IHI Wrap-Up: Berwick Returns; the Power of Patients

By Haydn Bush	December 08, 2011
A look back at the recently concluded IHI National Forum.

ORLANDO ? It's been another whirlwind week at the IHI 2011 National Forum, with highlights that included the return of former IHI president and recently departed CMS administrator Don Berwick, M.D., who talked frankly at a press briefing yesterday about his experiences crafting Medicare's accountable care organization rule and the political climate that led to his departure from Washington. During his keynote speech Wednesday, Berwick reiterated his contention that the current political and economic situation makes the work of health care quality advocates more important than ever. The health care industry is faced with a choice between cutting health care services or finding ways to reduce costs that also improve quality, Berwick said Wednesday.

"The choice is stark?it is to chop or improve," Berwick said. "The credibility or leverage of the quality movement will rise or fall on the success of in reducing health costs," Berwick said.

Berwick also tipped his cap to current IHI president and CEO Maureen Bisognano, telling the audience at his keynote that he asked her for advice in 2010 before heading to Washington.

"She told me to mention a patient five times a day," Berwick said.

Indeed, Bisognano focused heavily in the primacy of the patient in the future of health care design during her IHI keynote. She added that health care systems would have to undertake this work even as they battle significant financial obstacles. When I had the opportunity to talk to her in person Wednesday, I asked about how those competing priorities would play out for hospitals. Bisognano noted that many of the patients who attended the IHI meeting had taken time away from their jobs and lives to promote this philosophy. She then had this to say about the synergy between patient engagement and cost containment:

As if to illustrate that very point, one of the featured patient guests this year at IHI was Christian Farman, a Swedish nurse who battled kidney failure several years and ended up working with a nurse at Ryhov Hospital in J�nk�ping, Sweden, to allow patients to administer self-dialysis in a dedicated space at the hospital. Farman, Bisognano and a small group of hospital CEOs appeared at a press briefing Tuesday, and one of the big questions in the room was whether a patient would have been able to create a similar program in a U.S. hospital. As it happens, Michael Dowling, CEO of North Shore-Long Island Jewish Health System in New York, was in the room, and after hearing about Christian's story several months ago, he decided to give it a shot.

"We're working to have this implemented in our system," Dowling said, adding that he's aware of another hospital in New York State that instituted a similar program a decade ago.

What should a patient-centric health care system look like? Email your thoughts to hbush@healthforum.com.

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