Day 1 at IHI's Improvement Advisor Course

I'm a student again and loving it. I'm joined by 26 other students from around the world, representing 10+ countries. In my table of six, fellow students are coming from Afghanistan, Russia, India, and the US. We're all here to learn the same thing: how to improve quality in low-resource settings, in a way that's sustainable and scaleable. Many represent hospitals or lead projects to decrease maternal mortality or ensure their institutions are more patient-centric. Quite a few come from URC, an organization that works with USAID to improve healthcare quality abroad. While most are clinicians, others are country heads of their organization and quite a few of us have business backgrounds... which is helpful, since "What's the business case for quality improvement?" is an important question that often gets ignored in conversations such as this.

It's still morning of Day 1, but already learning a ton. The first morning is around the "Model for Improvement", which encompasses three questions for every quality improvement project:

1) What are we trying to accomplish?

2) How will we know that a change is an improvement?

3) What changes can we make that will result in improvement?

Concurrent with that is Deming's PDSA cycle:

Plan - Do - Study - Act, which can be considered the "scientific method" for improvement. I really liked the quote: "Failing often to succeed sooner" -- which seems much easier to say than to implement.

To reinforce this, we played a game around predicting the number of the next card. Some reflections from this:

- Keep the theory simple and use evidence to refine theory

- Recognize that everyone will be at varying degrees of belief that the change will result in improvement -- can't force someone to jump to implementation

And just like school, we have 150+ pages of reading for tonight. That part perhaps is not as fun (especially when the World Cup is on!), but I wouldn't want to be anywhere else.