Visiting the IHI - January 13, 2012

I visited the Institute for Healthcare Improvement today. I had the opportunity to ask three of their senior leaders about their career paths, what motivated them, what opportunities they had been given and what education, training or other support had helped them. I also spoke with the Open School team and the Triple Aim team. I approached my first meeting with some degree of trepidation as the IHI is such an icon in the healthcare quality and safety world.
And of course they're an icon for a many reasons, not least of which is the calibre of their leaders, who were welcoming, open and very humble. I was hard pushed to get anyone to admit to having leadership skills even in the face of their clear success!
I had loads of questions and each one was answered with such reflection and honesty. I was deeply impressed that they would take the time to debate issues with me, at times disagreeing but always with considered reasons. It was a great example of a 'safe space' in which to try to articulate ideas, have them considered by experienced people who then add breadth and depth. I looked for, and found, many parallels to the way in which Innovation Support works.
It was also great to be able to ask the Triple Aim team what they mean by each of the 3 terms that they use, and how they support and measure their achievement. They said that there were many groups who misinterpreted the Aims and some who reinterpreted them. In particular, they clarified their meaning of 'Improving patient experience' which is different to the way I had been interpreting it. The Director, Martha Rome, said that they mean the whole of patient care. They would like to be able to measure it across all the dimensions of quality but have tended to use a single question such as "How would you rate your health?" Martha described this Aim as a balancing one for the other two.
This is in contrast to the questions we ask in relation to patient satisfaction or patient expereince, which Martha described a measures of patient-centredness. Interestingly, one of the non-Triple Aim people also thought the same as us, so perhaps that's something the team could make clearer.
Another very interesting point was that the focus of IHI has really only recently expanded beyond hospital care. For example, the Open School has few resources for ambulatory care services and none aimed at primary care.
Overall, a very inspiring and enjoyable day!