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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 have been surprisingly few resources available to support the development of "core" healthcare improvement skills. Fewer still have been:
- 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. They 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.
For several years HISC access for diplomates of the American Board of Internal Medicine, The American Board of Pediatrics and the American Board of Family Medicine to this website was subsidized by these three medical boards in a variety of ways. But now the contents of the entire site are available to all, free of charge.
We ask you to register primarily so that you can easily track your progress through the site. It also allows us to get a sense of how and how much the resources on this site are being used.
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.
This site is no longer sponsored by an accredited provider of CME credit. When the site was last sponsored for CME credit it was sponsored by the Case Western Reserve University School of Medicine. In addition to the CWRU School of Medicine, over the years the site was for a time also been sponsored by the University of Missouri, Columbia, School of Medicine and the Vanderbilt University School of Medicine.
When sponsored by CWRU, the CME committee consisted of the following individuals:
| 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 |
For several years these four individuals made particularly important contributions to the HISC website in an advisory capacity.
| 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.
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.