A Collaborative is an intensive effort of health care professionals making significant changes that improve clinical outcomes and reduce costs. Collaboratives carried out through IHI's Breakthrough Series bring together health care organizations that share a commitment to making major, rapid changes that produce breakthrough results: lower costs and better outcomes at the same time. Typically, they involve 20 to 40 health care organizations working together for six to eight months on improving a specific clinical or operational area. Under the guidance of IHI, RAND, and a panel of national experts, team members study, test, and implement the latest knowledge available to produce rapid improvements in their organizations. Teams take part in a series of learning sessions throughout the Collaborative as well as National Congresses at the end of their work together to show off their results.
IHI and RAND have learned many things from working with provider organizations during Breakthrough Series Collaboratives. Most importantly, we learned that improvements can be made quickly and effectively. Nearly every team that stayed committed to the process for at least a few months made major improvements in some area that matters to patients. For example, one hospital cut the time a patient had to wait for better pain medication in half, another program nearly eradicated serious shortness of breath, a third program showed that advance planning could cut the rate of frightening episodes to one-quarter of the usual rate, and one Veterans Medical Center increased the rate of written advance care plans for patients with serious chronic illnesses from 15% to 90%. In addition, nearly all of the programs that worked with heart and lung failure patients cut their rate of hospitalization by 20-50%, and one program had trained nurses available to come to the patient's home within half an hour to help with an exacerbation of symptoms. The availability of this innovative service cut the rate of using emergency rooms to well under half of the program's previous rate.
For further information about teams' success stories and tools to use within your organization, please see our sourcebook, Improving Care at the End of Life.
Interested in more information about starting a Collaborative in End-of-Life Care? Contact us at smyers@rand.org.
| This content is provided by The Washington Home Center for Palliative Care Studies (CPCS) with the support of RAND Health. Visit www.medicaring.org to find help with quality improvement projects in end-of-life care. |