Thursday, May 17, 2012

Quality is Goodness

I attended a wonderful talk today by the former Administrator of the Centers for Medicare and Medicaid Services, Dr. Don Berwick.

Here are just a few take aways.

"Waste threatens health care as a human right."
This has great meaning for me and probably confirms what many of you likely already know about me. Yes, I believe all people have a right to health and health care. Our health system should leave no one out.

"Quality is Goodness"
Taking on the broad use of the term quality, Dr. Berwick drew boundaries around the term and poignantly described meaningful quality as goodness.

What do we need to do? This is the 2.6 trillion dollar question isn't it? Here is a list to help guide us.
1. Put patients first
2. Protect the disadvantaged
3. Start at scale –move fast – go "all in"
4. Return the money
5. Act locally

"The mission is perfection."
Yes, he said perfection. This means we must take aim at zero and 100%.  

"To transform we need a transition in self-image and sense of purpose. We must accept our ethical duty to learn from and redesign our system to prevent harm."

The Ethics of Improvement
  1. Professionals have a duty to help improve the systems in which they work.
  2. Leaders have a duty to make 1. Logistical, feasible and supported.
  3. No excuses for inaction on 1 and 2 are acceptable.
  4. The duty to improve encompasses safety, efficiency, patient-centeredness, timeliness, effectiveness, and equity requires continual reduction of waste. The IOM six dimensions quality of are dimensions of goodness
  5. Those who educate professionals have the duty to prepare them for improvement work.

Don's dream:
That we will embrace improvement as our duty to accomplish great and ever greater good.

I was honored to join the panel today and am grateful to California Hospital Association and John Muir Health for such a rich day of learning and collaboration.
A good day....

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