Dr. Don Berwick brought up uncontrolled chronic illness, inadequate patient safety, insufficient investment in disease prevention and the social determinants of health, high costs, an excessive emphasis on technology, and a lack of joy in work in his powerful plenary session speaker at the 2017 IHI National Forum. He concluded: Our care is ineffective." "We need a fundamentally different system," he stated. I concur.
As a professor at a business school, I think that attempting to make American health care more "businesslike" kills its soul. The primary goal of health care is to improve health and quality of life. To maintain their viability and support their valuation, commercial businesses focus on making a financial profit. For health care to fulfill its promise to society, it must concentrate on social profit. Yes, health care needs to be effective, efficient, and profitable enough to continue providing services and improving. However, when financial metrics dominate health care, its fundamental purpose is sacrificed. Social conscience is a factor in the financial success of our best businesses. However, as with most businesses, health care must prioritize mission over margin.
At the 2017 Forum, Dr. Berwick and other keynote speakers talked about a few things that are necessary to create a fundamentally different healthcare system. They mentioned joy, closeness, humility, shared purpose, trust, transparency, inclusion, empowered execution, and proximity. Health care will move much further than RVUs, incentive payments, and multilayered documentation if these ideas are accepted.
The Equal Justice Initiative was founded by social justice lawyer Bryan Stevenson, who emphasized the significance of being close to the poor to effectively advocate for them. He stated, "Nearby proximity confers power." Things you can't see from a distance are what we see. Health care needs to be closer to us. Hospital administrators, politicians, and other government officials need to be closer to what happens on the front lines of healthcare delivery and what prevents care from being effective and efficient. It is necessary for doctors to be closer to their patients' feelings, anxieties, preferences, and limitations. Senior health care administrators should spend more time on the floor where care is delivered to learn what they cannot from their offices, just as airline executives should occasionally fly in coach class (in the middle seat) to better understand the customer experience.
Derek Feeley, president, and CEO of IHI, Dr. Rana Awdish, a critical care physician at Henry Ford Health System, and Tiffany Christensen, a professional patient advocate at The Beryl Institute, participated in the opening plenary session. Awdish and Christensen talked from their encounters as patients so sick they almost kicked the bucket. Awdish's medical practice was altered by proximity, and Christensen became a ferocious advocate for patient rights as a result. “Medical education trains us to see the pathology, not our patients,” Awdish said in her remarks to the Forum. I hadn't met the disease's cause before I got sick. Being debilitated I had the chance to think about what medication had given me and what it had not." The stories of Awdish and Christensen supported Feeley's opening concept of "mutuality," which refers to partnerships, shared purpose, and distributed power. No one knows everything; Nobody has all the information. Health care must embrace the process of pooling knowledge toward a common goal in a climate of trust, respect, transparency, and humility to transform, move beyond incremental improvement, eliminate a lot of waste, and become not only technically more effective but also more humane for patients and more joyful for clinicians.
General Stanley
McChrystal, the American commander of the Joint Special Operations Task Force in Iraq, delivered a clear message: "Mutuality transformed how we engage our enemies." When McChrystal took over, the structure of the organization resembled that of a corporation: multiple management levels and distinct reporting relationships Because ground forces closest to the action were not privy to crucial information or had to wait for approval before acting, the Task Force was stable and orderly but took a long time to adjust to fast-moving events. Al-Qaeda, the enemy, was unhindered by such a structure. The previous strategy of waging war was ineffective; The military required "a fundamentally different system," just like the healthcare industry did. McChrystal realized as he said in his speech, "We had to change the way we interacted, the way we operate." We didn't have a common consciousness.
Individual clinicians, non-clinical staff, administrators, and specific organizations all contribute to the American healthcare landscape's numerous pockets of excellence. However, the system as a whole is wasting its sacred calling in an erroneous effort to become more professional. In business, and in health care, there is a right way to try to increase productivity. Medical care can adjust specific business ideas to accommodate its central goal, however, it can't embrace them. The speakers in the plenary session inspired me to leave the Forum because they challenged us to reclaim the fundamental purpose of health care: improve the quality of life by improving one's health.
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