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National Forum on Quality Improvement
December 6-9, 2009 | Orlando, Florida
Avoiding rehospitalizations and using information technology to improve care are among the topics under discussion by 5,000 health care professionals convening for the Institute for Healthcare Improvement's 21st Annual National Forum on Quality Improvement in Orlando. H&HN Managing Editor Bill Santamour and Haydn Bush of the AHA Quality Center share useful advice and colorful observations from the meeting. All comments are welcome and may be posted to the blog. Comments may be edited for clarity or length. Click here to return to the H&HN blog homepage. |
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- “Health care has no intrinsic value,” said IHI President Don Berwick. “Health does. Joy does. Peace does.” He added, “The best health care is the least health care that we need.”
- Paul Hamnett, IHI vice president of engineering, quoting President Obama: “We don’t have excellent health care, we have islands of excellence. Let’s figure out how those islands do it.”
- Laura Adams, president and CEO of the Rhode Island Quality Institute, confessed she was going through a Wendy’s drive-in when she had an “Aha!” moment. She realized the fast-food chain had more effective IT in place for ordering a burger than most health care providers have for patient care.
- Adams said her state is working hard to link all physicians, hospitals and pharmacies. Noting that Rhode Island is only 35 by 45 miles in size, with 1 million people and 13 hospitals, she said, “If we can’t do it here, we should be slapped.” By the way, two weeks ago 100 percent of Rhode Island’s pharmacies were connected to a patient record.
- Adams also noted that some studies have come out recently questioning the value of health IT, including one proclaiming that EHRs have not been shown to affect quality of care. “Well, of course not,” she said, rolling her eyes. “We’re at 4 percent adoption in this country. And they’re not connected to each other.” Those studies are not only premature, Adams said, they’re also dangerous because they could discourage progress on HIT.
- David Classen, M.D., who led a session on ARRA funding for clinical IT, said that there had been a tug-of-war within the Obama health care team over how to define meaningful use of the EHR. One side wanted it to focus on vendors and software and the other side wanted it to be based on outcomes. “The National Quality Forum won,” said Classen, associate professor of medicine, senior partner and CMO, Computer Sciences Corp. “The quality and safety model was adopted, and NQF is the place to watch.” How did that happen? “There was a strong belief on the insurance side of CMS that the only way to achieve efficient care is to achieve better care,” Clausen said.
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The pickle theory of health reform
by Haynd Bush @ 12:00PM
In a few hours, I’ll be leaving sunny, humid Orlando to return to what I understand are frigid and snowy conditions in the Midwest. A few quick thoughts on this year’s IHI:
After attending HIMSS and other conferences this year, the low-key, noncommercial nature of IHI—no tchotchkes to take home!—is a nice change of pace. The presentations and seminars were dominated by providers—from C-Suite execs to nurses—with interesting innovations to share and engaged give and take with their peers in the audience. There were the Kaiser Permanentes and Geisingers of the world with the usual integrated, population-driven programs to improve care—and then there were decidedly smaller providers with equally impressive innovations. The national health reform debate heating up in Washington only came up sparingly in the official sessions.
But that doesn’t mean that reform isn’t on everyone’s mind. One longtime hospital administrator I talked to at length said vertical integration and payment reform to better reflect the continuum of care delivery are the only chance the U.S. has for meaningful change that both stems rising costs and creates more effective systems. IHI President Don Berwick made a similar point during his opening keynote, arguing that the system as a whole encourages perfectly upstanding providers to behave in their own best interests and drive costs ever higher—a sort of “Tragedy of the Commons” writ large, as Berwick put it. Regardless of what emerges from health care reform, the current system can’t sustain itself, Berwick said.
“We can’t spend more on health care and we can’t do less for people,” Berwick said. “That’s a pickle.”Submit a Comment | Back to Top
What in the world is M.U.?
by Haynd Bush @ 10:30AM
The federal definition of meaningful use—the jargon used to describe compliance with health information technology standards—should be released by the end of the month, David Blumenthal, the National Coordinator for Health Information and Technology for HHS, said Wednesday morning.
Blumenthal acknowledged that time is running out on the Obama administration’s goal of defining meaningful use in 2009—or M.U., as he claimed it is referred to in health IT circles. Meaningful use of health IT is expected to include guidelines for using certified electronic medical records, privacy and security standards and quality benchmarks. Providers who meet the standards would receive financial incentives and increased reimbursement starting in 2011. The framework will include a national health information network, help with health information exchanges and strategies to include small hospitals and physician practices in fully operational systems.
“What we are trying to do is leapfrog what many other countries have accomplished in the health information technology domain,” Blumenthal said.
Beyond the meaningful use definition, plenty of questions remain about widespread HIT adoption. One audience member asked Blumenthal when he thought most doctors and hospitals will be able to access the majority of information that they need via health information technology. Declining to make a guess, Blumenthal characterized the move toward universal HIT adoption as “the start of a long journey” and predicted incremental progress in coming years.
Another attendee asked Blumenthal how health information exchanges will be funded in the future, a good question considering that many HIEs have been short-lived. Blumenthal said he hopes the meaningful use framework will lead to “fairly cheap models of exchange” and more “lightweight” HIE structures in coming years.
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When rurals collide
by Bill Santamour @ 10:00AM
Theft was widely endorsed at a session today examining the challenges and opportunities of patient safety in rural hospitals. The focus was the Maine Critical Access Hospital Patient Safety Collaborative, in which 14 of the state’s CAHs have come together to work on common issues around safety and quality improvement. Each hospital received a $50,000 state grant to implement medication safety projects, including purchasing and installing smart pumps, bar coding and other technologies. They work within the collaborative to exchange ideas and share lessons learned along the way.
The major obstacle for such far-flung hospitals was evident from the get-go. “To start a collaborative, you need to build relationships,” said Judy Tupper of the University of Southern Maine’s Muskie School of Public Policy. “That’s really hard to do when you have to drive five hours to a meeting.” Though most of the interaction among participants takes place via conference call, the grant criteria require face-to-face meetings every quarter. In a small hospital, when a staff member leaves for any length of time, there’s nobody to replace them, Tupper pointed out.
On the other hand, building an interdisciplinary team to tackle a problem like medication safety is much easier with a small staff. One attendee pointed out that most people working at rural hospitals wear so many different hats the staff is interdisciplinary by nature. And they bring that varied experience to bear within the collaborative.
Another advantage: “There seems to be a rapidness to the change cycle that happens in small hospitals,” a participant said. Because staffs are so small, a large percentage of them have already taken part in planning for IT implementation, for instance. When it comes time to roll the project out, most folks already have signed off on it.
Nevertheless, there are bound to staff members who don’t follow the new process for one reason or another. That can make for an uncomfortable situation. “People in a small community know each other,” Tupper said. “People working in the hospital are your friends and neighbors. It can be tough when the time comes to hold people accountable, because you know them so well.” Be firm, Tupper urged: Demonstrate your personal commitment to patient safety and quality improvement and make it clear everyone is expected to have the same commitment.
Collaborative participants at today’s session were enthusiastic about the project and said it allows them to learn from each as they go along. “Even in failure, you learn from one another,” one participant said. “It’s powerful to share this much information.”
Or, as another participant put it: “The thing I like best is we’re able to steal the great ideas everybody else has.”
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A poet even I like
by Bill Santamour @ 7:00AM
You’re sitting in a conference hall awaiting the next keynote speaker. He’s introduced as a “motivational poet and strategic presenter.” Admit it: Your first inclination is to sprint toward the exit.
Sekou Andrews gets that reaction a lot. “When I tell people I’m a spoken word poet, they look at me like I just told them I’m a mermaid or a warlock,” admitted the former South Central Los Angeles fifth-grade teacher who now makes it his business to, as he puts it, “crowbar people out of their comfort zone” through words and performance. He’s appeared before “some of the most unhip organizations out there,” though he diplomatically excluded the health care professionals sitting before him from that group.
While admitting to a limited knowledge of the field, Andrews gamely tried to tailor his presentation to the IHI conferees. “The first step to fix health care is to fix self-care,” he told the surprisingly (to me at least) enthusiastic audience. “You can’t take care of anyone else if you can’t take care of yourself.”
He did a very funny piece about a guy fighting a losing battle with a treadmill. “I haven’t even burned off the calories from the Altoid I’m still sucking on,” he moans, and then tries to persuade himself that further exercise is really unnecessary. “Do you know how much work it took to get these symmetrically sculpted love handles?” he asks.
Andrews went on to do poignant pieces—some humorous, some decidedly not—based on personal encounters with the medical field. He described the shock of learning his father—a lifelong health and fitness addict—had died suddenly of cardiac arrhythmia and of the ensuing grief that led to his grandmother’s death. “The heart killed my father, though his spirit was strong,” he said. “The spirit killed my grandmother, though her heart was strong.”
In the end, the fact that Andrews’ presentation at the close of Tuesday’s jampacked conference agenda had little direct relevance to the matters that had brought us all to Orlando was beside the point—or, more accurately, was the point. We’d come through a long day of soul-searching and earnest discussion. It was nice to be entertained for a change, and even to be a little inspired.
To learn more about Andrews, go to his blog at www.thesekoueffect.com.
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RAC-style audits for IT?
by Bill Santamour @ 2:00PM
Health care providers need to take some giant IT steps—quickly—if they want to cash in on $46 billion in Medicare and Medicaid incentive payments intended to promote electronic health records. Hospitals will likely be required to use CPOE for 10 percent of all patient care orders in 2011 and for all orders by 2013, David Classen, M.D., said at a session titled “Clinical Decision Support: Implications for Meaningful Use and the American Recovery Reinvestment Act.” In 2015, the “carrots” of incentives will be replaced by “sticks” in the form of payment penalties. Classen is associate professor of medicine, senior partner and CMO, Computer Sciences Corp.
Providers expecting the government to relax its requirements are likely to be disappointed. The timelines are very explicit, Classen said, and the whole initiative is law-based, not rule-based, so loosening criteria would be very difficult. “What they are saying is ‘You will do this and we’re not going to change anything,’ ” he said. “They are deadly serious about implementing EHRs to achieve savings in health care.”
Hospitals will probably be paid the Medicare incentive money per patient, Classen said; to qualify, they’ll need to include extra coding in their Medicare reimbursement forms showing the patient was treated with an EHR according to the meaningful use criteria. After paying the bonus, CMS will likely come back to audit the hospital to verify it did what it said it did. If the audit goes against the hospital, the money will have to be returned.
Classen drew a loud groan from the audience when he shared the rumor that CMS will carry out those reviews by using the same firms it now uses for RAC audits. Most audience members nodded agreement when one person said, “In my opinion, those companies are nothing more than bounty hunters.”
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A humbling road to harm reduction
by Haydn Bush @ 1:15PM
Harm reduction is a marathon, not a sprint, Henry Ford Health System Chief Quality Officer James Conway said Tuesday. The Detroit-area system has been actively engaged in quality initiatives since 1989, when it began using performance improvement methods borrowed from general industry. So when Henry Ford launched a campaign to eliminate harm in 2004, top administrators expected quick results; they thought they could reduce harm across the board by 50 percent in two years.
Bad news arrived early, when system leaders learned that their hospitals’ mortality rates were higher than national averages.
“By 2004, we were pretty confident, and maybe arrogant we could take on any audacious goal,” Conway said. “We met our match with the elimination of harm campaign. It didn’t come as easily as other initiatives.”
Also, the harm reduction team couldn’t find a good existing framework for measuring harm, so it had to create its own metrics, said Henry Ford Administrator of Quality Jack Jordan.
Gradually, the program bore results—after years of uneven progress, harm per patient days dropped from 55 in January 2008 to 45 in September 2009. Key to the effort, Jordan said, was the notion that culture is an ever-changing, malleable force that the administration must work to influence positively.
“Culture is always changing in your organization,” Jordan said. “Dr. Conway can remember a time when people smoked cigarettes on the ICU rounding team. Today we would say, “How could you possibly do that?”Submit a Comment | Back to Top
Beyond reform and back to the bedside
by Haydn Bush @ 1:00PM
One of the interesting side notes that came out of Don Berwick’s wide-ranging keynote this morning was his remark that many attendees had asked him to focus on clinical issues, and not health care reform, during his remarks.
While Berwick wisely ignored that advice and gave a pretty well-received speech that deftly tied together the big picture and the little—red squirrels, that is—picture, after attending IHI, I can see where his would-be advisors are coming from. In the midst of a fractious national debate on the future of health care, the passion that clinicians have for improvement is a welcome reprieve from arguments over the public option, death panels and Medicare cuts.
At session after session, I’ve watched countless administrators, physicians and nurses engage presenters with well-thought out, practical questions about their projects. I’ve heard folks say they pay their own way here from far-away locales simply because of the quality of the event.
For the time being, of course, the debate in Washington is going to take center stage over the grass-roots clinical experiments on display in Orlando this week, as Berwick himself acknowledged. But it’s worth taking a step back from the big picture every once in a while to remember that better care starts with real, lasting engagement from every part of a hospital’s team, no matter what the national picture looks like.
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The squirrelly secret to better care
by Haydn Bush @ 12:45PM
What do we really, really want from health care?
For IHI President and CEO Don Berwick, who asked the audience at his keynote speech Tuesday morning to ponder that question, the answer is simple—he wants just enough care so he can ski near his New Hampshire cabin on a trail overrun by little red squirrels.
Five years ago, Berwick was suffering persistent tendinitis in his knee that began with a medical error during surgery decades ago and was aggravated by years of jogging. Three doctors recommended Berwick undergo surgery for a prosthetic knee, but at the last minute he opted for a steroid injection at the suggestion of a fourth surgeon.
Today, Berwick has a slight limp, but is still able to ski. That wouldn’t have been possible with an artificial knee, a far more expensive option.
“Health care wanted to give me a medical knee and I wanted to visit a squirrel,” Berwick said. “My care was dignified and professional. But it missed the point.”
The U.S. health care system as it exists today also misses the point, Berwick continued, arguing that rising costs threaten not just care delivery but the country’s economic stability for decades to come. In the next few years, the industry will need to reduce costs by 10 percent to reverse the current, unsustainable growth, Berwick said.
Berwick cited several U.S. cities that have driven down health care costs with a community-centric strategy while remaining competitive in delivering quality outcomes—notably Cedar Rapids, Iowa. He also mentioned McAllen, Texas, which was cited in Atul Gawande’s highly publicized New Yorker article last summer for its extraordinarily high Medicare costs.
Only a concerted effort to share resources and coordinate care among communities will lead to more Cedar Rapids stories and fewer McAllens, Berwick said.
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Hop to it
by Bill Santamour @ 10:00AM
Steven J. Spear is the author “Chasing the Rabbit: How Market Leaders Outdistance the Competition,” which IHI President Don Berwick called “a profoundly important book.” It examines why certain organizations, including top-tier health systems, essentially make mincemeat out of their competitors. They thrive in what Spear, a senior fellow at IHI and senior lecturer at MIT, calls our “high velocity world” by “innovating relentlessly” in a constant, almost automatic drive for self-improvement.
Spear led an IHI learning lab called “What the World’s Greatest Companies Can Teach About Perfecting Care.” He identifies four key capabilities hospitals must master to put themselves “on the fast track to operational excellence, where you will generate faster, better results using less capital and fewer resources.” They are:
- Build a system of “dynamic discovery” designed to reveal operational problems and weaknesses.
- Attack and solve problems at the time and in the place where they occur, converting weaknesses into strengths.
- Disseminate knowledge gained from solving local problems throughout the company as a whole.
- Create managers invested in the process of continual innovation.
Spear elaborates on his ideas in his blog.
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A turning point?
by Bill Santamour @ 7:00AM
The IHI conference keeps charging along, with lots of interactive sessions built around one of the organization’s core themes, “All Teach, All Learn.” Yesterday included 25 daylong mini-courses focusing on everything from decreasing rehospitalizations to designing a patient-centered medical home. All the topics were compelling, but in the end, I chose to sit in on “When Two Worlds Collide—Bringing Improvement and Health IT Together.”
Enhancing quality and patient safety has been on everybody’s radar screen big time since the IOM released its study on medical errors a decade ago, but “we’re still harming patients at an unconscionable rate,” said Laura Adams, president and CEO of the Rhode Island Quality Institute. Brian Robson, M.D., an IHI Health Foundation Improvement Fellow, noted that up to 67 percent of admission charts include unintended discrepancies.
While health IT is no panacea, Adams acknowledged, providers “are mired in a paper-based system” that sabotages even their best intentions at making patients safer. Robson cited data showing that 83 percent of ambulatory care providers and 90 percent of hospitals do not use an electronic health record.
The billions of dollars in federal funds earmarked for health IT could be a turning point, and Adams offered a detailed description of how those funds will be used to spur a national EHR. Especially noteworthy: the feds plan to identify 15 “beacon communities,” places that have already established themselves as leaders in health IT. They will receive a total of $235 million to move their efforts forward and will serve as models for the rest of the nation.
The government is also funding regional extension centers to work on-site in physicians’ offices to help implement EHRs. Adams is impressed with how integrated the government initiative is compared to previous efforts, when “you couldn’t tell if anybody involved had even talked with each other.”
Despite all the money available, don’t expect a stampede of doctors to sign up. “Medicine is a cottage industry,” Adams said, “and information moves very slowly.” She figures maybe half of all physicians don’t even know the money is out there to help them wire up and that many who do figure it’s another government mandate they want no part of.
She recommended that health care leaders adopt the “diffusion of innovation” theory: identify “peer innovators” in your state or community, doctors who are respected by their fellow physicians and who, through an innate interest in technology and a commitment to improve care, are early adopters of IT. Spread the word about their accomplishments and their peers are more apt to say, “If they can do it, I can do.”
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Those pesky physicians, from Seattle to Stockholm
by Haydn Bush @ 2:20PM
During several breakout sessions at my seminar on microsystems Monday (see my previous blog from today), that oh-so-familiar refrain of getting physician buy-in came up time and time again. I’m sure you’ve heard the anecdotes before: Physicians were often too busy to set aside time to join work groups—or simply not interested. Carrying out evidence-based medicine initiatives was still difficult, attendees said, with many longtime physicians steadfast in viewing their profession as a craft. Independent physicians had a set of goals that didn’t always coincide with the best interest of the hospital.
The age-old problem of physician alignment extends far beyond the U.S.; our table included an attendee from Sweden. He spoke favorably of an active, elected board that set a broad clinical agenda while empowering staff to carry it out—but said that getting physicians to change their preferred methods of practice was still challenging.
That’s part of the beauty of IHI—over the last two days, I’ve heard health care leaders from around the world lament many of the same core delivery problems that hospitals here face. In an era of widespread hand wringing about the U.S. health care delivery system, it’s instructive to take a step back and realize that the rest of the world doesn’t have the essential questions of quality, scheduling and physician relations figured out either.
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For big improvements, start by thinking small
by Haydn Bush @ 2:00PM
Microsystems—you know, that term of art to being used to describe teams of physicians, nurses, housekeepers and other staff that provide direct care to the patient—were the hot topic at the Monday morning session I attended.
The speakers, from Geisinger Health Systems in Pennsylvania and Cooley Dickinson Health Care in Massachusetts, discussed tactics hospitals can use to empower these small groups, which directly work with patients, to create better processes based on their expertise. The empowerment of so-called microsystems is seen as a critical first step in delivering patient-centric care, an idea generating quite a bit of buzz at the moment.
The challenge, outlined by Eugene Nelson, director of quality education, measurement and research for the Dartmouth-Hitchcock Medical Center and an expert in clinical microsystems, lies in creating change throughout the system; so clinical improvements in a given department aren’t merely islands of excellence.
“You can have improvement project by project that’s not necessarily systemic,” Nelson said. “It’s incredibly important to grow leaders at all levels of the organization that get it.”
During the breakout session at my table, one of the attendees noted that her institution, after years of a more top-down approach, had recently empowered small work groups to make real practice changes based on grassroots input. Still, the clinical teams weren’t sure if they had to jump through the old administrative hoops to initiate new practices, she said.
And the challenge of implementing lasting, systemic change at smaller institutions that don’t employ their docs or have the institutional advantages of big integrated systems is another hurdle. The speakers acknowledged as much: Al Bothe, chief quality officer for Geisinger, got big laughs when he relayed a story of overhearing an attendee at a hospitalist conference who turned to an acquaintance and said, “If I hear one more reference to Intermountain or Geisinger, I’m going to throw up.”Submit a Comment | Back to Top
Nostradamus in the OR
by Haydn Bush @ 1:00PM
I started off this year’s National Forum on Quality Improvement Sunday afternoon listening to health care systems guru Eugene Litvak preach the gospel of managing variability in the operating room. Litvak, a professor of operations management at Boston University’s Health Policy Institute, argued that most hospitals have huge inefficiencies in scheduling surgeries that impact the bottom line, overload staff and even contribute to medical errors by over-stressing their systems.
By better separating scheduled and unscheduled procedures, Litvak said hospitals can handle more capacity in an orderly fashion without the need for huge capital expenditures to add capacity and beds. He cited Cincinnati Children’s Hospital for saving $137 million in operating costs and passing on a related $100 million expansion project by developing more rigorous scheduling processes and addressing organizational variability.
The chatter from the audience was that while better control over scheduling is desired, predicting and managing future capacity is trickier than it seems, something Litvak readily admitted. “It’s easier to predict when someone will break a leg than when an elective admission will take place,” Litvak said.
One person in attendance said the work of transforming a hospital’s scheduling system may take years, not months, and predicting the future, even with a plethora of evidence and past experience, is never straightforward.Submit a Comment | Back to Top
Nothing small about CPOE
by Bill Santamour @ 11:00AM
Hospitals planning to purchase a computerized provider order entry system should be forewarned: Think big. Real Big.
“CPOE is not plug and play,” Jan Gibson-Gerrity told an IHI session. “It’s a major, complex transformation for an organization, and it will take years. And you will need a big budget. You can’t cut corners.” Gibson-Gerrity, a RN, is director of clinical informatics at Christiana Care Health System in Delaware.
Any technology is only as good as the processes in place. Know your culture, know what changes will be needed to effectively implement your IT systems. And, Gibson-Gerrity stressed, don’t neglect the infrastructure necessary to support CPOE. “You will have zero tolerance from physicians if they have to wait for a screen to change. They will have zero tolerance for any downtime.”
The No. 1 planning priority for CPOE, she said: Identify key physician leaders who understand how critical the technology is and who will continue to champion it against the inevitable pushback from their colleagues on the medical staff.
There is a strong business case to be made to physicians, she said. For example, how many times are they interrupted now with calls from a nurse or pharmacist who can’t understand their written medication orders? CPOE will put a big dent in those interruptions.
One selling point hospitals can make on behalf of CPOE that all physicians will certainly appreciate, Gibson-Gerrity said: It will make their patients safer. And that’s really big.
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Magical thinking in IT
by Bill Santamour @ 8:15AM
A fifth of all medication doses are administered in error, according to data cited at a session Sunday titled “Medication Safety Technology: Lessons for All.” The consensus among health care quality leaders is that bar coding, CPOE and the like are critical tools to cut those numbers. Yet several hospitals that have implemented the technologies report no significant progress.
Don’t blame the technology, experts say, blame your groundwork—or lack thereof.
Frank Federico, the IHI’s executive director, strategic partners, said some hospital leaders are guilty of “magical thinking.” “They say, ‘If only we had CPOE, we’d be the safest hospital in the world. If only we had all the technology in place, we’d prevent all errors,’ ” Federico said. But when the IT is in place, the opposite can happen. Why? Doctors and nurses talk to each other less and increasingly rely on what the computer tells them. CPOE delivers so many error alerts that physicians suffer “alert fatigue” and ignore them all. Nurses and others create workarounds because the technologies are set up in a way that complicates and slows down their work process.
Before you choose an IT system, study your care processes carefully, Federico said. Know how doctors, nurses, pharmacists and others really do their jobs and then design the IT to help, not hinder, them. Better yet, involve them in the design of the IT system. “We’ve been letting the technology drive how we deliver care rather than letting the care drive the technology,” Federico said.
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Edible airline food and other tall tales
by Bill Santamour @ 7:00AM
Confession: I was not looking forward to attending the National Forum on Quality Improvement in Health Care this week in Orlando. I understand and fully endorse the imperative to deliver safer, higher quality care, and I have the utmost admiration for the folks at the Institute for Healthcare Improvement, who are hosting the event. But … work is crazy these days … I just got back from Thanksgiving with the relatives … the really big holiday season is bearing down upon us ... and how could I be away from my dog, Roxy, for four whole days?
Well, with a mere half-day of pre-conference under my belt, I can say without reservation that I’m glad I came—and not just because I got bumped to first class on the flight from Chicago to Orlando. (Did you know they serve food in first class? Cooked food with recognizable ingredients and identifiable flavors?) It was the shuttle ride from the airport to the hotel that actually won me over; sharing the ride was a delegation of men and women from Singapore who had just spent 25 hours, including layovers and delays, getting to the conference—all so they could share their experiences trying to improve health care at home and pick up some useful strategies to take back. Their enthusiasm, if not their abiding energy, was contagious.
I would call enthusiasm the operative word at this conference. There are 5,000 health care professionals from more than 40 nations in attendance. By Wednesday’s close, 127 sessions will have taken place and, according to IHI staff, the average attendee will have spent more than 33 hours listening to keynotes, participating in discussions and viewing exhibits. An orientation session for first-time attendees Sunday drew an overflow crowd and the No. 1 message was “talk to each other.”
“It’s exponentially easier to improve together than it is alone,” one of the presenters said. Judging by the spirited conversations I’ve already participated in, this conference will surely help.
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Quality takes center stage
by Bill Santamour @ 2:00PM
What happens when 5,000 health care types get together to talk about quality? We're about to find out as we head to Orlando for the 21st Annual National Forum on Quality Improvement in Health Care. With a keynote lineup that includes Don Berwick, whose Institute for Healthcare Improvement hosts the conference; outspoken health care economist Uwe Reinhardt, we're sure to hear words that will encourage, surprise and, let's face it, dismay us about the current state of American health care and the seemingly endless debate over reform.
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