Programs /
Custom Programs

IEHSS works with organizations worldwide to co-develop programs and processes, from the front line to the top of the organization, to improve care experiences for those we serve, guided by the Microsystem Improvement Process (MIP). Learn more about our expertise.

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Organizations we have worked with

Cystic Fibrosis Foundation

For nearly 20 years, IEHSS has worked with the Cystic Fibrosis Foundation to decrease practice variation in the systems and processes of lung transplant referrals and transitions from cystic fibrosis (CF) programs to transplant programs. Using a wave model, interprofessional Lung Transplant Transition Learning and Leadership Collaboratives (LTT LLCs) are developed and coached through a customized Microsystem Improvement Process (MIP) and leadership development program for 18 months. LTT LLCs then join the Regional Dissemination Network (RDN) for 12-18 months to develop and disseminate best practice recommendations. The programs then reach a stage of continuous improvement to sustain achievements in patient care.

The work continues today and over 90% of CF centers participating and multiple process improvements closely linked to the impact of CF LTT LLC, including:

  • Percentage of patients seen by physical therapist each year increased
  • Percentage of patients seen by dietician each year increased
  • Percentage of patients seen by a social worker increased
  • Additional site-specific improvements

Quality Registry Centre Stockholm

38 organizations and 80 improvement coaches engaged in strategies for change that included:

  • Used 26 Swedish National Quality Registers to measure local quality improvement results
  • Developed two parallel learning programs tailored for frontline staff and leadership
  • Created a professional network
  • Offered specific support to enhance patient partnership in improvement
  • Established a contract teaching agreement comprised of 15 higher education credits
  • Outcomes included reduced HbA1c (form of hemoglobin that is chemically linked to sugar) for patients with type 1 diabetes, improved blood tests in patients after myocardial infraction, reduced door-to-needle time in acute stroke, decreased time in ventilator in intensive care and
  • increased re-visit rate to midwife after birth.

Dartmouth-Hitchcock Medical Center

Using the Dartmouth Microsystem Improvement Curriculum (now the Microsystem Improvement Process), the Plastic Surgery Section has seen improvement in patient and staff satisfaction, access to care and clinical productivity. It has become the leading clinical program for achieving productivity rates exceeding national benchmarks (Nelson, Batalden, Godfrey, 2007). Read more in Quality by Design: A Clinical Microsystems Approach by Eugene C. Nelson, Paul B. Batalden and Marjorie M. Godfrey.

Sheffield Coaching Academy

Our team supported the creation of the Microsystem Coaching Academy in the UK as part of Sheffield Teaching Hospitals, part of the National Health Service Foundation Trust. To date, the academy has trained 273 microsystem coaches and taught over 1,400 staff in “Introduction to Quality Improvement” courses.

Individual Self-Health Action Plan for Empowerment (inSHAPE)

32 professionals from seven agencies participated in 18 electronic learning sessions to build community partnerships to advance health promotion for seriously mentally ill clients.

Additional Results Include:

  • Formalization of a buddy system for leaders
  • Implementation of Primary Palliative Care
  • Improved % of patients provided with educational material during the appointment from 0% to 83%
  • Implementation of regular zoom meetings with the multidisciplinary team that include following effective meeting skills, shared agendas and evaluation of the meeting effectiveness
  • Increase in FEV1 in people with Cystic Fibrosis by 19% from 2011 to 2021
  • Increase of BMI in people with Cystic Fibrosis by 99% from 2011 to 2021
  • % of referrals sent from Diabetes clinic to Dental Clinic increased from 38% to 71%

Every Number Has a Story

“Using the team coaching model in my leadership role has changed the whole unit where I am a manager. Staff now regularly offer solutions, ideas and have better communication and relationships. Patients and families are included and eager to help.”
- Gay Landstrom, CNO, Dartmouth-Hitchcock
“I now have more confidence to leave my home. I used to be afraid to leave my home and would sit there all day. I enjoy meeting new friends at the gym and my health mentor has helped me lose 15 pounds.”
– Individual Self Health Action Plan for Empowerment Client
“We have been doing QI (quality improvement) work for years but this is far and away the best QI momentum that we’ve ever had.”
– Cystic Fibrosis Lung Transplant Transition Learning and Leadership Collaborative Team Member
“The improvements in research and care in CF in the past 20 years have been nothing short of extraordinary, and today’s announcement of the increase in population of people living with CF is a testament to that.”
- Bruce Marshall, MD, Executive Vice President and Chief Medical Officer of the Cystic Fibrosis Foundation from CF Foundation Estimates Increase CF Population published July 28, 2022 on CFF.ORG
"Rounding twice a day has led to the development of an “escalation” pathway for issues and fewer interruptions."
- Custom Program Participant
“...the clinic nurses … got pulled in a room for 30 minutes, and turns out that they're already explaining 50% of what the physician already explained… So, it's kind of like, "What can we do to help make your job easier?" And that … draws in a little bit more of, "Okay, maybe I do want to work with this (quality improvement), and get this to work, because it makes my job easier."
- Custom Program Participant
"And I think working with the transplant, […] hospital as well has helped us […] as a group, to try to figure out any missing pieces that we might, […] need to make sure that we […] communicate to the families, and the patients […]. I think that's so important, keeping that communication link open, because sometimes, […] you send them off, and it's like you don't [hear] anything. And I think a lot when you keep that continual communication going, […] it will benefit the family, […] to keep that going. And that's what we've been able to try to work on as well."
- Custom Program Participant