intention to re-energize the safety movement in the US with foundational safety principles and priorities.

 If you’re looking to continue the conversation, join industry leaders at this year’s IHI National Forum on Quality Improvement in Health Care and attend a special interest breakfast with members of the NSC.

WIHI: Black Women and and Maternal Care: Redesigning for Safety, Dignity, and Respect

WIHI: Black Women and and Maternal Care: Redesigning for Safety, Dignity, and Respect

August 8, 2019

Date: August 8, 2019

Featuring:

  • Joia Crear-Perry, MD, FACOG, Founder and President, National Birth Equity Collaborative
  •  Ebony Marcelle, CNM, MS, FACNM, Director of Midwifery, Community of Hope
  •  Shannon Welch, MPH, Project Director, Institute for Healthcare Improvement (IHI)

A significant rise in maternal deaths in the United States, especially among black women, has recently gotten a lot of public attention. According to the US Centers for Disease Control and Prevention (CDC), acute events tied to childbirth are contributing to the upward trend. Experts also highlight other factors putting black women, in particular, at risk: racism and implicit bias within health care, the daily struggles of poverty, and disregard for pregnant women’s knowledge about their own bodies and potentially dangerous symptoms.

 With lives at stake, we invite you to listen to this WIHI: Black Women and Maternal Care: Redesigning for Safety, Dignity, and Respect to learn more about the issues that have led to an alarming rise in maternal mortality disproportionately impacting Black women and what can be done to reverse this trend. Dr. Joia Crear-Perry, Ebony Marcelle, and Kiddada Green are among national and local leaders of organizations that are co-creating solutions and interventions with Black women all across the US to improve the quality of support and health care surrounding pregnancy and childbirth. Shannon Welch will describe how the current partnerships and learning with IHI promise to offer new and better practices to improve outcomes and save lives.

WIHI: Aim High For Equity in the Health Care Workforce

WIHI: Aim High For Equity in the Health Care Workforce

July 18, 2019

Date: July 18, 2019

Featuring:

  • Stephen Mette, MD, Chief Clinical Officer, interim Chief Executive Officer, Senior Vice Chancellor Clinical Programs, University of Arkansas for Medical Sciences (UAMS) Medical Center
  • Andrea Werner, MSW, Senior Vice President, Bellin Health Systems
  • Kalyn Witak, Talent Acquisition Specialist, Bellin Health Systems
  • Saranya Loehrer, MD, MPH, Head of Innovation, Institute for Healthcare Improvement

If you’re looking to learn more about the role health care systems can play in the efforts to improve workforce equity, then this episode of WIHI, Aim High for Equity in the Health Care Workforce, is for you. We’ll hear from two members of IHI’s Leadership Alliance: Bellin Health Systems and the University of Arkansas for Medical Sciences Medical Center (UAMS) on their work in the Alliance’s Equity Workgroup. In 2018, the Workgroup developed a Call to Action to Achieve Health Equity, pledging to create “a more diverse, inclusive, and equitable workforce in our organizations.” Health system leaders recognize the need to better understand and address the ways in which workplace inequities, e.g., low income or stagnant career growth, impact the health of the communities in which their institutions reside. IHI's Saranya Loehrer kicks off the dicusssion, followed by leaders from Bellin andUAMS who highlight the implementation details of their workplace equity efforts and share their learnings thus far.

 

WIHI: Assessing the Value of Age-Friendly Health Care

WIHI: Assessing the Value of Age-Friendly Health Care

June 13, 2019
  • Victor Tabbush, PhD, Adjunct Professor Emeritus, UCLA Anderson School of Management
  • Robert Scott Dicks, MD, FACP, Chief, Division of Geriatric Medicine and Gerontology; Director, Geriatric Me​dicine, Hartford Hospital
  • Christine Waszynski, APRN, Coordinator, Inpatient Geriatric Services, Hartford Hospital
  • Suzanne Engle, RN, BSN, Director of Care Coordination, St. Vincent/Ascension
  • Jennifer Allbright, RN, BSN, Manager, Center for Healthy Aging, St. Vincent/Ascension

It hasn't always been easy to talk about the business case for quality improvement, let alone isolate the financial benefit. Now, there's a way to do both, in the context of transformative, age-friendly care. On this episode of WIHI our expert panel discusses a new IHI and Age-Friendly Health Systems (AFHS) report, The Business Case for Becoming an Age-Friendly Health System, and reviews the Report’s two prominent case studies: Hartford Hospital and St. Vincent’s Hospital. The panel discusses the potential to unlock cost savings and generate new revenue through the adoption of the 4Ms Framework, all while providing safer, more appropriate care. If you’re looking to learn more about the financial benefits of being an Age-Friendly Health System, this episode of WIHI is for you.

 

Short description (for IHI.org preview only): What are the financial benefits of being an Age-Friendly Health System?

 

WIHI: Taking Acute Pain Seriously, Treating it Safely

WIHI: Taking Acute Pain Seriously, Treating it Safely

June 4, 2019

May 30, 2019

Featuring:

  • John Krueger, MD, MPH, Division Vice President for Quality, CHI Franciscan
  • Joan Maxwell, Patient Advisor, John Muir Health
  • Scott K. Winiecki, MD, Director, Safe Use Initiative, US Food and Drug Administration (FDA)

The key components of safer acute pain management systems, along with tools and resources to support new practices, are highlighted in a new IHI report, Advancing the Safety of Acute Pain Management​. In this episode of WIHI, we dive into the report with three experts: John Krueger, Joan Maxwell, and Scott Winiecki. John and Joan discuss establishing shared expectations with their video simulation of a doctor and patient discussing her upcoming surgery,​ and Scott shines light on the work being done by the Safe Use Initiative at the FDA.

Our WIHI guests all agree that health care needs to create safer processes for a patient population that is becoming more aware of the risks of opioids, more realistic about their ability to tolerate some pain, and more open to non-opioid remedies for pain management. If you’re looking to learn more about how to create these processes, then this WIHI is for you.

WIHI: What’s an Apology Worth? The Case for Communication and Resolution

WIHI: What’s an Apology Worth? The Case for Communication and Resolution

April 18, 2019

Date: April 18, 2019

 Featuring:

Thomas H. Gallagher, MD, Professor, Department of Medicine, University of Washington; Associate Chair, Patient Care Quality, Safety, and Value

Allen Kachalia, MD, JD, Director, Armstrong Institute for Patient Safety and Quality; Senior Vice President for Patient Safety and Quality, Johns Hopkins Medicine

Description:

When a patient is unintentionally harmed during medical treatment, how should organizations respond?

 Not that long ago, steps like these were unthinkable and, from a risk manager's perspective, totally unwise. Today these practices are at the core of what are called communication and resolution programs (or CRPs)​, and their architects say there's been a significant uptick in US health systems using them. Our guests are two leading experts on CRPs, Tom Gallagher and Allen Kachalia. They and a team of researchers have been teasing out the reasons why so many health care leaders are committed to the principles of CRPs, but hesitant to deploy the practices.

 If you've been wondering what's been going on with CRPs and new ways forward, this WIHI is for you.

WIHI: How to Make Patient Safety Easier to Explain and to Champion

WIHI: How to Make Patient Safety Easier to Explain and to Champion

March 21, 2019

Date: March 21, 2019

Featuring:

  • M.E. Malone, MS, MPH, Deputy Director, Betsy Lehman Center for Patient Safety
  • Rose Hendricks, PhD, Researcher, FrameWorks Institute 
  • William Berry, MD, MPA, MPH, Associate Director and Senior Advisor to Executive Director, Ariadne Labs​

Certain concepts have become hallmarks of improving patient safety and second nature to improvers — for example, systems thinking and building a culture of safety. However, try explaining this work to people outside safety improvement circles and you're likely to confront the reality that the degree to which health care can be unsafe and that medical errors and near misses occur is not universally shared. Or understood.

The Betsy Lehman Center has been working on a multi-phase effort to better understand these disconnects and the messaging and terminology that might fix them. They've published a new report​, and we dug into the findings and recommendations on the March 21 WIHI: How to Make Patient Safety Easier to Explain and to Champion.

WIHI: How to Speak So Leaders Will Listen

WIHI: How to Speak So Leaders Will Listen

February 22, 2019
  • Derek Feeley, President and CEO, Institute for Healthcare Improvement (IHI)
  • Angela A. Shippy, MD, FACP, FHM, Senior Vice President & Chief Quality Officer, Memorial Hermann Health System

How much thought and preparation go into how you pitch new ideas and initiatives to leaders in your organization? If you've been frustrated by lack of support or buy-in from a leader, it's possible that you did not win that person over at the start.

IHI's President and CEO, Derek Feeley, recently penned a blog? on the ingredients he's found can help an initial pitch succeed and was joined on this episode of WIHI, How to Speak So Leaders Will Listen, Derek was joined by Angela Shippy, Memorial Hermann Health System's Senior Vice President and Chief Quality Officer, to offer feedback on pitches from improvers in the IHI community.

Together, Derek and Angela reflected on how challenging it can be to lack the backing or active involvement of leadership to pursui improvement work in health and health care, shared their suggestions and advice for getting the attention of leaders in order to spark meaningful improvement and change.