The Institute for Behavioral Healthcare Improvement (IBHI) began as the National Initiative for Behavioral Health Care Quality Improvement (NIBHcQI) in early 2004. Its creation followed several months of reflection among key founding members and other leaders in the Behavioral Health and Healthcare Quality on the importance of creating more robust, effective quality improvement processes within behavioral healthcare. These conversations grew from an appreciation and understanding of the process and impact of the Institute for Healthcare Improvement (IHI). Over 15 years IHI had established an international reference and benchmark for effective application and spread of quality improvement methods within general health care.

The founding members of IBHI saw a very real need to recreate a similar or extend the effort of IHI to improving quality of behavioral health care. The extended conversation included many who recognized this effort needed to include a basic restructuring of organizations in the field, which would demonstrate improved quality, as measured by the outcome of care. Many of these individuals have become members of the recently organized Board of Directors. The Board has established as AN ORGANIZATIONAL AIM: To dramatically improve behavioral health care outcomes by creating a high performing national learning organization that invites organizations out of their historical silos. IBHI seeks to encourage a movement that translates a passion for quality improvement into sustained action.

History and Focus

In 2004, The Center for Healthcare Strategies agreed to fund half the cost of the first Forum of Experts on the possibility of creating a national initiative in this area. The Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services agreed to cover the other half of the costs. The first Forum was held in December, 2004 in Baltimore, a second meeting was held in April, 2005 and a third in September, 2005, with support from the participating organizations and in part from SAMHSA. Regular conference calls have helped tie together face–to-face learning sessions.

The Forum, as a cross-section community of interests, agreed that:

  • a national initiative to develop a quality of care effort in behavioral healthcare was very much needed;
  • no single group could be expected to initiate development of the initiative required;
  • collaboration by a broad community of interests was required;
  • ample material for action existed which needed to be more fully recognized and deployed;
  • a specific project would be considered for development as a demonstration of the impact of a quality of care initiative;
  • a not-for-profit, charitable corporation should be established;
  • alliances with other like-minded groups would be helpful.

IBHI actively developed the Behavioral Healthcare Track at the 2005 IHI Forum. It also began incorporation as the Institute for Behavioral Healthcare Improvement, a not-for-profit charitable corporation, to carry on this work.

IBHI maintains or participates with partners in a series of Leadership Learning Forums across the nation to inform behavioral healthcare leaders about the recommendations of the recent Institute of Medicine report(s) about the quality of health care and behavioral health care, and ways to initiate systems changes to realize them. (See Events.)

As IBHI listened to leaders nationally about key areas for improvement, the difficulty of adequately caring for Behavioral Health Care clients in hospital emergency departments re-occurred. The emergency department is often where the general healthcare system meet most often, and frequently systems are un-prepared for the challenge. The result is exasperated staff, confused patients, and often poor and costly results. The gap between what is known and what is practiced is significant, and contributes to poor quality, waste and sub-optimal outcomes. These realities created a wide consensus on the need for improvement in Emergency care.

In late 2006, the IBHI Board of Directors authorized a Learning Collaborative on emergency care based on the Breakthrough Series methodology of the Institute for Healthcare Improvement (IHI). No body of known ‘best practices” or ideas for change existed, although other improvement work in ED care was ongoing. An Expert Panel was created to establish a “Change Package” of ideas and faculty that could serve as a resources for a “Pioneering” Collaborative. Six “Pioneering” hospitals were recruited to test the concept and change package, and held their first learning conference in January, 2008.

Over the next ten months, significant improvement occurred in internal operations. Measurement issues were refined, and the need to balance internal and external connections was demonstrated. Click here for a summary of this collaborative.

The Change Package is being expanded, and plans are underway for a subsequent national collaborative to begin April, 2009, as well as subsequent application of the approach in regional settings. Briefing calls will be held to describe the Collaborative and opportunities for future participation.

The Board of Directors of IBHI are a nation-wide group of experts with many years experience in the field of behavioral health care.

IBHI is supported by Membership dues, program registrations and grants. Membership in IBHI is open to any person or organizations interested in development of quality improvement in the outcomes of mental and substance use treatment and the integration of special and general health care services. Click here for more information about IBHI membership.