This workshop highlights dual topics: Equity and Population Health

 The Spreading Community Accelerators through Learning and Evaluation (SCALE) initiative uses Improvement Science (IS) tools, methods, and approaches to improve well-being in communities in order to strengthen collaboration with stakeholders; commence innovative improvement projects and develop sustainable systems that focus on equity. Core teams comprised of institutional leaders, improvement coaches and community participants will share how adaptation of key frameworks and IS tools can facilitate systems change in SCALE communities. The aim of this session is to share knowledge gained from the evaluation of SCALE and demonstrate how best to adapt IS tools tools in community settings. Participants will leave with concrete tools and approaches to collaborate with stakeholders in their community to improve health, well-being, and equity. Outline 1. (10 min buffer) 2. Introduce our team and SCALE initiative 3. Introduce Race, Racism, and Equity (RRE) and IS Framework and Tools 4. Overview of IS tools and findings from SCALE (SCALE Evaluation Team) a. RRE and Community Engagement b. Improvement Science and Measurement c. Community of Solutions Skills and Community Transformation Mapping 5. Hands on activities with participants: examples from SCALE communities using IS tools, modifications, and how they address equity and strengthen collaboration a. Race, Equity and Inclusion Training and the Race Equity Map (Melvin Jackson, Raleigh North Carolina) b. Community Transformation Map and Journey Mapping (Will Douglas, Tenderloin District, San Francisco) c. IS Tools, Driver Diagrams, Model for Improvement (Becky Henry, Maricopa County, Arizona) d. IS tools, Trauma Informed Community Engagement (Amy Turk, Downtown Women’s Center, Los Angeles)

After this presentation you will be able to:

1. Identify lessons learned from community processes and a range of models to address equity.
2. Demonstrate how IS tools/methods have been adapted by SCALE communities to work toward health equity and facilitate community collaboration.
3. Practice how to apply IS tools using an equity lens with session participants in their own communities.

This workshop highlights dual topics: Improvement Science and Care and Health for Older Adults 

This Learning Lab provides a structured approach to high-velocity improvement, including tools and methodology. Expert faculty will challenge attendees’ thinking and simulate the critical skills required for high performance. Learning will be enriched with examples of digital solutions that enable rapid identification and real-time connectivity. The following case studies with data will be shared: The translation of Toyota theory to achieve redesign of care systems for Older Adults, including the concept of ‘Flipped Discharge’; The Baldrige Award–winning Charleston Area Medical Center sustained transformation of reducing deferrals and increasing revenue while improving staff satisfaction and patient experience.

After this presentation you will be able to:

1. Identify why system complexity requires us to take a methodical approach to system design, operation, and improvement.
2. Be able to identify specific applications of translated Toyota tools and methodology to achieve graceful care.
3. Access credible data and results of transformational redesign of complex systems, including older adult care.

This workshop highlights dual topics: Population Health and Mental Health and Well-being 

The Indiana Rural Health Association (IRHA) works with communities impacted by behavioral health needs including substance use disorder, suicide, depression, and anxiety. IRHA created the Crossroads Partnership for Telehealth (Crossroads), funded by the Health Resources and Services Administration, which has implemented telehealth programs to increase access. This session will discuss the steps involved, including technology selection, workflow, and billing support. The team will share tools to measure program success and strategies for quality improvement.

After this presentation you will be able to:

1. Identify potential opportunities to implement tele-behavioral health.
2. Describe strategies to implement a tele-behavioral health program
3. Identify steps to successfully run a tele-behavioral health program.

This workshop highlights dual topics: Population Health and Mental Health and Well-being 

Patients with a behavioral health emergency often confront over-crowded emergency departments that are ill-equipped to meet their needs. Taking the patient perspective, this session will share the work of an 18-month IHI Learning Community that tested new ways to care for patients in the emergency department and to connect them more effectively with community resources. Participants will learn about successes, challenges, and ideas for how to make meaningful improvements in their own systems.

After this presentation you will be able to:

1. Describe how to incorporate the patient and family perspective into the redesign of ED care
2. Understand key changes to improve care in the ED for individuals with behavioral health needs
3. Understand key components of a coordinated system of behavioral health care

All National Forum attendees are invited to this informal networking meeting to interact with colleagues from around the globe.

This workshop highlights dual topics: Joy in Work and Mental Health and Well-being 

Critical gaps exist in the data that enables organisations to identify current and emerging risks to patient safety. Safety failures continue to occur in health services worldwide. In order to combat this, we need to rethink how safety risks are identified. In this session we explore how, with data organisations already collect, risks to patient safety can be identified and care improvements can be directed. This session will deliver a framework for identifying and analysing non-traditional patient safety data to drive healthcare improvement. The framework encompasses such data as patient feedback, medico-legal claims, sentinel events, reports to government clinical councils, practitioner regulator notifications, care volume, and more to identify and address current and emerging safety risks. This session assumes no QI knowledge, and would be suitable for everyone from consumers and students to system managers. Beyond the provision of a framework, in this session we will share our own experience of implementing routine monitoring of non-traditional patient safety data. This will include a discussion of what worked and what didn’t, challenges in enacting the framework, and strategies to engineer prospective data-sharing agreements.

After this presentation you will be able to:

1. Deliver a clear framework for attendees to identify sources of underused safety risk data in their own organisations in an interactive design-thinking activity during the session.
2. Provide a road-map for participants on how to incorporate these data into routine safety risk monitoring systems in their organization.
3. Give insight on how participants can implement and measure improvements to patient safety and patient centred care by incorporating lessons from data feeds including patient complaints, medicolegal claims, practitioner notifications and more, and sell this change to managers and system leaders within 6 months following the conference.

This workshop highlights dual topics: Population Health and Mental Health and Well-being 

Many current responses to the opioid crisis focus on the immediate overdose and short-term survival, rather than addressing the need for long-term prevention and treatment strategies across a community. Experiences from around the country suggest that successfully addressing the opioid crisis requires multiple stakeholders across a community to work together, building new partnerships and developing creative strategies to prevent and treat opioid use disorder. This interactive session will highlight the innovative work of four approaches in Wisconsin, Ohio, New York, and Indiana. Each team will demonstrate the importance engaging disparate partners in a multi-pronged, community-wide approach that includes work on community engagement and education, education and training for clinicians, peer recovery coaches, enhancing access to Medication Assisted Treatment, and more. In the first part of the session, participants will hear a range of perspectives on successes, failures, and lessons learned. Patients stories will be shared from a diverse group including individuals in recovery, clinicians, a social worker and a fire chief. The second part of the session will break into small groups to share learning and challenges among participants and discuss specific, actionable strategies and tools.

After this presentation you will be able to:

1. Explain the importance of a community-wide approach to addressing the opioid crisis
2. Describe different strategies and tools being used in communities around the country
3. Communicate the ability to adapt approaches with peers, clinicians, researchers and health system leaders

A detailed agenda for the workshop can be located here.

Harm, as a result of both individual and systemic errors, is commonplace in today’s delivery of oral health care. Although these harms are usually less severe than in medicine, there is still considerable potential for reduced quality of life for patients. This session for anyone with an interest in improving the quality and safety of oral health care delivery will present approaches for dental adverse event (DAE) reporting and dental quality metrics (DQM) development. The morning session will incorporate a series of short talks discussing cutting-edge dental patient safety efforts ranging from sedation safety to safety culture. With quality improvement (QI) as the focus for the afternoon, we will introduce the Dental Quality Learning Consortium and explore DQMs developed for sealants, caries risk assessments, caries treatment, and periodontal disease. Additional short talks will canvas the use of technology to drive QI, the intersection between cost and QI, and how a large practice successfully strives for high quality.

After this presentation you will be able to:

1. Discuss cutting-edge research and strategies for improving quality and patient safety in the dental care setting.
2. Explain the concept of pain as a neglected dental adverse event.
3. Describe existing dental quality measures and their real-world implementation within the dental care setting.

This workshop highlights dual topics: Joy in Work and Mental Health and Wellbeing. 

All health care disciplines are struggling with burnout, substance abuse, depression, dropping out, and suicide. Addressing the harmful effects of second victimization through peer support and expedited linkage to mental health resources can change the culture of medicine and promote longer and healthier careers. This session’s presenters were successful in launching the Helping Healers Heal (H3) second victim program in the two largest safety net systems in the United States. Participants of this interactive session will walk away with the background, expertise, and skillset to provide second victim peer support to their colleagues. They will also understand the structure of a second victim peer support program and be able to build similar programs at their home institutions.

After this presentation you will be able to:

1. Describe how to develop peer support champions who can provide emotional and psychological support to second victims in their home institutions.
2. Prepare to develop second victim champions who have the knowledge and expertise to start second victim programs at their home institutions.
3. Develop empathy and emotional intelligence.

In this session you will explore coproduction and its relation to healthcare improvement with examples from the vibrant international participants and presenters of the learning community, with methodologies, change ideas, measurement possibilities and results. Specifically, we will explore the coproduction learning cycle, a novel approach developed by the ICoHN: International Coproduction Health Network learning community, to describe the stages of an approach between healthcare providers and users to coproduce health. We will delve deeper into the coproduction of health and learn from the successful and innovative ‘Always Events’ program. You will explore the place of coproduction in medical education, including experience from Jönköping, Sweden. Providing specific examples, context and research, The Beryl Institute will provide a perspective on where experience, satisfaction and coproduction intersect. Expect to have fun and to leave with ideas, connections and applications to your own work to take your coproduction to the next level.

After this presentation you will be able to:

1. Understand and explore the steps of the coproduction learning cycle, including how this meets traditional improvement methodology and how it leads to the formation of a value-creating business model
2. Gain insights from the coproduction experience of patients, providers, projects and partnerships, including the successful ‘Always Events’ program, evidence from The Beryl Institute and the Jönköping GME pilot course
3. Work together with presenters and participants to identify ways to utilize each stage of the learning cycle and apply its principles to your own work

This workshop highlights dual topics: Population Health, Improvement Science, and Maternal and Neonatal Health 

As Improvement Science is being applied through a Collaborative model to achieve population-level outcomes, now in multiple sectors and across sectors, there are common adaptive challenges emerging across the work. Without existing roadmaps for navigating these challenges, there is a growing need and opportunity for leaders working in this space to learn from each other and collaborate to discover improved ways of supporting this work. To address these population-level outcomes there is increasing pressure to develop frameworks which can be adapted for use to address a wide range of complex problems. This dynamic session will use case studies from the fields of health care, homelessness, education and work across the non-profit sector to teach methods, tools and frameworks ranging from high-level theory of change frameworks to tools developed to cut through complexity and address adaptive challenges. Session participants should plan to walk away with tools and frameworks that they can readily apply to their work, new connections to peers doing similar types of scaled improvement work, as well as ideas co-produced with other participants on how to address common and emerging challenges.

After this presentation you will be able to:

1. Understand and apply tools and frameworks presented to achieve breakthrough results in participants’ unique context
2. Identify emerging challenges in multi-stakeholder improvement initiatives and leverage peer to peer engagement to generate change ideas to address these challenges

This workshop highlights dual topics: Joy in Work and Mental Health and Wellbeing. 

If we are going to sustain our joy at work, create a culture of psychological safety, and truly be there for our patients, we’re going to need to change the culture of medicine, especially in the aftermath of significant emotionally stressful events. There is ample evidence that many healthcare team members suffer negative emotional consequences after being involved in events such as errors, caring for trauma victims, illness of a colleague, patient aggression, or facing potential litigation. Peer support programs can drive culture change by supporting clinicians during times of heightened stress and vulnerability.
During this interactive session, we’ll use shared stories of being involved in difficult events and explore why the culture of medicine needs to change. The participants will learn the key steps in building a peer support program. This will include the essential components of peer support interventions, “making the case” to get resources, creating a “coalition of the willing” to co-create and sustain a program, and overcoming challenges in program development.
In the spirit of moving this mission forward with transparency and compassion, I’ll share my successes and challenges in creating and directing a peer support program as well as helping dozens of organizations develop and sustain peer support programs.
If you or anyone you know has been involved in an emotionally stressful event in the course of caring for patients and you want to be a force for improving your team or organization’s response after such events, you are welcome to join this session. If you care about the wellbeing of anyone on the healthcare team, you are welcome to join this session.

After this presentation you will be able to:

1. Recognize the emotional consequences for clinicians involved in errors and other emotionally stressful events..
2. Describe the basic skills for providing effective peer support to colleague.
3. Identify components of creating an institutional peer support program and develop strategies for building coalitions and overcoming barriers.

This workshop highlights dual topics: Person-Centered-Care and Care and Health for Older Adults 

Understanding what matters to older adults is key to best aligning the health care they receive in wellness, sickness, and end of life. Work with a focus on “What Matters” has evolved at IHI over the past several years in two different streams: the Age-Friendly initiative and Conversation Ready work. Age-Friendly work focuses on improving care for older adults through the 4Ms Framework: What Matters, Medication, Mentation, and Mobility. Conversation Ready work focuses on making sure patients’ end-of-life care wishes are received, recorded, and respected, including by understanding who they want to serve as their proxies. These two streams of work have been tested in many health care systems, and there are toolkits to share for translating the learning into action. Baystate Health system provides an example of an interdisciplinary team that has used the toolkits to improve care for older adults with great success.

After this presentation you will be able to:

1. Explain why understanding "What Matters" is a key to providing the best health care to older adults.
2. Describe key resources available for improving care and outcomes for older adults across the health care spectrum.
3. Delineate critical aspects of the Age-Friendly and Conversation Ready initiatives.
4. Identify a starting point and develop an action plan to improve care for older adults in your health care setting.

This workshop highlights dual topics: Population Health and Mental Health and Well-being 

Swedish Medical Group is a not-for-profit healthcare system in the greater Seattle area. Primary Care Behavioral Health (BH) has been increasingly integrated into our primary care clinics starting in Q4 of 2014. At present, a BH provider is integrated into 15 of the 28 primary care and pediatric clinics. BH providers are considered members of the primary care team, and see patients for brief interventions related to health behaviors throughout episodes of care. However, no program evaluation looking at the impact of this integration has been explored to date. The current study was designed to better understand the population accessing BH in the Swedish health system, as well as impact on utilization patterns. As systems try to move from fee for service towards more value based care, clarity around the overall financial impact of integration is necessary. Study questions include a description of the health care utilization patterns of patients who have had interactions with BH in their primary clinic. A program evaluation question of whether engagement with a BH provider in primary care reduces avoidable ED visits will be explored. We will also explore whether there is a difference in shifting utilization based on the frequency of visits with BH. This presentation will include methodology, lessons learned, and goal of improved understanding of healthcare utilization (i.e. avoidable ED visits/ hospitalizations) for support of further integration efforts.

After this presentation you will be able to:

1. Describe the impact of integrating BH providers into primary care on healthcare utilization
2. Identify ways that BH has been integrated and supports appropriate healthcare utilization

Every year, we gather as a health care community to remember and honor our patients, friends, family members, and colleagues who have been lost to adverse events. Candles will be provided.

All National Forum attendees are invited to meet and connect at a reception with IHI leaders and staff as well as colleagues from around the world to discuss equity initiatives in their organizations.

This session highlights dual topics: Equity and Maternal and Neonatal Health

Disrespect and abuse of women during childbirth is a widespread problem that is particularly severe in marginalized populations. In this session for caregivers, administrators, and community advocates, a young mother will share her personal experience and her vision of quality care, and presenters will describe a curriculum in empathic communication that improved care in Ethiopia. We will provide a practical approach to improving care and reducing disparities through trainings in empathic communication.

After this presentation you will be able to:

1. Describe the scale of disparities in care provision and care outcomes for mothers and newborns across the globe.
2. List theoretical approaches to decreasing disparities in marginalized populations.
3. Identify practical approaches and available tools for increasing empathy as a strategy to decrease disparities in care and outcomes.

This session highlights dual topics: Improvement Science and Mental Health and Well-being 

By identifying and monitoring the key elements of quality standards in a patient’s care journey, patients can be well-prepared for the next phase of their recovery. This presentation will demonstrate how the implementation of clinical pathways supported efforts to integrate quality-related practices while improving efficiencies for inpatient units at a specialized mental health institution. A hospital-wide target was established to measure the percent of non-forensic and forensic patients whose discharge length-of-stay (LOS) met the overall clinical pathway target. Strong patient flow processes such as a cohesive bed-management system, discharge activities, and standardized assessment tools were implemented to provide individualized care planning focused on efficiency, improving quality, and identifying an expected LOS for most patients. In 2018/19, there was a 15 percent improvement in the LOS target. Additionally, the impact of this work has demonstrated a 12 percent improvement in the number of admissions for the facility from 2016/17 to 2018/19.

After this presentation you will be able to:

1. Explain how the engagement of point-of-care and physician leaders in the development of clinical pathways can improve the quality of care for patients and patient flow in a specialized mental health care setting.
2. Describe how reducing process variation improves patient outcomes by sequencing activities and ensuring the right disciplines are engaged at the right time.
3. Specify tools and practices that are important considerations for implementing clinical pathways in inpatient mental health settings.

This session highlights dual topics: Population Health and Mental Health and Well-being

With 1 in 5 individuals experiencing a mental health concern in any given year, timely access to high-quality behavioral health remains a persistent challenge. The integration of behavioral health has clearly emerged as a best practice, both for expanding access to care as well as improving quality; however, questions around implementation, scale, and sustainability remain. This session will describe the development of a population health framework for behavioral health in a large integrated health system serving diverse populations. Augmenting traditional acute care and ambulatory services, this emerging continuum of integrated services includes collaborative care treatment of mental health in primary care, “reverse integration” of physical health in mental health settings, comprehensive care management through the Health Home model, adult and pediatric behavioral health crisis centers, and telehealth consultation. Application of these services to specific populations will be examined through a series of case presentations, with emphasis on care pathways, data collection, and outcomes reporting.

After this presentation you will be able to:

1. Describe skills and strategies for increasing access and quality of care for a wide range of behavioral and mental health issues among diverse patient populations.
2. Understand the role of collaborative case-based supervision and consultation in clinical settings for leveraging scarce specialty psychiatric resources and improving integration of behavioral health services.
3. Recognize the need for a variety of developmental and age-based strategies across the continuum of integrated behavioral health care.

This session highlights dual topics: Population Health and Mental Health and Well-being 

Opioid-related deaths have increased six-fold over the last two decades, with more than 130 people dying each day from an opioid-related overdose. Emergency Departments (EDs) are at the frontline of the opioid crisis and often the place of first presentation for patients at risk of or suffering from opioid use disorder (OUD). Given their open-door, 24/7 access to care, EDs are well-positioned to diversify practices to improve patient care. This session will highlight the innovative work being done at two U.S. health care organizations (an urban, safety net hospital and a large public health system), describing specific changes, results, challenges, and lessons learned. Participants will hear from an interprofessional panel about their comprehensive approaches to refine practices for screening, identification, harm reduction, treatment initiation, and linkage to care. Participants will also have an opportunity to interact with the presenters and each other to generate creative ideas for tests of change and identify how they can re-design a specific aspect of care for ED patients with OUD at their organizations.

After this presentation you will be able to:

1. Learn effective strategies to improve care for opioid use disorders in the ED
2. Understand the key roles of different team members in testing and implementing changes
3. Discuss and identify change ideas to test at your organization

This session highlights dual topics: Population Health and Maternal and Neonatal Health 

Perinatal outcomes in the United States are suboptimal, with infant mortality rates greater than many other developed countries, and maternal mortality rates that are not decreasing as they are in other countries. State-based, perinatal quality collaboratives (PQCs) have shown that the application of collaborative, improvement science methods can lead to better perinatal health outcomes. These state or multi-state networks are made up of multidisciplinary teams working to improve measurable outcomes for maternal and infant health by advancing evidence-informed clinical practices and processes using quality improvement (QI). Using this collaborative model, the Louisiana Perinatal Quality Collaborative (LaPQC) supports 35 hospitals to apply continuous quality improvement, aiming to reduce Louisiana’s severe maternal morbidity rate and racial health disparity. The LaPQC team centers and prioritizes equity by leveraging the power of patient stories, data stratification, and other techniques to encourage more thoughtful and consistent approaches to data quality and the identification of key processes that impact care as they relate specifically to disparities. Through this approach the LaPQC team works to build not only QI capacity, but a culture of equity-focused improvement. This session will highlight the essential elements of the PQC model of population-based QI, discuss key strategies that support successful statewide perinatal QI initiatives, and present examples from the Louisiana PQC, which is implementing this model to improve maternal health and reduce racial and ethnicity disparities in the state.

After this presentation you will be able to:

1. Apply quality improvement principles for improving statewide perinatal health
2. Identify the essential elements of a fully functional Perinatal Quality Collaborative, including participation of key partners and stakeholders
3. Describe why health equity is an essential driver in ensuring high-quality perinatal outcomes
4. Identify and integrate responsive techniques for supporting hospitals to accelerate improvement related to the reduction of disparities, such as facility team collaboration and on-the-ground coaching

This session highlights dual topics: Equity and Maternal and Neonatal Health 

Disrespect and abuse of women during childbirth is a widespread problem that is particularly severe in marginalized populations. In this session for caregivers, administrators, and community advocates, a young mother will share her personal experience and her vision of quality care, and presenters will describe a curriculum in empathic communication that improved care in Ethiopia. We will provide a practical approach to improving care and reducing disparities through trainings in empathic communication.

After this presentation you will be able to:

1. Describe the scale of disparities in care provision and care outcomes for mothers and newborns across the globe.
2. List theoretical approaches to decreasing disparities in marginalized populations.
3. Identify practical approaches and available tools for increasing empathy as a strategy to decrease disparities in care and outcomes.

This session highlights dual topics: Improvement Science and Mental Health and Well-being 

By identifying and monitoring the key elements of quality standards in a patient’s care journey, patients can be well-prepared for the next phase of their recovery. This presentation will demonstrate how the implementation of clinical pathways supported efforts to integrate quality-related practices while improving efficiencies for inpatient units at a specialized mental health institution. A hospital-wide target was established to measure the percent of non-forensic and forensic patients whose discharge length-of-stay (LOS) met the overall clinical pathway target. Strong patient flow processes such as a cohesive bed-management system, discharge activities, and standardized assessment tools were implemented to provide individualized care planning focused on efficiency, improving quality, and identifying an expected LOS for most patients. In 2018/19, there was a 15 percent improvement in the LOS target. Additionally, the impact of this work has demonstrated a 12 percent improvement in the number of admissions for the facility from 2016/17 to 2018/19.

After this presentation you will be able to:

1. Explain how the engagement of point-of-care and physician leaders in the development of clinical pathways can improve the quality of care for patients and patient flow in a specialized mental health care setting.
2. Describe how reducing process variation improves patient outcomes by sequencing activities and ensuring the right disciplines are engaged at the right time.
3. Specify tools and practices that are important considerations for implementing clinical pathways in inpatient mental health settings.

This session highlights dual topics: Population Health and Mental Health and Well-being

With 1 in 5 individuals experiencing a mental health concern in any given year, timely access to high-quality behavioral health remains a persistent challenge. The integration of behavioral health has clearly emerged as a best practice, both for expanding access to care as well as improving quality; however, questions around implementation, scale, and sustainability remain. This session will describe the development of a population health framework for behavioral health in a large integrated health system serving diverse populations. Augmenting traditional acute care and ambulatory services, this emerging continuum of integrated services includes collaborative care treatment of mental health in primary care, “reverse integration” of physical health in mental health settings, comprehensive care management through the Health Home model, adult and pediatric behavioral health crisis centers, and telehealth consultation. Application of these services to specific populations will be examined through a series of case presentations, with emphasis on care pathways, data collection, and outcomes reporting.

After this presentation you will be able to:

1. Describe skills and strategies for increasing access and quality of care for a wide range of behavioral and mental health issues among diverse patient populations.
2. Understand the role of collaborative case-based supervision and consultation in clinical settings for leveraging scarce specialty psychiatric resources and improving integration of behavioral health services.
3. Recognize the need for a variety of developmental and age-based strategies across the continuum of integrated behavioral health care.

This session highlights dual topics: Population Health and Mental Health and Well-being 

Opioid-related deaths have increased six-fold over the last two decades, with more than 130 people dying each day from an opioid-related overdose. Emergency Departments (EDs) are at the frontline of the opioid crisis and often the place of first presentation for patients at risk of or suffering from opioid use disorder (OUD). Given their open-door, 24/7 access to care, EDs are well-positioned to diversify practices to improve patient care. This session will highlight the innovative work being done at two U.S. health care organizations (an urban, safety net hospital and a large public health system), describing specific changes, results, challenges, and lessons learned. Participants will hear from an interprofessional panel about their comprehensive approaches to refine practices for screening, identification, harm reduction, treatment initiation, and linkage to care. Participants will also have an opportunity to interact with the presenters and each other to generate creative ideas for tests of change and identify how they can re-design a specific aspect of care for ED patients with OUD at their organizations.

After this presentation you will be able to:

1. Learn effective strategies to improve care for opioid use disorders in the ED
2. Understand the key roles of different team members in testing and implementing changes
3. Discuss and identify change ideas to test at your organization

Topics: Population Health and Maternal and Neonatal Health 

Perinatal outcomes in the United States are suboptimal, with infant mortality rates greater than many other developed countries, and maternal mortality rates that are not decreasing as they are in other countries. State-based, perinatal quality collaboratives (PQCs) have shown that the application of collaborative, improvement science methods can lead to better perinatal health outcomes. These state or multi-state networks are made up of multidisciplinary teams working to improve measurable outcomes for maternal and infant health by advancing evidence-informed clinical practices and processes using quality improvement (QI). Using this collaborative model, the Louisiana Perinatal Quality Collaborative (LaPQC) supports 35 hospitals to apply continuous quality improvement, aiming to reduce Louisiana’s severe maternal morbidity rate and racial health disparity. The LaPQC team centers and prioritizes equity by leveraging the power of patient stories, data stratification, and other techniques to encourage more thoughtful and consistent approaches to data quality and the identification of key processes that impact care as they relate specifically to disparities. Through this approach the LaPQC team works to build not only QI capacity, but a culture of equity-focused improvement. This session will highlight the essential elements of the PQC model of population-based QI, discuss key strategies that support successful statewide perinatal QI initiatives, and present examples from the Louisiana PQC, which is implementing this model to improve maternal health and reduce racial and ethnicity disparities in the state.

After this presentation you will be able to:

1. Apply quality improvement principles for improving statewide perinatal health
2. Identify the essential elements of a fully functional Perinatal Quality Collaborative, including participation of key partners and stakeholders
3. Describe why health equity is an essential driver in ensuring high-quality perinatal outcomes
4. Identify and integrate responsive techniques for supporting hospitals to accelerate improvement related to the reduction of disparities, such as facility team collaboration and on-the-ground coaching

Where is the only place in the hospital that will take away your phone while you wait for care? And when was the last time your hospital questioned why that process is in place, who benefits, and who might be harmed? Some protocols and procedures around mental health are based on gut reactions to isolated adverse events rather than on evidence and can cause real harm for patients and families. Join us for an informal and thought-provoking lunch conversation about re-visiting presumptions about practices related to mental health care, focusing on the patient and family experience of these protocols, and think together about ideas for changing the status quo.

Like most people, you know you should talk about your wishes for end of life care — particularly if you couldn’t speak for yourself. But something gets in the way — like how to start, or maybe plain old denial. Join The Conversation Project team for a casual lunch and friendly conversation about what matters most to you. Ensure your wishes will be expressed and respected. Don’t wait. It’s always too soon — until it’s too late.

This workshop highlights dual topics: Improvement Science and Care and Health for Older Adults

A Home-Based Primary Care Practice had a waiting list of eligible patients, and the team recognized a need to optimize processes to expand the program. In addition to expanding the patient census, the team envisioned increasing employee engagement and empowering staff to drive change. Multiple improvement strategies were implemented to meet all goals and can serve as an example applicable to any patient care practice. This session will provide insight into how improvement tools can be used in combination to maximize buy-in and benefit. The example walks through phases of work that included qualitative interviews, root cause analysis, value/non-value-add analysis, swim lane diagrams, brainstorming, a priority payoff matrix, and tracking ownership and timelines for completion.

After this presentation you will be able to:

1. Identify the value of process improvement tools to structuring a large redesign.
2. Describe the synergy created when using multiple improvement tools.
3. Describe how to implement a coordinated approach to process redesign using multiple improvement tools.

The session highlights dual topics: Population Health and Mental Health and Well-being 

Coordinating behavioral and physical health care for families with children ages 0–5 has been a challenge for those who live Pueblo, Colorado, one of the state’s most impoverished neighborhoods. Parents are dealing with multiple entities who, in the past, had little reason to harmonize efforts for individual families or the broader community. Launch Together has been improving the coordination of behavioral and physical care for young families by bringing together primary care, behavioral health organizations, home visiting groups, child care and educational agencies, public health, and child advocacy organizations to create seamless referral loops that improve outcomes for Pueblo’s most needy children. In this session, Launch Together team members will describe how tools such as IHI’s Psychology of Change white paper and the Model for Improvement have helped them create successful momentum in improving the lives of Pueblo’s neediest families and how other communities can combine IHI tools to make changes to take a “two-generation” approach to improving community well-being.

After this presentation you will be able to:

1. Describe an example of the use of IHI’s Psychology of Change for communities and organizations to emulate.
2. Discuss how health equity can be pursued beyond the typical walls of the health care ecosystem.
3. Describe methods to improve the social and emotional well-being of children ages 0-5 using quality improvement tools and a cross-sector approach.

The session highlights dual topics: Population Health and Maternal and Neonatal Health 

High quality maternity care is guided by the best available research and implemented using improvement science principles. Quality improvement bundles provide a structured way of improving processes of care and health outcomes. This session describes the outcomes and lessons learned using QI bundles from a U.S. maternity quality collaborative aimed at reducing the rate of primary cesareans in low risk women and a Nationwide QI Collaborative aimed at reducing the rate of severe perineal trauma in Australian women.

After this presentation you will be able to:

1. Describe the design and effective use of QI bundles in two large-scale maternity quality Collaboratives
2. Become familiar with the core leadership skills to initiate and lead a QI improvement project
3. Recognize the qualities of effective teams, best practices for team formation and management

This breakfast session will provide an opportunity to explore together successes and challenges in improving equity, dignity and respect in maternal care.

The session highlights dual topics: Patient Safety and Care and Health for Older Adults 

For clinicians and quality leaders, we provide a framework for deprescribing diabetes medications in older patients. This framework includes patient case studies and a toolkit for potentially difficult deprescribing conversations. We will share 1-year clinical outcomes of our program, which was associated with a potential survival benefit and a reduction in hypoglycemia while maintaining glucose control. In this session, we will discuss our journey to creating a dedicated deprescribing service with pharmacists and physicians.

After this presentation you will be able to:

1. Identify two challenges in deprescribing and methods to overcome those challenges.
2. List deprescribing opportunities which you will seek to recognize in your practice.
3. Describe behavioral science approaches to having a deprescribing-related conversation with a provider or patient.

The session highlights dual topics: Patient Safety and Maternal and Neonatal Health 

Scotland is a small country, with 55,000 births per year, so 274 stillbirths in one year — which was the case in 2012 — was a lot in this context. In response, the Chief medical Officer for Scottish Government gave the Maternity and Children's Quality improvement Collaborative (MCQIC) this aim: Reduce stillbirth by 15 percent by 2015. Using approaches that will be discussed in this session, such as building improvement capacity in the system and focusing on a few to impact many, MCQIC contributed to a 23 percent reduction in stillbirth from 2014, surpassing the goal. Data is submitted to the MCQIC team via run charts where it is aggregated and analyzed. Boards are supported to understand their own data.

After this presentation you will be able to:

1. Identify methods to successfully lead large-scale improvement.
2. Describe clinical improvements related to fetal movement that can reduce stillbirth rate.
3. Describe common challenges of leading large-scale improvements.

This sessions highlights dual topics: Improvement Science and Maternal and Neonatal Health

A growing awareness of preventable maternal harm stems in part from striking racial inequalities in outcomes in the United States. High-volume delivery centers in Washington, DC and Detroit have partnered with community organizations and individuals. They codesigned services which build trust and improve outcomes. This work is based on critical quality improvement principles: that those most affected by the delivery system possess a wealth of change ideas, and that communities possess key assets for improvement.

After this presentation you will be able to:

1. Describe current inequitable maternal health care experiences within delivery systems.
2. Identify principles of humble and respectful co-design within health care systems and community stakeholders.
3. Examine the method and application of gathering and testing ideas that the Washington, DC and Detroit communities are applying in their journeys.

This session highlights dual topics: Improvement Science and Population Health

Reducing opioid use is a complex problem that requires tailored solutions. Traditional quality improvement methods facilitate context-specific changes. Implementation science provides tools to increase uptake. We used a new framework, the Model for Improvement and Implementation (MFII), which systematically integrates both approaches. Through the MFII, we implement an intervention to reduce surgical prescribing of opioids. This framework to identify barriers and strengthen support for implementation is applicable to other complex issues.

After this presentation you will be able to:

1. Describe the interface between improvement science and implementation science.
2. Explain how to apply the Model for Improvement and Implementation to daily practice.
3. Identify crucial factors addressed in the implementation of a complex intervention to reduce opioid prescribing.

This session highlights dual topics: Person-Centered Care and Mental Health and Well-being 

Caregivers are at risk for stress, anxiety, social isolation, and declines in physical and mental health. Telehealth provides a unique opportunity to meet their needs. Using multi-phase human-centered design (HCD), we gathered perspectives of caregivers, patients, clinicians, and administrators and co-created solutions. We designed a telehealth ecosystem to better connect caregivers, patients, and the care team. We will share HCD principles and our roadmap for integrating telehealth into inpatient and post-hospitalization care delivery.

After this presentation you will be able to:

1. Describe caregiver needs and opportunities for the aging population and understand how to address these through application of a human-centered design (HCD) approach.
2. Develop an understanding of how to leverage human-centered design methods and mindsets to improve care delivery and access a step-by-step approach to applying co-design and human-centered design in your organization
3. Identify potential facilitators and barriers to implementing human-centered design in your organizational settings with a roadmap for integrating human-centered design in your project areas

This session highlights dual topics: Person-Centered Care and Mental Health and Well-being 

There is a major public health crisis across North America resulting in an unprecedented rise in deaths due to opioid overdoses. Improving access to treatments and support through interconnected services and programs is much more effective than simply telling people to prescribe less. In this session, you will hear two case examples of how primary care is working to address this critical challenge. We will begin with the BC Patient Safety & Quality Council’s recent journey of mapping current treatment options and support for people with substance use concerns in primary care settings, in which both health care provider and peer (patient) perspectives were explored. We will then hear from South Central Foundation, an Alaska Native customer-owned health care system that has employed a whole fabric of programs and services to meet this complicated challenge.

After this presentation you will be able to:

1. Explain the value of integrating patient and health care provider experiences in real time journey mapping sessions.
2. Describe how a well-coordinated range of services supported by a highly capable range of improvement staff, workforce training, and support infrastructure can address opioid addiction.
3. Discuss how the same approach can be mobilized to tackle other complex health equity problems.

This session highlights dual topics: Population Health and Maternal and Neonatal Health 

The majority of avoidable adverse events are due to teamwork and communication failures between clinicians and the people they are caring for. In obstetrics, these errors are occurring in the context of high maternal mortality rates, overuse of cesarean births, and birth trauma related to lack of adequate voice in childbirth. We have designed a process innovation, called Team Birth, that aims to improve both safety and dignity in care by improving psychological safety and reliability during team communication. The person-centered team during labor includes the birthing person and her support system, nurses, and midwives and/or obstetricians. Each member of the team has access to different pertinent information regarding events in childbirth. In this workshop, we will review a simple process that enables every member of the team to consider relevant information at the same time, with a shared mental model of how to proceed with the information when important labor management decisions are required. Based on four years of research, design, and testing, our Delivery Decisions Team at Ariadne will present findings and a set of tools to promote behaviors that enable high-performing teams in childbirth.

After this presentation you will be able to:

1. Discuss strategies and structures to enable high-performing teams to be person-centered.
2. Recognize opportunities to incorporate the person’s lived experience in their care.
3. Identify how context impacts the implementation of structures for teamwork and communication.

The session highlights dual topics: Patient Safety and Care and Health for Older Adults 

For clinicians and quality leaders, we provide a framework for deprescribing diabetes medications in older patients. This framework includes patient case studies and a toolkit for potentially difficult deprescribing conversations. We will share 1-year clinical outcomes of our program, which was associated with a potential survival benefit and a reduction in hypoglycemia while maintaining glucose control. In this session, we will discuss our journey to creating a dedicated deprescribing service with pharmacists and physicians.

After this presentation you will be able to:

1. Identify two challenges in deprescribing and methods to overcome those challenges.
2. List deprescribing opportunities which you will seek to recognize in your practice.
3. Describe behavioral science approaches to having a deprescribing-related conversation with a provider or patient.

The session highlights dual topics: Patient Safety and Maternal and Neonatal Health 

Scotland is a small country, with 55,000 births per year, so 274 stillbirths in one year — which was the case in 2012 — was a lot in this context. In response, the Chief medical Officer for Scottish Government gave the Maternity and Children's Quality improvement Collaborative (MCQIC) this aim: Reduce stillbirth by 15 percent by 2015. Using approaches that will be discussed in this session, such as building improvement capacity in the system and focusing on a few to impact many, MCQIC contributed to a 23 percent reduction in stillbirth from 2014, surpassing the goal. Data is submitted to the MCQIC team via run charts where it is aggregated and analyzed. Boards are supported to understand their own data.

After this presentation you will be able to:

1. Identify methods to successfully lead large-scale improvement.
2. Describe clinical improvements related to fetal movement that can reduce stillbirth rate.
3. Describe common challenges of leading large-scale improvements.

This sessions highlights dual topics: Improvement Science and Maternal and Neonatal Health 

A growing awareness of preventable maternal harm stems in part from striking racial inequalities in outcomes in the United States. High-volume delivery centers in Washington, DC and Detroit have partnered with community organizations and individuals. They codesigned services which build trust and improve outcomes. This work is based on critical quality improvement principles: that those most affected by the delivery system possess a wealth of change ideas, and that communities possess key assets for improvement.

After this presentation you will be able to:

1. Describe current inequitable maternal health care experiences within delivery systems.
2. Identify principles of humble and respectful co-design within health care systems and community stakeholders.
3. Examine the method and application of gathering and testing ideas that the Washington, DC and Detroit communities are applying in their journeys.

This session highlights dual topics: Improvement Science and Population Health 

Reducing opioid use is a complex problem that requires tailored solutions. Traditional quality improvement methods facilitate context-specific changes. Implementation science provides tools to increase uptake. We used a new framework, the Model for Improvement and Implementation (MFII), which systematically integrates both approaches. Through the MFII, we implement an intervention to reduce surgical prescribing of opioids. This framework to identify barriers and strengthen support for implementation is applicable to other complex issues.

After this presentation you will be able to:

1. Describe the interface between improvement science and implementation science.
2. Explain how to apply the Model for Improvement and Implementation to daily practice.
3. Identify crucial factors addressed in the implementation of a complex intervention to reduce opioid prescribing.

This session highlights dual topics: Person-Centered Care and Mental Health and Well-being 

Caregivers are at risk for stress, anxiety, social isolation, and declines in physical and mental health. Telehealth provides a unique opportunity to meet their needs. Using multi-phase human-centered design (HCD), we gathered perspectives of caregivers, patients, clinicians, and administrators and co-created solutions. We designed a telehealth ecosystem to better connect caregivers, patients, and the care team. We will share HCD principles and our roadmap for integrating telehealth into inpatient and post-hospitalization care delivery.

After this presentation you will be able to:

1. Describe caregiver needs and opportunities for the aging population and understand how to address these through application of a human-centered design (HCD) approach.
2. Develop an understanding of how to leverage human-centered design methods and mindsets to improve care delivery and access a step-by-step approach to applying co-design and human-centered design in your organization
3. Identify potential facilitators and barriers to implementing human-centered design in your organizational settings with a roadmap for integrating human-centered design in your project areas

This session highlights dual topics: Person-Centered Care and Mental Health and Well-being 

There is a major public health crisis across North America resulting in an unprecedented rise in deaths due to opioid overdoses. Improving access to treatments and support through interconnected services and programs is much more effective than simply telling people to prescribe less. In this session, you will hear two case examples of how primary care is working to address this critical challenge. We will begin with the BC Patient Safety & Quality Council’s recent journey of mapping current treatment options and support for people with substance use concerns in primary care settings, in which both health care provider and peer (patient) perspectives were explored. We will then hear from South Central Foundation, an Alaska Native customer-owned health care system that has employed a whole fabric of programs and services to meet this complicated challenge.

After this presentation you will be able to:

1. Explain the value of integrating patient and health care provider experiences in real time journey mapping sessions.
2. Describe how a well-coordinated range of services supported by a highly capable range of improvement staff, workforce training, and support infrastructure can address opioid addiction.
3. Discuss how the same approach can be mobilized to tackle other complex health equity problems.

This session highlights dual topics: Population Health and Maternal and Neonatal Health 

The majority of avoidable adverse events are due to teamwork and communication failures between clinicians and the people they are caring for. In obstetrics, these errors are occurring in the context of high maternal mortality rates, overuse of cesarean births, and birth trauma related to lack of adequate voice in childbirth. We have designed a process innovation, called Team Birth, that aims to improve both safety and dignity in care by improving psychological safety and reliability during team communication. The person-centered team during labor includes the birthing person and her support system, nurses, and midwives and/or obstetricians. Each member of the team has access to different pertinent information regarding events in childbirth. In this workshop, we will review a simple process that enables every member of the team to consider relevant information at the same time, with a shared mental model of how to proceed with the information when important labor management decisions are required. Based on four years of research, design, and testing, our Delivery Decisions Team at Ariadne will present findings and a set of tools to promote behaviors that enable high-performing teams in childbirth.

After this presentation you will be able to:

1. Discuss strategies and structures to enable high-performing teams to be person-centered.
2. Recognize opportunities to incorporate the person’s lived experience in their care.
3. Identify how context impacts the implementation of structures for teamwork and communication.