I know when I set out to change something about my health, a few things make the process much easier and, for that matter, more likely to yield the benefits I'm after. I'm particularly aware of this these days as I've recently (successfully!) changed some health habits that put me at risk for heart disease, which, with my family history, really needed to be addressed. In making these changes, I realized that my success reflected the body of literature that tells us that change is easiest and more likely to stick when you:

• know what you need to change and why
• start with small, feasible objectives that move you toward a larger goal
• have support, especially from others who are also trying to change or who have done so successfully already
• track your progress and adjust your approach as needed
• measure and celebrate your results

Large organizations, such as hospitals or healthcare systems, are capable of change, too, and there's another body of literature on how effective organizational changes unfold. But knowledge of the problem, peer support, and tracking and measuring against feasible objectives are no less important. That's why I'm excited about the Institute for Healthcare Improvement (IHI) Perinatal Improvement Community. Any hospital interested in improving perinatal care and outcomes can enroll in the community and take advantage of their measurement tools as well as support from IHI experts and other participating hospitals. IHI organizes its improvement efforts around 'bundles' so that hospitals can work toward change in one focus area at a time, with the overarching goals of reducing harm through better communication and teamwork, patient-centered care, and less unwarranted variation in care practices. Hospitals that participated in the first round of the Perinatal Improvement Community worked on safe use of induction and augmentation, including eliminating elective inductions prior to 39 weeks. The next round of participation will focus on Second Stage Safety, and hospitals must enroll by nextWednesday, September 1. Check out IHI's web site to learn about the results of participating hospitals' improvement efforts and to find out how your hospital can enroll.

Published: August 23, 2010

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