IHI Open School Quality Improvement Courses

Overview

As the Institute of Medicine (IOM) declared in 2001, in words that still ring true, “Between the health care we have and the care we could have lies not just a gap, but a chasm.” This course launches you on your journey to becoming a health care change agent. 

In Lesson 1, you’ll get a high-level picture of the current quality of care in the United States and other nations. You’ll also see how health systems around the world are facing similar challenges and how countries can study and learn from one another.

In Lesson 2, you’ll learn about a 2001 report from the Institute of Medicine (IOM) that laid out six simple aims that have since guided countless improvements in health care and inspired people across the globe. Then you’ll hear from agents of change describing improvements in the real world.

In Lesson 3, you’ll learn why improvement, especially in a complex environment such as health care, requires us to think about the larger systems in which we live and work. You’ll learn about the development of theories and tools to help improvers better visualize and understand the interdependent components of a system. Finally, you’ll practice applying W. Edwards Deming’s four-part framework for improvement, the System of Profound Knowledge.

Estimated Time of Completion: 1 hour 15 minutes 

Lessons

• Lesson 1: Health and Health Care Today
• Lesson 2: The Institute of Medicine’s Aims for Improvement
• Lesson 3: Changing Systems with the Science of Improvement Course 

Course Objectives

After completing this course, you will be able to:

1. Describe common challenges for health care systems around the world.
2. List the six dimensions of health care, and the aims for each, outlined by the Institute of Medicine in 2001.
3. Explain the value of improvement science in health care.

Continuing Education Credits

The Institute for Healthcare Improvement designates this internet enduring activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity is approved to award 1.25 credit(s) toward Certified Professional in Patient Safety (CPPS) recertification.

This activity/program is approved by NAHQ® for 1.25 CPHQ CE credits. 

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:                               

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning requirements for the American Board of Ophthalmology’s Maintenance of Certification program.

Successful completion of this activity, which includes participation in the evaluation component, offers Lifelong Learning (MOC Part 2 CME) point(s) for the following boards:

Successful completion of this activity, which includes participation in the evaluation component, offers Self-Assessment (MOC Part 2 SA) point(s) for the following boards:

*ABPed and ABFM diplomates are required to complete all the selected courses within an activity to collect MOC activity points.   

It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

As a Jointly Accredited Organization, the Institute for Healthcare Improvement is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.25 general continuing education credits. 

Members of the College of Family Physicians of Canada are eligible to receive Mainpro+ Certified, Certified Assessment, or Non-Certified credits for participation in this activity due to reciprocal agreement with the American Academy of Family Physicians. 

The AAFP has reviewed QI 101: Introduction to Health Care Improvement and deemed it acceptable for up to 1.25 Enduring Materials, Self-Study AAFP Elective credit(s). Term of Approval is from 06/20/2024 to 06/20/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Overview

The Model for Improvement, developed by a group called Associates in Process Improvement, is simple to understand and apply. But it’s powerful. This course will teach you how to use the Model for Improvement to improve everything from your tennis game to your hospital’s infection rate. You’ll learn the basic steps in any improvement project: setting an aim, selecting measures, developing ideas for changes, and testing changes using Plan-Do-Study-Act (PDSA) cycles. As you go, you’ll have the opportunity to use this methodology to start your own personal improvement project.

Lesson 1 will provide an overview of the Model for Improvement. You’ll learn how a hospital system in Saudi Arabia successfully used it to reduce infections to zero in its neonatal intensive care unit. We’ll also introduce you to a couple other helpful frameworks for improving care, Six Sigma and Lean.

Lesson 2 teaches you to craft an effective aim statement. You’ll apply what you learn by continuing to work on the personal improvement project you began in Lesson 1.

In Lesson 3, we recommend three types of measures for you to define and collect in your improvement work: outcome measures, process measures, and balancing measures.

Lesson 4 will discuss several methods for developing good ideas for changes to test. We’ll show you how visual tools can help you think critically about the systems and processes that you’re part of. Finally, you’ll have the chance to start developing ideas to test in your project.

In Lesson 5, you’ll learn about testing changes on a small scale and tracking your results as you go.

Estimated Time of Completion: 1 hour 30 minutes

Lessons

• Lesson 1: An Overview of the Model for Improvement
• Lesson 2: Setting an Aim Lesson
• Lesson 3: Choosing Measures
• Lesson 4: Developing Changes
• Lesson 5: Testing Changes 

Course Objectives

After completing this course, you will be able to:

Overview

In this course, we’ll take you through basic concepts you need to know to run successful PDSA (Plan-Do-Study-Act) cycles in a clinical setting. Measurement is an essential part of testing changes with PDSA. It tells you if the changes you are testing are leading to improvement.

In Lesson 1, you’ll learn how to develop operational definitions for a family of measures (outcome, process, and balancing measures) during the “Plan” phase of PDSA. Then, you’ll learn how to track those measures during the “Do” phase. We’ll also provide some helpful data collection techniques, such as sampling, which can accelerate the pace of your improvement work.

In Lesson 2, you’ll learn the value of displaying your data over time, on a run chart. We’ll also show you how to break the data down into subsets, according to specific variables, to bring out additional learning and opportunities for improvement.

In Lesson 3, we’ll show you how to act on your results, in the “Act” phase of PDSA. We’ll explain how to increase the size or the scope of subsequent test cycles based on what you’re learning, so that you continue to grow your confidence that your change idea is leading to improvement.

Estimated Time of Completion: 1 hour 15 minutes

Lessons

• Lesson 1: How to Define Measures and Collect Data
• Lesson 2: How to Use Data for Improvement
• Lesson 3: How to Build Your Degree of Belief over Time

Course Objectives

After completing this course, you will be able to:

1. Describe how to establish and track measures of improvement during the “plan” and “do” phase of PDSA.
2. Explain how to learn from data during the “study” phase of PDSA.
3. Explain how to increase the size and scope of subsequent test cycles based on what you’re learning during the “act” phase of PDSA.

Continuing Education

The Institute for Healthcare Improvement designates this internet enduring activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity is approved to award 1.25 credit(s) toward Certified Professional in Patient Safety (CPPS) recertification.

This activity/program is approved by NAHQ® for 1.25 CPHQ CE credits. 

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

• 1.25 Medical Knowledge MOC point(s) in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program
• 1.25 MOC point(s) in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program
• 1.25 point(s) in the CME component of the American Board of Anesthesiology's redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. (Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.)
• 1.25 point(s) in the American Board of Ophthalmology's Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning requirements for the American Board of Ophthalmology's Maintenance of Certification program.

Successful completion of this activity, which includes participation in the evaluation component, offers Lifelong Learning (MOC Part 2 CME) point(s) for the following boards:                              

• American Board of Anesthesiology (ABA)
• American Board of Allergy & Immunology (ABAI)
• American Board of Colon & Rectal Surgery (ABCRS)
• American Board of Pathology (ABPath)
• American Board of Psychiatry & Neurology (ABPN)
• American Board of Plastic Surgery (ABPS)
• American Board of Nuclear Medicine (ABNM)
• American Board of Thoracic Surgery (ABTS)
• American Board of Urology (ABU)

Successful completion of this activity, which includes participation in the evaluation component, offers Self-Assessment (MOC Part 2 SA) point(s) for the following boards:

• American Board of Family Medicine (ABFM) (15pts)*
• American Board of Pediatrics (ABPed) (20pts)*
• American Board of Ophthalmology (ABOP)
• American Board of Orthopedic Surgery (ABOS)
• American Board of Radiology (ABR)
• American Board of Physical Medicine and Rehabilitation (ABPMR)

*ABPed and ABFM diplomates are required to complete all the selected courses within an activity to collect MOC activity points.

It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

As a Jointly Accredited Organization, the Institute for Healthcare Improvement is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.25 general continuing education credits. 

Members of the College of Family Physicians of Canada are eligible to receive Mainpro+ Certified, Certified Assessment, or Non-Certified credits for participation in this activity due to reciprocal agreement with the American Academy of Family Physicians. 

The AAFP has reviewed QI 103: Testing and Measuring Changes with PDSA Cycles and deemed it acceptable for up to 1.25 Enduring Materials, Self-Study AAFP Elective credit(s). Term of Approval is from 06/20/2024 to 06/20/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Overview

In this course, we’ll delve into how to draw an effective run chart to create a compelling picture of your progress toward improvement. We’ll teach you to distinguish non-random patterns in your data — that is, evidence that performance has actually changed. Once you’ve got that down, we’ll introduce you to three more excellent tools for displaying and learning from data.

In Lesson 1, you will learn the elements of an effective run chart for improvement work: an X and Y axis, 10 or more data points, the baseline median, and annotations of tests of change. You’ll have a chance to practice creating your own run chart for a hospital that’s trying to reduce wait times.

In Lesson 2, we’ll explain the difference between common cause and special cause variation. We’ll teach you four rules to distinguish between these two causes of variation, and we’ll introduce you to another type of chart that can also help with this, called a Shewhart (or control) chart.

In Lesson 3, IHI’s Dave Williams, PhD, teaches you to use other charts that can also help you understand variation within data sets: histograms, Pareto charts, and scatter plots. These tools may help you from time to time in your improvement work.

Estimated Time of Completion: 1 hour 30 minutes 

Lessons

• Lesson 1: How to Display Data on a Run Chart
• Lesson 2: How to Learn from Run Charts and Control Charts
• Lesson 3: Histograms, Pareto Charts, and Scatter Plots 

Course Objectives

After completing this course, you will be able to:

1. Draw a run chart that includes a baseline median, a goal line, and annotations.
2. Describe the difference between common and special cause variation.
3. Explain the purpose of a Shewhart (or control) chart.
4. Apply four rules to identify non-random patterns on a run chart.
5. Explain when and how to use the following tools for understanding variation in data: histograms, Pareto charts, and scatter plots. 

Continuing Education

The Institute for Healthcare Improvement designates this internet enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity is approved to award 1.5 credit(s) toward Certified Professional in Patient Safety (CPPS) recertification. 

This activity/program is approved by NAHQ® for 1.5 CPHQ CE credits.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

• 1.5 Medical Knowledge MOC point(s) in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program
• 1.5 MOC point(s) in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program
• 1.5 point(s) in the CME component of the American Board of Anesthesiology's redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. (Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.)
• 1.5 point(s) in the American Board of Ophthalmology's Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning requirements for the American Board of Ophthalmology's Maintenance of Certification program.

Successful completion of this activity, which includes participation in the evaluation component, offers Lifelong Learning (MOC Part 2 CME) point(s) for the following boards:

• American Board of Anesthesiology (ABA)
• American Board of Allergy & Immunology (ABAI)
• American Board of Colon & Rectal Surgery (ABCRS)
• American Board of Pathology (ABPath)
• American Board of Psychiatry & Neurology (ABPN)
• American Board of Plastic Surgery (ABPS)
• American Board of Nuclear Medicine (ABNM)
• American Board of Thoracic Surgery (ABTS)
• American Board of Urology (ABU)

Successful completion of this activity, which includes participation in the evaluation component, offers Self-Assessment (MOC Part 2 SA) point(s) for the following boards:

• American Board of Family Medicine (ABFM) (15pts)*
• American Board of Pediatrics (ABPed) (20pts)*
• American Board of Ophthalmology (ABOP)
• American Board of Orthopedic Surgery (ABOS)
• American Board of Radiology (ABR)
• American Board of Physical Medicine and Rehabilitation (ABPMR)

*ABPed and ABFM diplomates are required to complete all the selected courses within an activity to collect MOC activity points.

It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

As a Jointly Accredited Organization, the Institute for Healthcare Improvement is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.5 general continuing education credits. 

Members of the College of Family Physicians of Canada are eligible to receive Mainpro+ Certified, Certified Assessment, or Non-Certified credits for participation in this activity due to reciprocal agreement with the American Academy of Family Physicians. 

The AAFP has reviewed QI 104: Interpreting Data: Run Charts, Control Charts, and Other Measurement Tools and deemed it acceptable for up to 1.50 Enduring Materials, Self-Study AAFP Elective credit(s). Term of Approval is from 06/20/2024 to 06/20/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Overview

The first four IHI Open School quality improvement courses taught you basic improvement methodology, which you can apply to improve health care processes and make care safer. But when you assume a leadership role in a clinical improvement project, you’ll need more than just technical knowledge. In the real world, you’ll need to know the steps for managing the project through to completion. You’ll need to understand the psychology of change, and you’ll need skills in interdisciplinary teamwork. In the real world, the human side of quality improvement — that is, the ability to rally a group around a cause — is every bit as important as having a good idea for a change.

In Lesson 1, we’ll walk you through the five stages of IHI’s Improvement Project Roadmap. For each phase, we’ll provide a short checklist of the tasks you’ll need to accomplish before moving on. We’ll also share tools to help you along, including driver diagrams and IHI’s Framework for Spread.

In Lesson 2, you’ll learn how to assess your own and your colleagues’ natural tolerance for change. With that understanding, you’ll learn what makes people say “no” to improvement efforts, and how you can address their concerns to move them closer to “yes.”

In Lesson 3, we’ll cover who should be on a clinical improvement team and the interprofessional competencies you’ll need to make that team function. We’ll talk about strategies to promote teamwork and communication, including getting to know your teammates and writing down your plan.

Estimated Time of Completion: 1 hour 15 minutes

Lessons

• Lesson 1: The Four Phases of a Quality Improvement Project
• Lesson 2: Change Psychology and the Human Side of Quality Improvement
• Lesson 3: Working with Interdisciplinary Team Members 

Course Objectives

After completing this course, you will be able to:

1. Describe how to lead an improvement project through four key phases.
2. Identify and describe the components of IHI’s Framework for Spread.
3. Apply strategies to assess and overcome resistance to change.
4. Apply strategies to work effectively with interprofessional colleagues.

Continuing Education

The Institute for Healthcare Improvement designates this internet enduring activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity is approved to award 1.25 credit(s) toward Certified Professional in Patient Safety (CPPS) recertification.

This activity/program is approved by NAHQ® for 1.25 CPHQ CE credits.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to: 

• 1.25 Medical Knowledge MOC point(s) in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program
• 1.25 MOC point(s) in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program
• 1.25 point(s) in the CME component of the American Board of Anesthesiology's redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. (Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.)
• 1.25 point(s) in the American Board of Ophthalmology's Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning requirements for the American Board of Ophthalmology's Maintenance of Certification program.

Successful completion of this activity, which includes participation in the evaluation component, offers Lifelong Learning (MOC Part 2 CME) point(s) for the following boards:

• American Board of Anesthesiology (ABA)
• American Board of Allergy & Immunology (ABAI)
• American Board of Colon & Rectal Surgery (ABCRS)
• American Board of Pathology (ABPath)
• American Board of Psychiatry & Neurology (ABPN)
• American Board of Plastic Surgery (ABPS)
• American Board of Nuclear Medicine (ABNM)
• American Board of Thoracic Surgery (ABTS)
• American Board of Urology (ABU)

Successful completion of this activity, which includes participation in the evaluation component, offers Self-Assessment (MOC Part 2 SA) point(s) for the following boards:

• American Board of Family Medicine (ABFM) (15pts)*
• American Board of Pediatrics (ABPed) (20pts)*
• American Board of Ophthalmology (ABOP)
• American Board of Orthopedic Surgery (ABOS)
• American Board of Radiology (ABR)
• American Board of Physical Medicine and Rehabilitation (ABPMR)

*ABPed and ABFM diplomates are required to complete all the selected courses within an activity to collect MOC activity points.

It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

As a Jointly Accredited Organization, the Institute for Healthcare Improvement is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.25 general continuing education credits. 

Members of the College of Family Physicians of Canada are eligible to receive Mainpro+ Certified, Certified Assessment, or Non-Certified credits for participation in this activity due to reciprocal agreement with the American Academy of Family Physicians. 

The AAFP has reviewed QI 105: Leading Quality Improvement and deemed it acceptable for up to 1.25 Enduring Materials, Self-Study AAFP Elective credit(s). Term of Approval is from 06/20/2024 to 06/20/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Overview

Previous courses in the Quality Improvement catalog focused on testing and implementing a change in one location. This advanced course is about the next logical step: spreading the change.

In Lesson 1, you’ll learn how new ideas typically spread through a population, according to the work of psychologist Kurt Lewin and sociologist Everett Rogers. With their research in mind, you’ll learn what you can do to help motivate the more change-resistant individuals in your population to embrace a new idea, to allow your innovation to spread as far as possible.

In Lesson 2, you’ll learn about how to help a new idea spread across a population, both by motivating the people within the population to adopt the change and by developing new ideas that are inherently more likely to spread. Based on the five traits of innovations that spread, we’ll provide you with a tool, the New Idea Scorecard, to assess your idea for a change. Finally, we’ll provide you with a roadmap for spreading a change, which we call IHI’s Framework for Spread.

In Lesson 3, you’ll follow a detailed case study about how a hospital network in Central Texas used the concepts from the first two lessons to spread a major improvement initiative — widely improving care across a vast system.

Estimated Time of Completion: 1 hour 15 minutes 

Lessons

• Lesson 1: How Change Spreads
• Lesson 2: Tactics for Spreading Change
• Lesson 3: Case Study in Spreading Innovations: Transforming Care at the Bedside 

Course Objectives

After completing this course, you will be able to:

1. Describe how change spreads according to Kurt Lewin and Everett Rogers.
2. Assess the likelihood that a new idea will spread.
3. Apply IHI’s Framework for Spread to spread an innovation across an organization.

Continuing Education

The Institute for Healthcare Improvement designates this internet enduring activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity is approved to award 1.25 credit(s) toward Certified Professional in Patient Safety (CPPS) recertification. 

This activity/program is approved by NAHQ® for 1.25 CPHQ CE credits. 

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

• 1.25 Medical Knowledge MOC point(s) in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program
• 1.25 MOC point(s) in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program
• 1.25 point(s) in the CME component of the American Board of Anesthesiology's redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. (Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.)
• 1.25 point(s) in the American Board of Ophthalmology's Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning requirements for the American Board of Ophthalmology's Maintenance of Certification program.

Successful completion of this activity, which includes participation in the evaluation component, offers Lifelong Learning (MOC Part 2 CME) point(s) for the following boards:

• American Board of Anesthesiology (ABA)
• American Board of Allergy & Immunology (ABAI)
• American Board of Colon & Rectal Surgery (ABCRS)
• American Board of Pathology (ABPath)
• American Board of Psychiatry & Neurology (ABPN)
• American Board of Plastic Surgery (ABPS)
• American Board of Nuclear Medicine (ABNM)
• American Board of Thoracic Surgery (ABTS)
• American Board of Urology (ABU)

Successful completion of this activity, which includes participation in the evaluation component, offers Self-Assessment (MOC Part 2 SA) point(s) for the following boards:

• American Board of Family Medicine (ABFM) (15pts)*
• American Board of Pediatrics (ABPed) (20pts)*
• American Board of Ophthalmology (ABOP)
• American Board of Orthopedic Surgery (ABOS)
• American Board of Radiology (ABR)
• American Board of Physical Medicine and Rehabilitation (ABPMR)

*ABPed and ABFM diplomates are required to complete all the selected courses within an activity to collect MOC activity points.

It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

As a Jointly Accredited Organization, the Institute for Healthcare Improvement is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.25 general continuing education credits. 

Overview

If an organization is to avoid catastrophic failure, staff members need to call out small problems as they arise in daily work. In this lesson, you’ll learn that organizations that successfully manage complexity have a deliberate approach to escalating the small concerns and suggestions of employees. Staff members know how to recognize problems, whom to contact, and how to get that person’s attention immediately. The leaders, in turn, avoid blame and provide the resources necessary to solve problems.

Estimated Time of Completion: 1 hour 

Course Objectives

After completing this course, you will be able to:

1. Explain why system complexity requires us to take a methodical approach to system design, operation, and improvement.
2. Explain how the absence of this methodical approach will cause complex systems to fail predictably.
3. Propose specific applications of this methodical approach to the design, operation, and improvement of health care.

Continuing Education

The Institute for Healthcare Improvement designates this internet enduring activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity is approved to award 1 credit(s) toward Certified Professional in Patient Safety (CPPS) recertification.

This activity/program is approved by NAHQ® for 1 CPHQ CE credit. 

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

• 1 Medical Knowledge MOC point(s) in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program
• 1 MOC point(s) in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program
• 1 point(s) in the CME component of the American Board of Anesthesiology's redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. (Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.)
• 1 point(s) in the American Board of Ophthalmology's Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to satisfy the Lifelong Learning requirements for the American Board of Ophthalmology's Maintenance of Certification program.

Successful completion of this activity, which includes participation in the evaluation component, offers Lifelong Learning (MOC Part 2 CME) point(s) for the following boards:

• American Board of Anesthesiology (ABA)
• American Board of Allergy & Immunology (ABAI)
• American Board of Colon & Rectal Surgery (ABCRS)
• American Board of Pathology (ABPath)
• American Board of Psychiatry & Neurology (ABPN)
• American Board of Plastic Surgery (ABPS)
• American Board of Nuclear Medicine (ABNM)
• American Board of Thoracic Surgery (ABTS)
• American Board of Urology (ABU)

Successful completion of this activity, which includes participation in the evaluation component, offers Self-Assessment (MOC Part 2 SA) point(s) for the following boards:

• American Board of Family Medicine (ABFM) (15pts)*
• American Board of Pediatrics (ABPed) (20pts)*
• American Board of Ophthalmology (ABOP)
• American Board of Orthopedic Surgery (ABOS)
• American Board of Radiology (ABR)
• American Board of Physical Medicine and Rehabilitation (ABPMR)

*ABPed and ABFM diplomates are required to complete all the selected courses within an activity to collect MOC activity points.

It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.

As a Jointly Accredited Organization, the Institute for Healthcare Improvement is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1 general continuing education credits.