ORLANDO — With health care headed on a path toward a model that reimburses for value instead of volume, much of the first day of this year’s Institute for Healthcare Improvement forum centered on innovations that enact that change.
Officially called the IHI National Forum on Quality Improvement in Health Care, the meeting’s speakers and attendees shared some of their on-the-ground experiences in transforming health care.
Sessions included ideas for improving equity of care and outcomes and a method to formalize the innovation process.
During a workshop titled “Decreasing Racial and Socioeconomic Disparities,” members of the audience were invited to share their ideas, and there were some good ones. One attendee, from a Kaiser Permanente hospital, talked about an innovation resulting from a wish to get members of the local Filipino population to eat better. With a tradition for celebration with less healthful foods, hospital clinicians struggled to get individuals who needed to change their diet to do so. The hospital responded by including patients’ generally large families in the discussion and producing a video on how to celebrate in a healthful fashion, according to the attendee.
Officials for Health Partners, who were leading the disparities discussion, said they had success with a low-tech solution for boosting mammogram screening. The Bloomington, Minn.-based system implemented the use of a pink fast-track ticket for giving selected patients a same-day mammogram. “It made a big difference,” said Dave Johnson, regional clinic director.
Bellin Health, a system based in Green Bay, Wis., has used an institutionalized process for innovation to boost its revenue as it adapts to health care’s changing nature, informing its activities in accountable care organizations.
Capping off the day, appropriately, was a keynote speech by author and surgeon Atul Gawande, M.D., that highlighted his theory about why some health care innovations take hold quickly and others take a long time.
Gawande described how anesthesia gained relatively fast acceptance in health care, while antisepsis practices were slow to take hold. Anesthesia reduced pain in the patient, easing the surgery process immediately.
The antisepsis procedure, meanwhile, with its use of carbolic acid, actually caused pain, and required painstaking procedures to prevent a nebulous and theoretical infection days or weeks away.
“One made the life of the doctor easier and the other made the life of the doctor harder,” Gawande said.
That’s not to say Gawande is pessimistic about innovation in health care. He talked about how end-of-life care may be close to a tipping point in becoming truly patient-centric, as opposed to medical care focused and dependent on traditional nursing homes.
Echoing H&HN’s series on the boomers, Gawande said, “I don’t think the baby boom generation will put up with being institutionalized.”
We'll have additional coverage from the IHI meeting in tomorrow's H&HN Daily.