Aiming at Improvement
Notes on IHI’s 22nd National Forum
In recent years, the Institute for Healthcare Improvement’s (IHI) National Forum — held in Orlando in early December — has become for me as much a harbinger of the holiday season as leftover Thanksgiving turkey, the media’s obsession with Black Friday, and the dark, cold afternoons of early winter in New England. My trip to Orlando this year offered both new and familiar experiences.
This was IHI’s 22nd National Forum and the first held without founder and original CEO and President Don Berwick, serving now in Washington, DC, as head of the Centers for Medicare and Medicaid Services (CMS). The Forum provided an interesting snapshot of IHI’s transition to the post-Berwick era. On the one hand, many IHI regulars keenly missed Berwick’s unmistakable presence, which for many embodied the organization. On the other hand, more than half of the 5,800 who attended the Forum in person (15,000 attended via webcast) were there for the first time. Not distracted by memories of Berwick, they will associate the opening keynote early on Tuesday morning—always a highly anticipated, signature Berwick moment—with Maureen Bisognano, Berwick’s successor as CEO and president, who told her family’s compelling story of loss due to medical error and called on attendees to join efforts to improve public health, decrease cost, and improve quality: IHI’s Triple Aim.
The Triple Aim is a comprehensive approach to improving healthcare, which emphasizes the health of individuals and the community while decreasing cost. The Triple Aim emphasizes effective care coordination and efficient, patient-centered delivery of care, which in many cases will mean less care, less cost, and more health. It’s no coincidence that the Triple Aim dovetails nicely with healthcare reform legislation in the United States. The Triple Aim may not be well known by name, but IHI has been developing the concept and supporting programs that advance its principles for at least 5 years.
To learn more about the Triple Aim, see IHI’s website and the Commonwealth Fund’s report on three organizations that have been implementing the Triple Aim for some time. IHI’s website also offers a video clip from Bisognano’s address and other materials related to the Forum.
I began to learn principles of the Triple Aim during workshop sessions at the National Forum in 2006. In 2007, I attended an all-day “minicourse” on the Triple Aim taught by Don Berwick and IHI Senior Fellow and Board member, Tom Nolan, one of the Triple Aim’s chief architects. IHI offers the minicourse program on the day before the official beginning of the conference, and it has become my favorite part of the Forum. It’s an unmatched opportunity to spend a full day (8:30 a.m. – 4:00 p.m.) participating with a room full of experienced, committed learners in an interactive program taught by top-level experts.
This year, IHI offered 28 minicourses. I choose one lead by Brent James, chief quality officer at Intermountain Healthcare in Salt Lake City, and executive director of the Intermountain Institute for Health Care Delivery Research. His topic was “Internal Quality Improvement Training as a Vehicle for Organizational Change,” but by the end of the day, James had lead the group through discussion of many of the most pressing issues in efforts to reform the U.S. healthcare system, in addition to discussing in detail the educational program he designed and leads at Intermountain.
The day was stimulating, inspiring, and fun; I enjoyed getting to know the others working around my table for the day, which was just as valuable as other aspects of the program. James is both brilliant and folksy. He called us back to order from coffee breaks with some of the funniest YouTube videos I’ve seen, and somehow he makes statistics accessible and attractive, even to those — like me — who are not numerically inclined. I imagine that for some people, IHI’s minicourses make the trip to Orlando worthwhile.
The Intermountain Institute for Health Care Delivery Research offers information online about its programs, including extensive course materials.