The Institute for Healthcare Improvement (IHI) Breakthrough Series employs a sophisticated collaborative, team-based, blended learning approach to reach large numbers of learners. The model enables panels of five to eight experts to support dozens of learning teams simultaneously in one Collaborative project. Since 1995, the IHI Breakthrough Series Collaborative has enabled thousands of health care teams to achieve dramatic results in reducing costs and improving quality.
How this practice supports access:
The Institute for Healthcare Improvement (IHI) developed the Breakthrough Series Collaborative Model to help health care organizations make "breakthrough" improvements in quality while reducing or maintaining costs. The driving vision behind the Breakthrough Series is that there is much sound science about how to improve current health care practices, but much of this science is unused in daily work. The Breakthrough Series is designed to help organizations close the gap between what is known and what is done by creating a structure in which organizations can easily learn how to make improvements from each other and from recognized experts in topic areas of interest.
A Breakthrough Series Collaborative is a (learning system that brings together a large number of teams from hospitals or clinics to seek improvement in a focused topic area for a six to 15-month period. This approach is team-based in two ways:
Between the Learning Sessions, teams test and implement changes in their local settings during Action Periods, supported by the Expert Panel and by other collaborative teams via e-mail, phone conferences, monthly team reports, on-site visits, and assessments. During these Action Periods, local teams use the Model for Improvement developed by Associates in Process Improvement, which includes the following elements:
Since 1995, IHI has sponsored over 39 such Collaborative projects in the U.S., and five outside the U.S., on several dozen topics involving over 1,000 teams. Collaboratives range in size from 12 to 160 teams. Teams in Breakthrough Series Collaboratives have achieved dramatic results, including reducing waiting times by 50 percent, reducing worker absenteeism by 25 percent, reducing ICU costs by 25 percent, and reducing hospitalizations for patients with congestive heart failure by 50 percent. Some specific examples:
IHI has also trained over 650 people in the Breakthrough Series methodology, thus spawning hundreds of Collaborative initiatives throughout the health care world, sponsored by organizations other than IHI.
High -- significant expenditures are required to achieve this level of systemic change. Fees for joining a Collaborative are $15,000/team. Each enrolled team costs its sponsoring organization an additional $30,000 to $60,000, including tuition, travel, and accommodation for its year of work. These direct costs are prohibitive for many otherwise willing organizations and individuals.
See reference to Breakthrough Series paper below, which also contains references to numerous pertinent articles.
IHI is in the process of figuring out how to reduce the number of required in-person sessions from three to zero without compromising quality.
From a pedagogical point of view, compare this approach with Michigan State University's "event-centered, online-supported" approach.
For me, what makes this approach compelling is that it illustrates how to use team teaching to support high learner enrollments, collaborative learning, and process improvement. Thus, the approach illustrates a high degree of scalability as well as documentable results (all four Kirkpatrick levels, including behavior and ROI). [-- js, 1/29/04]