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About HISC version 3.0
The Healthcare Improvement Skills Center (HISC, version 3.0) is an internet resource for professionals in healthcare. It is here to help you make systematic improvement in the quality of care you provide to your patients.
Long after the publication of the National Institute of Medicine's Crossing the Quality Chasm report, there are surprisingly few resources available to support the development of "core" healthcare improvement skills. Fewer still are:
- Easily and always accessible
- More practical than theoretical
- Rich with examples and illustrative cases
- Written in straightforward language with a minimum of improvement jargon
- Highly interactive and engaging
- Helpful in dealing with issues that keep improvement efforts from getting off the ground
We spent several years crafting a set of learning activities and pulling together resources that would meet this need. Subsequently, we focused on the development and piloting of some additional resources, resources intended to provide a warmer welcome and make it yet easier for those new to quality improvement to begin using improvement science concepts, methods and tools in their work. These additional resources have been incorporated in the 3.0 version of the HISC website.
In addition to the six HISC modules, you will now also find tools to help you plan and assess your QI projects, and to assess your QI skills. Recently, a "Concise Practice Improvement Manual" (both abridged and unabridged versions) and a coaching guide have also been added to the site to provide the briefest possible introduction to QI for those new to this work.
The modules can be taken independently, as needed, even as you work on a particular improvement effort. Completing all of them is required in order to meet expectations of many residency and board level maintenance of certification programs. More importantly, doing so should furnish enhanced perspective concerning the many challenges and significant opportunities encountered when pursuing improvement in a systematic way.
The 2001 Institute of Medicine report described a large gap between evidence-based best practice and what we achieve on a daily basis for our patients. Clinicians who complete these self-study learning activities should find it easier to address this gap in their own practices. They will be able to:
- Analyze current care,
- Generate hypotheses about the link between action and results,
- Develop ideas about how to improve,
- Design a test of a change in practice, and
- Plan to disseminate and sustain successful results.
Information concerning access fee options can be found at the point of registration (see Register on this site's home page or the registration page of your particular medical specialty, residency program or healthcare system).
It is our intention to continually enhance and expand this collection of improvement resources, and to make this site a place well worth returning to, on a regular basis, in your search for tools, resources and tips to aid you in your improvement work.
Completion of each module and most activities will ordinarily take under an hour. Completion of improvement projects, of course, varies. Modest projects, lasting two to three months, are encouraged.
| Kurt Stange, MD, PhD | Case Western Reserve University |
| Mary Dolansky, RN, PhD | Case Western Reserve University |
| Christina Delos-Reyes, MD | Case Western Reserve University |
| Srinivas Merugu, MD | Case Western Reserve University |
| Mark Cheren, EdD | Case Western Reserve University and Improvement Learning, LLC |
| Mark Cheren, EdD | Editor in Chief |
| Melanie McGee | CIO, Application Development & Information Architecture |
| Sandeep Khosa, MD | Contributing Editor |
| Scott Moneypenny | Administrative Assistance |
| Duncan Neuhauser, PhD | Case Western Reserve University |
| Kurt Stange, MD, PhD | Case Western Reserve University |
| Mary T. Coleman, MD, PhD | Louisiana State University |
| Laurel Simmons, MPH | CSI Solutions |
- Use a PC or Macintosh computer.
- This site is not yet fully functional (and not able to be used) with iPads or other tablet devices.
- HISC 3.0 supports these browsers:
- Firefox 2.0+
- Internet Explorer 7+
- Safari 3+
- Opera 9+
- Chrome 1+
- JavaScript must be enabled.
- If you have installed any "pop-up stopper" software, you will need to disable this software before entering any of the modules.
- Use a monitor with the resolution set to 1024 x 768 pixels or greater.
- • You will need a free copy of Adobe Acrobat Reader (verson 4.0 or higher) installed on your computer to read and download supplemental files.
The Healthcare Improvement Skills Center (HISC) was originally conceived and lead by Dr. Linda Headrick, past president of the Academy for Healthcare Improvement (AHI), and Co-Chair of the annual AHI / IHI Scientific Symposium. Her idea was to convert already successful learning units (peer reviewed by an interdisciplinary editorial advisory board of practicing clinicians, technical experts and internationally known quality improvement experts) into highly engaging, self-study web modules.
Early work was funded by the Center for the Health Professions at the University of California, San Francisco, and the Division of Information Technology Services at Case Western Reserve University. Initial development pooled the efforts of professionals at the schools of medicine at Case Western Reserve University and the University of Missouri, Columbia, and others in the dynamic network of healthcare improvement practitioners and educators nourished by the Institute for Healthcare Improvement (IHI), Cambridge, MA.
Review of our initial efforts suggested additional development work was warranted to achieve contemporary eLearning production standards. With help from the Case Western Reserve University Division of Information Technology Services, an rfp was prepared and the services of one of the nation's leading e-publishing firms, Medical Directions Inc. (MDI), headed by Dr. John (Skip) M. Harris, Jr., were secured. With MDI's guidance, the modules were completely revamped. They were published on the web in the fall of 2005.
The HISC site and six modules have been well received by the healthcare improvement and medical education communities. They have been used by the Veterans Administration as a resource in the training of improvement coaches. They have also been incorporated into the American Board of Internal Medicine's "Essentials of Quality Improvement" maintenance of certification performance improvement module (PIM). The latter implementation is accessible exclusively at the Maintenance of Certification area of ABIM's website.
Along the way, Module 6 was extensively revised. And with the help of a small grant from the Institute for Healthcare Improvement's New Health Partnerships project, Module 2 was revised so as to incorporate an example of patient involvement in the work of an improvement team.
By the time the modules were first published on the Internet, in 2005, administrative responsibility for the project had been transferred to and housed at the Academy for Post Graduate Health Care Education (APGHCE), in Columbia, Missouri.
Five years later, on July 1, 2010, full administrative and editorial responsibility for the next chapter in the project's history passed to Improvement Learning LLC, in Shaker Heights, Ohio. At that time, Dr. Mark Cheren, President of Improvement Learning, who had previously served as Executive Director for the HISC initiative, became Editor in Chief for HISC version 2.0.
Over the past year, in response to the invitation that we make the site available as a self-assessment option for medical specialty board level maintenance of certification programs, we have developed and piloted additional resources appropriate for that purpose, and for use in medical residency programs, that are intended to make it much easier and more inviting for those newer to quality improvement work to join in. These additional resources have been fully integrated into this new 3.0 version of the Healthcare Improvement Skills Center.
We are pleased to announce that both CME credit and MOC credit will soon be available to clinically active American Board of Pediatrics Diplomates and American Board of Internal Medicine Diplomates via their respective Maintenance of Certification programs and websites, as MOC Part 2 "HISC Quality Improvement Self-Assessment" options.
The framework for this new implementation of the HISC2 modules has been specifically designed to help medical board Diplomates better prepare to demonstrate their improvement skills (their competence in practice-based learning and improvement) in MOC Part 4, the "Performance in Practice" segment of all American Board of Medical Specialties affiliated maintenance of certification programs.
Authors: http://www.improvementskills.org/aboutus/authors.cfm
Advisory Board: http://www.improvementskills.org/aboutus/advisory_board.cfm
Acknowledgements: http://www.improvementskills.org/aboutus/acknowledgements.cfm