1. Collaboratives: Purpose and Structure John Bingham Vice-President, Performance Improvement Chief Quality Officer

2. I keep six honest serving-men (They taught me all I knew); Their names are What and Why and When And How and Where and Who. “Just So Stories” Rudyard Kipling, 1902

3. Collaboration : A recursive process where two or more people or organizations work together in an intersection of common goals — for example, an intellectual endeavor [1] [2] that is creative in nature [3] by sharing knowledge, learning and building consensus.recursive [1] [2] [3] From Wikipedia, the free encyclopedia What?

4. IHI Definition of Collaborative: “A Breakthrough Series Collaborative is a short- term (6- to 15-month) learning system that brings together a large number of teams from hospitals or clinics to seek improvement in a focused topic area.” The Breakthrough Series Whitepaper © 2003 IHI’s Collaborative Model for Achieving Breakthrough Improvement

5. Key Elements of IHI Collaboratives: 1.Topic Selection 2.Faculty Recruitment 3.Enrollment of Organizations/Teams 4.Learning Sessions 5.Action Periods 6.The Model for Improvement 7.Measurement and Evaluation 8.Summative Congresses and Publications

6. How? IHI Breakthrough Series Select Topic (Develop Mission) Planning Group Develop Framework & Changes Expert Meeting Supports: Email (listserv) Phone Conferences Visits Assessments Sponsors Monthly Team Reports *AP3 – continue reporting data as needed to document success © 2003 Institute for Healthcare Improvement Participants (10-100 Teams) Prework LS 1 P S AD LS 3 LS 2 Dissemination Publications, Congress, etc. AP1AP2AP3* LS – Learning Session AP – Action Period Holding the Gains P S AD P S AD

7. UT Health System: Who? Source: The University of Texas System Fast Facts 2009 6 8,081 41,579 Number of Institutions Number of Physicians Number of Employees

8. The University of Texas Health Science Center at Tyler

9. Where?

10. Why? Source: The University of Texas System Fast Facts 2009 86,030 5,348,270 1,402,284 Number of UT Admissions Number of UT Outpatient Visits Number of UT Hospital Days ? %Percentage of UT System Patients Receiving all of the Evidence-Based Care That They Were Eligible to Receive

11. Why? “Please… Don’t Make Me Wait… As I Have So Little Time Left!”

12. So… What Should/Could We Do? 1.Continue with Current UT Model 2.Develop More “Robust” UT Model 3.Join One or More of IHI’s Collaboratives 4.Partner With IHI to Develop IHI/UT System Collaborative Model

13. IHI Improvement Map Focus Areas: 70 Evidence-Based Processes

14. New IHI Collaboratives Beginning Fall 2009: IMPACT Leadership Community Transforming Care at the Bedside Improving Perinatal Care Reducing Readmissions Reducing Sepsis Mortality

15. Now When?

16. Thank You!

17. Save the Date! David Eddy, M.D., Ph.D. on Nov. 17 Special event for CS&E Alumni Physician-mathematician makes return to M. D. Anderson Half-day event on use of evidence- based guidelines Plan to Attend! Nov. 17, 2009 7:30-11:30 a.m. FCT 3.4165, Room 7 (Pickens Tower)