This year's Institute for Healthcare Improvement National Forum was certainly worth the time and money to attend.
Leaders who are focused on the advancement of healthcare quality from around the globe assembled in Orlando, Florida to demonstrate their achievements, identify barriers limiting the adoption of those methodologies, and create a road map for improving quality moving forward.
Among the many insightful points made, two important messages stuck out in my mind.
It is our responsibility to change healthcare
This can happen by each of us altering what we do by just a few degrees. Palo Alto Medical Foundation (PAMF) presented a brilliant example. They graphed the cost for treating patients for the same conditions by physician (OMG!). The gaps in cost and care were significant. PAMF management asked their physicians to explain to each other these differences in patient care. The resulting discussions produced significant drops in cost and increased consistency of care based on efficacy. Further, they continuously publish the graphs “by physician.” This is radical and courageous for any healthcare organization.
It is a page out of the quality movement in manufacturing – identify what quality is and let the workgroups self manage to it. If every clinical organization in the country acted this way, health costs would drop by at least 40%. The Dartmouth Atlas supports this number. Further, it happens to be the cost gap between universal healthcare systems in other industrial countries and the United States.
The conference attracted a number of visitors from other countries. I asked some folks from Britain if they had come over to find out "how not to do healthcare." The truth is that there are many innovative approaches being done that fly below the radar and the dysfunctional debate in Washington. This was clear in the hundreds of storyboards presented – each one describing a local process improvement project, like PAMF’s, that will collectively change the course of healthcare.
I did get a glimpse of the future. A group from the Netherlands presented the Dutch approach to quality. Three individuals representing an insurance company, a provider network, and a patient organization presented how they collaborate to improve patient safety, quality, and satisfaction — a partnership not regularly seen in the U.S. healthcare system.
Lean, TQM, Six Sigma tools are becoming mainstream
The second message delivered at the conference was revealed in the hundreds of process improvement storyboards. It is clear that the industry is at the tipping point with regard to quality improvement. Lean, TQM, Six Sigma tools are entering the mainstream. Institutions will be transformed. The message was clear – if you can’t play here, you will not be viable in the near future.
Further, in his closing remarks, Don Berwick said the time for demonstration projects is over – we know what needs to be done; it is time to act with scale.
In sum, much of the healthcare industry conferences, meetings, and journals are focused on costs, drugs, clinical procedures and the like. IHI is refreshing because the patient's voice is present throughout the workshops, presentations, and even the keynote addresses.
